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Suggest Treatment For Difficulty In Breathing Due To Emphysema
Question: I am 36 years old, have had asthma since I was four. I have been to the emergency room thousands of times for an attack. I use abuteral inhalers several times every day. In a three I used 46 puffs of the albuterol inhaler. I have smoked half a pack of cigarettes a day for twenty three years. I moved from California to Oklahoma in January of 2014 and have been having a difficult time breathing since. I saw a doctor and had a spirometry test done. About an hour before the test I had to use the inhaler when I started having trouble breathing after taking a shower. During my follow up visit with the doctor I was told that I am not experiencing problems breathing due to asthma. The problems are due to the early stages of emphysema. I believe that I may very well have early stages of emphysema, but I strongly believe that I am having trouble breathing because of my asthma on a day to day basis. Should I look for a second opinion or do you agree that the difficulty breathing is not related to asthma?
Brief Answer:
You could be having both asthma and emphysema.
Detailed Answer:
Hello Dear,
I have gone through your query and it is apparent that you are greatly troubled with your symptoms and are confused regarding the correct diagnosis.
I would like to tell you that you could be having both the conditions. Asthma, emphysema and chronic bronchitis are three conditions which are categorized as obstructive lung diseases. A person may suffer from either but very often there is an overlap and and a person may have two of the three conditions and at times even all three together.
All these conditions have same symptoms of cough and breathlessness except that in asthma there is reversibility of symptoms with inhalers esp in the early stages of diseases where as in other two conditions, reversibility is not significant. Treatment is more or less same in all these conditions esp early in diseases.
You could be having emphysema from the beginning which is progressive in nature and has worsened now. The worsening may have been hastened because of your smoking.
Beside PFT, a CT Chest will help in establishing the diagnosis of emphysema.
Albuterol inhaler will give you only symptomatic relief for a short period. To control the symptoms, you have to use inhalers having combination of inhaled corticosteroids and long acting beta agonists. Some of the commom ones are seroflo, formeterol or seretide accuhaler. You may check the local brand from your pharmacist. Another inhaler having tiatropium should also be used.
At times you may have to use short courses of oral steroids to achieve control over symptoms and then it is maintained on inhalers as above.
First and foermost step in the treatment is complete cessation of smoking which you should do straight away if you do not want any further deterioration in your condition.
I suggest, you consult a local pulmonologist for correct advice, medicines, dosages and technique of taking inhalers.
Take care.
You could be having both asthma and emphysema.
Detailed Answer:
Hello Dear,
I have gone through your query and it is apparent that you are greatly troubled with your symptoms and are confused regarding the correct diagnosis.
I would like to tell you that you could be having both the conditions. Asthma, emphysema and chronic bronchitis are three conditions which are categorized as obstructive lung diseases. A person may suffer from either but very often there is an overlap and and a person may have two of the three conditions and at times even all three together.
All these conditions have same symptoms of cough and breathlessness except that in asthma there is reversibility of symptoms with inhalers esp in the early stages of diseases where as in other two conditions, reversibility is not significant. Treatment is more or less same in all these conditions esp early in diseases.
You could be having emphysema from the beginning which is progressive in nature and has worsened now. The worsening may have been hastened because of your smoking.
Beside PFT, a CT Chest will help in establishing the diagnosis of emphysema.
Albuterol inhaler will give you only symptomatic relief for a short period. To control the symptoms, you have to use inhalers having combination of inhaled corticosteroids and long acting beta agonists. Some of the commom ones are seroflo, formeterol or seretide accuhaler. You may check the local brand from your pharmacist. Another inhaler having tiatropium should also be used.
At times you may have to use short courses of oral steroids to achieve control over symptoms and then it is maintained on inhalers as above.
First and foermost step in the treatment is complete cessation of smoking which you should do straight away if you do not want any further deterioration in your condition.
I suggest, you consult a local pulmonologist for correct advice, medicines, dosages and technique of taking inhalers.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I saw a procedure online called bronchiothermoplasry. Would I possibly be able to meet the criterea and benifit by having this procedure? I read the the largest clinical study was done by the company owing the equipment used for the procedure. The bias of the study possibly being comprimised, do you know of any patients that have had the procedure and to what level was it successful? Did they experience any complications?
Brief Answer:
It may not be indicated in your case.
Detailed Answer:
Bronchial thermoplasty is a new modality of asthma treatment offered to patients having severe persistent asthma. I do not think you fit in that category. Besides, your diagnosis may not be pure asthma. It may be emphysema. Enough literature is not available if bronchial thermoplasty is indicated in emphysema.
I do not have much experience with this modality and I suggest you consult a pulmonologist with experience in this field.
It may not be indicated in your case.
Detailed Answer:
Bronchial thermoplasty is a new modality of asthma treatment offered to patients having severe persistent asthma. I do not think you fit in that category. Besides, your diagnosis may not be pure asthma. It may be emphysema. Enough literature is not available if bronchial thermoplasty is indicated in emphysema.
I do not have much experience with this modality and I suggest you consult a pulmonologist with experience in this field.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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