Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Respiratory Disorders (Expert Forum)
Asthma/emphasemic changes/nodule in NON SMOKER?!
Answered by
This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis.
Asthma/emphasemic changes/nodule in NON SMOKER?!
by Babs1176, Oct 28, 2006 12:00AM
I am a 54 YO fe in relatively good health.Abt 3 years ago I decided to take charge of my health and lose some weight and begin regular excersize.Lost 45 pounds and have kept it off 5'4-145lbs.smoked for 1 yr in college-some 30 yrs ago.Feb started with SOB no attacks just a 24/7 sob wheezing slightly at tail end of expiration-only audible when things were very quiet.Stridor and EXTREME sensitivity to strong perfumes and cig smoke.
MD did echo-neg-PFT WNR- bloodwork- neg.sent me to ENT-they saw nothing wrong and sent me to pulmonologist.checked carefully for vocal cord dysfunction.No GERD Symptoms but did treat 6weeks.
He began treating empirically.albuteral-short course prednisone-no help.Then had bronchoprov...went to -13% on saline and then
-22% at .1% of methocholine.Have been on advair 250/50-just increased to 500/50 last week-total of about 5 weeks.
CT scan showed sl emphysemic changes and 3 mm nodule rlung.Am assured nodule is nothing worrisome
My question is this:
how common are these things in NON SMOKERS?Pulm did all the genetic enzyme def/allrgy tests and all were neg(mom died of COPD-heavy smoker)
I am told I have hyperactive airway disease as well as emphysemic changes are diagnosis of COPD-even though I have no changes on PTF indicating emphysema.Is this correct?
Do feel better than I have felt energy wise in over a year.I was getting so frustrated that the wieght loss and regular excersize did not help the overwhelming, relentless fatigue. Still have some breathing issues..but they are improving too.
I can find no info on asthma/copd in NON SMOKE
MD did echo-neg-PFT WNR- bloodwork- neg.sent me to ENT-they saw nothing wrong and sent me to pulmonologist.checked carefully for vocal cord dysfunction.No GERD Symptoms but did treat 6weeks.
He began treating empirically.albuteral-short course prednisone-no help.Then had bronchoprov...went to -13% on saline and then
-22% at .1% of methocholine.Have been on advair 250/50-just increased to 500/50 last week-total of about 5 weeks.
CT scan showed sl emphysemic changes and 3 mm nodule rlung.Am assured nodule is nothing worrisome
My question is this:
how common are these things in NON SMOKERS?Pulm did all the genetic enzyme def/allrgy tests and all were neg(mom died of COPD-heavy smoker)
I am told I have hyperactive airway disease as well as emphysemic changes are diagnosis of COPD-even though I have no changes on PTF indicating emphysema.Is this correct?
Do feel better than I have felt energy wise in over a year.I was getting so frustrated that the wieght loss and regular excersize did not help the overwhelming, relentless fatigue. Still have some breathing issues..but they are improving too.
I can find no info on asthma/copd in NON SMOKE
Doctor's Answer
by National Jewish, Nov 06, 2006 12:00AM
, Nov 06, 2006 12:00AM
The term COPD is an abbreviation for chronic obstructive pulmonary disease. COPD is a general term used to describe the chronic lung disease linked with cigarette smoking and worsened by contact with industrial dusts and other toxins. This is also called emphysema. It is a disease that worsens over time. There is a relatively irreversible decrease in airflow and permanent destruction of the airsacs in the lung. With your limited smoking it is unlikely that this is COPD. Pulmonary function testing (PFT) usually clarifies if you have asthma or COPD.
A very small number of cases of COPD are linked with a genetic based alpha-1 antitrypsin deficiency. Not having enough of this major protein in the blood can lead to severe emphysema even in people who have never smoked. AAT deficiency is determined by two blood tests. One test measures the amount of alpha-1 antitrypsin and the other determines the phenotype or genetic pattern. Families with multiple members who develop severe emphysema early in life or in non-smokers should be tested for this deficiency.
There is a complex asthma test that is the gold standard for diagnosing asthma. This is called a methacholine challenge. You will blow into a spirometer before and after each increasing dose of an inhaled medicine. This test is positive for asthma if the result after the inhaled medicine is 20% lower than it was before the inhaled medicine.
With asthma the basic problem is chronic inflammation along with tightening of the smooth muscles that surround the airways of the lungs. This tightening is called bronchospasm. Usually asthma is treated with 2 types of medicine for long-term control and quick relief. This is how they work:
· an inhaled steroid, like Flovent Diskus® (fluticasone propionate inhalation powder), decreases and prevents the inflammation when it is used daily; and
· an inhaled bronchodilator relaxes the smooth muscle tightness. A long-acting inhaled bronchodilator, like Serevent® Diskus® (salmeterol xinafoate inhalation powder), prevents bronchospasm when it is used daily. If it is known that something like exercise causes asthma symptoms, a fast-acting inhaled bronchodilator is used as a pre-treatment before exercise to prevent bronchospasm. When asthma symptoms happen, a fast-acting inhaled bronchodilator is used as a rescue medicine to quickly relieve bronchospasm and stop the asthma symptoms.
Needing to use a fast-acting inhaled bronchodilator as a rescue medicine more than twice in a week means that the inflammation and asthma are not well controlled. If this inflammation is not controlled, it increases the sensitivity of the airways to a variety of things that make asthma worse. These asthma triggers vary from person to person. For some people allergies cause more asthma problems, but for other people allergies do not cause asthma problems at all. People are not allergic to perfume or cigarette smoke. However perfume and cigarette smoke are irritants that can trigger asthma. It is important that your asthma be well controlled, so that perfume and cigarette smoke do not trigger your asthma. Please read the information on the National Jewish Medical and Research Center’s website at http://www.nationaljewish.org/disease-info/diseases/asthma/index.aspx to learn more about asthma.
When aerobic exercise is done on a regular basis, this conditions the entire body so that the muscles are working as efficiently as possible. This allows the breathing muscles to use the least amount of energy to move air in and out of the lungs. Over time this helps to lessen shortness of breath.
A very small number of cases of COPD are linked with a genetic based alpha-1 antitrypsin deficiency. Not having enough of this major protein in the blood can lead to severe emphysema even in people who have never smoked. AAT deficiency is determined by two blood tests. One test measures the amount of alpha-1 antitrypsin and the other determines the phenotype or genetic pattern. Families with multiple members who develop severe emphysema early in life or in non-smokers should be tested for this deficiency.
There is a complex asthma test that is the gold standard for diagnosing asthma. This is called a methacholine challenge. You will blow into a spirometer before and after each increasing dose of an inhaled medicine. This test is positive for asthma if the result after the inhaled medicine is 20% lower than it was before the inhaled medicine.
With asthma the basic problem is chronic inflammation along with tightening of the smooth muscles that surround the airways of the lungs. This tightening is called bronchospasm. Usually asthma is treated with 2 types of medicine for long-term control and quick relief. This is how they work:
· an inhaled steroid, like Flovent Diskus® (fluticasone propionate inhalation powder), decreases and prevents the inflammation when it is used daily; and
· an inhaled bronchodilator relaxes the smooth muscle tightness. A long-acting inhaled bronchodilator, like Serevent® Diskus® (salmeterol xinafoate inhalation powder), prevents bronchospasm when it is used daily. If it is known that something like exercise causes asthma symptoms, a fast-acting inhaled bronchodilator is used as a pre-treatment before exercise to prevent bronchospasm. When asthma symptoms happen, a fast-acting inhaled bronchodilator is used as a rescue medicine to quickly relieve bronchospasm and stop the asthma symptoms.
Needing to use a fast-acting inhaled bronchodilator as a rescue medicine more than twice in a week means that the inflammation and asthma are not well controlled. If this inflammation is not controlled, it increases the sensitivity of the airways to a variety of things that make asthma worse. These asthma triggers vary from person to person. For some people allergies cause more asthma problems, but for other people allergies do not cause asthma problems at all. People are not allergic to perfume or cigarette smoke. However perfume and cigarette smoke are irritants that can trigger asthma. It is important that your asthma be well controlled, so that perfume and cigarette smoke do not trigger your asthma. Please read the information on the National Jewish Medical and Research Center’s website at http://www.nationaljewish.org/disease-info/diseases/asthma/index.aspx to learn more about asthma.
When aerobic exercise is done on a regular basis, this conditions the entire body so that the muscles are working as efficiently as possible. This allows the breathing muscles to use the least amount of energy to move air in and out of the lungs. Over time this helps to lessen shortness of breath.
