Which Specialist Should My 72-Year-Old Dad See for Breathing Issues?

Please advise me on which medical specialty my dad should see?

Hello, doctor! My father is 72 years old and does not have a smoking habit.
However, he has been experiencing some symptoms over the past few years, and despite seeing doctors, we haven't found any answers, so I'm reaching out on his behalf.
He often becomes very short of breath after walking just a few steps, especially when climbing stairs, and needs to rest afterward.
Whenever I pass by him, I can hear him breathing rapidly and shallowly, similar to tachypnea, even when he is not doing anything.
He feels like he can't catch his breath and believes he has asthma, but the doctors he has seen have said everything is normal.
He has consulted both cardiology and otolaryngology, and all tests came back normal.
Additionally, at night while he is sleeping, he often shouts and kicks his arms and legs, making a lot of noise.
We frequently have to wake him up, and this behavior continues after he falls back asleep.
The cardiologist prescribed a mild sedative, but he said it made him very sleepy, so he stopped taking it.
He enjoys gardening, but I wonder if his frequent bending over has contributed to his noticeable kyphosis, as he also walks in a hunched posture.
He has seen orthopedic and neurosurgery specialists, who indicated that there are issues with his spine that may require surgery.
I'm unsure which specialty he should see for the above issues.
If surgery is necessary, I worry that his ongoing symptoms might affect his recovery.
I would appreciate any guidance you could provide.
Thank you!

ken, 40~49 year old female. Ask Date: 2016/07/29

Dr. Hou Angting reply Family Medicine

Hello, if your father has been experiencing shortness of breath after exercise and his cardiology examination shows no abnormalities, he can undergo further evaluation by a pulmonologist.
Regarding the impact of surgery, it may vary based on your father's overall health status and could affect postoperative recovery.
It is advisable to have a detailed discussion with orthopedic and neurosurgeons.
Wishing your father good health.

Reply Date: 2016/07/29

More Info

For your 72-year-old father experiencing breathing issues, it is essential to approach this situation with a comprehensive understanding of his symptoms and medical history. Given the complexity of his condition, it would be prudent to consult a specialist in pulmonary medicine, also known as a pulmonologist. This specialist focuses on diagnosing and treating respiratory system disorders, which seems to align with your father's symptoms of shortness of breath, rapid and shallow breathing, and potential sleep disturbances.

Understanding the Symptoms
1. Shortness of Breath: This symptom, especially when exacerbated by physical activity like climbing stairs, can indicate various underlying conditions, including chronic obstructive pulmonary disease (COPD), asthma, or even heart-related issues. Although your father has seen cardiologists and ENT specialists, a pulmonologist can provide a more focused evaluation of his respiratory function.

2. Rapid and Shallow Breathing: This could be a sign of anxiety, respiratory distress, or other pulmonary conditions. A thorough assessment, including pulmonary function tests, can help determine if there are any obstructive or restrictive lung diseases.

3. Sleep Disturbances: The fact that your father experiences loud vocalizations and movements during sleep could suggest a sleep disorder, such as sleep apnea. This condition can significantly impact breathing and overall health. A sleep study (polysomnography) might be recommended by the pulmonologist or a sleep specialist to evaluate his sleep patterns and breathing during sleep.

4. Posture and Physical Activity: His reported kyphosis (hunchback) and the physical strain from gardening may contribute to his breathing difficulties. Poor posture can restrict lung capacity and efficiency. A physical therapist specializing in geriatric care could provide exercises to improve posture and strengthen respiratory muscles.

Recommended Steps
1. Consult a Pulmonologist: Schedule an appointment with a pulmonologist who can conduct a comprehensive evaluation, including a review of his medical history, physical examination, and necessary diagnostic tests (like spirometry or imaging studies).

2. Consider a Sleep Study: If the pulmonologist suspects sleep apnea or other sleep-related breathing disorders, they may refer your father for a sleep study to monitor his breathing patterns during sleep.

3. Physical Therapy: If posture is a concern, a referral to a physical therapist could help address mobility issues and improve his overall physical condition, which may alleviate some of his breathing difficulties.

4. Monitor and Manage Anxiety: If anxiety is contributing to his breathing issues, consider discussing this with a mental health professional. They can provide strategies to manage anxiety, which may help improve his overall respiratory function.

5. Follow-Up Care: Ensure that your father has regular follow-ups with the pulmonologist to monitor any changes in his condition and adjust treatment as necessary.

Conclusion
In summary, your father's symptoms warrant a specialized approach. A pulmonologist will be best suited to evaluate his respiratory issues, while a sleep specialist may address his sleep disturbances. Additionally, addressing physical posture through therapy could enhance his quality of life. It’s crucial to advocate for your father’s health and ensure he receives the appropriate evaluations and treatments to improve his breathing and overall well-being.

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