30/09/2025
“Disangka susah nafas kerana masalah jantung, rupanya…”
Setiap nafas adalah anugerah. Namun, bagi Encik Wong, 86 tahun, nafas yang sepatutnya menghidupkan, kini menjadi beban yang menyeksakan.
Beliau datang ke klinik saya dengan langkah yang berat, disokong oleh anak perempuannya yang kelihatan runsing. Wajahnya pucat, bibirnya kebiruan. Setiap tarikan nafas berbunyi seperti wisel lembut yang mendayu, penuh usaha.
“Doktor… doktor tolonglah ayah saya,” pinta anaknya, Su Lin, suara menggeletar. “Dua bulan ni, dia makin susah nak bernafas. Naik satu anak tangga pun macam nak panjat Gunung Kinabalu.”
Saya menghulurkan kerusi. “Sila duduk, Encik Wong. Ceritakan pada saya.”
Dengan suara yang tercungap-cungap, Encik Wong berkata, “Dulu… dulu saya kuat, doktor. Boleh buat kerja kebun. Sekarang… semangkuk nasi pun rasa macam batu.”
Misteri di Sebalik Susuk Jantung yang Sihat
Rupa-rupanya, ini bukanlah perhentian pertama mereka. Mereka telah berjumpa dengan rakan sejawat saya, pakar kardiologi yang terkenal.
“Kami dah buat scan jantung dan paru-paru,” jelas Su Lin sambil mengeluarkan sekumpulan laporan perubatan. “Tapi doktor jantung kata, jantung ayah saya baik saja. Ada sedikit masalah, tapi taklah teruk sampai sebabkan sesak nafas macam ni.”
Saya meneliti setiap laporan. Jantung memang stabil. Paru-paru pada scan kasar kelihatan normal. Tapi, naluri saya sebagai pakar paru-paru berbisik… ada sesuatu yang tidak kena. Sesak nafas yang progresif tanpa sebab jantung yang jelas adalah satu amaran.
“Encik Wong,” saya bertanya, peka pada setiap detil, “Ada batuk? Kahak? Demam? Turun berat badan?”
“Batuk sikit… kadang-kadang ada kahak berdarah,” jawabnya lirih.
Kahak berdarah. Tiga patah perkataan itu seperti loceng penggera di dalam kepala saya.
“Doktor jantung yang rawat ayah saya, dia cadangkan kami jumpa anda,” sambung Su Lin. “Dia kata, mungkin ‘silap alamat’.”
Saya mengangguk. “Bagus juga dia cakap macam tu. Kadang-kadang, punca sesak nafas bukan di jantung, tapi di paip udara itu sendiri—di paru-paru. Kita kena tengok dalam.”
Memasuki Lorong Gelap: Detik-Detik Cemas Sebelum Bronkoskopi
Keputusan dibuat untuk melakukan bronkoskopi—sebuah prosedur di mana kamera kecil dimasukkan melalui hidung atau mulut untuk melihat secara langsung saluran pernafasan.
Di bilik persediaan, ketegangan terpancar jelas.
“Saya takut, doktor,” bisik Encik Wong, genggamannya erat pada tangan anaknya.
Saya memegang bahunya. “Encik Wong, saya akan tidurkan encik sebentar. Encik tak akan rasa apa-apa. Kita kena cari punca masalah ni, supaya kita boleh rawat.”
Su Lin memandang saya, matanya berkaca. “Doktor, selamatkan ayah saya.”
Prosedur bermula. Di bawah sedasi, Encik Wong kelihatan tenang. Saya mula mengarahkan skop fleksibel itu, meneroka setiap cabang saluran pernafasan. Kanan, bersih. Kiri atas, bersih. Semuanya kelihatan normal, dan untuk seketika, saya mula berasa runsing. Adakah saya tersilap?
Kemudian, saya sampai ke saluran pernafasan kiri bawah.
Dan di situlah saya melihatnya.
Sebuah ketulan. Ganas, tidak teratur, menyekat sebahagian besar saluran udara seperti penyumbat yang mengancam. Ia berdiam di sana, diam-diam menjadi dalang di sebalik penderitaan Encik Wong.
Jantung saya berdebar kencang. Inilah punca segala penderitaannya. Dengan berhati-hati, saya mengarahkan forsep kecil melalui bronkoskop, dan mengambil sampel tisu (biopsi) dari ketulan itu. Setiap gerakan mesti tepat. Satu silap langkah, boleh menyebabkan pendarahan.
“Dapat,” bisik saya kepada jururawat yang membantu.
Kebenaran Pahit yang Terungkap
Beberapa hari kemudian, keputusan biopsi tiba. Ia seperti menanti keputusan peperiksaan hidup dan mati.
Saya memanggil Su Lin dan Encik Wong ke pejabat saya. Udara terasa berat.
“Keputusan biopsi dah keluar,” saya mulakan, cuba untuk tetap tenang. “Apa yang kita nampak dalam paru-paru ayah tu… adalah kanser. Jenis adenocarcinoma.”
Su Lin menutup mulutnya, air matanya mengalir laju. Encik Wong hanya terdiam, pandangannya kosong, seolah-olah dunia di sekelilingnya runtuh.
“Kanser?” ulang Encik Wong perlahan-lahan. Suaranya hancur. “Saya dah tua… tapi saya belum bersedia…”
Saya duduk di sebelahnya. “Encik Wong, ini bukan pengakhirannya. Kita jumpa dia di peringkat awal kerana salurannya tersumbat dan ayah ada gejala. Ini sebenarnya nasib baik yang terselindung.”
Mata Su Lin bersinar dengan secercah harapan. “Maksud doktor?”
“Maksudnya, kita dah jumpa musuh kita. Sekarang, kita boleh lawan. Ada rawatan—kemoterapi, imunoterapi, terapi disasarkan. Usia bukan halangan untuk kita berusaha.”
Pegangan tangan Encik Wong di tongkatnya kelihatan semakin kukuh. “Saya… saya nak cuba, doktor. Nak bernafas dengan lega semula. Nak lihat cucu-cucu saya membesar.”
Detik itu, saya melihat satu semangat yang tidak mudah patah di sebalik tubuhnya yang uzur.
Pengajaran :
Kisah Encik Wong meninggalkan banyak pengajaran yang mengesankan :
1. Sesak Nafas Bukan Selamanya Jantung: Gejala sesak nafas mempunyai banyak ‘alamat’. Jantung adalah satu, tetapi paru-paru, saluran pernafasan, dan psikologi juga boleh menjadi punca. Jangan cepat membuat kesimpulan.
2. Pentingnya Pemeriksaan Menyeluruh: Scan yang kelihatan ‘normal’ tidak semestinya benar-benar normal. Pemeriksaan klinikal yang teliti dan prosedur seperti bronkoskopi adalah penting untuk melihat apa yang tidak dapat dilihat oleh mesin scan.
3. Suara Hati Seorang Pesakit: “Kahak berdarah” adalah gejala amaran (red flag). Jangan sekali-kali memandang ringan atau menganggapnya sebagai perkara biasa. Segera dapatkan nasihat perubatan.
4. Kanser Paru-Paru Boleh Menyerang Sesiapa Saja: Walaupun perokok mempunyai risiko tinggi, kanser paru-paru seperti adenocarcinoma juga boleh berlaku kepada mereka yang tidak pernah merokok.
5. Diagnosis Awal Menyelamatkan Nyawa: Jika Encik Wong tidak dirujuk, ketulan itu mungkin terus membesar dan merebak. Diagnosis melalui bronkoskopi memberikannya peluang untuk rawatan dan harapan.
Perjalanan Encik Wong belum selesai. Ia adalah sebuah perjalanan yang penuh dengan cabaran, tetapi kini dilalui dengan keberanian dan harapan. Setiap nafas barunya adalah kemenangan.
Jangan abaikan nafas anda. Dengarkan ia.
Jika anda atau orang tersayang mengalami masalah pernafasan yang berterusan, jangan tunggu. Dapatkan pemeriksaan menyeluruh.
Untuk buat temu janji, sila klik: https://encoremed.io/smcv /154
Gambar : Ketulan di salur pernafasan yang boleh dilihat melalui prosedur Bronkoskopi
Dr. Nurul Yaqeen
Pakar Perubatan Respiratori (Pakar Paru-Paru)
———-
"Breathing difficulties were thought to be due to a heart issue, but it turned out to be..."
Every breath is a gift. Yet, for Mr. Wong, 86 years old, the very breath that should give life had become a burdensome torment.
He came to my clinic with heavy steps, supported by his anxious-looking daughter. His face was pale, his lips bluish. Every breath he took sounded like a soft, laboured whistle.
"Doctor... please help my father," pleaded his daughter, Su Lin, her voice trembling. "For the past two months, it's been getting harder for him to breathe. Climbing just one step feels like climbing Mount Kinabalu."
I offered a chair. "Please sit, Mr. Wong. Tell me about it."
In a breathless voice, Mr. Wong said, "I used to be... strong, doctor. Could work in the garden. Now... even eating a bowl of rice feels like lifting a rock."
The Mystery Behind a Healthy Heart
It turned out this wasn't their first stop. They had already seen my colleague, a renowned cardiologist.
"We did a heart and lung scan," Su Lin explained, pulling out a stack of medical reports. "But the heart doctor said my father's heart is fine. There are minor issues, but not severe enough to cause breathlessness like this."
I scrutinized every report. The heart was indeed stable. The lungs on the initial scan looked normal. But my instinct as a lung specialist whispered... something was wrong. Progressive shortness of breath without a clear cardiac cause is a red flag.
"Mr. Wong," I asked, attentive to every detail, "Any cough? Phlegm? Fever? Weight loss?"
"A little cough... sometimes there's phlegm with blood," he whispered softly.
Phlegm with blood. Those three words were like an alarm bell in my head.
"The heart doctor who treated my father suggested we see you," Su Lin continued. "He said maybe we got the 'wrong address'."
I nodded. "It's good he said that. Sometimes, the cause of breathlessness isn't in the heart, but in the air pipes themselves—in the lungs. We need to look inside."
Entering the Dark Passage: The Anxious Moments Before the Bronchoscopy
The decision was made to perform a bronchoscopy—a procedure where a small camera is inserted through the nose or mouth to directly view the airways.
In the preparation room, the tension was palpable.
"I am scared, doctor," whispered Mr. Wong, his grip tight on his daughter's hand.
I held his shoulder. "Mr. Wong, I will put you to sleep for a while. You won't feel a thing. We need to find the cause of this problem so we can treat it."
Su Lin looked at me, her eyes glistening. "Doctor, please save my father."
The procedure began. Under sedation, Mr. Wong looked peaceful. I began guiding the flexible scope, exploring every branch of the respiratory tract. Right side, clear. Left upper, clear. Everything looked normal, and for a moment, I began to feel anxious. Had I been wrong?
Then, I reached the left lower airway.
And there I saw it.
A mass. Irregular, menacing, blocking most of the airway like a threatening plug. It sat there, silently the mastermind behind Mr. Wong's suffering.
My heart raced. This was the cause of all his suffering. Carefully, I guided small forceps through the bronchoscope and took a tissue sample (biopsy) from the mass. Every movement had to be precise. One wrong move could cause bleeding.
"Got it," I whispered to the assisting nurse.
The Bitter Truth Revealed
A few days later, the biopsy result arrived. It was like awaiting a life-or-death verdict.
I called Su Lin and Mr. Wong into my office. The air felt heavy.
"The biopsy results are out," I began, trying to remain calm. "What we saw in your father's lung... is cancer. The type is adenocarcinoma."
Su Lin covered her mouth, her tears flowing fast. Mr. Wong just sat silently, his gaze empty, as if the world around him had collapsed.
"Cancer?" Mr. Wong repeated slowly. His voice was shattered. "I'm old... but I'm not ready..."
I sat down beside him. "Mr. Wong, this is not the end. We found it at an early stage because his airway was blocked and he had symptoms. This is actually a blessing in disguise."
Su Lin's eyes shone with a glimmer of hope. "What do you mean, Doctor?"
"It means we have found our enemy. Now, we can fight. There are treatments—chemotherapy, immunotherapy, targeted therapy. Age is not a barrier for us to try."
Mr. Wong's grip on his walking stick seemed to tighten. "I... I want to try, doctor. I want to breathe easily again. I want to see my grandchildren grow up."
In that moment, I saw an unyielding spirit behind his aged body.
Lessons and Guidance
Mr. Wong's story leaves many touching lessons:
1. Shortness of Breath Doesn't Always Mean Heart: The symptom of breathlessness has many 'addresses'. The heart is one, but the lungs, airways, and psychology can also be the cause. Don't jump to conclusions.
2. The Importance of a Thorough Examination: A scan that looks 'normal' isn't necessarily truly normal. A careful clinical examination and procedures like bronchoscopy are crucial to see what machines cannot.
3. A Patient's Telling Symptom: "Coughing up blood" is a RED FLAG symptom. Never take it lightly or assume it's normal. Seek medical advice immediately.
4. Lung Cancer Can Affect Anyone: While smokers have a higher risk, lung cancers like adenocarcinoma can also occur in those who have never smoked.
5. Early Diagnosis Saves Lives: If Mr. Wong hadn't been referred, that mass might have continued to grow and spread. Diagnosis via bronchoscopy gave him a chance for treatment and hope.
Mr. Wong's journey isn't over. It is a journey filled with challenges, but now it's faced with courage and hope. Every new breath he takes is a victory.
Don't ignore your breath. Listen to it.
If you or a loved one experiences persistent breathing problems, don't wait. Get a thorough check-up.
To make an appointment, please click: https://encoremed.io/smcv /154
Dr. Nurul Yaqeen
Respiratory Medicine Specialist (Lung Specialist)