After having pneumonia in Oct.-Nov. of 03 my right middle collapsed. My Pulmonary Dr. did a Broncoscopy(sp?) and found nothing outstanding,but said it was possibly caused by a mucus plug. Did a biopsy and that was ok. I am a smoker, 52yrs. old, have previous PE of left lung and am on coumadin. My PCP thought the pulmonary dr. should have waited to see if the collapse would reoccur and it did. (at least 3 times so far.) I take breathing treatments 2-4x per day of Xopenex and Atravent. Since the collapse has returned over and over again is the PCP correct in saying the plug is reccuring and might have to be released by another brocoscopy and will this go on and on....I know I should quit smoking but I'm have very little success. I am taking it slow and cut down from 2 packs a day to less than one pack per day.
What is your advice?
The collapse of your right middle lobe (RML) may be due to a plug. It might also be due to structural damage of the RML from the pneumonia. RML syndrome describes recurrent RML collapse, infection or a combination of the two. Of all the lobes of the lung, the RML has the poorest drainage or clearance. The airway to this lobe is long and thin. As a result mucus gets trapped. Infection frequently fails to clear and the result is permanent damage to the RML. If a person has rare recurrences, nothing needs to be done other than antibiotic treatment. One can live with a collapsed RML, comfortably and safely if it is just mechanical collapse. If however, this area becomes the site of recurrent infection, the RML may eventually need to be surgically removed.
You should consult with the pulmonologist. The decision of how best to proceed is not always an easy one and requires that an on-site expert have access to all the information. If the decision is made to wait and watch, a CT scan might be preferable to a repeat bronchoscopy.
Congratulations on cutting your smoking by more than half! You may want to look at our Quit Smoking Topic Center at http://www.nationaljewish.org/topic/smoking_cessation.html for ways to help you to quit smoking. Also check with your doctor for other quit smoking resources in your area.
There have been many posts regarding the cesation of smoking. Instead of repeating myself, I made a rather lengthy note a few months ago that I will copy/paste here:
As far as quiting goes, the way you are quiting is almost PERFECT. The cold turkey style is rarely sucessful and it has been documented that THAT method usually takes approx 10 attemtps before any success.
A smoker first needs to identify when he/she smokes. When you first wake up? During or after the morning coffee? In the car on the way to work? During lunch break? In the car on the way home from work? After dinner? Before bed? Most of these cigarette times are ROUTINE events. You expect to light up without even thinking. This is aside from the few you have when your out with your friends at the bar, at a ball game, watching tv...or what ever. The thing to do here is...cut out the routine cigarettes. First thing you need to do when accomplishing this is WILL-POWER. You have to want to stop. Make a date to start. TELL PEOPLE. Ask that they support you. Tell friends not to smoke around you. One by by...slowly, cut out those routine cigarettes. Skip the moring smoke when yer outta bed. Or perhaps, skip the morning smoke in the car on the way to work. Just do one for a while....a week or so. So you get used to the new routine. Then cout out another daily routine smoke. And keep going on and on. Smoking half a cigarette is a waste. You dont get the nicotine your body craves and what usually happens is you spoke more 1/2 cigarettes to compensate. Light cigaretts can even be worse. Studies have shown that people who smoke lights actually suck back harder and more forcefully. This is to get more taste, and more sensation in their lungs. Which in turn the tar deposit is greater!
Anyways, during your gentle cutback, it is infact a good idea to start suplimental nicotine treatments. See your doctor about the patch or chewing gum. It definately helps and will curve those cravings.
The biggest thing I can't emphacize enough about quitting smoking is you....WANTING TO STOP. You have to want to stop to actually stop smoking! You cant have the mentality: "Oh, just one now won't hurt".....once you do that....you've let your gaurd down and mostlikely wont be successful. Try getting a friend to stop with you. (with the above method) Support each other and set goal dates. As these dates are met...REWARD YOURSELF. Dinner and movie? Clothes shopping? New fishing pole? etc...etc.
As far as your reaccuring pneumothorax, it is possible that a mucous plug can cause that, but very uncommon to say the least. Due to the fact that it keeps reoccuring, a sclerosing of your pleura may need to be done. This is a procedure that entales inserting a needle/tube that instills an adhering agent. Such as talc or bleomycin. This sill make the lining of the lung stick to the other chest wall. It will prevent your lung from collapsing. You may want to speak with your doctor regarding that. The fac that your on blood thinners may deter such a procedure however.
There are many people that come to this form that seek advice to troubling conditions. Most of these people get sound advice from professionals and other patients who may have experienced similiar situations.
Although I am not here to police this board, I think it is necessary to remind you that information posted here should be CONSTRUCTIVE....not CRITICAL. I suggest that if you do no know the answer to questions being asked, do not post. Your reply to synjyn is not acceptable and should not be tollerated here.
Thank you Andy for your insightful comments. I HAVE tried quitting cold turkey and you're right, it doesn't work. Now I want to quit and am doing it on my own with the help of family. I write down when I smoke and now that I know what (I think causes me to pick up a cig.) I can help myself better to quit. I have tried my times than I can count, but I hope and I am pretty sure that I will this time because I want to quit!
I have some complications to using the gum because I have TMJ and I have a rare disorder which prohibits me from using the patch so my PCP says he will prescribe something nasal that should help. It's those darn cravings that get me, but I'll do it this time.
P.S. (this if for the other person's comment which were not appreciated.) It is not productive to try and browbeat anyone to quit smoking or quit any bad habit. Shaming someone never works!
Thank you again Andy,
It's certainly no fun skip through the park -- GOOD FOR YOU. Every day you'll be closer to being a "non-smoker" until you ARE one. That mindset worked well for me (and still makes me proud) when I was becoming a "non-smoker" after being a smoker for over twenty years. Best of luck to you!!
Sorry for my reply. You'd have to know my circumstances to know why I had such a harsh reaction. But that was no excuse for my behavior. Please accept my heartfelt apology. I will make no more comments and stay off the site. My apologies again. All the best.
shiney, I appreciate the comments and to find someone that has gone this way and won. It is hard to quit after 35 years, but I know it is well worth it! Thank you for your support.
And to fotobug, apology accepted. I don't know what you have gone through and you don't know what I've gone through, but thank you for your honesty.
Don't give up! I had been smoking for over forty years, was a very heavy smoker, and thought I'd never be able to quit. I more or less had to quit cold turkey as I had lung cancer and needed surgery. It was very hard. The bad headaches and shakiness were awful. It was especially hard at such a stressful time. I don't want to see you or anyone go through the terrible pain of lung cancer and the shortness of breath which makes it hard to do anything I enjoy. I don't know if I'll live very long as they discovered during the surgery that the cancer had already spread to my chest lymph nodes. Lung cancer is so very hard to diagnose. For that reason, so many patients are not discovered until the disease has progressed. Please keep trying. I know you'll make it! Best wishes
I forgot to mention that my sister quit very gradually like you are doing and has been very successful for about eight years. She said she did not have any withdrawl (withdrawal) symptoms as she withdrew very gradually. She can even treat herself to a cigarette every once in a while and it doesn't seem to bother her. I would be afraid that if I fell off the wagon, I would be smoking as heavily as I did before. I guess it is different for everyone.
The Cat Lady
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