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What It Is
What To Do About It

SHORTNESS OF BREATH (SOB)

People with CHF have trouble with shortness of breath. They feel winded. They can’t catch their breath.

There are five kinds of Shortness of Breaths (SOBs for short)

On exertion — Stuff like:

  • Climbing stairs or carrying a heavy laundry basket through the house (Doing stuff that might not get everybody winded, but it definitely a little hard)

Moderate exertion

  • Getting out of a chair, walking a block, getting dressed (stuff you wouldn’t think would get a person winded)

Minimal Exertion

  • Brushing hair, eating (At this point, life is really limited. There isn’t much you can do without feeling out of breath)

At rest

  • You become short of breath when your just sitting in a chair watching TV. This necessarily all the time.

Lying in bed

  • You become short of breath when you lie flat in bed. People who have “orthopnea” often sleep with several pillow, or even sleep sitting in chairs. (Don’t sleep in chairs—it can pull water into your feet all night long, which can cause venous stasis ulcers, that are very, very difficult to heal.)

 

What causes SOB? The simple answer is: WATER RETENTION Holding onto extra water can cause two problems that lead to shortness of breath. 1. It can put extra water in your lungs. Not enough water to drown you, but enough water to block oxygen from getting to the little hands on the inside surface of the lungs (called alveoli). After that handoff:
  1. The alveoli that hand the oxygen over to the blood
  2. The blood delivers that oxygen all over the body
  3. Where the oxygen makes everything work
  4. It makes the muscles move, the brain think, and everything else in the body do what it does.
Except, if those parts of the body don’t get enough oxygen—Especially the brain. When your brain doesn’t get enough oxygen, you feel short of breath or, in another way to put it, oxygen hungry.
  • When you don’t get enough oxygen to your brain, you feel short of breath.
  It can put extra water in your blood.

Here’s an interesting fact. Blood is about 50% water and 50% red blood cells.

It’s kind of like the way Kool Aid is water mixed with tiny granules of red powder that make Kool Aid drinks red (and tasty sweet). Blood water mixes with millions of tiny red blood cells that make your blood red (and carry oxygen—but that’s a different story). People with heart failure hold onto too much water in their blood—It’s called extra “blood volume.” It’s just like mixing a packet of Kool Aid with two quarts of water instead of one to make extra “Kool Aid volume.” That extra water in your blood can cause shortness of breath in two ways:
  1. Those red blood cells not only make your blood a red color. They also carry the oxygen around. So, if there’s more water in the blood, there’s “proportionately” less red blood cells to carry oxygen. So your blood is carrying less blood around your body, especially to your brain, meaning that you’re going to feel short of breath.
  2. That extra blood volume doesn’t fit easily in your blood vessels—it jams your blood vessels up. That strains your heart. Damages your heart. And finally makes your heart too weak to pump and push blood around your body as well as it should. And that means that oxygen isn’t getting pumped around your body the way it should. And that makes you short of breath.

What It Is

SHORTNESS OF BREATH (SOB)

People with CHF have trouble with shortness of breath. They feel winded. They can’t catch their breath.

There are five kinds of Shortness of Breaths (SOBs for short)

On exertion — Stuff like:

  • Climbing stairs or carrying a heavy laundry basket through the house (Doing stuff that might not get everybody winded, but it definitely a little hard)

Moderate exertion

  • Getting out of a chair, walking a block, getting dressed (stuff you wouldn’t think would get a person winded)

Minimal Exertion

  • Brushing hair, eating (At this point, life is really limited. There isn’t much you can do without feeling out of breath)

At rest

  • You become short of breath when your just sitting in a chair watching TV. This necessarily all the time.

Lying in bed

  • You become short of breath when you lie flat in bed. People who have “orthopnea” often sleep with several pillow, or even sleep sitting in chairs. (Don’t sleep in chairs—it can pull water into your feet all night long, which can cause venous stasis ulcers, that are very, very difficult to heal.)

 

How It Happens

What causes SOB? The simple answer is: WATER RETENTION Holding onto extra water can cause two problems that lead to shortness of breath. 1. It can put extra water in your lungs. Not enough water to drown you, but enough water to block oxygen from getting to the little hands on the inside surface of the lungs (called alveoli). After that handoff:
  1. The alveoli that hand the oxygen over to the blood
  2. The blood delivers that oxygen all over the body
  3. Where the oxygen makes everything work
  4. It makes the muscles move, the brain think, and everything else in the body do what it does.
Except, if those parts of the body don’t get enough oxygen—Especially the brain. When your brain doesn’t get enough oxygen, you feel short of breath or, in another way to put it, oxygen hungry.
  • When you don’t get enough oxygen to your brain, you feel short of breath.
  It can put extra water in your blood.

Here’s an interesting fact. Blood is about 50% water and 50% red blood cells.

It’s kind of like the way Kool Aid is water mixed with tiny granules of red powder that make Kool Aid drinks red (and tasty sweet). Blood water mixes with millions of tiny red blood cells that make your blood red (and carry oxygen—but that’s a different story). People with heart failure hold onto too much water in their blood—It’s called extra “blood volume.” It’s just like mixing a packet of Kool Aid with two quarts of water instead of one to make extra “Kool Aid volume.” That extra water in your blood can cause shortness of breath in two ways:
  1. Those red blood cells not only make your blood a red color. They also carry the oxygen around. So, if there’s more water in the blood, there’s “proportionately” less red blood cells to carry oxygen. So your blood is carrying less blood around your body, especially to your brain, meaning that you’re going to feel short of breath.
  2. That extra blood volume doesn’t fit easily in your blood vessels—it jams your blood vessels up. That strains your heart. Damages your heart. And finally makes your heart too weak to pump and push blood around your body as well as it should. And that means that oxygen isn’t getting pumped around your body the way it should. And that makes you short of breath.

What To Do About It

What you should do about shortness of breath: It’s two things:
  1. Take your water pills!
  2. Tell the doctor if your shortness of breath gets even a little bit worse, so he can do something about it before it gets a lot worse.

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