Suggest Treatment For Emphysema

Posted on Tue, 21 Mar 2017

Question: I have COPD, EMPHASEMA and got bronchitis 3episodes in a row the third time seen my pulmonologist and asked me how I feel told him didn't really feel good think bronchitis coming back said time for O2and walked out of room, no explanation, said come in three months for f/u, no antibiotics nor predizobe ended up in hospital for 5 days with respitory failure with hypoxia, now they say need O2 for rest of life, I'm 57, is there a chance of anything to do with proper diet and exercise and when is o2 really needed permanently since I didn't get any explanation. XXXXXXX n I was told I had EMPHASEMA at 18 and went on rebalance tx and cleared it up, but is it to late I feel like I need a second opinion, then I asked about the stem txt said waist of money. Which I also have PTSD AND ANXIETY SO I WAS TOLD ONE CAN TRIGGER THE OTHER SO DO I HEED O2 24/7 or not

Answered by Dr. Drkaushal85 (34 minutes later)

Brief Answer:
May I know your daily drugs, inhalers and oxygen saturation?

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I need more information before answering whether you need 24*7 oxygen or not.
Please let me know
1. Which are your routine drugs and inhalers?
2. What is your last PFT (Pulmonary Function Test)?
3. What is your resting oxygen saturation?
Newer ultra long acting inhaled bronchodilators (indacaterol and glycopyronium) should be tried in your case. Chest physiotherapy and deep breathing exercises will also help.
Adult pulmonary vaccines are also needed for control.
So please let me know answers of above asked questions so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (9 hours later)

Hi my routine daily inhalers are spiriva 1day, cymbalta 2 puffs 2xday, albuteral tx 1-4 times day as needed, Claritin once at bedtime they also say I have asthma now which is new, cymbacort as a emergency inhaler as needed, I take valume for ptsd and anxiety and Pepcid and proton is for reflux, last put test was 51/41, room air with finger ode story is between 95 and 98, never had pulm rehab, or taught breathing exercises

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Pulmonary rehabilitation is very important and should be started in your case

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Pulmonary rehabilitation is an integral part of COPD treatment. This should be started in your case. This will definitely help you to reduce your symptoms.
Your oxygen saturation is between 95-98. And this does not mean require 24*7 oxygen.
You are taking spiriva (tiotropium) and albuterol (short acting) inhalers. This therapy is not optimal for COPD.
In my opinion, you should start ultra long acting inhaled bronchodilators (indacaterol and glycopyronium) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
And I think you should also start oral long acting bronchodilators like acebrophyllin.
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 (2 hours later)

I'm sorry I forgot to mention that I had a episode after the 3rd episode after he put me on 02 24/7 a week to 2/12 was I went into respitory failur wth hypoxia, I thought I was having a panic attack and had to call ambulance was admitted pumped with lot of steroids and antibiotics got on sepsis alert but my labs came down and er dr said I need the oxegyn now is that because I was already on it or did the respitory failure damage more, and now say I got the asthma, but I was told that if my o2 was over 95 to100 I could blow lungs out that's why I'm seeking 2nd opinion the er dr said wasn't true o2 only at 2 , so the oft don't have anything to do with being on 02, and where could u suggest I learn the difference between anxiety, panic attract and respitory problem, my dr has me scared said if anxiety and do breathing tx could have a heart attract, need to learn difference,can I get too much o2 and can that cause lung spasm which could cause respitory failure and heart rate was 145

Answered by Dr. Drkaushal85 (5 hours later)

Brief Answer:
No too much oxygen is harmful for COPD patients.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Excess oxygen is harmful in COPD patients.
This can cause respiratory failure. So even if you start oxygen, take upto 2 liters /minute. Not more than this.
And COPD patients are at risk of heart attack. So with every exacerbation, we need to rule out heart attack.
In my opinion, you should first try ultra long acting inhaled bronchodilators (indacaterol and glycopyronium). Also start Pulmonary rehabilitation, chest physiotherapy and deep breathing exercises.
I am sure you will mostly improve with all these.
Also consult psychiatrist for anxiety and panic attacks.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Drkaushal85 (5 hours later)

Hi.Dr I forgot to thank you for you information u provided but I need to clarify sum thing my husband said once in a while my o2 does go as low as 90, but usually comes back up, and I will be seeking another Md for 2nd opinion, I don't want to say challenge my pulmonologist that I have, but I have requested pulmonary rehab said it wouldn't do me any good as well a nutritionist. If you know anyone in the us , California that you can refer me to would be greatly appreciated, XXXXXXX ca again thank u

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
Sorry to say but I am not known to California.

Detailed Answer:
Thanks for your follow up question on HealthcareMagic.
I can understand your concern.
Sorry I have no idea about California health system and doctors.
Yes, you should definitely consult another MD and discuss about pulmonary rehabilitation and newer ultra long acting inhaled bronchodilators.
And for COPD patients, oxygen saturation above 88% is considered to be good.
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. Prasad