'Tis but a cough (warning signs of pneumonia)
Updated: Jul 25
“May I arrange my life every day in every way in such a manner that when my time comes to leave this world, I shall be unafraid to go and shall have the knowledge that I left the world at least a little better than it was when I came into it.”
(Discourses on Buddhism, CK Seet)
This is a quote from a book my grandpa wrote in Malacca many years ago. He passed away in 2013 just before I graduated with my PhD, and I only found it when going through my mum’s paperwork when she passed earlier this year.
My mum is not the reason for my lack of blogs this year – I’ve just had a corneal ulcer (couldn’t see the keyboard for a couple of months) and a very heavy schedule. I wasn’t a carer, I wasn’t driving up and down to Hastings every weekend – not because I was eschewing my “duty” - but because mum, to all intents and purposes, was “OK”, and I’d just seen her as I would normally a week before.
Maureen Tang was one of the most healthy people I know and her death was both sudden and unexpected. She had diabetes – which she managed. She followed all the “healthy advice” on nutrition shows. She was fit and walked every day. The only thing I noticed a few days before she passed as she had a cough but we all – including her - thought she would soon recover.
It turns out she had bronchopneumonia.
Looking at the medical encyclopaedia of Google – “Bronchopnemonia” or “Pneumonia” was known as “Old man’s friend” as death often was peaceful and quick…depending on how you look at it. Some strains of pneumonia could also be a build-up of fluid in the lungs, which is something I prefer not to think about.
It is the difference between pneumonia and “a cold” that is the most significant, because those with compromised immune systems (including those over 65, and children) are at the greatest risk of the wrong diagnosis being fatal. Saying that, I also read with sadness about the number of people, not in those groups, who went to bed with “a tickle in their throat”, and didn’t wake up.
My work focuses on raising awareness – and perhaps it is time to jump on the soap box again momentarily.
From the NHS (https://www.nhs.uk/conditions/pneumonia/):
Pneumonia is swelling (inflammation) of the tissue in one or both lungs. It's usually caused by a bacterial infection.
Common symptoms of pneumonia include:
a cough – which may be dry, or produce thick yellow, green, brown or blood-stained mucus (phlegm)
difficulty breathing – your breathing may be rapid and shallow, and you may feel breathless, even when resting
feeling generally unwell
sweating and shivering
loss of appetite
chest pain – which gets worse when breathing or coughing
Less common symptoms include:
coughing up blood (haemoptysis)
nausea or vomiting
joint and muscle pain
feeling confused and disorientated, particularly in elderly people
It is the “less common” symptoms and a couple of others I read about that I want to draw attention to:
In the elderly the fever may be BELOW normal
Pneumonia and Flu don’t tend to have the symptom of sneezing (differentiating from a cold)
Feeling confused and disorientated
Aside from the fact that pneumonia may not necessarily result in any symptoms, the common ones are often the ones that you will seek medical attention for. The last of the least common however – feeling confused and disorientated – perhaps because there is a constant low level of asphyxiation going on is something that is both telling and most likely to be misinterpreted.
That’s what happened to me.
I was later advised by a neighbour that my mum had been a little disorientated, but no-one had associated this with pneumonia and even I had seen that symptom before and could give a reason for it. On the rare occasion where we’d had to wait for a meal and her blood sugar level dropped, she was disorientated. Disorientation is a common symptom of UTIs. Some disorientation is not seen as significant of physical illness in an elderly person who perhaps may be developing alzheimers.
Mum had seemed perfectly lucid when I spoke to her on the phone, and when she had emailed me the day before; and these symptoms were not seen as significant enough to merit calling an ambulance – not that my mum would have gone anyway – she herself was talking about “…going back to bingo” after the weekend.
I don’t propose to now turn this into a long piece about my mum – I spoke at her funeral earlier this month in a service full of flowers and friends, which I do hope she would have liked. (And I respectfully request that my privacy continues to be respected on this score). But she was - like my dad is, like her own parents were, and like I am today – an educator, and I hope this – released on March 24th 2018 - which would have been her 77th birthday – will make at least one more person question the anomalies in the way this killer presents, and maybe save a life. Hopefully also continuing the family quest to make the world at least a little better.
For more information on pneumonia: British Lung Foundation
Dr Audrey Tang is a chartered psychologist and author. Listen to her podcast Retrain Your Brain here; and catch her practical masterclasses Psych Back to Basics on DisruptiveTV & Energy Top Up for resilience For quick tips and tools: click for SKILL PILL and Q&A videos and here for Media appearances. Twitter/IG @draudreyt