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What Do My Scan Reports Indicate?

Posted on Fri, 19 Jan 2018

Question: Small airways disease is reflected by what indicators in a PFT
Small airways disease does or does not show up in a CT SCAN. If it does show up, what are the signs.
Does sad affected by chronic anxiety. If so how.

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
FEV 25-75 % on PFT reflects small Airways.

Detailed Answer:
Thanks for your direct question on Healthcare Magic.
I can understand your concern.
FEV 25-75 % on PFT reflects small Airways.
So any reduction in this parameter is highly suggestive of small Airway disease.
HRCT (high resolution CT) thorax is best for small Airways.
If it shows mosaic attenuation or tree in bud appearance then possibility of small Airway disease is more likely.
Yes, stress and anxiety can influence small Airways.
Stress and anxiety cause release of inflammatory mediators which in turn affect small Airways.
Hope I have solved your query. I am always ready to help you further. Wish you good health. Thanks. I am so happy to hear from you.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (32 hours later)

if stress releases mediators which affect airways, could the affected airways then affect the 25/75 outcome?

Answered by Dr. Drkaushal85 (3 minutes later)

Brief Answer:
Yes, you are right.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, you are right.
Stress induced mediators affect airways and cause reduction in FEV 25-75 %.
What is your last PFT report?
I will be happy to help you further. Wish you good health. Thanks.

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

Follow up: Dr. Drkaushal85 (8 hours later)

You saw the last one a little over a year ago.
Initially it was 69% after Broncho test it went to 99%

Since the Lung Surgery nothing has been done to know what my Stats look like so in December we are gonna do a new PFT. The results will be a new set of numbers with the lung gone. A follow up PFT would be a year later I am guessing.

BTW, I talked to a psychiatrist who is in Pakistan, we talked about my anxiety and all my lung tests and results and he is like you, believes that its all stress related. I have been taking a good listen to both of you and yes I have been improving tremendously. I still have some bad days and bad thoughts but I am working them through.

I will keep you informed on the upcoming Ct regarding the Cancer check up and also the pft results.

Thanks

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Did you had lobectomy or pneumonectomy?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
It's strange that they didn't check for PFT before and after surgery. This is must.
And in between, which surgery you had?
Lobectomy or pneumonectomy?
And exactly on which date?
Please reply me 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. Kampana

Follow up: Dr. Drkaushal85 (36 minutes later)

Well they went with the pft from 7 months before
I had upper right lobe lobectomy.
The lobectomy was 2/13/2017
Chemo began late March thru most of July

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
Some of the chemotherapy drugs can also cause small Airway disease.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, they should have checked PFT immediately before surgery.
What were your symptoms before surgery?
Some of the chemotherapy drugs can also cause small Airway disease.
So please let me know which chemotherapy drugs you have taken?
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 (8 hours later)

cisplaten and navelbein

Answered by Dr. Drkaushal85 (11 minutes later)

Brief Answer:
These are safe chemotherapy drugs.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
These are safe chemotherapy drugs.
They won't cause small Airway disease.
May I know your symptoms at present?
I will be happy to help you further. Wish you good health. Thanks.

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

Follow up: Dr. Drkaushal85 (47 minutes later)

Not a whole lot, just mild sob when I work outside or do some work inside. But I am not to sure what to attribute this to. The thoracic surgeon said that I lost 20% lung capacity roughly. and It would be a minor change from before the surgery. I notice that when I am physically working i dont really notice it unless i think about it then its a minor irritation that i have to stop for a few minutes. Strange but its almost like it was when it all began 4 years ago. I am working at reducing the stress and anxiety and the more i do, it seems to lessen so I am not sure what to attribute anything to.
Tomorrow, I get the follow up ct scan for the oncologist.
A copy will go to the pulmonologist. I get the pft in 3 weeks we will find out then what it will look like and what new numbers i will start working with. I have a feeling that they will be similar to the other 7 pfts except a little less on the capacity

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Yes, PFT will be great.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, PFT values will be great.
Don't worry about it.
And I don't think FVC will also change. It will stay to normal only. This is because there is compensatory hypertrophy of lower and middle lobes of right lung
You start thinking about lung discomfort and you start feeling it. Right?
If yes, then it is only and only because of stress and anxiety.
Do let me know your progress.
I will be happy to help you further. Wish you good health. Thanks.

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

Follow up: Dr. Drkaushal85 (19 minutes later)

I will keep you updated. I have been watching the changes for the better as I reduce the thoughts of SOB and stop the anxiety but the Psych said not to believe in just 6 months to overcome. Some patients can take much longer depending on how deep it is ingrained in your head that there is something wrong.
I think the two of you are brothers, just live in different countries

I think of you quite often. Of course as a close friend and not just a dr

Answered by Dr. Drkaushal85 (0 minute later)

Brief Answer:
I am always there for you.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I appreciate your positive attitude.
And believe me, I am always with you.
Thanks for considering me your close friend, this means a lot to me.
And yes I know how deeply ingrained your anxiety is.
It will take time.
Are you taking any drugs for anxiety to help you?
And are you seeing new psychiatrist?
I am so happy that you are back and talking to me.

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

Follow up: Dr. Drkaushal85 (38 minutes later)

I have clonazapam, and Long term Lexapro.

I went back to my old Psych here in my home town but I really am not satisfied after chatting with the Psych in Pakistan. There has to be more like him here so I must go looking.

Answered by Dr. Drkaushal85 (12 minutes later)

Brief Answer:
These are your old drugs.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Better not to go again if you don't feel good there.
Trust is very important when it comes to psychiatrist consultation.
These drugs (clonazepam and Lexapro) are your old drugs only. Right?
Are you taking in a same dosage?
Do you take any inhaler for SOB?

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

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