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Archive: Dr. Tom 42 Questions about Zicam Peggy A. Dear Peggy, Dr. Tom
Welding and Vocal Cords Robert A. Dear Robert, Dr. Tom
Questions about Spirometry Changes Paula A. Dear Paula, Dr. Tom
Supplemental Humidification with Oxygen Tori A. Dear Tori, Dr. Tom
Would Like a Diagnosis About 10 years later, I was diagnosed with a sarcoma of the breast [cystosarcoma phyllodes-soft tissue sarcoma] and I had a mastectomy. My cancer did not reappear and their feeling was that I should take nothing that would interfere with my autoimmune system. In general, my health has been good and I function very well [drive, cook, entertain, etc]. My major health problem is controlled hypertension. Three years ago, we lost two daughters to cancer within eight months of one another. The stress was unbelievable. On one visit to the second daughter while she was in the hospital, my feet swelled up and she (a respiratory therapist) put her pulse oximeter (a machine that measures your oxygenation) on my finger when I entered her room. My O2 level was 71! I went to my internist the next morning and was examined for heart failure and had an echocardiogram. My heart was fine. After that episode, I was fine but began to feel very tired all the time. I had expected an MS reaction to the situation and thought little or nothing of it. I am/was a smoker and at some point began to smoke "as much as I could"- or at least that is my memory of the episode. I soon became [as I know now] very paranoid and did not want anyone to know there was something wrong with me. I began to feel less and less well, lost my appetite and energy, and as I remember, just smoked all the time and hoped nobody would notice that there was something wrong. Another daughter who is a nurse wanted me to go to the doctor and I said that I would. My feelings, as I remember them, were that I had to "get ready for IT" although I had no idea what IT was. On my last conscious day, I went out to put a hold on our mail and the whole world had turned blue. My family called an ambulance and I was in intensive care for a week, near death with a CO2 reading incompatible with life. My internist fought the urge to intubate (placement of a breathing tube that can be connected to mechanical ventilators for the purpose of delivering air and/or gases into the lungs) me and I slowly recovered. I was discharged with O2 to use when I need it and purchased a pulse oximeter. On room air during the day, my O2 readings vary but always return to 90-93. I sleep with 1/2 liter of O2. I have no cough, no wheezing, no shortness of breath and good breath sounds when examined. My docs have changed my diagnosis from terminal emphysema, to COPD to MS! What do you think? Pat A. Dear Pat, You need to have spirometry and other lung function tests such as a diffusion test (a test to determine how well your lungs take in air and moves the oxygen into the bloodstream) and lung volumes (this test not only measures the amount of air you breathe out when you exhale but also measures the amount of air that remains in your lungs after complete exhalation) to make a diagnosis. Your pulmonologist will be able to make a diagnosis and provide an estimate of your prognosis with these tests. It is hard for me to understand your previous acute respiratory failure, but it was nicely reversible. Let me know your test values, when you get them done. Dr. Tom
Questions about CT Scan Results Jill A. Dear Jill, Dr. Tom
Problems with Getting Good Care She treated me with one antibiotic and then with Levaquin 750 mg (antibiotic). I had coughed terribly with this cold and my nose was running constantly. The first antibiotic she used for five days and Levaquin for seven days. When I was still coughing up green I called again and nurse said they "had done all they could for me as I had taken top-of-the-line antibiotics and did I understand that?" When I first called I got the shock of my life because my family had traveled from S.C. to me for a short visit and I didn't want them to catch my cold either so mentioned this in my conversation and the nurse said "to hell with them, they could catch a cold grocery shopping, we only care about you" and so I hung up. I have coughed for the past two weeks but seem to be getting it under control with some tussinex (cough suppressant) left over from the pneumonia. I have very severe emphysema, with about 30% of lung function left. I had thought maybe with this cold I could have used a script of prednisone too but she said no, and since then I'm wondering if I should go to another doctor or pulmonologist. Since my doctor is brand new and the nurse had asked me how long samples of Spiriva lasted, I wondered if they knew enough about emphysema. I am not sure yet what to do. There have been a couple things that happened when ordering nebulizer meds and 02 that made me wonder. They seemed so nice and personable, but that won't help in a crisis. Am I being too sensitive??? Dot A. Dear Dot, Dr. Tom
Worried and Smoking Thank you for answering my question. Patricia A. Dear Patricia, Dr. Tom
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