Symptoms of Lung Diseases: A Guide for Concerned Families

Could you please specify the suspected pulmonary diseases?

Hello Doctor: My father is nearly sixty years old, and he has recently exhibited the following symptoms: (1) About 3 to 4 months ago, he started coughing persistently every night, leading to chronic sleep deprivation.
He has difficulty falling asleep, and one night he experienced excessive sweating all over his body, after which his physical strength noticeably declined.
(2) About a month ago, he frequently had intermittent fever, but this phenomenon has since resolved.
(3) His complexion has consistently appeared dark, particularly around the facial features.
(4) He previously underwent a chest X-ray, which indicated "pleural effusion." As a result, he visited a hospital in the northern part of the country and was hospitalized.
The doctor suggested it might be caused by "pneumonia," but after less than a week of treatment, he returned home and stopped seeking medical care.
A few days after returning, he began coughing again.
(5) Later, he received intravenous therapy at a small clinic multiple times, and upon returning home, he developed "severe edema in his legs with numerous red spots resembling an allergic reaction, appearing in patches." (6) Not long after, he also experienced "severe edema in his hands." (7) About two weeks ago, he went to another hospital for diagnosis, where the doctor suspected "tuberculosis" and prescribed medication.
His cough showed significant improvement, but he has been excessively sleepy, sleeping over 15 hours a day for about a week, yet the swelling in his hands and feet has not improved, the spots on his legs remain, and he experiences body aches, making it difficult for him to lift his arms.
(8) Additionally, his throat has become hoarse, making it hard for him to speak, his complexion remains poor with localized darkening, he appears lethargic, and his appetite has significantly decreased, leading to noticeable weight loss.
I am truly worried and saddened to see my once vibrant father in this condition.
Could you please provide me with some insights and advice? I would be very grateful.

Xiao Mi, 20~29 year old female. Ask Date: 2007/02/22

Dr. Yang Wenda reply Pulmonology

Hello Xiaomi,
Your father currently has several issues to address:
1.
After a confirmed diagnosis of tuberculosis, he needs to adhere to the medication regimen for 6 to 9 months, and most cases can be cured.
2.
During the medication period, it is important to monitor for any side effects from the anti-tuberculosis drugs (such as drowsiness, loss of appetite, etc.) that may require adjustments to the medication.
3.
Edema may be related to long-term poor nutritional status, such as insufficient protein intake, and nutrition should be gradually supplemented.
4.
There may be other underlying conditions that need to be treated concurrently.
If you want to address the above concerns simultaneously, it is advisable to persuade your father to consider hospitalization for treatment (even though he may not like the idea of being hospitalized).
Choose a larger hospital or one with more experience in treating tuberculosis (you can consult with a public health nurse).
Since it is currently the Spring Festival period, I apologize for the delayed response to your concerns.

Wishing your father a speedy recovery.

Reply Date: 2007/02/22

More Info

I'm sorry to hear about your father's health issues. It sounds like he is experiencing a complex set of symptoms that could be indicative of several underlying conditions, particularly related to lung disease. Given the symptoms you've described, including persistent cough, fatigue, facial discoloration, and swelling, it is crucial to seek comprehensive medical evaluation and management.

Understanding Symptoms of Lung Diseases
1. Persistent Cough: A chronic cough lasting more than three weeks can be a sign of various lung conditions, including chronic obstructive pulmonary disease (COPD), asthma, pneumonia, or even lung cancer. The fact that your father has been coughing for several months and has experienced significant fatigue and night sweats raises concern for a more serious condition, such as tuberculosis (TB) or pneumonia.

2. Fever and Fatigue: The intermittent fever and extreme fatigue could suggest an infectious process, such as pneumonia or TB, especially given the history of lung water (pleural effusion) and the recent diagnosis of suspected TB. TB can cause systemic symptoms, including fever, night sweats, and weight loss, which align with what you have described.

3. Facial Discoloration: The darkening of the skin, particularly around the facial features, may indicate a lack of oxygen (cyanosis) or could be related to other systemic issues. This symptom, combined with respiratory problems, should be evaluated by a healthcare professional.

4. Pleural Effusion: The presence of fluid in the lungs (pleural effusion) can be caused by infections, heart failure, or malignancies. It is essential to determine the cause of the effusion, as this will guide treatment.

5. Swelling and Rashes: The swelling in the legs and arms, along with the appearance of red spots, could be related to fluid retention, possibly due to heart issues or kidney problems. It may also indicate an allergic reaction or a side effect of medications.

6. Hoarseness and Weakness: The hoarseness and overall weakness can be attributed to several factors, including respiratory distress, medication side effects, or even malnutrition due to decreased appetite.

Recommendations
1. Immediate Medical Attention: Given the complexity and severity of your father's symptoms, it is crucial to seek immediate medical attention. A thorough evaluation by a pulmonologist or an infectious disease specialist is recommended. They may perform imaging studies, such as a chest X-ray or CT scan, and laboratory tests, including sputum cultures, to confirm the diagnosis.

2. Medication Compliance: If your father has been prescribed medication for suspected TB, it is vital that he adheres to the treatment regimen. TB treatment typically lasts for several months, and completing the course is essential to ensure the infection is fully eradicated.

3. Monitoring Symptoms: Keep a close watch on his symptoms, particularly any changes in breathing, increased swelling, or new symptoms. Documenting these changes can provide valuable information for healthcare providers.

4. Supportive Care: Ensure that your father is well-hydrated and receives adequate nutrition. Encourage small, frequent meals if his appetite is poor. Managing his environment to reduce exposure to irritants (like smoke or strong odors) can also help alleviate respiratory symptoms.

5. Follow-Up Appointments: Regular follow-up appointments with healthcare providers are essential to monitor his condition and adjust treatment as necessary. If he experiences any worsening of symptoms, seek medical help immediately.

6. Emotional Support: This situation can be distressing for both your father and your family. Providing emotional support and encouragement can help him cope with his health challenges.

In conclusion, your father's symptoms warrant a thorough medical evaluation to determine the underlying cause and appropriate treatment. Early intervention can significantly improve outcomes in lung diseases, especially when infections like TB are involved. Please ensure he receives the care he needs as soon as possible.

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