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I Think We Have Discussed This Before But I Am

Posted on Sat, 13 Oct 2018

Question: I think we have discussed this before but I am checking on it after a visit to new pulmonologist. We have talked about how anxiety, stress and panic can inflame airways. In the small airways is what i still have an issue with. First what does the stress anxiety and panic episode release in the body that causes lung inflammation. Does this inflammation react the same as COPD type inflammation or Asthma type? My new Pulmonologist does not seem overly worried or concerned on my reports. She does wish for me to stay on a Cortico Steroid to manage or preventative maintenance on COPD Small Airways from worsening. since i have a tight feeling in my upper lung area and a very tiny amount of air trapping, if it is anxiety driven, when the anxiety goes down will this return to normal or will the inflammation that has persisted cause damage to the airways.

Other than that, I am good, Still Cancer Free, time for another CT Scan to see my condition. Speaking of CT. Does a CT taken during exhale actually show if air trapping exists?
Adding to my household soon. I have an English Bulldog Pup coming so that my other dog has company when i am at work. More House Breaking and Teaching no no no to a baby pup. Ha ha

Hope you are good, Any additions to your family yet?

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
It is not reversible.

Detailed Answer:
Thanks for your direct question on Ask a doctor forum.
I can understand your concern.
The damage caused by inflammatory mediators (stress and anxiety induced) is permanent.
This is same happening in long standing asthma.
Initially, lung inflammation is reversible but when it is chronic (on long run), lung damage is permanent and they behave similarly as COPD.
So long standing stress and anxiety cause permanent lung damage.
Regarding air trapping, yes, if CT taken in expiratory phase can pick up air trapping.
It must be high resolution CT thorax.
It's good that you are have a new dog.
And Yes, we have an addition in our family - Baby girl is now Three and half months old.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Drkaushal85 (42 minutes later)

Well Well, Congratulations, That is good news, now you can worry like fathers about their daughters and the frustrations they give you Ha Ha.

So Its not reversible if chronic,
What in your mind is the time it would run to be chronic.
Does inflammation grow to other airways when the stress triggers cease

Answered by Dr. Drkaushal85 (16 hours later)

Brief Answer:
The time limit is not exact.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Thanks, dear for your wishes.
In XXXXXXX we don't take daughters as a burden, we take them as blessings and believe me XXXXXXX daughters are very good in terms of family bonding and care.
Back to your query.
Well, the exact time for chronicity is not fixed. It depends on so many factors.
But you can say at least 1-2 years are needed to be it chronic.
No, inflammation will not grow to normal airways if stressors are gone.
Why you are asking about the time needed to be chronic?
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (5 days later)

I asked because the Followup at the dr office discussed small airways inflammation and I recall it being an issue 4 years ago. So it has been chronic but i do not know what if any amount of damage i have created because of it.

My daughter and grand daughter are blessing too but they love to test you to see what you will let them do or not do. But I cherish them no matter what

Answered by Dr. Drkaushal85 (16 hours later)

Brief Answer:
What is your recent PFT report?

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
To know the severity of damage, you need regular PFT s.
So please let me know your recent PFT so that I can guide you better.
Sorry for late reply as I was busy in social work.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Drkaushal85 (20 hours later)

My most recent pft had vary little change from previous one .The lobectomy changed fvc just a little and the fef 25/75 still hangs around the 60-70 %. Otherwise the same. My pulmonologist said it was still in a mild COPD stage and nothing to concern

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
This is good.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
So reduction in FEF 25-75 is permanent damage of small Airways.
If this value reduce further then it is said that your stress and anxiety has damaged more lung.
Hope I am clear.
Are you awake?
I will be happy to help you further. Wish you good health. Thanks.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy