Wheezing

Wheezing is a characteristic high pitched whistling sound made while breathing, a primary symptom of a chronic respiratory disease - Asthma. It is not uncommon in those with respiratory allergies, especially during the hay fever season. Sometimes, other respiratory infections could be accompanied by mild wheezing, especially when acute Bronchitis is experienced. It is also noticed in those with heart failure and Chronic Obstructive Pulmonary Disease COPD. While most commonly wheezing occurs during breathing out, it can sometimes also be related to breathing in.

Causes of Wheezing

Narrowing of airways results in breathing difficulty and wheezing. There could be several causes for narrowing of airways including inflammation from asthma, infection, allergic reaction or a physical obstruction such as tumor or foreign body inhalation. Among the possible causes of wheezing include allergies, insect bite or medication or pollen, pet dander, dust, foods, Bronchiolitis, bronchitis, childhood asthma, epiglottitis, GERD, heart failure, lung cancer, pneumonia, sleep apnea, smoking and vocal cord dysfunction.

Respiratory Syncytial Virus (RSV) Infection is also known as Bronchiolitis - inflammation of the bronchioles which in turn refer to the the narrow airways which branch from bronchi to the air sacs called as alveoli. This RSV infection largely affects infants and children.

To determine the cause of wheezing, your doctor will ask questions about any symptoms that triggers it. If you have no history of lung disease and develop wheezing after eating a certain food or in a certain season, respiratory allergy is suspected. The doctor checks the lungs with a stethoscope to find out where the wheezing is and how bad it is. During a first time evaluation, the doctor performs a spirometry - breathing test, and also a chest X ray.

Sometimes other blood tests and procedures become necessary depending upon the health condition. In case it is allergic wheezing, then a variety of tests to determine the allergies including dermatological examinations are done.

Wheezing problems

Wheezing is accompanied by difficult breathing, rapid breathing and briefly bluish skin color. Emergency care must be sought if wheezing begins suddenly after being stung by a bee, while taking medication, or eating an allergy-causing food or after choking on a small object or food.

Wheezing in infants

In case of a baby, wheezing could be due to cold or problematic asthma. But it is not always clear if the infant has asthma. It is essential to get a firm diagnosis and make sure that the child gets treated for any breathing problems. In some infants, Bronchiolitis could occur due to a viral infection. The airways swell making breathing difficult. As the airway of an infant is small, infants are easily affected. Wheezing could result due to Bronchiolitis, which may develop into asthma in later life. Otherwise a child could be born with a tendency to wheeze and therefore could be prone to bronchiolitis and asthma. Less common reasons for wheezing in infants include inhalation of a foreign object or piece of food into the lungs, premature birth, insufficiently developed airways and cystic fibrosis.

Treatment options

A variety of treatments are available to help alleviate wheezing. However, regular monitoring by a doctor is a must, especially if the patient has asthma, chronic allergies, severe bronchitis, emphysema or chronic obstructive pulmonary disease. In some, wheezing can be relieved by certain medications or by using an inhaler. Some might need insertion of a breathing tube into the throat. The doctor may recommend some or all of the following to reduce inflammation and open up the airways obstructing breathing to stop wheezing:

• A bronchodilator inhaler, which can act fast to dilate constricted airways.
  
• An inhaled Corticosteroid
  
• A long-acting bronchodilator and Corticosteroid combination
  
• A controller pill for asthma to reduce airway inflammation
  
• A non-sedating antihistamine pill or a prescription nasal spray for nasal allergies, which are available over the counter.

Self-care measures to ease wheezing

Moisturize the air by either using a humidifier or a steamy shower or just sit in the bathroom with the door closed while running a hot shower. This is simply because moist air can help relieve mild wheezing in some cases.

Drinking fluids can relax the airway and loosen up sticky mucus in the throat.

Active or passive smoking can worsen a cough and hence it is best to avoid tobacco.

Emergency

Normally, mild wheezing that accompanies bronchitis disappears when the infection subsides. But in case of breathing difficulty, she needs to rush to the doctor who can administer the following:

• A shot of epinephrine to open up the clogged respiratory passages.
  
• Oxygen
  
• Frequent nebulizer to ease breathing
  
• A mechanical ventilator to help you breathe

It is for the doctor to determine the cause of wheezing and then treat the patient for the specific cause.

PFT

PFT - Pulmonary Function Test refers to one or different types of tests that are conducted on a patient to assess the condition of the lungs and their efficiency in transferring oxygen to the blood. PFT can help diagnosing the cause of 'shortness of breath' and confirm lung diseases like Emphysema, Bronchitis and Asthma. PFT aids in measuring occupational hazards of exposure to contaminants such as asbestos or radon. It helps monitoring of disease treatment. These tests are mandatory before any major lung surgery. However, PFT is not given to patients who had a recent heart attack or has a history of heart disease.

Spirometry is a vital PFT that measures how well the lungs exhale. This diagnostic test is prescribed for patients suffering from asthma or COPD. This tests involves breathing into a mouthpiece that is connected to a spirometer. The amount of air and rate of exhalation are measured over a specific time.

Peak Expiratory Flow Rate - PEFR meter is a handheld device that measures the rate of exhalation in a patient. This PEFR test results can vary depending upon a number of factors - age, height and sex. So peak flow meters are mostly useful for monitoring the medications of some Asthma patients.

Lung volume measurement test can aid detection of restrictive lung diseases. Such patients are often unable to inhale normal volumes of air due to inflammation or scarring of lung tissue. This PFT can be done as a body plethysmograph.

Gas diffusion test measures the amount of oxygen and other gases that are absorbed into your body from your lungs.

Inhalation challenge test aids in identifying possible allergens that can cause asthma or severe respiratory allergy. Other tests to measure lung function include residual volume, gas diffusion tests, body plethysmography, inhalation challenge tests, and exercise stress tests.

Patients scheduled for PFT must restrain from use of bronchodilators or inhaler medications for few hours prior to the test. Patients are advised not to eat a heavy meal or smoke for a few hours prior to the PFT. Typical normal values for pulmonary function tests are based on the age, height, ethnicity, and sex of the person being tested. Factors such history of smoking, wheezing and obesity can affect results of PFT. Pulmonary function tests are not advised for patients who have recently suffered heart attack.

First Degree Burns

Burns are classified as first-degree burns, second-degree burns and third-degree burns according to their severity. In the case of first-degree burns, only the outer layer of the skin is affected. Swelling, pain and redness is the resulting discomfort caused by this type of burns. Dry heat like fire, wet heat such as steam or boiling liquids, heated objects, sun, chemicals, electricity and friction accidentally become the causes for burns. When hot metals, scalding liquids, flames or steam accidentally gets into contact with one's skin, thermal burns occur. They can also occur due to fire and automobile accidents, electrical malfunctions and space heaters. Unsafe handling of firecrackers and kitchen accidents are some of the other causes for thermal burns. Inhaling smoke, steam, toxic fumes and superheated air in a badly ventilated space can cause burns to the airways.

The severity of the burn is not directly proportional to the degree of pain. The most serious burns often occur with less pain. Blisters occur at the place of the burn. There will be peeling of the skin and it will turn red. Pale and clammy skin, weakness and drop in alertness are often noticed with the shock due to burns. Lips and fingernails may turn blue due to shock. Swelling and white or charred skin also are some of the symptoms. If burns affect the airways, the symptoms may vary from charred mouth, burned lips, wheezing and difficulty in breathing. There may be a change in voice of the patient. A dark, carbon-stained mucus will ooze out from the place of the burn. Sunburn can be classified as a first-degree burn.