Help me with telling a patient the dyspnea is just deconditioning..

I have had 2 patients thus far who have gotten very upset because I + a bunch of others couldn't find anything to explain their dyspnea. And this was not for lack of compassion, interpersonal communication, time spent going over data, appropriate testing. One couldn't even give me an RER>0.9 on their CPET, has a BMI of 37 and put on 10kgs since the eval started 3 months ago (which they blame on not being able todo anything due to dyspnea).

I've told them that I realize it's frustrating to...

Help me with telling a patient the dyspnea is just deconditioning..