Can Doctors Tell if Someone Has Been
Q. My cousin is a COPD patient and is on oxygen 24/7. She
said that she is not smoking and I believe she is. To try to get her to at
least quit for a little while I told her that her doctor would be able to tell
if she had a cigarette in the last two weeks, and maybe that way she would
realize that if she could put them down for two weeks she could do without for
Is there such a test or a way for a doctor to tell if she
had smoked within the last two weeks?
A. Dear Susan,
Yes, thiocyanate levels remain elevated, as do nicotine
levels for several days on stopping smoking. CO clears in hours.
Question about Treatment for Interstitial
Q. My mother has interstitial lung disease (ILD). Is it true
that there is no treatment for it, and if not what should I do? How can I go
for a lung transplant, is it possible to get a transplant in India?
A. Dear Preeti,
There are several forms of ILD, some are treatable and
others not. You would have to go to a transplant center; I suggest Bombay
University as a starter.
Q. I’m a 28 year old man. I had asthma when I was a child. I
have had mild dyspnea
for a year and I also cough up green/brown mucus plugs regularly. Those plugs
are strange because they have small flecks inside. I’m really worried because I
also had some episode of blood-streaked sputum.
A. Dear Luciano,
This material you are coughing up may be dried asthma mucus.
It may be associated with some blood streaking.
Sister is Ill with Lung Disease and Cancer
Q. My sister is in her final stages of emphysema, she had
lung cancer and beat that, but now the doctor said she needs to get her affairs
in order. She is also DNR (do not resuscitate). What is her prognosis?
We have cancer running rapid thru the family my mother,
sister and this sister and also lost a niece last month to liver cancer and
have another niece with non-Hodgkin lymphoma.
A. Dear Linda,
Only her doctor can give her an accurate prognosis. I do not
have enough information, but obviously her life will be shortened.
Treatment for Idiopathic Pulmonary
Q. Are there any medicines in the near future that will work
on stopping idiopathic pulmonary
A. Dear Joseph,
There are many under study, but no certain effective drug
yet. Keep hoping.
Life Expectancy and COPD
Q. I read on your site that COPD patients have a life
expectancy of 10 years. I was diagnosed more than ten years ago but still
manage to go to rehabilitation once or twice a week. I must admit that I
require oxygen more as the years go by. My oxygen level at rest is 90%-94%. I
feel that I still have at least another five years. I am 67 years old.
A. Dear C.,
You are probably correct. Enjoy the life that remains for
you. It is a gift.
Taking Ambien and While Using Oxygen
Q. Is there a danger of taking Ambien while on oxygen?
A. Dear Joanne,
No, unless the Amibien dose is very high.
Shortness of Breath for Seven Months
Q. I’ve had a bad cough along with phlegm and shortness of
breath everyday for the past seven months. I have no medical insurance, which
is why I haven’t gone to the doctors. I also suffer from back pain in my lung
If I go to the doctors can anything be done to reverse my
symptoms or at least some of them?
A. Dear R.,
This all depends on your diagnosis. I suggest seeking care
through some volunteer clinic. Your problem may be easy to solve.
Brother Has to Continue to Have His Lungs
Q. My brother started getting strange symptoms last
November, his lungs keep filling with fluid and he has to go to the hospital
every few weeks to have his lungs drained of two-three liters of
fluid each time.
They ruled out pneumonia, asbestos exposure, but took biopsies
to check for cancer; he is very exhausted and worn out and hasn’t worked in
four months. The doctors can’t figure out why the fluid keeps coming back—any ideas?
A. Dear Mike,
A hidden cancer or heart failure are the best possibilities.
Your doctor should be able to make a diagnosis.
Should a Benign Tumor be Removed?
Q. I am 65 years old and have COPD. I take Spiriva, work,
stopped smoking at 45. When I was 30 had two spontaneous pneumothorax and they repaired the blebs.
I have a benign
tumor at lower lobe of my lung, which has not grown for a couple of years, but
now it has grown a little.
They want to take the tumor out, but with it goes 25% of
lung due to location of tumor and scar tissue. If I let it grow, for 12 months,
would it affect my breathing, and cause infection and pneumonia?
If it were anywhere else they could easily remove it, they
have CyberKnife at
Saint Francis in Hartford. I have gotten two opinions, but I need another one.
A. Dear Dan,
A growing tumor should be removed in most cases. Usually
this can be done without sacrifice of much surrounding lung tissue.
Steps for Follow-Up
Q. I have a spiculated
nodule in the left upper lobe. My lungs show extensive emphysematous change.
My question is directed at determining the next step toward
diagnosis. What about biopsy? How serious would it be if a biopsy resulted in
an air leak or collapse? Should I consider surgery when it is not clear that
there is cancer? Please comment on the next best step I should take.
A. Dear Carol,
A spiculated nodule, assuming calcification, is almost
always benign and needs no treatment.
You did not specify a calcific spiculation, however. If you
are talking about a non-rounded lesion with tiny shadows arising from it that
are not calcified; that is a completely different matter. Your doctor
can tell you in an instant, which one you are dealing with.
Q. My grandson had a bout of RSV at 14 months old.
Is he condemned to get asthma?
A. Dear Linda,
Q. You have indicated that a person diagnosed with COPD can
live UP to ten years. That is disheartening, as I have mild COPD in the form of
emphysema. I am not on an inhaler or oxygen and I still play doubles in tennis.
I can’t believe I’ll be dead in 10 years! I am currently 61 years old - was
diagnosed last year.
A. Dear Nino,
In your case, you will live a lot longer than the ten year
average. The ten year life expectancy, I quoted in the previous question was
for moderately advanced COPD.