Grant Stewart: Pain, panic, and panting—the reality of “shortness of breath”
Words have always been my thing. I learned english and i love to read. I had even published a few novels in a previous life.
Words are powerful things, the story goes. Indeed. I recently heard the music of veteran songwriter Chip Taylor. “Fix your words,” he says in a song, a request to choose your words carefully when speaking to someone in any situation. Because they are important – the words and the people. “Words are hammers / pounding nails,” he warns.
But what if they are not and have to be? What if the words don’t have the power they should have, are not purposeful? What if, to paraphrase another song, the words don’t work?
I’ve been getting almost obsessively angry about the “shortness of breath” phase lately. It has of course been used a lot lately in relation to severe Covid-19 that I was felled with just before the lockdown began.
But what does that mean, this shortness of breath? And what do people think it means? I’ll tell you what it doesn’t mean. Shortness of breath does not mean shortness of breath. shortness of breath This is the case when you climb the stairs too fast on a hot day or add a mountain sprint to your jog.
Medical shortness of breath is something else.
This shortness of breath had always found me to be an oddly weak term for breathing difficulties. Breathing difficulties are serious, aren’t they? Yes. But I didn’t know half of it until that covert lark.
. . . And so, along with Covid, with all the psychedelic thoughts, fears, and theories that bring fever, pain, and isolation to your head when you have a new and terminal illness (You know the feeling) that came Anger that these . . . these . . . symptom I was Experienceg had been named by someone who had apparently never coughed a greenie, let alone struggled to hold the breath of life.
How did that happen, did I rage? How did this completely inadequate torrent of words come about? tickle of words, this skippety hoppety haiku segment, come to stand up for such a pillar of suffering? Related to covid, these is what these words cover:
Fear of cough. This is the unconscious stage of breathlessness where you don’t see yourself as breathlessness: you are just afraid of coughing because you coughed so much that coughing now hurts. Not only your lungs, but also the muscles in your chest, throat and back are tense, tender and sore. Instead of breathing normally, gasp shyly so the cough doesn’t notice you.
Afraid of turning over in bed. By this point, you realized that your lungs were in trouble. When you went to bed you chose one of several available reclining positions. Lying down moved your lungs. This hurt, panicked and caused frantic gasping until your lungs settled in their new position. Unfortunately, by that point, the alien pain in your legs, neck, or elsewhere had told you it was time to turn around. And it was time for the cycle of pain, panic, and wheezing to begin again.
Ah, you thought: these is shortness of breath – pain, panic, and wheezing. Nice sound. Hmm I kind of can’t see it in literature. But I would like to.
Fear of getting up. Sometimes you have to: go to the bathroom for a drink, vomit, take off another pajama shirt that is still wringing out. That means standing up, which means your lungs are moving and hurting. That means walking, which means gasping for the air you need to walk. And then when you’ve been drinking, peeing, or vomiting, you have to go back to bed and lie down, and the cycle of pain and wheezing begins all over again.
Inability to sleep. Breathing should be something you do without thinking. If not, it’s hard to turn off.
Just panic. You cannot breathe: you panic. And when you are alone, panic on your own.
Inability to speak. Breath is important to language. In general, we have a lot of breath and can talk without consciously gasping for breath. With shortness of breath you can’t. You can utter a word on every third or fourth pair of pants unless you are so hoarse that you have completely lost your voice.
Inability to do. Oxygen is muscle fuel. We don’t work without it. You need water. Can you make it to the kitchen Can you stand by the sink or will you sink? Can you turn on the tap? Can you pick up a glass Can you turn the tap off again? (For six weeks, I thought my plumbing was messed up because I didn’t have the strength to turn off the taps properly.)
So there you have it, the reality of shortness of breath. A reality that doesn’t fit into these three weak, airless words.
The punch line, of course, is that you’re wondering how we could fail with some of our other words. Do we give names to symptoms and conditions that trivialize human suffering? No doubt. When we talk to patients face to face (not to me by the way: trust me, I’m not a doctor), when we write to and about them, are the words we use for the job? It doesn’t take long to think of a few who might need visiting again. Follow-up consultation, if you will.
Fatigue. Light pain. Anxiety. Stiffness. Sleep disorder. Concern. Light. Common. I won’t even start with the technical terminology. That’s a different story.
First, let’s think of the simple words that are often used in patients, perhaps thoughtlessly. Let us remember how we can at least use, if not change, the words to indicate that we understand what they really mean. To People. Put an old-fashioned index card literally or as a mental picture on your real or mental wall: Fix Your Words.
See also: My experience with covid-19 – not just another experience
Grant Stewart, Consumer Health and Multimedia Manager, Knowledge Center, BMJ.
Competing interests: None declared.