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Lung Problem...or Heart ??
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Lung Problem...or Heart ??

Last winter, I had this *bug* that went around, which led to the doctor sending me for chest x-rays and the report came back that I had a partially collapsed lung, so she wanted a follow-up done in a month.  When that report came back, she said it had gotten worse, and wanted a cat scan.  The report said that I had COPD(mild) and a slight enlargement of the heart.. (I do have CAD) She put me on an inhaler(Albuterol) because my O2sats were only 93 due to the congestion,and  when I went back for my follow up  I did a pulmonary function test in her office with this computerized little tester, and it said *normal* lung function (89%). (I now run 97 or 98) This time she put me on  Advair diskus(low dosage-100/50).
I understand her prescribing the Albuterol while I was congested and my O2 sats were low, but I am wondering WHY when my spirometry shows normal she wants me on ADVAIR.. That to my knowledge is a steriod drug... I am still coughing to this day, and I do get short of breath at times, but I believe that is heart related rather than lung..  I have gained 10 lbs. since she started me on this, and my face looks puffy.. I am thinking it could be the Advair.. Your opinion?  
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Having shortness of breath and coughing is why your doctor put you on the Advair. The inhaled steroid is to control airway inflammation and the bronchodilator is to keep the airways open. The airways could be causing the continued problem even with normal lung function. However, if the Advair is not helping and you have concerns about your heart, I would recommend speaking with your doctor.
As far as the weight gain, this is unusual with the dose of Advair, but certainly possible. The inhaled steroid is a potent one. It is possible to take less inhaled steroids in another preparation if these side effects are due to the inhaled steroid.
14 Comments
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Avatar_n_tn
I think your doctor did the right thing by giving you the Advair. I was recently diagnosed with Asthma. When i went to my Respiratory Specialist they did a chest x-ray, EKG, and a pulmonary function test. They all came back normal. The doc said my lungs looked good and my breathing was above normal. This made him concerned that it could be my heart. He sent me to have an echocardiogram done and it came back normal. He then sent me to have another pulmonary function test taken, a Methacholine Challenge test. I had to inhale a lung irritant ( Mathacholine ) and then do the breathing test. This test was what made the diagnosis of asthma.
You can have normal breathing tests, but still have a lung problem. You could have your doc request a Methacholine Challenge test to determine if your lungs are the problem.
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Avatar_m_tn
Hello - You're on the lowest dose of Advair that they offer, actually the 100/50 is what they usually prescribe for children, which may be why your doctor put you on that particular one.  Can I ask if your doctor is a specialist?  A Pulmonary Doctor is probably who you should be seeing, especially if you have COPD.  That is probably why your doctor put you on Advair.  Advair helps to control the inflammation in your lungs, which in turn helps you to breathe better.  But honestly, you should probably ask your doctor why you are using it if she didn't tell you at the time.  Also, breathing tests can be normal even with COPD if it hasn't affected your breathing, but it may be what is causing your coughing.  As for the Methacholine test, it's not a test that many specialists will subject their patients to, mostly due to the fact that it's not 100% accurate, meaning you could test positive and not have asthma, or test negative and really have it.  And unless your doctor thinks you have asthma, there's no reason for you to take it, anyway.  
Take care of yourself, and don't hesitate to write again if you need to.
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Avatar_n_tn
From what I've been told, a Methacholine Challenge is a aure test to diagnose asthma. You inhale a lung irritant and then they perform brathing tests to see how your lungs are functioning. If your lung function drops 80% or more it is a SURE sign you have asthma.
My lung function dropped 80%+ by the 3rd round. They do 6 rounds.
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Avatar_n_tn
Well, if you really have asthma, don't you think your asthma medications would be helping you then?  Somewhere on here I believe you said your medications weren't helping you a whole lot.  There is no definite test for asthma, they will simply come to that conclusion if all other tests are normal.  A sure way to find out if someone has it is to send them home with an asthma medication plan and see if they get better while they're on it.
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Avatar_n_tn
I never said my medications weren't helping me. I simply said that I went out of town to a cooler climate, came home and developed a slight cold. This has a huge affect on asthma, and in some cases if it is an infection then you will need certain antibiotics to rid the infection. I said my meds had been helping until I developed the cold.
Also, finding the right meds to treat asthma is a LONG process. What works for one might not work for the other. It is a process of elimination to find what works the best for you.
I know I have asthma, no where on this board did I say I didn't, nor did I say my meds weren't helping at all. I simply said that my meds weren't helping me b/c of my cold. They were helping up until then.
By the way, do you have asthma??
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Avatar_n_tn
Dear Angel Eyes,

For your asthma, I hope you will investigate the BUTEYKO breathing methods (under good medical supervision), in addition to eliminating, lessening, & treating all your underlying causes of asthma (similar causes, triggers, etc. to VCD causes, triggers, etc.). :-)

Hang in there! I think many people on this message board are ALSO trying to figure out if they actually do or don't have asthma. If they could go to Nat'l Jewish Hospital (NJH), the wonderful experts there could help them get a definitive answer.

If they can't go to NJH, they could telephone the LUNG LINE at 1-800-222-LUNG (5864), Mon.-Fri., 8am-4:30pm, to ask if there are any good docs in THEIR areas, who had training at Nat'l Jewish Hospital! :-)

Good luck to all! :-)

Concerned lady
http://cantbreathesuspectvcd.com

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Avatar_n_tn
Reading these posts, I feel sorry for the person who receives so many different opinions.

And, may I add my 2 cents. For the past 5 chest x-rays I have had over a 7 year period for breathing problems, they always showed scarring at the top of my lungs. (x-rays are carried to the pulmonolgist office right after I have them) This past week, the X-ray was very good and showed no scarring.  My pulmonologist was pleased and I was estatic. The x-rays were always taken at the same hospital. I have been diganosed in the past with asthma, allergies, mild copd, bronchial asthma, pulmonary infiltrates, and the list goes on.

I made my self sick with worry over all this and continually paid attention to how i was breathing. I was wrapped up in this mess.  Yes, I still have problems catching my breath but I also have GERD and maybe, VCD, that Concerend Lady talks about.

Today, the pulmonolgist sent me the radiolgist report in the mail, on my latest chest x-ray.  100% normal and normal was underlined.

Sometimes, I think we are our worst enemies and we listen to too many people and get so confused that we make ourselves worse.

Give yourself a break and do breathing exercises.  There are some good ones posted on various sites on the net.  I found some great ones using a search engine.

Good Luck to All.

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Avatar_m_tn
Well, so glad to see someone on here is healthy.  Are you saying then, that your past diagnosis' were incorrect, and that you don't have copd, or asthma, etc?  Do they know what caused the scarring in the first place, and is that what was contributing to your breathing problems?  I didn't think scarring went away like that, but I'm happy for you that yours did.
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Avatar_n_tn
Could someone please tell me what VCD is?
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Avatar_n_tn
I started my wheezing and whistling sounds in July 1996. In August of 1996, I came down with a doozie of a upper and lower repiratory mess.  I was placed on Albuterol via the mask, Antibiotics, predisone.

This chest x-ray showed nothing out of the normal.  Then, one year later when i got sick again, the scarring appearred and 5-6 subsequent chest x-rays all showed the scarring as was noted by the radiologist and shown to me via the pulmonologist. This scarring was also noted on a CT scan of the chest.  Broncospcopy and several washings of the bronchial and lungs proved negative for disease and infection.

I was told that this scarring may be the result of pneumonia that was not properly treated or reflux getting up into the lungs.

I am not a doctor but this is what I was told by 2 different doctors.  The CT scan of 2 years ago also noted everything else was normal but did see 2-3 very tiny cysts sitting on the surface in the middle of the lung.  

They were not concerend about these tiny cysts as I was told many people have these and especailly at my age. (Fifties)

But, the allergist was concerend about the scarring.  The Pulmonary doc was not. He said it was not Fibrosis.  

He wanted yearly chest x-rays so the other day, I had my yearly and this time there is no scarring.  It also stated no cardio-pulmonary disease is seen and heart size is normal and lungs have good expansion.  

I did ask the doc about this.  He said he has seen this before where a patient has scarring for whatever reason and then it disappears.

He is pleased and I am elated.  I pray next years will be normal also.  

I am not saying I am 100% healthy as I do have allergies to a lot of things plus I do have grade 1 espohagitis caused my GERD.

Plus,The wheezing and whistling in my throat area is pronounced when I lay down and has been going on and off now since 1996.  Have no idea what this is.  Cat? Mold? Dustmites? Pollen? Ozone?

Inhalers do little to help with this.  

I wish for everyone better days ahead.

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Avatar_n_tn
VCD is "Vocal Chord Dysfunction" and this can cause breathing problems.  Concerend Lady has posted several times about this on this site and the gastro site as she has been diagnosed with this by the Jewish Hospital Group in Denver.
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Avatar_n_tn
Thanks Addie! :-)

Shari, please look at my website about VCD/Vocal Cord Dysfunction/Laryngospasm. Start with the home page, at http://cantbreathesuspectvcd.com and please read all 12 web-pages.

In my website, I have links to many other good websites, like National Jewish Hospital's website, etc.

Sincerely, Concerned lady
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Avatar_m_tn
Hi - Was just reading these postings and was curious about your asthma and if your medicines are indeed helping you.  I've never heard of asthma that you didn't know you had.  Can I ask what your doctor gave you to take and how long it took before they worked, if at all?  My friend has asthma and they can't seem to find the right medicines to help her.  Would appreciate any info you can give.......
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A related discussion, Lung/thoart was started.
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A related discussion, Bronchiospasms was started.
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