OET Listening Part A: Chronic Breathlessness Case Study

Good morning, Mr Miller.

Now, looking at your notes, I see you've been having a few problems recently.

Could you tell me a little about what's been happening, in your own words?

Well, yeah, it's a combination of things really.

To kick-off, I feel pretty tired most of the time,

just haven't got the energy I used to have.

And I've got this cough, it's there all the time and it feels dry...

I mean, I'm not coughing up phlegm or blood or anything like that.

But the worst thing, which really bothers me, is that I'm so short of breath,

even if I'm just getting dressed in the morning or going up a few steps,

I have to stop 'cos I get breathless so quickly.

And I've lost quite a bit of weight, too.

I mean, I didn't notice at first because it was very gradual.

But all in all, I'm about ten kilos lighter than I was six months ago.

I've not been dieting or anything, I love my food!

And, well have you noticed anything else?

Yeah, just take a look at my fingers.

The tips look swollen, don't they?

And it's the same with my toes, which are bulging out at the end too.

Weird.

And my nails, I don't understand it, they've become soft.

They're not hard like they used to be... look!

Erm, okay... I see what you mean.

And tell me a little about yourself....

Uhm... what do you do for a living?

Well, till recently, I worked as a farm labourer.

Did it for about twenty years in total.

It was hard physical graft, and it finally got to the stage where I just couldn't cope with it any more.

It really took it out of me.

So, this last couple of years, I've been a security guard,

working nights at a local DIY warehouse.

It's a bit boring, and the late shifts took a bit of getting used to, but it's okay.

And, erm... are you finding it less physically demanding?

That's right.

I just haven't got the stamina now for anything else.

In fact, I've even had to give up my golf.

Can't manage it any more.

Any spare time now goes on looking after my pigeons, I've done that since I was a teenager.

Oh, very nice.

And, uhm, what about your medical history.

Now, I see you were diagnosed with hypertension last year,

and you're taking beta blockers at the moment for that.

That's right.

My GP said it'd help.

Something the GP also said, when I saw him about my breathing problems was that...

he heard what he called 'crackling' noises in my chest.

I can't hear them, but he could, through the stethoscope.

And is there any family history of breathing or lung problems, or any serious illnesses that you know of?

I don't think so.

My mother was always healthy,

but my dad developed bad eczema as an adult.

I remember the red patches on his hands and face.

But he didn't have any lung problems as far as I know.

Right, and...

well, looking at your previous tests, you were diagnosed with hypertension about 6 months ago, you had...

Oh yeah, um... an echocardiogram, you know, to check my heart...

and a chest x-ray about four weeks ago after I saw my GP.

That came back okay as far as I know.

I see.

I'm not keen on hospitals, to be honest.

Am I going to need to have lots more tests?

Well, I'm going to suggest you have what's called an arterial blood gas test.

This will let us check how well your lungs are working,

how they move oxygen into your blood and remove carbon dioxide from it.

Okay.

And, I'm also going to order a CT scan.

Now, this'll be more revealing than the chest x-ray you had.

And I may then prescribe a course of corticosteroids.

This will depend on what the tests show up.

Now, I'd start you on a relatively low dose...