Medical English 專欄(五)

THE RESPIRATORY SYSTEM

(I)               Case

  Frank, a 65-year-old stockbroker with a 90 pack/year history of smoking, had a screening Chest X-ray that showed a small (three-eight-inch) nodule in the lower lobe of his left lung. The spot was not present on his Chest X-ray two years before. Exploratory surgery proved that it was a cancer, without any evidence of having spread. The lobe containing the tumour was removed. Frank recovered easily and wisely used his hospitalization as a time to stop smoking.

(II)           Q & A

Q: Do you have any problem?

A: 1. I cough frequently and cannot sleep well at night.

   2. I have had persistent cough for 3 months and sometimes felt breathless.

   3. I cough up sputum and feel muscle ache.

   4. I have runny nose, sore throat, and headache.

   5. I was suffered from night cough and shallow breathing in this winter.

   6. The dry cough at night persistently bothered me for a year.

   7. I feel headache and tired, because my nose is stuffy. I can’t breathe normally.

Q: Do you have fever, chest pain or other symptoms?

A: 1. I have fever, sometimes up to 38.5 degree.

   2. I feel upset in stomach when I have a bad cough.

   3. I have a sense of constriction in the chest.

   4. My mucus becomes yellow and sometimes contains blood.

(III)        Early Detection of Lung Cancer

Your first symptom of lung cancer may be an irritating cough or a streak of blood in the sputum. The tumour may block a small bronchial tube, causing pneumonia in the lung tissue beyond the blockage. Chest pain and shortness of breath indicate a more advanced tumour that has invaded neighbouring sensitive tissues or has affected a large amount of the lung. Occasionally, the first symptom is caused by the cancer’s spread to the brain, bone, or liver.

(IV)        After Operation

Postoperatively, you awaken in the recovery room, and a short time later are moved to the ICU (Intensive Care Unit). The breathing tube, left in place until you need no further breathing assistance, can usually be removed after the effects of anaesthesia have worn off. If you are debilitated or have poor function in your remaining lung tissue, the tube may be necessary for several days, or even longer. Lines and tubes monitor your EKG, lung and cardiac function, blood pressure, and urinary output. Once you are off the ventilator and are in stable condition, you can be moved out of the ICU.

(V)           When to Call a Health Professional

Any of the following symptoms may mean that your lung infection is getting worse or that you are developing a bacterial lung infection.

l   A cough that

-- Occurs with wheezing or difficulty breathing that is new or different.

-- Brings up bloody sputum.

-- Frequently produces yellow, green, or rust-coloured sputum from the lung (not post-nasal drainage) and occurs along with a fever of 38.3 degree or higher.

--Lingers more than 7 to 10 days after other symptoms have cleared, especially if it is productive (bringing up sputum).

l   A fever of 40 degree or higher that does not go down after 2 hours of home treatment.

l   A fever that persists for 3 days despite home treatment.

l   Laboured, shallow, or rapid breathing with shortness of breathe.

l   Significant chest-wall pain when you cough or breathe.

                                

(VI) Lifestyle Change

1.      Don’t smoke

The average cigarette smoker is 10 to 15 times more likely to develop lung cancer than his non-smoking counterpart. And his risk increases as the number of cigarettes per day increases. A man who smokes two or more packs per day, is 20 to 25 times more likely to develop lung cancer than a non-smoker.

2.      A study of 1,500 Chinese men and women indicates that people who inhale oil vapours while frying food are more likely to get lung cancer than those who don’t.

(VI)        Vocabularies

                     Flu / Influenza

                          Asthma

                          Pneumonia

                          Lung Abscess

                          Chronic Bronchitis / Smoker’s Cough

                          Sneezing

                          Wheezing

                          Runny Nose / Stuffy Nose

                          Cyanosed Lips

                          Itchy Eyes

                          Post Nasal Drip

     Questions to ask

1.      What type of cancer do I have and how far has it progressed?

2.      How does this type of cancer usually respond to treatment?

3.      What are my treatment choices?

4.      When will treatment start and end, and how often will I have it?

5.      What are the possible side effects of this type of cancer or its treatment?

6.      How can I manage side effects?

7.      Should I make changes to my day-to-day life?

(VII)    Dialogues

P: I am afraid I have got a mild temperature, doctor. My nose is stuffed up.

D: Open your mouth and let me see your throat.

P: I know I have a sore throat.

D: Yes, and you have a temperature of 38 degrees as well. You have all the symptoms of the flu.

P: What am I supposed to do?

D: There is very little you can do for the flu. Drink more water and take a rest certainly will help.

P: Doctor, my eyes are tearing and I keep sneezing. It is interfering with my work now.

D: You are suffering from the allergic reactions of hay fever. How long have you had them?

P: I had my first hay fever symptoms four years ago. It has been getting worse each year.

D: It would e a good idea to stay indoors when the pollen count is high. It is caused by the pollen particles in the air from trees and weeds.