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Can a girl get a wheeze? Please?

Posted Apr 14 2009 11:40pm
I like lung sounds. I like hearing different types of lungs sounds. I listen to lung sounds on pretty much all my patients and depending on your problem I may listen to them over and over. Your lung sounds tell us so much about you. In the absence of x-rays and lab tests, all we have to "see" into your lungs are our ears. Wet noises, nasty chunky thick rhonchi noises, squeaky musical wheezes. They each tell us a story. The worst lung sound to hear? silence. Not the familar woosh of air moving in and out that says clear lung sounds, but nothing. A cavernous omnious absence of any sound. Have an asthma attack and wait too long and you get silence. Spontaneous or traumatic pneumo or hemothorax and you get zip for noise. Immediately the mind shifts into gear and the possiblities on how to fix it start bouncing around. Take this case for example:

50 y/o female asthma pt. Out of meds for 2 days. seen frequently for uncontrolled asthma. Waited all day to go to ER.She is known to compensate well then just wear out quickly. Working hard to breath, non speaking, accessory muscle use. Absent lung sounds on the left upper and lower, right side has barely a squeak when she exhales. What do these lungs say to you? What do you "see" when you listen? I saw teeny irritated little passages that air could barely move through and had wicked inflammation. She and I are on a first name basis I see her so much. She gets an Albuterol/Atrovent tx and 125mg solumedrol IV. By the time she got to the ER she was wheezing everywhere.

I guess my point to this is that not all wheezing is bad. I will take a wheeze over silence any day. I think sometimes in class we make a big deal of the lung sounds and what they mean and how we treat them but we don't spend as much time on silence and how afer silence some noise is good. If there is noise then something has to be moving around in there when before nothing could.

So. Can a girl get a wheeze, please?
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