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Archive: Dr. Tom 32
Posted September 9th, 2005

Worried About Mother’s Health
Q. My mom has been on oxygen for the past few months. She has asthma and has been on several medicines for it. The doctor has told her her lungs are damaged and is irreversible. Right now she has fluid on her lungs and seems to be getting worse.

My brother and I want to get another opinion in Indianapolis. The medicine is helping but her blood pressure is dropping when she is taking it, so they have stopped giving it to her.

Is there hope for her or is she beyond hope like they say?

Debbie

A. Dear Debbie, Of course there is hope. Get another opinion. COPD has many treatments, and usually the quality of life can be improved and the length of life extended. Don't give up.

Dr. Tom

 

Shortness of Breath when Taking Medicine
Q. Every time I take certain medications, such as antibiotics or anti depressants I get real short of breath. Even vitamins cause shortness of breath.

Do you know what causes this?

Gwyn

A. Dear Gwyn, Can't say. Don't take any medicine that makes you short of breath. A pulmonologist or an internist should be able to find medicines that will help your breathing.

Dr. Tom

 

Draining Tubes
Q. Is a pleuroperitonal shunt and pleurex catheter painful?

Cindy

A. Dear Cindy, Generally not. This procedure is aimed at draining fluid from the space around the lungs, called the pleural space. It transports this fluid to the abdomen, where it can be absorbed back into the circulation.

Dr. Tom

 

Is Small Airway Disease Something to Worry About?
Q. I am 46, an obese female, in a smoke-free environment (except for a year or two in college when we all smoked cigarettes). This summer I developed severe allergy symptoms (rhinitis) and also wheezing and being unable to breathe lying down.

My pulmonary function test was 65% and I was told that I have Small Airways Disease. Is this something I can recover from? How?

Pat

A. Dear Pat, Yes. Small airway inflammation can subside with avoidance of any inhaled irritant. Lots of times the designation of small airways disease is incorrect, however. It is not diagnosed accurately by spirometry. 

Dr. Tom

 

Shortness of Breath is Getting Progressively Worse
Q. Short version. Four years I’ve had frequent bronchitis, clearing throat, progressive shortness of breath, many tests and specialist (new pulmonologist) says chronic bronchitis, mild emphysema and uncontrolled asthma.

But spirometry and PFT (Pulmonary Function Test) all in normal range except FEV75, so she says I have small airway disease.

The medications Albuterol, Qvar, and Floradil not helping the feeling like airway collapsing when inhale. I have 3 good days then a week bad.

Did just start IVG treatment (antiviral medicine) for Hypogammaglobulinemia (an immune deficiency disorder that is caused by low levels of immunglobulins, antibodies, in the blood) as cause for frequent infections.

Very frustrated that breathing feels as if progressively worse...Dr. still hearing a whistle. Could this be some restrictive type rather than obstructive. Quit smoking 10 years ago. Age 55 Thank You

Paula

A. Dear Paula, Forget the FEV75, it does not mean anything special.

I think that treating your immunodeficiency disease with immune globulin, should help you prevent repeated chest infections and will improve you a lot.

Dr. Tom

 

Gas Stoves and Oxygen Safety
Q. Parents are moving in with me - I have a gas stove and they are both on oxygen 24/7 - if they do not cook do I still need to get rid of my stove?

Stephanie

A. Dear Stephanie, No, not at all. Just keep their oxygen tubing away from the open flame. About three feet is safe. Oxygen will not explode, it just causes things to burn fiercely, so use common sense and you will be fine.

Dr. Tom

 

Follow-Up From Thelma Regarding Her Tracheomalacia Care
Q. I wrote to you 3 times telling you that I had Tracheomalacia and was going to Boston, Beth Israel Hospital for a Polyethylene stent to be put in. When I went in April and the stent was put in, I could not tolerate it and had difficult breathing.

Luckily, the Thoracic Surgeon who could perform the Tracheoplasty was there. I ended up staying in 3 ICU's, at one having a heart fibrillation where CPR was done. Later found out they broke 3 of my ribs in the process.

I then went to Youville Rehab Center and in total from April to June stayed 66 days. I just thought you should know the results.

Thelma

A. Dear Thelma, God bless you, Thelma, you have courage. Thanks for the follow-up and keep on dealing with your difficult problem. You are in good hands, and you will get better.

Dr. Tom

Thelma's Previous Questions

70 yr. woman with Tracheomalacia
Q. I am a 70 yr. old woman who has moderate emphysema but just recently my pulmonologist did do a bronchoscope and found that I had Tracheomalacia (usually found in babies.) He sent me to a specialist who seems to be stalling as he told me to go to a gastroenterologist, which I did and he did an endoscopy. Everything was fine. This specialist wants to do another bronchoscopy so he can see for himself how far down the Tracheomalacia goes. All I want is for him to put a stent in to keep the trach open so I can breathe. It is quite difficult to breathe when I shower, dress or exert myself. I have oxygen but that does not help as much as my nebulizer containing Albuterol and Ipratropium. I think the Albuterol relaxes the Trach. Is it possible for you to tell me more about Tracheomalacia in adults and what should be done and if the specialist won’t put a stent in, where can I go to have someone correct this problem. I’m getting close to being housebound. Thank you for whatever information you can give me.

Thelma

A. Dear Thelma, Tracheomalacia is a weakening of the supporting structure of the trachea (cartilage). It comes from inflammation and forceful coughing in some people with COPD. Stenting is the treatment. You need to find a pulmonologist who is experienced in stenting. Ask your pulmonologist to refer you to a doctor, pulmonologist or thoracic surgeon who is experienced in placing stents.

Dr. Tom

Tracheomalacia
Q. I sent you a question about Tracheomalacia and I did see a pulmonologist in regard to putting a stent in. Unfortunately I am allergic to the nickel in the stent.

He is going to ask the manufacturer if a non-metal stent could be made. Do you know of any stents that are not metal?

Thelma

A. Dear Thelma,
Sorry, I do not know of a nonmetal stent. There are other ways to deal with trachealmalacia.

Sometimes removing the loose tissue in the back of the trachea, is helpful. Check with your experts in Boston on this.

Dr Tom

Tracheal Stent
Q: Do you know of anyone who has Tracheomalacia and have had a stent put in? I want to know what they feel? Do they have trouble eating, cough or gag causing the stent to move?

Thelma

A: I have had patients with stents and tracheal procedures known as tracheoplasty. Only very experienced surgeons should do these procedures. They may help some, not all persons with this rare disorder.

Dr. Tom

 

Out of Breath and Chest Soreness after a Martial Arts Test
Q. I recently did a martial arts test. During the test, I got very out of breath and started to taste blood. I had a cough after the test, which lasted for a day. I had a sore chest for two days.

I train very regularly but the test was more strenuous and stressful than my regular training. Any idea what the problem is, or if it's even a problem at all?

Whitney

A. Dear Whitney, It may not be a problem at all. Are you sure you tasted blood? Did you spit some out? If so, this requires an explanation. Keep exercising, and stay healthy.

Dr. Tom

 

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