Hyperinflated lungs

[momkatp]

Hi. I'm 51 with a hx of thyroid ca, and am somewhat of a hypochondriac. I went to a clinic insisting they check my lymph nodes in my neck and lungs. The physician assistant pointed out that my lungs were hyperinflated and that the diaphragm was somewhat flattened, as consistent with emphysema, now I am a wreck.

I had an xray 5 yrs ago and was fine. I am never short of breath, go up 3 flights of stairs several times a day, in fact often I run up the stairs and carry laundry up too. I also walk up a rather significant hill twice a day. I take it back, I do get a bit winded when I talk on the phone whilst walking up and nearing the end of the hill, though the bikers struggle with it as well.

I have had horrible sinus issues over the last 6 months, nasal swelling with post nasal drip, along with coughing. It started suddenly, I remember the day, we were staying in a mold infested cottage. The ent says I am allergic to something, have reactive sinuses with obvious signs of GERD. We moved to Denver in May and I assumed it would get better, but it didn't... until I moved from sleeping on a sofa to a cotton futon. Since I moved from the sofa, sinus issues are almost completely resolved to the point where they were prior to the mold. Coughing also gone. I did smoke.... up until this xray! About a half pack for 20 yrs, then 3-4 cigs a day for the last 10 yrs. I have a long history of allergies/eczema, had sinus surgery in my 20's. I wonder if inflated lungs are related to this mold/sofa issue. I wonder if my sinuses were reacting, so might my other airways? Actually, I have heard wheezing, like a gurgle at times, but in my throat, not my lungs. One of my kids has asthma, nothing like that! Here's my question: could I have asthma without being short of breath? Could asthma account for this xray? Does this sound like emphysema and I'm just in denial? I did my kids breathing meter and got a 400. Moving back to Chicago in 2 wks, no time for docs right now!!!

[shinglesagain]

A related discussion, Contradicting Tests was started.

[David Tinkelman, M.D.]

Hyperinflation and associated “flattening” of the diaphragm can be indirect, non-specific signs of emphysema/COPD but can also be associated with asthma, usually but not always symptomatic.  An X-ray is not the way to establish the diagnosis of asthma, bronchitis or emphysema.  Pulmonary function testing (simple Spirometry) in conjunction with consideration symptoms, history and clinical findings is the way this is done.

You ask if the X-ray findings might be related to the mold. The answer is yes but only to the extent that the mold and sinus disease could result in irritation of what are called the lower airways, causing bronchitis and/or asthma.

In any event, your fine exercise capacity would, in any event, be highly inconsistent with the diagnosis of emphysema. What you describe and the circumstances surrounding it do not suggest the diagnosis of any but minimal chronic lung disease. You should have this checked-out in Chicago but, in the meantime, you should not lose any sleep over concern about emphysema.

Good luck.