My partner and I took care of a 29-year-old man complaining of exertional dyspnea. He was frustrated that he would become winded on the walk between his bed and the comfortable chair in the living room. It wasn't like he got winded after several flights of stairs, after all, but just a walk from one room to another.
At the time I met him, he was not dyspneic. He was, though, 450 pounds. I find that medics often overestimate patients' weights, but this patient was discharged from a local hospital the week before and his weight was documented on his discharge paperwork. Four hundred fifty-two pounds, to be exact.
Working through the call, I discovered that he had a history of asthma, hypertension, congestive heart failure, gout, and type 2 diabetes. He didn't know the names of his medications, but that was okay because he had been noncompliant with all of his medications for two weeks. Neither of us knew why he wasn't taking his prescribed meds. He did say, though, that he didn't often wear his oxygen, even when he felt short of breath, because "it smelled funny."
The exertional dyspnea issue had been worsening for months, and the man was frustrated that modern medicine couldn't figure out the problem well enough to find a solution. Noncompliant with his medications, 450 pounds, off his oxygen.
It was a genuine medical mystery.
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