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Respiratory Disorders (Expert Forum)
Nodules, viral count, respiratory problems
Answered by
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Nodules, viral count, respiratory problems
by Stew48, Feb 06, 2005 12:00AM
The doctor discovered small lung nodules in my wife's lower lobe. She is awaiting her 3rd Ct scan to see if they have grown. She had bloodwork at that time showing something was going on virally. Four weeks later, she went in to the doctor coughing as if she had asthma..no history. The doc ran bloodwork which show a high viral count...put her on a med pack, gave her a breathing treatment and an inhaler to use 4 times a day. Her cough sounds as if things are squeezing off. She feels as if a weight is on her chest when on her back at night.
Can this be related to the nodules....any idea if the viral is connected. Any idea of what might be going on? She has no history of respiratory problems.
Can this be related to the nodules....any idea if the viral is connected. Any idea of what might be going on? She has no history of respiratory problems.
Doctor's Answer
by National Jewish, Feb 14, 2005 12:00AM
, Feb 14, 2005 12:00AM
The symptoms you have described do not sound like they are related to the nodules, unless the nodules are of recent origin related to a viral infection. A nodule is usually a small, round shadow seen on chest x-ray anywhere in the lungs. A chest CT scan is usually the next test that is done because it is more sensitive and shows more detail than a chest x-ray. The shape, smoothness, and density of the nodules will be seen on the CT scan. This will help in determining what this could be. If your wife has had previous chest x-rays or CT scans it would be helpful to locate them. Then her doctor could compare them with her most recent chest x-ray and CT scan. The comparison could be most helpful to her doctors, in interpreting these findings and the significance of the nodule.
Nodules are due to infections, inflammation, or tumors. Nodules that are 1 centimeter (10 millimeters) in size or smaller are very unlikely to be cancer. A nodule that will eventually grow may be unchanged for 6 months. The important thing is that they have not grown after 6 months. As long as your wife feels well it is reasonable to repeat the CT scan in 6 months, again in another 6 months, and then, if no change is seen repeating the CT scan 2 years from when the nodules were first discovered. Only if they have grown would more testing be done to know what these nodules could be. When the nodules have not changed for 2 years they are considered stable and no further testing would be needed.
Infections can cause inflammation of the airways of the lungs. When this occurs your wife may cough, especially when she is active or laughs. After the cold is gone, it is possible for the inflammation to linger. This inflammation can last for several weeks. Sometimes this inflammation may linger for 3 to 6 months. Eventually the inflammation will go away, and then the coughing will stop. This is called reactive airways disease (RAD) and behaves a lot like asthma. On a simple breathing test, called spirometry, this may not show up. This inflammation often clears more quickly when it is treated with an inhaled steroid medicine, which is given to treat asthma. Usually this medicine does not provide immediate relief of symptoms. It may need to be used every day for several weeks to months for it to help. Your doctor is the best judge of this.
Asthma symptoms can develop at any point in time even in someone who has never had lung problems before. For some people, the first time they develop asthma is after an infection of their lungs. This can happen at any age, but is more common in adults. To know for sure if your wife’s symptoms are due to asthma she will need to have testing done. Generally testing for asthma starts with a simple breathing test called spirometry. This test provides detailed information about how her lungs are working. It will show if there is obstruction in her airways. To really test for asthma this test may be repeated after using a rescue inhaler, a fast-acting inhaled bronchodilator. This measures how much the bronchodilator helps her lungs by reversing the problem. When there is a 20% increase the test is positive for asthma. However it is possible for this test to be normal when a person with asthma is not having breathing difficulty. A chest x-ray is done to be sure that there isn’t any other problem that would need to be treated differently. An allergist or a pulmonologist would be the type of specialist to arrange for this testing and to help your wife get the best treatment.
The symptoms of asthma are chest tightness, coughing, shortness of breath, and wheezing. Wheezing is the most common symptom. However some people only cough. Each person with asthma could have only one of these symptoms or a combination of any of these symptoms, including all four of them. It is important that your asthma is well controlled so that triggers like infections do not make your wife’s symptoms worse. If she needs to use a fast-acting inhaled bronchodilator medicine more than twice in a week this means that her asthma is not controlled. Please read the information on the National Jewish Medical and Research Center’s website at http://asthma.nationaljewish.org/ for more information about asthma.
Nodules are due to infections, inflammation, or tumors. Nodules that are 1 centimeter (10 millimeters) in size or smaller are very unlikely to be cancer. A nodule that will eventually grow may be unchanged for 6 months. The important thing is that they have not grown after 6 months. As long as your wife feels well it is reasonable to repeat the CT scan in 6 months, again in another 6 months, and then, if no change is seen repeating the CT scan 2 years from when the nodules were first discovered. Only if they have grown would more testing be done to know what these nodules could be. When the nodules have not changed for 2 years they are considered stable and no further testing would be needed.
Infections can cause inflammation of the airways of the lungs. When this occurs your wife may cough, especially when she is active or laughs. After the cold is gone, it is possible for the inflammation to linger. This inflammation can last for several weeks. Sometimes this inflammation may linger for 3 to 6 months. Eventually the inflammation will go away, and then the coughing will stop. This is called reactive airways disease (RAD) and behaves a lot like asthma. On a simple breathing test, called spirometry, this may not show up. This inflammation often clears more quickly when it is treated with an inhaled steroid medicine, which is given to treat asthma. Usually this medicine does not provide immediate relief of symptoms. It may need to be used every day for several weeks to months for it to help. Your doctor is the best judge of this.
Asthma symptoms can develop at any point in time even in someone who has never had lung problems before. For some people, the first time they develop asthma is after an infection of their lungs. This can happen at any age, but is more common in adults. To know for sure if your wife’s symptoms are due to asthma she will need to have testing done. Generally testing for asthma starts with a simple breathing test called spirometry. This test provides detailed information about how her lungs are working. It will show if there is obstruction in her airways. To really test for asthma this test may be repeated after using a rescue inhaler, a fast-acting inhaled bronchodilator. This measures how much the bronchodilator helps her lungs by reversing the problem. When there is a 20% increase the test is positive for asthma. However it is possible for this test to be normal when a person with asthma is not having breathing difficulty. A chest x-ray is done to be sure that there isn’t any other problem that would need to be treated differently. An allergist or a pulmonologist would be the type of specialist to arrange for this testing and to help your wife get the best treatment.
The symptoms of asthma are chest tightness, coughing, shortness of breath, and wheezing. Wheezing is the most common symptom. However some people only cough. Each person with asthma could have only one of these symptoms or a combination of any of these symptoms, including all four of them. It is important that your asthma is well controlled so that triggers like infections do not make your wife’s symptoms worse. If she needs to use a fast-acting inhaled bronchodilator medicine more than twice in a week this means that her asthma is not controlled. Please read the information on the National Jewish Medical and Research Center’s website at http://asthma.nationaljewish.org/ for more information about asthma.
