Case study ( 1787 views as of March 22, 2018 )
Marty is a 63-year-old life-long smoker who had to retire 6 years early from his job as a longshoreman, as "he got the emphysema". He doesn't much like going to see his doctor, as "as she wants to do is give me pills and puffers". He has cut down his smoking from 2 packs per day to 1 pack per day, with the expectation that this will improve his breathing problems.
Marty has very poor exercise tolerance, and has to sit on available benches to rest and catch his breath when doing errands at the mall. He is no longer able to do anything active, and regrets this, as he used to be an enthusiastic hiker and outdoorsman. Early retirement forced him to sell his boat, and his disability benefits do not cover his monthly expenses. He has had to rely on a 'reverse mortgage' to support his admittedly limited lifestyle.
Marty may benefit from reconnecting with his primary care provider, and finding a common set of health goals to improve his quality of life. He has many of the manifestations of severe, possibly end-stage lung disease. He would almost certainly benefit from seeing respiratory illness specialists, learning about the role and proper use of medications and pills. He may also benefit from seeing a cardiologist for risk stratification for cardiac disease, which commonly accompanies these diagnoses.Author: Dr. Adam Lund