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Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 5578
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Live in Yosemite National Park, Ca at 4,000 feet I am 65

Customer Question

Live in Yosemite National Park, Ca at 4,000 feet
I am 65 yrs young, 5'4" and weigh about 160
No form of illness or taking any form of meds.
Just have Asthma.
Lately feeling Extremely exhausted, when I walk I feel like I weigh about 5 times my weight, some times shallow breathing, coughing at times feel like a sand paper and coughing out a hot substance or blood.
Comes and goes.
But when I am in the city I have no problem.????
luisgtorres at gmx com
Submitted: 7 months ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 7 months ago.

Hi,

Im sorry to hear about your symptoms. Can i ask do you have any history of smoking in the past? or any exposure to any sort of chemicals or smoke of any kind?

Expert:  Dr. Muneeb Ali replied 7 months ago.

Since you seem to be offline , ill leave a response here which we can discuss later.

There are two major possibilities here, one is that you do have an underlying lung disease which worsens with high altitude. This could be in the form of diseases like bronchiectasis which can mimic asthma or even hypersensitivity pneumonitis or even another form of interstitial lung disease. This would be picked up on a simple clinical examination followed by a HRCT of the chest. This would explain the symptoms in your case and would also explain why they occur at a higher altitude.

The second possibility here could be that you are developing high altitude pulmonary edema, this is a condition which exlcusively occurs in patients at higher altitudes. Although it usually occurs at levels higher than 4000 ft however it has been known to occur in patients at altitudes even lower than 4000 ft. This is because each person has a slightly different tolerance for high altitudes. This occurs because of a lower oxygen tension at higher altitudes and this leads to fluid moving out of the vessels and into the lungs. this would cause shortness of breath, decreased exercise tolerance as well as blood in your sputum which would usually be frothy in nature. The solution is to slowly ascend to the altitude to allow your body to acclimatize to the higher altitude.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

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Customer: replied 7 months ago.
I do not smoke.
Winter time i do fire places
I do use Tilex to clean at work.
I was told i am asthmatic / bronchitis
I have been up here about 12 years and this has been going on for maybe 3 yrs.
***************
Expert:  Dr. Muneeb Ali replied 7 months ago.

Then high altitute pulmonary edema is unlikely to have caused your issue. However i feel pulmonary edema is the most likely explanation here, pumlonary edema which is occurring because of a cardiac etiology. while you are at normal altitudes the heart is functioning well and is able to keep up with the oxygen demands however when you go to a higher altitude the heart has to work harder in order to achieve the same amount of oxygenation due to the decreased oxygen tension at an altitude. Now this means that your heart is affected but not so much that you would experience symptoms at normal sea level. This could be the result of your asthma or bronchitis which has been known to lead to right sided heart failure. Also patients with heart failure do worsen at higher altitudes. A simple echocardiogram would be able to determine if this is the case. In addition a serum BNP level would be able to help in diagnosis as well.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/