Unusual Breathing Sounds: When to Seek Medical Advice

Regarding respiratory issues?

Hello, doctor.
I have a question.
Sometimes my breathing sounds very loud (not during sleep).
It’s like after normal breathing, there’s a sudden loud exhale, and it feels like I have tightness in my chest and can’t breathe out properly.
I’m not sure when this started, but I often cough.
I’ve always had a sudden dry throat that makes me want to cough, but there’s no phlegm, and I don’t think it’s a cold.
When I cough, I immediately drink water to soothe it.
I wonder if this is related.
I have a constitution that in Taiwanese is referred to as "abdominal heat," where my temperature can’t be measured accurately from the outside, but I feel very hot all over, indicating that I might have a fever.
Sometimes I feel very hot, but my family doesn’t feel the same way, which makes me feel abnormal.
When I turn on the air conditioning because I feel hot, my family feels cold and asks me to turn it off, but I don’t feel cold at all; instead, I think it’s just right or even still hot.
This issue worries me, and my family has caught colds from the air conditioning.
I once wondered if it was a side effect of the COVID-19 vaccine, but considering it’s been a long time since I got vaccinated (7 months), that doesn’t seem right.
I am overweight, weighing around 70 kg and only 160 cm tall, with a history of type 2 diabetes.
The medications I take regularly are: 1.
Glyxambi Tablets 25/5mg, 2.
Amaryl M Tablet 2/500mg, 3.
Atorvastatin (Lipitor) <20mg>/tab.
I haven’t paid much attention to this issue, thinking it’s normal, but I still wanted to ask online if I need to get checked.

Ling Er, 20~29 year old female. Ask Date: 2022/09/14

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
Regarding the respiratory sounds, being overweight can cause airway compression, which may lead to wheezing or audible breathing.
If you are feeling very uncomfortable, you can visit an outpatient clinic for an X-ray to ensure that your lungs are healthy.
If it is already affecting your quality of life, you may seek consultation at an otolaryngology clinic.
2.
As for feeling easily overheated, it is speculated to be due to individual constitution.
However, if you are concerned, you can visit a family medicine clinic to check if it is related to any endocrine factors, such as thyroid issues.
3.
Regarding diabetes, it is recommended to manage blood sugar levels according to medical advice.
Moderate exercise is also believed to help improve the aforementioned two conditions.
Thank you for your inquiry.

Reply Date: 2022/09/14

More Info

Understanding unusual breathing sounds and associated symptoms can be quite complex, especially when they are accompanied by other physical sensations and health conditions. Based on your description, it seems you are experiencing significant respiratory sounds, a sensation of chest tightness, and a persistent dry cough, along with a unique perception of body temperature. Let's break down these symptoms and discuss when it might be necessary to seek medical advice.

Breathing Sounds and Chest Tightness
The unusual breathing sounds you describe, particularly the loud exhalations that feel like a release of pent-up air, could be indicative of several underlying issues. Conditions such as bronchospasm, which is a tightening of the muscles around the airways, can lead to wheezing or loud breathing sounds. This can occur in individuals with asthma or other respiratory conditions. Additionally, if there is any inflammation or irritation in the airways, it could also contribute to these sounds.

The sensation of chest tightness you mentioned could be related to anxiety, respiratory issues, or even gastrointestinal problems, especially if you have a history of "腹內燒" (a term that may refer to a sensation of internal heat or discomfort). It’s important to note that stress and anxiety can exacerbate respiratory symptoms, leading to a cycle of discomfort.

Dry Cough and Throat Irritation
Your persistent dry cough and the feeling of a dry throat could be linked to several factors, including allergies, environmental irritants, or even acid reflux, which can cause throat irritation and a sensation of needing to cough. Given your history of diabetes and the medications you are taking, it’s also possible that some side effects could contribute to these symptoms.

Body Temperature Perception
The perception of feeling hot while others do not can be attributed to various factors, including metabolic changes, hormonal fluctuations, or even psychological factors. In individuals with diabetes, fluctuations in blood sugar levels can sometimes lead to feelings of heat or discomfort. It’s essential to monitor your blood sugar levels regularly, as uncontrolled diabetes can lead to various complications.

When to Seek Medical Advice
Given the complexity of your symptoms, it is advisable to consult a healthcare professional, particularly a pulmonologist or an internist, who can perform a thorough evaluation. Here are some specific indicators that suggest you should seek medical attention sooner rather than later:
1. Worsening Symptoms: If your breathing sounds become more pronounced or if you experience increased difficulty breathing, it is crucial to seek immediate medical attention.

2. Chest Pain: Any new or worsening chest pain, especially if it feels like pressure or tightness, should be evaluated promptly.

3. Persistent Cough: If your cough persists for more than a few weeks or is accompanied by other concerning symptoms such as fever, weight loss, or night sweats, it is essential to get checked.

4. Changes in Blood Sugar Levels: Given your diabetes, if you notice significant changes in your blood sugar levels or experience symptoms of hyperglycemia (such as excessive thirst, frequent urination, or fatigue), you should consult your healthcare provider.

5. Mental Health Concerns: If you find that anxiety or stress is affecting your breathing or overall well-being, consider discussing this with a mental health professional.

Conclusion
In summary, while some of your symptoms may seem manageable, the combination of unusual breathing sounds, chest tightness, persistent cough, and altered body temperature perception warrants a thorough medical evaluation. It is always better to err on the side of caution when it comes to respiratory health, especially with your existing medical history. Regular check-ups and open communication with your healthcare providers will help ensure that any potential issues are addressed promptly.

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