IPPB
Q. Is IPPB therapy still widely used form of treatment for patients with rib fractures and lung contusions?

JPS

A. Dear JPS, No, It was never, IPPB per se, but controlled mechanical ventilation via a definitive airway, for a period of about two weeks for chest stabilization. Mechanical ventilation is still used if there is accompanying respiratory failure.

Dr. Tom

 

Is There a Time Where You don’t Need Inhalers?
Q. I was born without breathing problems, spent 4 years in the military, and no problems. I was a smoker and smoked for 25 years. I was diagnosed with asthma, and was on a variety of inhalers. After two years of non-smoking, I am only on one inhaler [Advair].

I had an ear infection and was given 600 per day of an antibiotic.

I now run 3 miles per day without the need of albuterol. I am still on Advair, but feel much better.

I am 30 lbs overweight; do you think that has anything to do with a small lack of breathing?

Will I breathe better the more years I go without smoking?

Are there any homeopathic cures you think I could do to get off Advair and start breathing without it?

Do people ever stop using inhalers?

Victor

A. Dear Victor, Lots of questions here. Since you are running 3 miles a day, I doubt if your weight is a factor. You will be even better at lower weight.

The way to see if you still need Advair is to stop it and see how you can still exercise. Get spirometry before and after stopping. Some times inhalers are no longer needed when asthma is in remission.

I know of no homeopathic approach for the treatment of asthma.

Dr. Tom

 

Son has Been Diagnosed with Alpha 1 Antitrypsin Deficiency
Q. My 17 year-old son has just been diagnosed with Alpha 1 Deficiency (Alpha-1 - Antitrypsin Deficiency is a hereditary disorder that can effect the lungs and liver). His lung CT scan, blood work and x-rays are conclusive.

My husband and I are going to be tested to see who is the carrier and our daughter as well. We would like to know that since no one in our family has died from emphysema other than my husband’s mother that was still smoking when she died at 79 also with cancer.

Could my husband or I have liver disease since we do not have emphysema? My son was only detected because of an asthma attack from smoking. He seems to be in the mild to moderate stage of emphysema. Thank you.

Debbie

A. Dear Debbie, Your son needs phenotyping to see what form of Alpha-1 Deficiency he has. There are many variants. Of course he must stop smoking. I doubt if he has much emphysema, but he is headed that way if he continues to smoke.

It is good that all family members will be tested. Most liver disease is in the young and I doubt if you or your husband have a liver abnormality, since you imply that you are otherwise healthy.  

Dr. Tom

 

Driving Under the Influence (DUI) and Medications
Q. I got a DUI (Driving Under the Influence). I had 4 draft beers. I take Quinapril 20 mg and Effxor XR 75mg and two Combivent 14g/200 actuations.

Larry

A. Dear Larry, I am not sure what your questions are. Four draft beers, if consumed in a short time can give you a significant blood alcohol level. The drugs you take do not affect the alcohol level, but the Effexor (antidepressant medicine) may affect your performance.

Dr. Tom