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Archive: Dr. Tom 43
Posted December 13th, 2005

Singulair
Q.
Does the asthma medication Singulair treat asthma or just reduce the symptoms?

Nate

A. Dear Nate, Singulair blocks some of the mediators of asthma. In this sense it is treating the disease process. Singulair does not work in all asthma patients. When it does, it also relieves symptoms and preserves lung function.

Dr. Tom

                                                              

Questions about COPD
Q.
Is COPD reversible? What do you think of Combivent for COPD?

Art

A. Dear Art, Yes, some degree of reversibility is common in COPD. This is particularly true in mild to moderate stages of disease. Combivent is good for relief of bronchospasm. It contains two effective short acting bronchodilators.

Dr. Tom

 

Medications for a cough
Q.
I have been diagnosed with allergy-related asthma, I take Advair and Combivent and I have been unable to sleep at night due to coughing. I use albuterol when I can’t take the cough and it helps for two hours. Can you suggest something that would help?

Caro

A. Dear Caro, A class of bronchodilators known as anticholinergics work to suppress cough and improve airflow in some asthmatics. A short-acting drug ipratropium (Atrovent), and a long-acting drug, tiotropium (Spiriva) are available by prescription.

Dr. Tom

 

Worried about lungs diagnoses
Q.
Dear Dr. Tom, I am 52 years old. I smoked for nearly 25 years about 1 to 1.5 packs a day. I have not smoked in about 14 years. I started having shortness of breath when I was pregnant at 44 and was treated after delivery for asthma. In the last couple of years I came down with pneumonia once. I have had three PFT with the results at

SVC 91%
FVC 73%
FVC1 38%
MVV 47%
DLCO 42-52%

My pulmonologist is stumped so I got a second opinion which said I have significant emphysema. I am on Advair 500/50 and Spiriva (does Spiriva cause weight gain?) Neither the radiologist nor my pulmonologist saw anything on the CT Scans.

I feel great. I have a hard time on inclines but other than that, I do impact aerobics for 30 minutes each day. Plus I do sit-ups and most days, two miles on a stationary bike.

My husband and I are worried that I will be on a breathing machine in the near future. I have an 8-year old and I would hate that. Could I get worse in a short amount of time? Is there anything else it might be? I would appreciate any info you can give me!

RH

A. Dear RH, Your lung function tests are suggestive of moderate emphysema, but I am surprised the CT does not show this. In any case you have good lung function remaining, and since you have stopped all smoking, your rate of lung function decline will be slow. You are physically fit, and should keep up your exercise program. Look forward to seeing your daughter graduate from college and to grandchildren. Remember to live!

Dr. Tom                                   

                                   

My child is having relapse. Can I use the medications that were prescribed for the original illness?
Q.
My one-year-old baby had a treatment with a humidifier where we added Combivent and Pulmicort to it. This treatment also benefited my older child of six years old. Unfortunately they got in touch with other ill children and now are kind of failing again. Would it be O.K. to use the humidifier again and more importantly do I have to use both medicines because I still have only Combivent.

Hilda

A. Dear Hilda, I cannot give you specific advice about your children. A humidifier is fine at any time. Consult your doctor before giving more medication to your children.

Dr. Tom

 

How do I stop excessive secretions?
Q.
I am 48, and had PAP (Pulmonary Alveolar Proteinosis a disease in which a phospholipids, a compound widely distributed in living cells, accumulates within spaces in the lungs where oxygen and carbon dioxide are exchanged) 25 years ago that went into remission. In the last few years, I started getting any respiratory virus that came along. I had a CT, and was diagnosed with traction bronchiectasis, caused by some fibrosis from the old disease. I can still exercise, and am generally healthy, but do get short of breath easily. My TLC is 60%. My main complaint is how do I stop the mucus hypersecretion that goes along with my condition? Thanks. 

Armand

A. Dear Armand, I do not know the answer to your question. I know of no medication that specifically treats PAP. Treatment of chest infections remains important. Be sure you are seeing a pulmonologist.

Dr. Tom                            

                                   

Nutritional Supplements
Q.
I see some are interested in glutathione. Immunocal® is a protein supplement that you eat to make glutathione in your cells, as the pills in the store will not make it past the digestive tract.  Are you familiar with Immunocal®?

April

A. Dear April, No. I doubt if it will improve your glutathione levels, since nothing is known to reliably do this.

Dr. Tom

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