There are several parts to this. Why? Partly because I’ve lived a pretty long life and done a lot of things, and partly because it seems that there are areas of medicine in which a great many doctors seem not to be particularly well-versed. One of these is disorders of breathing - including but not limited to lungs.

An observant friend of mine has picked up on a number of signs and symptoms which my physicians, over the years, have missed. In some cases, they are of very serious, potentially life-threatening, conditions.

In this way, I was able to convince my physician (who respects my friend’s knowledge and acumen) to refer me to a sleep clinic. Bingo! Severe Obstructive Sleep Apnea! Now I sleep with a CPAP machine, and many things are beginning to improve in my life.

For years, I have had bad colds turn into long bouts of bronchitis, some as long as 4 or 5 months. (That’ll take the starch out of even a pretty scrappy older woman!) Treatments were prescribed, and they were usually somewhat palliative, but nothing was really changing. What was missing? –A thoughtful and comprehensive approach to history-taking.

For instance, nobody asked me, so I told no one in particular, that I had been part of renovating 8 or 9 older houses, over the years, and (to be ’smart’ and save money) had lived in all of them during the process. Some of these renovations were major, some minor, but most all involved scraping or sanding walls and woodwork … lead dust, anyone? I am sure I was exposed to lead and asbestos, possibly radon, and certainly mold. Nobody ever asked about these, or anything like them. But I am certain that they have played a large part in my health problems, as time went on.

It took either inescapable ‘coincidences,’ in the short run, or large leaps of association and intuition, in hindsight, for me to begin to ‘connect up the dots.’ Nobody did it for me! I was raised in a medical household, and trusting doctors was a way of life. I’ve had to unlearn that, at least as an automatic response.

Now, I find, in my seventies, that it is up to me to learn everything I can about whatever is going on, even when I’m so tired or in so much pain, that ‘googling’ around is the last thing I want to be doing. Nobody’s gonna do it for me.

But I’m fortunate to have this friend who knows a lot and observes keenly. She’s the one who suggested to me, recently, that I may also have COPD I am a mouth-breather, she noticed. (I didn’t know that!) I get short of breath on certain kinds of exertion. (I never thought much about it.) I cough a good bit, and raise sputum often. And so on. Time to check it out, she says. I will.

I know this is long and diffuse. That’s how it is with these conditions - the ones that don’t just leap the mind of doctors when you come in with a cough.

I just want to alert people to draw their own inferences (not conclusions, necessarily) and try to bring as much data to medical interviews as they can, so you and the doctor can work as a team in what is, basically, detective work. Even if you don’t know that facts A and B are related, they may somehow help to flesh-out the portrait and get some accuracy into the picture.

Your doctor may need some prodding to think with a more open mind. If s/he won’t, you may need to look for one who will. But you are also going to have to be open to making changes in the way you live your life, and changing long- habituated patterns is not easy to do. I am learning that, and learning to do what I’d call ‘creative wondering.’

For instance, I wonder what COPD and OSA have in common? How are they different? Do they have similar causes or completely different ones? When I had awful bronchitis AND (I was told) asthma and the beginnings of pneumonia after a few weeks living in a newly-renovated house, was it actually COPD?

What about Multiple Chemical Sensitivities? And why does NOBODY pay any attention to MOLD exposure (or try to discover which kind of mold you were dealing with) or do anything about it?

Questions, questions, questions: I wish I could find some answers!