Severe Breathing Problem During Exercise

[johnm750]

I moved to the Philippines two years ago.

I saw a respiratory specialist last week about severe breathing problems during exercise.  Very quickly, he noted edema in my legs and feet and I was hospitalized for three days for tests on my heart.  Thankfully, the tests turned out negative.  The results were "excellent."

Upon discharge, the cardiologist gave me two "possibilities" for my breathing problems: 1. My body cannot adapt to the heat & humidity of the Philippines; 2. Maybe I am an "excitable" person...I guess she was inferring that I am having panic attacks.  However, I am pretty relaxed and laid back, especially here.

I'm not a doctor, but neither of these seem plausible based on my history (see below).  I am returning to see the respiratory specialist I saw last week (he seemed very good), but in general the doctors here seem...um...lacking.  Most doctors here will prescribe you medicine and hardly mention your problem, much less what the medicines do, what their side-effects are, and what else I should be doing about my problems.

For months ago I saw my normal doctor (one of the better ones here) about this problem, only at that time I was thinking it was heat exhaustion.  She ordered tests which all came back fine and she suggested that I cut out MSG from my diet, which I have always avoided anyway.

I have been heavily physically active since I was 15 years old.  I'm 41 now.

From 1997 to 2007, I worked in an athletic dome...the balloon-typed filled with air, no air conditioning, and extreme humidity during summer months.  I spent many hours of intense exercise in those conditions, which is actually more hot and humid than here in the Philippines.  The only difference was there was no direct sunlight.

Perhaps four years ago, I started noticing shortness of breath and I would sometimes feel very tired and need to quit early.  ("Early" being after an hour or maybe two...I have always been able to keep playing...)  At the time I attributed it to being out of shape.

Over the past two years, exercise has become harder and harder for me.  No, I have not been exercise with nearly the frequency as I did previously, but I'm 100% sure this is not my problem (as also suggested by a couple of doctors).

Recently, after only a small amount of light to medium exercise, I feel like I am overheating and I have extreme troubles breathing.  I ran long distance track in high school and the shortness of breath is not a normal outcome of exercise.  It's hard for me to put into words, but I am gasping for air more.  Even after running four miles or more (previously), it was easier to breath.  This is a different kind of "hard to breath."

Until a few weeks ago, I had thought that heat exhaustion was causing my shortness of breath.  But now I know it is the other way around.  Before, I could pour water on myself and feel somewhat better.  That's not working as well now.

My verticle leap has reduced to literally almost nothing. Even when I am trying to jump high, I jump about 12 inches.  Recently, my legs have been almost giving out from under me after only a small amount of light exercise.  I think they are not getting sufficient oxygen (??? I'm not a doctor!!).

I have always drank plenty of fluids during exercise, and the last year or two have drank even more, maybe two liters an hour.  I have always sweated profously, even in moderate weather.  I know the heat & humidity makes it harder for the body to cool itself, but I did not experience these problems in the dome where I previously worked (until relatively recently, as noted).

My sister was diagnosed with a small case of asthma a few weeks ago.  Even before then, I was beginning to think it was asthma.

I had a CBC and some results were out of range.  The doctor didn't even inform of this.  I asked to have a photocopy of the results and read it myself.  She said she was not concerned about the results.  See the bottom of this post for all relavent test results.

Doctors here are notorious for not explaining everything or considering everything, though I'm hoping the respiratory specialist is different.

I know over-the-Internet diagnosis is extremely difficult, but...

When I go back to doctor, what questions should I ask?  What tests might be wise to run?  Where should we be looking for possible problems?

Could the edema be related to my breathing problem?  Additional info: about eight months ago, my legs started itching at night like crazy.  It pretty much subsided about six weeks ago.  I was scratching so hard that I drew blood a couple times.

Thank You!
John

********
Test results:
Stress/Echo test
* Slightly dilated left ventricular dimension with adequate wall motion and contractility (Ejection Fraction 59%)
* Slightly dilated right ventricular dimension w/adeq. w. motion/cont.
* Normal left atrial dimension
* Dilated R. atrial dimension w/o evidence of thrombus
* Structually normal mitral valave, aortic valve, tricuspid valve and pulmonic valve w/good opening and closing motino
* Normal main pulmonary artery & aortic root dimensions
* Normal pulmonary artery pressure

DOPPLER STUDY
* Normal E:A ratio across mitral valve
* Mild pulmonic regurgitation
******
Hepatitis NEG
Electrocardiographic Report: Sinus bradycardia with early repolarization; otherwise normal

Chest X-Ray: Lung fields clear.  Heart not enlarged. Trachea in midline. Throacic aorta not tortuous.  Diaphragmatic leaflets & costphrenic sulci intact.  Soft tissues and bony thorzx unremarkable.  ///Normal heart & lungs

CBC (only out of range stats)
Hemoglobin 13.4 (range 14.0-17.5)
Hematocrit 39.6 (41.5-50.4)
neutrophil 71 (40-70)
red cell count 4.4 (4.5-5.9)
RDW 13.4 (14-18)

Other blood test:
CO2 Combining Power 31 (23-30)

[Gimpster]

John

I would like to know if you have had any luck with a diagnosis as i have exactly the same symptoms, i also overheat whilst doing minimal tasks but notice if i stop and get my breath i am ok but as soon as start again i'm back to square 1.
Carl

[AMY16]

Exercise induced asthma?

[Victoireh]

Well here in Canada they don't explain things either unless it's a concern, but having been an asthmatic for most of my life, I can give some ideas. For starters have you had a pulmonary function test done? Seeing that you don't have any breathing symptoms outside of exercise, then you might very well not see anything on that test. But you can do  a lung function test with exercise. They measure your lungs after a certain amount of time of exercising to see if you get a 20% drop in lung function. This would be indicative of exercise induced asthma. Sounds like there are no major problems with your heart, so I doubt that would be the cause of your symptoms during exercise. I too was once had to do a heart stress test and the likes because I was having all sorts of breathing problems during running, but my heart passed with flying colours. It was all due to my out of control asthma. Your hemoglobin isn't bad, you have to be worse (below 10) to start showing symptoms on a daily basis. Outside of that I don't know. Some people tend to hyperventillate during exercise, but this diagnosis is only given after everything else has been eliminated.