Want to Help Mother Get a Better Quality of Life
Q. My mother was diagnosed four years ago with COPD. She
sees a pulmonologist, a general practitioner and goes to a respiratory center
for rehabilitation (a supervised workout) twice a week. Recently she has had
some problems related to her condition (blood clots in the
nose), sinusitis, depression, etc.
It seems like each doctor she sees treats just the one
aspect of her condition. The doctors don’t seem to communicate with
each other. She’s not getting the best possible care as a result and I’d
like to know if there is an organization or type of caseworker that can help with
the day-to-day aspects of living with COPD and get her a better
quality of life?
She’s developing anxiety over going out of the house and
using her portable oxygen. She’s afraid she’s going to run out, so she’s
becoming house bound.
Any advice you have to help this situation, I’d appreciate
it. I live in New York and can’t go with her to doctor visits.
A. Dear Barbara,
You need a specialist in COPD, probably a pulmonologist who
can coordinate all facets of her care. It is a complex situation, and beyond
any simple explanation I can give you here.
Odors are Causing Problems with My Lungs
Q. I cannot be around perfumes, smoke, cleaning chemicals,
body sprays, or anything that has an odor. I was told that I have mild to
I cannot get my doctors to understand that these smells hurt
my lungs. They think that I am nuts. I have been sick since May 2008. I am
seeing MDs at UNC Chapel Hill, N.C.
I get better and then I come in contact with something and I
am right back to where I started. Do you have any suggestion of what I can do
or whom I can see? Please let me know.
A. Dear Rose,
These reactions to smells are common in asthma. Be
persistent and see one who will deal with your total problem, maybe change
Life Expectancy for Someone Who has COPD
Q. How long can someone live with COPD?
A. Dear Raymond,
It depends on the age, comorbidities,
and degree of impairment. Many with COPD live 10 or more years.
Recently Diagnosed with Alpha-1
Q. I have been recently diagnosed with Alpha 1,
specifically, the null allele. I know this is bad, but what can I expect in the
next few years?
I am only 35 years old and I have made a few life style
changes to protect my lungs, but I don’t know what to expect. My doctor tells
me that my null variant is very rare and they really don’t have anything to
compare my situation with.
The Internet offers little help when it comes to the null
variant. I just want to know.
A. Dear Jay,
The null variant can be treated with replacement therapy
just like other forms of AAT deficiency. Don’t despair. Find a pulmonologist
who is experienced in replacement therapy.
For more information see Alpha-1 Foundation: http://www.alphaone.org/
Would Like Closure to a Question my Family Has
Q. You have always been so helpful with my questions
regarding my 76 year-old mother. She had been on 2L oxygen therapy for three
years for her bronchiectasis.
Unfortunately, she was diagnosed with pancreatic cancer and because of
her frailty; no treatments were advised.
Sadly, my Mom passed away after four months of being
I do have a question and none of the physicians have
answered it for our family. A few days before my Mom passed away, we took her
to the ER. Although she felt short of air her oxygen level was 100%. She NEVER
had it this high. The physician listened to her lungs and said there was little
air intake. How then could the number be 100%? Any information would be
welcome. We need some closure. Thank you.
A. Dear Rose,
The number was probably an error.
What are the Risk Factors for Lung Cancer?
Q. I have never smoked, but my mother did and now has stage
IV lung cancer. I lived with her for the first 23 years of my life. I also live
in a home that where the previous owners smoked, though no one smokes inside
our home now.
I have heard that lung cancer can be genetic. Is that true? Does
what I’ve told you make me more likely to develop lung cancer than someone else
even though I don’t smoke?
A. Dear Molly,
A family history doubles the chance of lung cancer, even in
Can’t Afford Medication and Just Don’t Like Taking Medicines
Q. For about a year and a half I have started wheezing and
coughing, mainly at night, the cough is productive I also have episodes
sometimes when I am playing basketball with my son. Not all the time.
I have gone to my internal doctor and she prescribed me Advair,
which seems to work. She told me I probably have asthma. I haven’t been taking
it regularly lately because of cost and I hate taking medicine. I have had
x-rays, and have had breathing tests done which came out very slightly
What do you think I should do now?
A. Dear Dawna,
I think you should take Advair as advised by your doctor.
Asthma seems the most likely diagnosis and cannot be ignored.
Symptoms of COPD
Q. I have been diagnosed with COPD. However I do not have
the symptoms you list on this site. I have shortness of breath on any exertion
but I recover faster than when I smoked. I don’t
think it’s progressing or getting worse. I guess I just need a second
A. Dear Tom,
A second opinion is always wise if there are serious
questions about diagnosis and treatment. Shortness of breath with exertion is
the most common symptom of COPD. You also need spirometry to see about your
Now is the time to take care of yourself and avoid
complications down the line.
Husband Diagnosed with Severe Emphysema; What are His Chances for Surviving
Another Two to Three Years?
Q. Three years ago, my husband’s physician said my husband
would PROBABLY be dead in one year. His diagnosis was severe, advanced
emphysema (which had been diagnosed seven years previously),
At that time the diagnosis was primarily based on the
following: he was smoking about two packs a day, he weighed 138 pounds, pursed
lip breathing, barrel chest, very impaired stamina, an FEV1 of less than 26.
Two months afterwards he stopped smoking and remained a
non-smoker for these past three years. He has continued to use the
Nicotrol inhaler. He uses Spiriva and Advair.
He has not seen a physician in almost a year. He has
gained six pounds. He never misses a day of work, but when not working is
almost completely sedentary.
His pursed lip breathing has disappeared almost entirely.
For someone with this history, what are his chances of surviving another two to
A. Dear Kate,
They are excellent. Keep encouraging your husband to enjoy
Aging of the Lungs
Q. What affect does aging (non-smokers) have on the lungs?
A. Dear Jake,
There is a slow loss of lung function as you age.
What is Hilar Prominence Mean?
Q. My doctor said I have an abnormal left hilar prominence.
Can you explain that better to me?
A. Dear Charles,
It is an enlargement of the base of one of the lungs. It is
up to your doctor to explain this to you and to make a diagnosis. There are
Worried that Grandmother Will Not Live Another Ten Years
Q. My Grandmother was diagnosed about three years ago with
She has failed to do any of her breathing treatments and can
barely walk out to the car without getting out of breath. She rarely showers
because it is so difficult for her. She uses oxygen 24/7.
She has ideas of living another ten years but I was
wondering realistically with her lack of breathing ability what you would say
her life expectancy is at this point and what can we do to help her?
A. Dear Brittany,
Her life expectancy depends on her age and degree of
impairment now, as well as co existing diseases. She may well live 10 years in
spite of advanced COPD and need for oxygen.
Believe Inhaler Caused Voice Changes
Q. I’m a 60 year old singer who hasn’t been able to sing the
past several years because of diplophonia,
which I believe to be related to years of inhalers—most especially, Advair. I’ve
seen a couple of ENTs in
past years, but they can’t see anything and give me the standard advice to keep
well hydrated (which I do).
My question: Since my asthma is mild (since moving to the
Southwest) could I take a different medication, thus, hopefully, reversing the
damage caused by Advair? Can the damage be reversed?
A. Dear Mary Lee,
The dysphonia is most likely due to Advair. Try taking it
only once a day or an equivalent Symbicort as a wet inhaler, not the powder of
Advair. The damage is reversible.
Are Vocal Volumes Affected by Lower Lung Capacity?
Q. I have a strange question about an acquaintance but I
hope you can help. He has something like 50%-70% of his normal lung capacity.
Should he still be able to speak loudly and/or shout if necessary?
A. Dear James,
Yes, this is enough lung power to be able to shout or
Nineteen Years Old and Constantly Yawning
Q. I am a nineteen year-old female. For almost a year I have
had difficulties breathing. I feel like my lungs are not filling up with air
and I am constantly yawning and taking deep breaths. I have been to my normal doctor
multiple times and she has run tests for asthma and done chest x-rays and
everything comes back normal.
I had my left tonsil removed and I thought that might help
and it did for a little bit but now it is just as bad as it was before. I have
tried stopping medications that I started when my breathing problems started
but nothing is helping.
I am getting increasingly concerned for my health, and it’s
honestly really annoying to me and to my college roommate that I am constantly
taking deep breaths.
Can you help?
A. Dear Ashton,
This may be hyperventilation syndrome. If so, it should get
better during exercise.
Another Question about Father
Q. Thank you for your answer.
This is in continuation with my question subject,
“Worried about Father who is on a Ventilator”. Today my dad is on the
24th day on the ventilator. As you had suggested, we looked for a ventilator
hospital but we don’t have such facility hospitals in our area. His lungs are
clear some days, and then again some days he goes bad.
Please advice what needs to be done.
A. Dear Praseetha,
You need to try to wean very, very slowly. It should finally
Best Way to Administer Aerosol to Children
Q. Is there any difference in aerosol delivery to a child using a mask
vs the blow-by method? After 13 years as a therapist I feel it is better
to use blow-by on a relaxed child vs trying to keep a mask on a
screaming child constantly pulling the mask off and turning his back and
forth while trying to hold the mask to his face.
A. Dear Gary,
Many studies have shown that blow-by by delivers almost no aerosol to
the lower airway. Even holding an aerosol tube absolutely still in front
of an open mouth, more than 85% of the usual deposition is lost at a
distance of less than an inch. In our studies we have found that young
children tolerate blow-by and mask delivery equally well (or poorly).
The screaming child who lets you hold blow by 6 inches gets no
medication in their lungs. Blow by should never be used.