Paralyzed Phrenic Nerve
Q. I have an unknown paralyzed phrenic nerve on my left side, causing the
left diaphragm to not work. I suffered no trauma, but did have my appendix
removed one year ago. My question is, what are my chances that this will come
back on its own and is there anything I can do to help fix this besides
A. Dear Adam,
Loss of one diaphragm reduces lung capacity only about 15%.
It is possible that the diaphragm will function again after the nerve
Precautions when Using Inhaled Steroids
Q. With inhaled steroid do you rinse swallow or spit?
A. Dear David,
Rinse and spit is best.
Doctor Reduced Oxygen Liter Flow
Q. I have COPD. I was on two litters of oxygen and my doctor
cut me down to one and a half. He said maybe I would do good with less. What
does that mean, that my lungs are little better?
A. Dear Delores
I do not know the reason why your doctor reduced your oxygen
flow. I see no advantage.
Q. You've been kind enough to answer a question or two for
me, just want to thank you for your being so generous with your time and good
health (and fishing) to you.
A. Dear Don,
Thanks. It is nice to be appreciated.
Questions about Lungs
Q. So many questions--guess I'll just ask a few.
Would airway restriction or inflammation cause a person’s
FEV1 numbers to drop?
Could a lump like/choking feeling be associated with a
Okay—that’s all I'll ask today.
A. Dear Gary,
Both airway restriction and inflammation can reduce FEV1.
A lump in the throat does not cause bronchospasms.
Mother has had Multiple Problems Since Colonoscopy
Q. My 86 year-old Mom recently had a chest x-ray. My 90
year-old Dad said the doctor told him mom had some density in one of her lungs;
what does this mean?
My mom was healthy except for some arthritis till she sent
in for a colonoscopy in November. Ever since then, my mom has suffered one infection
after another, has had 4 blood transfusions, two staph infections, repeated
urinary tract infections and C. diff, one stroke and one mild heart attack; all in a matter of four months.
A. Dear Idolina,
Sounds like you should stay away from doctors. You will have
to get an explanation for the blood loss and need for transfusions.
Oxygen Saturations and Exercise
Q. I developed SOB with minimal exercise, but my oxygen
saturation stays in the 94-98%.
I have had all the heart test and everything is O.K. Do not
need oxygen as my stats stay in that range all the time.
A. Dear Mary,
You may still need oxygen. Consult your pulmonologist.
Staying Healthy with Have COPD
Q. I am a 60 year old female with COPD. My FEV1 has remained
between 46-49 for the past three years. I exercise five days a week, have lost
my excess weight from quitting smoking and am doing my best to keep my diet in
check. I still work full time and am on O2.
Do you feel that if I continue on this path I can hope to
live beyond 10 years in reasonable good shape.
A. Dear Sally,
Yes I do. Your prognosis is good. Enjoy life.
Can Sarcoidosis Cause COPD?
Q. I was a pack a day smoker and in 1997 I joined the Boy
Scout Leaders Program to help out with my son’s troop. One of the stipulations
was you can not smoke around the scouts, I quit 01/01/1997. Have not
smoked a cigarette since and I did not have to go off and hide from scouts to
smoke. I also have two great Eagle Scouts now too.
But, ten years later I ended up in the hospital with
pneumonia and congestive heart failure. Tests were run, like the Pulmonary
Function Test and I was diagnosed with COPD with emphysema.
When I smoked I never had the smokers cough, I never had any
lung problems other than some upper respiratory infections and ear infections,
but now I have emphysema. I thought the longer you got away from that quit
date the healthier your lungs would get and even one day be like you never
smoked. That really confused me and my wife, but to make it even worse, I had a
biopsy and bronchial wash done and the biopsy came back with a diagnoses of sarcoidosis of the lungs.
So now I have COPD with emphysema and sarcoidosis of the
lungs. Can the sarcoidosis have caused the emphysema, not my smoking?
I really felt great until that bout of pneumonia and
congestive heart failure. Also to add salt to the wound I have a fibrosis scar
on my heart and liver now too. I have heard that sarcoidosis usually attacks
more than one organ, it that true, too?
I am presently on three lpm of oxygen 24 hours a day and a
prednisone therapy program for eight weeks and see if this can be slowed down.
But back to the emphysema, is it possible that the sarcoidosis
caused the emphysema not the long time back smoking of 20 years a pack a day
and being quit ten years.
A. Dear Sam,
No. Sarcoidosis did not cause the emphysema.
Lung Trauma from Car Accident
Q. My colleague was involved in an accident and the doctors found
blood in her lungs how dangerous it is?
A. Dear Sybil,
This is not dangerous at all. The blood will simply
Pulmonary Hygiene for Older Adults
Q. How might pulmonary hygiene measures be revised for an
elderly patient with CHF and
A. Dear Tamara,
I do not know how to answer your question, because you did
not give me enough information in order to be able to make a reasoned
Pain and Breathing
Q. I have a protruding right scapula and severe pain upon
breathing. It feels like my right lung is not working. Respirologist did tests
and all are clear and told me it was muscular. But I can no longer breathe
lying down and I will lose my job soon as I cannot breathe comfortably sitting
either. What can this be?
A. Dear Nitsa,
There are many possibilities, most are benign. It should
subside with time.
Pulmonary Hypertension and Emphysema
Q. Does emphysema cause pulmonary hypertension? Is there a
relationship between the two?
A. Dear Deborah,
Pulmonary hypertension is common in emphysema with
oxygen deficits. The treatment is for the emphysema to restore lung
function and oxygen.
Side Effects of BiPAP
Q. What are the bad side effects of using a BiPAP machine
for treating mild sleep apnea?
A. Dear Sam,
Essentially none, except for the discomfort of the facial
What Does Moderately Advanced COPD Mean?
Q. What is considered “moderately advanced COPD”? I am 66%
of predicted with “a good pulmonary reserve” (whatever that is?). I am not on
oxygen or inhalers and still quite active. I am 61 (diagnosed last year), quit
smoking about 20 years ago!
A. Dear Nino,
This is a pretty meaningless term for you. Your
prognosis is excellent.
Could Exposure to Wood Smoke be Harmful to Someone with COPD?
Q. I was working with a homeowner to develop a plan for
remodeling their house. Unfortunately the homeowners use a wood stove to heat
their home. I was at their home about five times while they were burning their
stove. The last time I was there it required going outside to look at the
exterior of the home, the air outside was so saturated with smoke it made me
choke. I was probably exposed to the outside air for around an hour.
Since that time I have informed the owners that if they
wanted me to perform the remodel, they would need to put the fires completely
out. But I fear the exposure I've already had has harmed my lungs.
I guess my question is how likely is it that a few
short-term exposures to wood smoke would further harm a person with Emphysema?
A. Dear Gary,
This short-term exposure will have no lasting damage to your
Can Untreated Pneumonia Cause Interstitial Lung Disease?
Q. I have recently been diagnosed with interstitial lung
disease. I have begun to use a nasal and lung spray daily. I feel better after four
My question is... do you think I could have gotten this
disease from untreated pneumonia which did not show signs of illness because my
body is guarded with INH antibiotic taken in 2006. I am still experiencing
night chills but no sputum now but did for many months previous.
A. Dear Angie,
I do not believe the untreated pneumonia is the direct cause
of your interstitial lung disease. I suggest consulting a pulmonologist.