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Archive: Dr. Tom 97
Posted April 26, 2007

Readers: Read Dr. Tom’s Commentary on Spirometry to understand the importance of this diagnostic lung test.



Mucomyst Dosage
Q. What dosage of 10% solution of Mucomyst nebulized would you consider appropriate for a pediatric patient?


A. Dear Cindy, 10% is a concentration, not an amount. Read the package insert for pediatric use.

Dr. Tom


What is Pleural Thickening?
Q. What causes Biapical pleural thickening, and can it be reversed?


A. Dear Kathy, This is usually due to old apical inflammation, such as a childhood pneumonia. It may be congenital. It has no significance.

Dr. Tom


Quit Smoking Since Finding Out Results of Old CT Scan
Q. I had my gallbadder out two years ago, and during the testing that they did before my surgery, they found issues with my CT scan involving my lungs. I just got the records just now and I am very concerned since it has been two years since the scan. The report reads, "a 4 mm nodule at the left lung base and some nodular atelectasis at the right lung base.

I have smoked for 10 years and I am on day five of smoke-free. I would have stopped two years ago, had I known about the scan. What do you suggest and how worried should I be? I really don't know what the scan means.


A. Dear Erica, Your scan does NOT represent much of a risk for the later development of lung cancer. Remain abstinent from smoking and get a follow-up in about six months. You should be fine.

Dr. Tom


Had a Chronic Cough for Five Months
Q. I have had a chronic cough for the past five months with coughing attack lasting about an hour on average of every two to three days. A CT scan of my sinuses revealed: maxillary, ethmoid and sphenoid sinusitis. obstructed ostiomeatal unit bilaterally. 

I wheeze all the time. I also have acid reflux.  I have been told by doctors to have sinus surgery and see my gastroenterologist to get rid of the cough.  The only medication that seems to help the cough is Proventil.  Can you suggest anything? 


A. Dear Frank, Both chronic sinusitis and acid reflux can cause chronic cough. Both should be addressed in view of the severity and duration of your symptoms.

Dr. Tom


Seem to be Allergic Lots of Medications
Q. Dr. Tom, I am 62 yrs. old and have severe COPD.  Every kind of pill I try to take affects my breathing making it worse. I've tried antibiotics, vitamins, and even the last time I took prednisone, my breathing became worse after taking it for only one day.  Have told my GP about this but he doesn't say anything. 

The only antibiotic that doesn't affect my breathing is Amoxicillin in caplet form. Do you think it could be something the pills are coated in that I am allergic to? Have you ever heard of this before?


A. Dear Gwyn, A very few people are allergic to COPD medications, or find them irritating, or with systemic side effects. I would consult a pulmonologist and see if an acceptable management program can de designed for you, it probably can.

Dr. Tom


Help Clarify CT Scan Results
Q. Please help clarify CT Scan results: The subpleural irregular opacities seen in the dependent portions of both lower lobes are probably gravitational. There is some linear interstitial thickening in the anterior basal segment of the lower lobes.

second question, if the Pulmonary Fibrosis is in the early stages how come it showed in one of the CT Scan and it didn't show on the second one? Can it be in of them they used a contrast dye and not the other?


A. Dear Irene, Different views give different shadows in pulmonary fibrosis. The chest x-ray does not correlate well with lung function or response to therapy. Be sure you are seeing a pulmonologist for your pulmonary fibrosis.

Dr. Tom


Burning in Chest that Goes Away When Taking Deep Breaths
Q. Recently, I woke up in the middle of the night with a burning in the area of my sternum. It felt like indigestion, but was a bit higher up than when I've had indigestion. With deep breaths, the burning went away but returned upon normal breathing. This condition lasted for several hours. Is there any significance to this symptom?


A. Dear John, This is hard to determine. I believe it will be a transient happening and will not trouble you again. If not so, see a pulmonologist.

Dr. Tom


How Do I Explain the Progression of COPD to my Husband
Q. Welcome back Doc! I need to know how to explain the progression of this disease goes even without exacerbation. I can't make it clear enough to my husband/caregiver.


A. Dear Judith, COPD generally progresses slowly, mostly as a consequence of age. Most patients can be stabilized and lead normal lives. Things are changing with new medications and new knowledge, plus the emphasis on early identification.

Dr. Tom


Does Breathing in a Paper Bag, for Hyperventilation, Work?
Q. Do you recommend breathing into a paper bag for someone who is hyperventilating?


A. Dear Kathleen, It can't hurt and often aborts an attack.

Dr. Tom


I am 54 Years Old and I Have COPD
Q. I am a 54 year-old woman who never smoked! I resent the fact that I have COPD and emphysema. I saw an ad for lung transplant and believe I should be eligible. Please contact me, I am willing to be a volunteer for any kind of surgery offered.


A. Dear Marylou, About 15% of COPD patients have been non-smokers. I doubt if you are any where near the need of a transplantation. See a pulmonologist for a full evaluation.

Dr. Tom

2024 American Association for Respiratory Care