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Pleural Plaque and Coarse Lung Thickening
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Pleural Plaque and Coarse Lung Thickening

I'm a firefighter of 13 years. Every two years until we turn 40, and then each year after that (I just turned 39) we're required to get chest x rays which go along with our biannual physicals. Mine have always been clear. My last one was two years ago. A few weeks ago that changed when mine came back with abnormal swelling to the hilum and perihilar region. They sent me for a second which confirmed it and then back for a CT with contrast.

The results of that CT show pleural plaque in both the right and left lung and coarse pleural thickening of the right lung base.

What concerns me is that the morning of my physical, prior to being told the results of my x ray, I explained to the doctor that I was having right lower lobe pain upon inspiration and since then have had some pain upon inspiration in the middle of my chest. I also failed the breathing test we're required to do which measures the volume of our respirations - a test which I've never had an issue with prior to this.

As the soonest I can be seen by a pulmonologist is the 25th I've got plenty of time to stew, worry and wonder.

I don't understand why I've got this at a relatively young age. I have no idea whether or not this will progress and make the career of firefighting become an impossibility for me or if I'll be carrying around an oxygen tank in ten years. I have no clue if I have cancerous cells now or how much I have to worry about that in the future though the radiologist and my regular GP both suggested that I be rechecked in 3 months - and the GP went so far as to say that it might be every three months.

While I'm not a smoker I grew up with parents who smoked several packs a day inside the closed up house and cars with the windows up. I've been around second hand smoke most of my life.

Frankly I'm sort of at a loss for all of it. Is there anyone who has dealt with this on these forums? I want to be as prepared as possible when I walk into the specialist's office.  
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While there are other causes of pleural plaques, the most common cause is prior exposure to asbestos.  Pleural plaques continue to be the most frequent and often the only manifestation of asbestos exposure, and asbestos exposure is the most common cause of pleural plaques. Bilateral pleural plaques are more likely to be associated with occupational exposure than unilateral plaques, for which other causes should be considered.  Asbestosis is often, but not always, associated with a restrictive lung function; that is, reduced lung volume.

I am sorry, but here is no easy answer to the question of how much and how fast this condition might (or might not) progress.  The best advice I can give you is, if the diagnosis is confirmed by the pulmonary specialist that you are scheduled to see, that you and your doctors consult with an expert on asbestos related lung disease.  One such is:   E. Brigitte Gottschall, MD  at National Jewish Health in Denver, Colorado.  The link below will give you more information on Dr. Gottschall.    http://www.nationaljewish.org/about/people-search/detail/?id=194
National Jewish Health is the organization I work for.

There are numerous other medical centers with expertise in the diagnosis and treatment of asbestos related disease and here is a website that lists some of those:  http://www.asbestosnetwork.com/tools/tl_medcent.htm

Good luck
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David Tinkelman, M.D.Blank
National Jewish Health
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