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Archive: Dr. Tom 33
Posted September 12th, 2005

Will Aspirin Prevent Another Stroke?
Q. I had 2 minor strokes a couple of years ago. I am on aspirin. Will I have anymore, while I am on aspirin?

I do smoke can’t give it up because of stress.

Judy

A. Dear Judy, Aspirin is protective against stroke. Another drug, Plavix may be even more protective. Ask your doctor about it.

The most important way to reduce your stroke risk is to stop smoking. Get some help on this.

Dr. Tom

 

Coughing Three Months after Lobectomy
Q. I had a lung lobectomy (surgical procedure to remove a lobe of the lung) three months ago. Now I have a cough. Is this normal? Thank you.

Helen

A. Dear Helen, I assume that a lobectomy was done for lung cancer. A cough should not be still present. Better get checked again about this.

Dr. Tom

 

What is “Lung Age”?
Q. I just got a report from the lab that says my lung age is 171 years. I'm 59 and 5'4" tall and stopped smoking just two months ago.

The report did not suggest I make another appointment for any kind of drug treatment. Do I need to make an appointment for some kind of therapy or am I just doomed to die soon?

Edna

A. Dear Edna, Lung age is the age, where your lung function would be normal. A lung age of 177 is impossible, of course.

Better to know your FEV1 and % of normal and FVC and % of normal. Even with bad lung function, there are many treatments that can help.

Keep positive and you might surprise yourself.

Dr. Tom

 

Sleepy, After 10 Hours of Sleep?
Q. Could there be any reason for my wanting to sleep for hours? I can sleep l0 hours a night (interrupted though because of some hip pain) but the minute I sit down during the day, I'm sleepy and want to nap.

Could that be retaining O2, I'm on 02 for nights and on exertion...????

A. Dear Dot, I wonder if you might have sleep apnea.

You may think you sleep, but do not get good quality sleep, and have many interruptions that you might not be aware of. You don't retain O2. CO2 can be elevated in patients with sleep apnea.

Ask your doctor if you need a nighttime monitored sleep study.

Dr. Tom

 

Shortness of Breath
Q. Hi, Two years ago I was hospitalized with pneumonia. I was discharged with 4 months of Cipro (antibiotic) and Clindamycin (antibiotic).

Approximately six months after discharge I experience extreme fatigue and sore joints and was diagnosed with Polymyalgia Rheumatica (a disorder involving pain and stiffness in the hip or shoulder area) and was put on prednisone.

Recently I have been having shortness of breath when I try to do anything and my pulmonologist says its inflammation that’s causing the SOB (shortness of breath). My spirometry (a test to measure lung function that can be done in a doctor’s office) reading is

FVC-107%
FEV1- 91%
FEV1/VC -67%
MMF-54%.

I had a bronchoscopy (is a diagnostic procedure where a doctor uses a scope to take a look at the inside of the airways and lungs) and the results were benign and all cytology was negative.

Then what’s causing the SOB? I am a 53 yr old male, 165Lbs.

Dave

A. Dear Dave, Your shortness of breath is not coming from your lungs.

Forget the MMF test that does not mean anything special. It is confusing.

There are other reasons for your shortness of breath and you need a diagnosis. Polymyalgia Rheumatica, which I believe you have, is a nuisance, since I have it myself. It does not cause shortness of breath. Have your heart evaluated.

Dr. Tom

 

Taking Spiriva
Q. I'm currently taking Spiriva for COPD. Is Spirivia one of the most recent drugs on the market, and your opinion of it?

Do I also have to take a cortisone medication in conjunction, or is Spirivia enough.

Art

A. Dear Art, Spirivia is a very good long acting bronchodilator. But it does not reduce inflammation in the lungs. An inhaled corticosteroid may be helpful in reducing attacks of worsening.

Dr. Tom

 

Medications are Expensive, Do I Need All of Them?
Q. I have been using Spiriva for about a year now. I also use Flovent and Floradil twice a day.

Could I possible stop using the Flovent and Foradil? With the cost of medications now if I don't have to use them, it would help financially.

Betty

A. Dear Betty, I cannot give you specific advice about what to take. All three medications work through different mechanisms. Ask your doctor about this.

Dr. Tom

 

Are There Hazards with Taking Non-Steroidal Anti-Inflammatory Drugs and Having COPD?
Q. Hello Dr. Tom, I enjoy reading your columns and the other material on your website. What a great resource you have made available to all of us!

I want to know whether the same precautions that people with asthma have to take with aspirin and NSAID’s (non-steroidal anti-inflammatory drugs i.e. Advil, Aleve, Celebrex) also apply to people with COPD?

Carolyn

A. Dear Carolyn, These drugs generally do not aggravate COPD like they can in asthma. I would use them cautiously, and one at a time.

Dr. Tom

 

Weight Loss and Emphysema
Q. Hello Dr. Tom, My Mom has "end stage"(hate that term) emphysema and is losing so much weight. As of the last 6 months, she is down to 85lbs. from 105lbs a year ago.

I have been told this is the end due to this sudden weight loss. Is that true? Her breathing was worse but after a round of prednisone she is breathing easier but must use her oxygen at night.

JoJo

A. Dear JoJo, Weigh loss is common in advanced emphysema. Your mom should eat high calorie foods, and frequently. Take food supplements, such as Ensure, if she does not eat much at mealtime.

She may be better using oxgyen all of the time. She can still have a good quality of life, if she eats, exercises, such as walking a little twice a day probably with oxygen and gets good sleep at night.

Dr. Tom

 

 

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