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Expert Q&A:
Could you explain why, at 28 weeks, my lungs are burning all the time?

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Margaret Freda
Answered by Margaret Freda Ed.D., R.N., C.H.E.S., F.A.A.N.
"I've been a professional nurse working with pregnant women and parenting families since 1966," says Margaret Comerford Freda. "Pregnant women and parents need to know as much as possible about their own health and that of their children."

Margaret Comerford Freda, Ed.D., R.N., C.H.E.S., F.A.A.N., is a Professor in the Department of Obstetrics &; Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, and also serves as Director of Patient Education Programs for that department. Since 1993, Dr. Freda has been the Consultant for Nursing at the National March of Dimes Birth Defects Foundation and the Chair of the National March of Dimes Nurse Advisory Council. In addition, Dr. Freda serves as the editor of MCN, The American Journal of Maternal Child Nursing.

Dr. Freda received her Master's Degree in Nursing from New York University and her doctorate in Health Education from Columbia University. She has worked in women's health for her entire professional career. Dr. Freda has published 50 research articles in professional journals, and is a frequently invited speaker at nursing and medical conferences. She has written two books: Perinatal Patient Education, published by Lippincott Williams &; Wilkins, and Miscarriage After Infertility, published by Fairview Press, written with her daughter Carrie Semelsberger, who is also a nurse.

Dr. Freda has received several noteworthy awards, such as the Distinguished Professional Service Award and the First National Award for Excellence in Nursing Research from the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), the Woman of Distinction Award and the Maternal Child Nurse of the Year Award from the March of Dimes, the Patient Care Award for Excellence in Patient Education from the American Academy of Family Physicians, the Research Recognition Award from Molloy College, and several Outstanding Research Paper awards at national conferences. She serves on the Scientific Advisory Council for the March of Dimes, and was selected to serve on the Select Panel of the Centers for Disease Control to advise on prenatal health. Dr. Freda has developed patient education booklets and videotapes that are now distributed nationally.

Dr. Freda has been married for four decades. She has two daughters, two sons-in-law, three grandsons, and a granddaughter.
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Question


Of course, from a distance it's not possible to really know what's causing your shortness of breath, but I can give you some educated guesses.

Answer


Of course, from a distance it's not possible to really know what's causing your shortness of breath, but I can give you some educated guesses. First of all, breathing problems are common throughout pregnancy, and occur in the beginning because of hormonal changes. At the end of pregnancy, breathing difficulties are more often due to the size of the baby and the pressure on the lungs and diaphragm.

I'm so glad that you quit smoking. Quitting smoking is not only important for your baby but essential for your own health. It seems that you only recently quit smoking—you could still be experiencing respiratory problems that occurred because of smoking, so that's one guess. I also wonder about asthma. Some asthmatics say that their lungs "burn," and that's the phrase you use. Do you wheeze? And as for other causes of shortness of breath, are you coughing? Do you ever cough up blood-tinged mucus? Do you ever have a bluish tinge to your lips or fingernails? Do you get fevers? You might need to see a pulmonary specialist or a maternal fetal medicine specialist (a doctor who only works with women with high risk pregnancies) if you need to be treated for asthma or another respiratory condition during this pregnancy. I think the most important advice I can offer you is that you should not accept advice that doesn't feel right to you. If you are worried about your breathing, and your doctor is not satisfying your worry with an adequate response, then find another doctor who will take you seriously and at least answer your question or refer you to a specialist. While your respiratory difficulty might not be anything to worry about, there is a chance that it is from asthma, or pneumonia, or any number of other conditions.

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