Suggest Treatment For Atelectasis

Posted on Thu, 10 Aug 2017

Question: 69 year old female, never smoked. Diagnosed with atelectasis 4/17. Pulmonary specialist found mucus pouch from 2 close episodes of pneumonia. Using spirometer, no improvement. Today repeat CT scan. Short of breath through airport, mall, extensive walking, stairs and ongoing dry cough, primarily at night. Since no improvement is it possible this is a pneumothorax and will need treatment. Specialist did mention possible bronchoscope (?) Breast cancer survivor; basal cell carcinoma (7 surgeries)

Answered by Dr. Dr. Jolanda (31 minutes later)

Brief Answer:
Bronchoscopy a useful procedure in this situation

Detailed Answer:
Hello and thank you for asking HealthcareMagic,

I have gone through your history of symptoms and I can understand your concern.

As you explain you are experiencing shortness of breath during long walks, I don't think this might be a pneumothorax (PNX). The most common sign of PNX is an immediate sharp chest pain and then be shortness of breath. If it is the chest CT result will show it and then it will decide about its treatment.

Yes, if you were my patient I would definitely go for a bronchoscopy examination. It is very important in detecting the Airways if something in them might be the cause of a cough which means to be sure about your actual lungs' status.

Don't worry, but the best thing is to do this procedure.

After having the result than your treating doctor will decide for further treatment or follow up if needed. You can also attach the results here and we can discuss again.

Take care and feel free to ask me again.

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Jolanda (26 minutes later)

is the bronchoscopy to do a biopsy since I have history of cancer? also, would I be under general anesthesia or able to drive home? I have difficulty with transportation which also causes me stress. thank you.

Answered by Dr. Dr. Jolanda (8 minutes later)

Brief Answer:
Don't worry you will be safe

Detailed Answer:
Hi again,

If during bronchoscopy something not normal is seen then only the biopsy should be taken. Otherwise, probably a bronchial lavage will be taken.

Usually, this procedure is performed under the local anesthesia, not a general one. After that, you will be under medical observation usually for some hours up to one night (depending on the intra and post-procedure status) and then you can come back home safely.

Don't worry everything will be okay.

Regards

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Jolanda (16 minutes later)

thank you. I see my specialist in 6 days. I would like to keep this discussion open. does that work?

Answered by Dr. Dr. Jolanda (3 minutes later)

Brief Answer:
follow-up answer

Detailed Answer:

Yes, I think so but for further info, you can ask the customer care, they'll guide you about this.

Besides, whenever you want to ask me, please mention my name during the follow-ups, while addressing the query and it'll be directed to me.

Best Wishes

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Jolanda (45 hours later)

Dr. Jolanda,
I have the results of the CT scan from my previous question and discussion with you. The previous mucous pouch (atelectasis) has healed and is gone since the previous CT scan 3 months ago. There are no new findings, lungs appear clear. My follow up question today is, what else could cause this shortness of breath and dry cough? I had an ECHO of the heart that was fine. I see the pulmonary specialist again next week but would appreciate any medical expertise that you could provide to me. thank you. XXXXXXX XXXXXXX

Answered by Dr. Dr. Jolanda (16 minutes later)

Brief Answer:
Continue discussion

Detailed Answer:
Hi again

I am happy for you

This is a good news because serious diseases of the lungs are ruled out.

Probably alergy may be the cause of the breathlessness and dry cough.

Do a Spirometry test and if it is positive than your doctor will prescribe inhalers to you (like Seretide twice)

If negative than acidic reflux of the stomach might be another common cause and Omeprazol orally once for a month may help.

I hope to have been helpful for you.

Regards

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Jolanda (3 days later)

Dear Dr.,
I have been taking a daily subcutaneous dose of Forteo for pelvic fracture and osteoporosis. This began at the time I began to experience the shortness of breath and dry cough. I have found that both of these are side effects of Forteo. I will see my pulmonary specialist this week. If my lungs are clear with no issue I will discuss the side effects of Forteo with the Dr. Do you have any thoughts on this?
Thank you for so much information, XXXXXXX XXXXXXX

Answered by Dr. Dr. Jolanda (7 hours later)

Brief Answer:
continue discussion

Detailed Answer:
Hi again

Side effects of Forteo with shortness of breath and discomfort are not so common.

However i suggest you bronchoscopy procedure even the above.Just to be sure

Regards

Dr.Jolanda

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

Follow up: Dr. Dr. Jolanda (13 hours later)

thank you, Dr. Jolanda,
I will see the pulmonary specialist tomorrow and advise you of treatment plan. Thank you for recommendation and information regarding Forteo.
XXXXXXX XXXXXXX

Answered by Dr. Dr. Jolanda (38 minutes later)

Brief Answer:
welcome

Detailed Answer:
You are welcome anytime

Wishes

Above answer was peer-reviewed by : Dr. Raju A.T