Can One Time Exposure of Asbestos Damage Lungs?
Q. At work the other day we had to take two ceiling tiles
out and there was dust everywhere even the corridor was dusty. I was only in
there about ten minutes. Anyway I've since found out they had asbestos in them.
Since then I've had a sore throat and chest. My work
mates say it's nothing to worry about as you have to be exposed to it over a
long period of time to do any damage. Do you think I could have damaged my
lungs with this one time exposure?
A. Dear Robbie,
It is highly unlikely that this short exposure damaged your
lungs. You are wise to ask.
What Does My Spirometry Mean?
Q. My spirometry says
Is it normal?
A. Dear Raffaele,
Not normal, but pretty good in general. You will have to ask
your doctor about the specifics. These numbers do not make a diagnosis.
I Faint when Doing Spirometry
Q. If you recall I am the gentleman who has trouble taking a
spirometry test because I faint. When I asked you about this you said that even
if you could give one good blow, it is impossible to blow a false number. So I
had my test a few days ago. My specialist is Dr. Robert Hyland from St.
Michaels hospital here in Toronto.
I gave one good blow, and my FEV 1 was 48% of predicted. The
last test I had was about a year ago and my FEV1 was 38%. Now, I have COPD with
a fair component of asthma, and I have been going to the gym every day, and
working out for 30 minutes. I attribute my improvement in my FEV1 to the
exercise program that I have been doing from Westpark Hospital.
The interesting thing is I took four puffs of Ventolin post
test and rested for ten minutes, and then repeated the test. The results were
worse, as I could feel myself getting very lightheaded, so I did not give a
good max effort.
Could you explain, Dr Tom, why I faint when exhaling hard?
It seems to happen every time. Otherwise, I am in good health, with no
A. Dear Phil,
You reduce the return of blood to your heart by generating
high pressures in your chest when you really blow hard. This is not indicative
of any serious disease.
How do you Relieve Dryness from Oxygen
Q. How do you relive dry O2 that my mom is on continuously?
She has water hooked up to it but still suffers from dry nasal passages.
A. Dear Marilyn,
You can use non-greasy
lubricants such as KY jelly.
Father-In-Law has Been on a Ventilator for Twelve Weeks
Q. My father-in-law is stuck in the hospital in Florida (we
all live in Washington State) on a ventilator for COPD and/or emphysema.
My wife keeps flying down to be with him and as it has now been about 12 weeks,
we are wondering if he is ever going to get better.
He has had a trach put in, but is pretty much in bed, as they seem to be limiting their help to
“maintaining” him. They have tried to “dial him down”
and get him breathing on his own, but it just does not seem to be
When she is with him, he does much better and shows
improvement. Unfortunately, we have jobs and she can only get down there
for a few days a month. The rest of the time they seem to try
half-heartedly and keep him medicated for the most part.
Part of the problem, in my opinion, is his lack of insurance
although she was able to get him on Medicaid. I know she has been trying
to get him Medicare, VA benefits, etc., but is just really getting
He is only 61 and is fairly strong other than the fact that
his lungs are failing. Does anyone know of an organization that can help
us determine what other options are available to us (lung transplant, transfer
to a rehabilitation center closer to us, etc.)?
We are not ready to give up on him, nor does he wish the
same. Any thoughts would be much appreciated.
A. Dear J.,
There are facilities for weaning such patients such as the
Kindred Hospital chain.
Using medications for shortness of breath or anxiety may
work against weaning. Most patients, such as your father, can be weaned by
experienced staff. Never give up.
No Improvement in Spirometry after Several Months of Prednisone
Q. I'm a 32-year-old female with mild asthma. Over the past
couple of months I began treating my asthma with a daily inhaled steroid
(Pulmicort) in the hopes that I would improve my spirometry tests. I also took
an initial dose of prednisone as my pulmonologist wanted to clear out the
Two months and three spirometries later, there has been no
improvement. My FVC has improved but my FEV1 remains around 2.3 to 2.5 (79%),
and on certain tests actually got slightly worse.
What could be going on? Should I be concerned there's been
some airway remodeling or something of that nature?
FYI, I have scoliosis, corrected with a rod, and a couple of
my doctors believe that might be impeding me from fully using my lungs. I
appreciate any insight you might have.
A. Dear Andrea,
Your functions are pretty good. The rod can be playing a
role. You may have some airway remodeling, but not bad. I would not continue to
take oral prednisone.
Newspaper Headline Seems Misleading
Q. Dr. Tom, The newspaper reported a brief article titled
“Studies show steroids don’t help wheezing kids”. The New
England Journal of Medicine was the reference. The study was not about
inhaled corticosteroids but oral prednisone. Do you agree this was a
misleading headline relating to treatment of childhood asthma?
An asthma educator
A. Dear Patricia,
The headline is misleading.
Can't Seem to Beat Bronchitis
Q. I was diagnosed with sleep apnea and pulmonary
hypertension about nine months ago. I use a Bi-PAP and oxygen machine at night. I
have been fighting bronchitis since the first of November and gone through
three rounds of antibiotics, however I continue to have a tight chest and am
coughing up dark green phlegm, usually in the morning. I am concerned that this
does not seem to be resolving itself.
I have replaced all replaceable oxygen equipment and I soak
mask and humidifier in water with vinegar. Is there anything that you can
suggest that may be causing this, and anything extra that I may do to help this
A. Dear Linda,
You are doing all the right things. I doubt if your
equipment is the cause of the problem. You should get more specific advice for
your case from your doctor.
Could 'Ugly Cough' and Thick Phlegm be Caused by Dust I Inhaled in Iraq?
Q. Lately I have had a very ugly cough. By ugly I mean the
sound it makes when it happens. Also the phlegm I produce is so thick sometimes
I feel as if I am going to choke. I do not have a cold, and I am not a smoker.
I recently came back from Iraq, could the cause be the
accumulation of sand from the desert in my lungs or something more serious?
A. Dear Hector,
I doubt if your problem is caused by the sand dust. I
suggest seeing a pulmonologist.
Can you Give Xopenex and Mucomyst Together
Q. Can I mix Xopenex and Mucomyst together or do I need to
give them separately? Also, what can you tell me about Pulmozyme treatments?
A. Dear Louie,
As far as I know these drugs are compatible and can be used
together. I do not know anything much about Pulmozyme.
Dealing with Symptoms of Upper Respiratory Infection
Q. I have been battling upper respiratory infection (excess
sputum production during the day and massive collection in my throat early in
the morning before rising from the bed) sharp pain in the left side which
refers to the back and spread to the shoulder blade causing pain. Now I tend to
have tightness in the breathing pipe quite frequently. Being in a cold place
triggers stabbing pain and phlegm.
What can I do and should not do?
Help is needed.
A. Dear Amanda,
You should see a pulmonologist for a diagnosis and
treatment. You should NOT procrastinate.
Questions about Symbicort
Q. I have been diagnosed with mild to moderate asthma about four
months ago and was prescribed Symbicort. I was told by the doctor to take
two puffs twice daily.
I am a teacher and found that the dose made me really irritable
towards my students and I had trouble sleeping at night. Therefore, I
reduced my dose to two puffs in the morning so that it would be out of my
system at night so I could sleep.
Then after I went to the lung association, I realized that I
should take it every 12 hours. So I started taking it two times a day
again, two puffs in the am and two puffs in the pm. Once again, I had the
same symptoms as before and I was feeling depressed. So I switched to one
puff in the am and one puff in the pm.
Now I have a lung infection; not sure what it is but it
feels like it's deep in my chest. I haven't had one in years.
I feel like this has been brought on by Symbicort and I am wondering if I
should be taking this medication while I feel like it has caused my chest
Is it OK to just stop the medication or should I continue on
it? Is there any other medication I should try? I've never taken an
inhaler before. Thank you and I hope to hear from you soon.
A. Dear Collen,
The Symbicort did not cause a chest infection. You can take
it once a day if it agrees with you. You should see a pulmonologist for further
What Affects Life Expectancy for Those with COPD?
Q. I am a 51-year-old male ex-smoker (by two days) with
COPD diagnosed about three years ago. My symptoms have been bad enough over the
last three years to warrant regular JetNeb and inhaler use. I often have
bronchitis and am able to spit up very little mucus. Is it possible to guess at
a life expectancy for me?
A. Dear Dee,
This is very difficult to make accurate predictions
about prognosis. You should live into your 70s if you take care of
Avoiding Lung Infections and COPD
Q. My wife has COPD resulting in chronic breathing issues.
Doctors have kept her using an antibiotic of some type or another for 20 years,
and always say this is scaring your lungs and you need to avoid getting these
Seems the infections are worse in winter. So are there any
areas in the U.S. that would let her get through the winter with out so
much difficulty? Would a southern humidity be worse?
I cannot seem to get an answer from the people she sees.
A. Dear Lee,
There is no perfect place to live. Warm dry places are
Trying to Figure Out Why Son is Short of Breath
Q. My son is 23. For five months now he has had bouts of
extreme shortness of breath. Everyday he is mildly short of breath and yawns a
lot to receive air. Does not wheeze. Denies stress.
He has been to a general practitioner and pulmonary doctor.
Had ECG, CT Scan of chest, pulmonary function pre and post medication. All
tests came back negative. Doctors presume it is anxiety.
This man is outgoing, works, attends school and has a
girlfriend. He is happy not at all stressed.
Could you recommend another test or what step should I go to
next. He now is wearing a 24-hour Holter heart monitor.
A. Dear Marilyn,
He needs a diagnosis. There are some rare things; he could
have such as pulmonary hypertension. I suggest seeing a cardiologist.
Chronically Bringing Up Phlegm
Q. My husband has been bringing up phlegm for approx eight
months. It has gotten to the point he throws up all the time. The color is
yellow and green. What can we do to?
A. Dear Mary,
You do not give me enough information to make a suggestion.
Obviously you need a diagnosis. I suggest a pulmonologist.
Mother has COPD and MRSA, How Can I Help Her?
Q. My mother is 73, has a pacemaker (100% pace maker
dependant) and has COPD. Her pulmonologist told her yesterday, after her
hospital follow-up, she has only 40% lung function. On top of that she
contacted MRSA during this last hospital stay.
I want to know what to expect, and what I could do to help
A. Dear Patti,
Lots of people who have been in hospitals or have received
antibiotics “carry” MRSA in the nose and throat. It may not be an
infection and does not require any treatment.
Wondering about Spirometry Results
Q. Dr. Tom, I just had spirometry test yesterday. The
FEV1 - 2.09
FVC - 3.28
FEV1/FVC - 63.83
FEV3/FVC - 81.18
The tech says this is not bad, but my doctor says it is
moderate Emphysema. Can you give me your opinion?
A. Dear Vicky,
These tests do not make a diagnosis. They measure lung
function. Discuss the diagnosis with your doctor and perhaps get confirmatory
tests such as a measure of diffusion and lung compartment sizes. A CT will also
help diagnose emphysema.
CT Scan or PFT
Q. In general, do pulmonary function tests or CT of the
chest reveal more information regarding possible scarring or airway remodeling
due to asthma? We financially cannot afford both. Our doctor is not helpful in
helping us choose, but the CT seems to give us a good baseline and seems the
A. Dear Dawn,
Spirometry, i.e. PFT is much less expensive than CT and
gives a measure of lung function. CT tells about lung structure. I would go
Smokeless Tobacco's Effect on Lung
Q. Does using smokeless tobacco have the same effect on your
lungs that cigarette smoke does?
A. Dear Richard,
No, but it is bad for the gums and teeth. Stay away from it.