Why do my lungs ache after I carry my backpack?
June 29, 2007 3:14 AM   Subscribe

ChestPainFilter: I am breathless and my lungs ache after I carry my backpack, even for short intervals.

(24 year old male, approx. 5'10" and 60Kg.)

I've been travelling with a backpack for six months. In mid-April I developed chest pain while travelling through the snowy eastern part of Turkey. Initially I put it down to the cold; venturing outdoors certainly made the feeling worse. My lungs felt heavy and constricted, and lifting my backpack (weighing less than ten kilos) caused considerable pain across the inside of my chest. That evening I developed an intense stabbing pain in my upper left abdomen every time I took a breath. I've experienced this sensation before, perhaps once every six or eight months, but it usually clears up within five minutes if I sit absolutely still and take shallow breaths. However, after trying to relax for three or four hours the pain was still just as intense. I became worried and found a doctor. He listened to my pulse and chest (no cough, no discharge) and said he thought I had either pleurisy, caused by a virus, or else a myalgic muscular strain. He instructed me to keep as warm as possible and prescribed both muscle-relaxant gel and some anti-inflammatories. Neither seemed to have a noticeable effect but, after finding an extremely warm room, the pain eased off and I was able to sleep, though the feeling of breathlessness and the 'heaviness' in my chest and arms persisted for several more days.

I've been trying to carry my backpack as little as possible since then, and also to lighten the load. It's now less than 5 kilos, but even after carrying it for five or ten minutes I'll usually feel a tightness in my chest for a day or so afterwards. I'm in Vietnam at the moment and the temperature is above 30 degrees, but two days ago the breathlessness and heaviness in my chest returned.

At the moment my lungs feel 'heavy' and breathing causes more effort than it should, though the pain isn't much worse during inhalation. I feel breathless when walking, and I am most comfortable when lying flat on my back. Additionally, my left arm feels 'full up,' as though someone is squeezing all the blood downwards towards my hand. This is most noticeable when walking.
I've woken up several times in the past couple of days with a racing and heart and very strong pins and needles sensation in my hand and arm, as if they were completely empty of blood. When I raise my left hand I have an unusual hot/cold feeling as though it's being suddenly drained of blood.

Other stuff that may be incidental: When I was 18 I was diagnosed with an irregular heartbeat and the arrythmia has been much worse than usual in the past two days, waking me up several times each night, though this is probably more to do with the bad indigestion and lots of trapped wind that I've experienced over the same period.

Has anyone experienced similar symptoms after carrying a backpack? I have no idea whether these symtoms are pleuritic, muscular, circulatory, caused by a hernia, etc.
Does pleuritic inflammation of the lungs sound like a good explanation, and can it be repeatedly triggered by carrying a light, properly-strapped backpack for even a couple of minutes at a time?

I intend to visit a doctor as soon as I arrive at the nearest city (Da Nang) but in the meantime I'd very much appreciate any feedback about what might be causing these symptoms.
posted by Black Spring to Health & Fitness (16 answers total)
Best answer: Please see a competent doctor IMMEDIATELY. 2 weeks ago, I was having trouble sleeping with some (not all) similar symptoms... a feeling of tightness in my chest, pins and needles in my arms, etc.

I had a heart attack. Angioplasty and 3 stents later I'm better, but chest pain of any type is not to be trifled with. EVER. In the next room was a 24 year old woman who had had a heart attack the day before mine. It can happen to anyone at any age.
posted by pjern at 3:29 AM on June 29, 2007

I'm going to second solipsist. If you have any asprin on you, take one *now*. If you're not in a big enough town to find a decent hospital, hire a taxi or private car to take you to one. Don't do it tomorrow, and don't wait for convenient or cheap transportation. This is not something to fool with. If it is heart trouble, the sooner you are treated, the better your chances of recovery without heart damage. If it's not, well then count yourself blessed.

Good luck.
posted by Philbo at 3:53 AM on June 29, 2007

This is not really about the backpack. This is what is caused "dyspnea on exertion," or difficulty breathing when you are not at rest. It's a bad sign. You notice the symptom more with the backpack because you're exerting yourself a little more when you carry it.

I echo those above telling you to restructure your trip so you can get medical care ASAP. I know it will be difficult for you, and being sick while travelling far away is scary, but you've got to do it. These are not benign symptoms and no one on the internet is going to be able to diagnose you, because the list of what you could have is endless, and the only way to get to the bottom of this is for you to be evaluated, in person, by a clinician. Good luck, and I hope you are well soon.
posted by tuff at 4:05 AM on June 29, 2007

Have you got travel insurance? If so, there's usually a helpline you can call, often reverse charge.

They should be able to give you advice on what to do. They may even have a list of recommended local doctors and hospitals.

Are you south of Da Nang at the moment? Hoi An is smaller than Da Nang but very touristy, so you'll probably be able to find an English speaking doctor there.
posted by roomaroo at 4:23 AM on June 29, 2007

The backpack trip is over. Get to a hospital in a larger city in Turkey and then on to your home country if the docs think its ok.
posted by Ironmouth at 5:09 AM on June 29, 2007

Sorry, I see you are in Viet Nam. My advice still goes.
posted by Ironmouth at 5:10 AM on June 29, 2007

get to a doctor immediately. talk to the embassy for a recommendation for a cardiologist. bring a list of your symptoms (or print out this note) so you can make sure the information doesn't get lost in translation.
posted by thinkingwoman at 6:02 AM on June 29, 2007

Best answer: I've had pleurisy and I was thinking of it even before you said the doctor mentioned it. It felt exactly like this. If you have some confusion or are more emotional than usual, then include that in your symptoms.

Here is what you need to do:

Go to a hospital immediately.

Write your symptoms, everything you can think of.

You probably have a low blood oxygen level at this time, which makes it difficult to remember things and difficult to make good decisions. If you have a friend or someone you trust, ask for their help getting you to and communicating with the doctor/hospital staff. If not, contacting your embassy may be a good first step.

Ask for oxygen. It makes decision-making a lot easier.

Pleurisy can be diagnosed with X-ray and ultrasound. Ask for one.

They can suck the fluid out with a needle. That is the treatment I would expect at this point, given that it's not going away on its own. If they diagnose you with pleurisy and do not offer this treatment, ask them why and make sure you understand the treatment they are offering.

Good luck!!
posted by carmen at 6:52 AM on June 29, 2007

Response by poster: Thanks for your replies and concern everyone. About two seconds after I read Solopsist's post, I headed for the hospital at Hoi An. There was a female doctor there who spoke some English- after some questions she took an X-ray of my chest and said I had bronchitis, showing me on the printout the white patches where the tubes in my lungs were inflamed.

She gave me an injection of calcium in my hip (which she said was to combat the numbness in my arm), an injection of antibiotic into my wrist, and also a bagful of tablets to take over the next week: an analgesic (Di-Angesic) an antibiotic (Scanax), Cefalexin to treat respiratory tract infection, and something called Alpha Chymotrypsin though I'm don't know what this is or what it's for.

I'm not sure whether this is what I had in Turkey. Between then and now I've felt fine for long periods: I've been on a three-day hike in the hills of northern Thailand, a fairly strenuous walk which only myself and one other individual completed. I have no idea if bronchitis can come and go like that, or if it can re-emerge from dormancy because of the strain of carrying a backpack.

I did have insurance, which unfortunately runs out tomorrow. The cost for the consultation and medicines was only 30 dollars though. IF, as the doctor predicted, I feel better within five days then I hope to continue the trip. I'm going to stay in Da Nang near the hospital during this time though. But I'm prepared to get back to the UK quickly if the symptoms continue.
As for the backpack I'm pretty damn close to just throwing it away and travelling in what I'm wearing, plus toothbrush and wallet...
posted by Black Spring at 7:22 AM on June 29, 2007

Sometimes lung infections can be tricky to defeat so don't give up if it takes a little longer than planned and you have to try a couple of different antibiotics. Once you are feeling better that pack will seem light again. Enjoy your trip and just be glad that your insurance didn't run out in the US of A.
posted by caddis at 7:54 AM on June 29, 2007

Just want to echo that bronchitis diagnosis - I didn't want to weigh in when everyone else had more experience with pleurisy and cardiac-related issues, but I've had something similar to what your last doctor saw. I came down with a hacking cough about a year ago, it hung around for a while, then finally tapered off... etc, flash forward four months and I was having chest pain, shortness of breath, etc. A doctor confirmed I had an "old bronchitis" shown in my chest x-ray, and the pain and difficulty breathing has gone away with time. I'm sure if I had better insurance/more money to pay doctor's bills, my discomfort would have gone away more quickly and efficiently, but I seem to be fine now. It was, however, a bewildering and significantly scary experience. I never thought that fears about heart attacks could have come from what started as a nasty cold - boy, do I know better now!
posted by AthenaPolias at 8:09 AM on June 29, 2007

Black Spring, on general principles, go and get an ECG. If you were say, my brother and I was speaking to you on the phone, I would nag you until you agreed to do this while your one day of insurance is left (but it' Vietnam so as you know, it's cheap).

Seriously, it's a very easy thing to get and just because of the whole array of symptoms you've described, irrespective of the xray, a cardiograph is one of those things worth getting. It's not for alarmist reasons, but rather, just because you should. And ask if they can make you a copy so you can take it with you. IANAD.
posted by peacay at 8:19 AM on June 29, 2007

Response by poster: Caddis: Will do, I think I'm in a good climate for my lungs if I need a while to recover: warm and humid. It could mean a couple of weeks of recuperation on Da Nang's beaches, mango shake in hand. Nightmarish.

AthenaPolias: Thanks for the info. I've just been looking up some information on bronchitis, and most of the sources state that a cough like yours is a defining feature of bronchial infection, but I have no cough at all, and I don't even remember having one in Turkey which I find odd.
posted by Black Spring at 8:23 AM on June 29, 2007

I've had bronchitis a bunch of times, and I rarely cough when I have it. My Mom's the same way. Usually what happens to me is I start out with a viral infection that lasts a little while, then feel somewhat better for a week or so, and then I come down with a secondary bacterial infection (the bronchitis). It happens pretty much every time I don't take it easy when I have a bad cold.
posted by doubtful_guest at 9:07 AM on June 29, 2007

I'm glad to hear you went to the hospital, and these seem like good results.

My bout with pleurisy was the culmination of about 4 months of on and off infections, at least one of them bronchitis (which is a common cause of pleurisy). What I learned during that time is that lung infections can wax and wane, and they can also lead to other infections and complications. Your plan sounds good; in addition keep an eye out for emotional turmoil (crying for no reason, or over something that isn't actually upsetting you), difficulty making decisions, and dizzy spells. For me that was the sign that I didn't have enough blood oxygen. If that starts to happen over the next little while, go back to the hospital, and don't second-guess whether you really need to or not.

Here's hoping the antibiotics are all you need, and you can stick with your trip :)
posted by carmen at 9:34 AM on June 29, 2007

My Jr year of college I came down with a respiratory infection (or series of infections) that inhabited my lungs and took 2-3 courses of anitbiotics over a month or two before I finally started mending.

However, my lungs have never been the same since. I'd have occasional coughing fits and a few years later, they became chronic, daily occurrences. When I wasn't coughing, my lungs felt tight. Cold air and any exertion often made things worse. When I went to the doctor, they diagnosed me with Asthma, gave me a week (or so) on prednisone to get things under control, and prescribed short and long-acting inhalers, which I probably used regularly for the next 5-7 years.

It's now ~18 years since the chronic bronchitis. The asthma is pretty much a non-issue, even without treatment. Cold isn't generally a problem, nor is exertion. It's only sometimes an issue when I catch a cold, and even then, it's really mild compared to what it had been like.

My point in mentioning all this is to say that even if you had a persistent bout of bronchitis that has now been properly addressed, you may still encounter respiratory difficulties for a while down the road.

Good luck
posted by Good Brain at 9:36 AM on June 29, 2007

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