severe emphysema need lung transplant

I am 57, diagnosed 3 years ago with emphysema. my ct scan shows multiple lung nodules. i have diastolic dysfuntion, grades ii and iv. along with polycythemia. i have a 1% lung function and my pulmonologist advises a lung transplant, since medications and oxygen makes very little difference in my fev. i cannot afford a transplant. i quit smoking last year. what would be my life expectancy without the transplant? i i now walk with a cane and go from bed to couch. last year i was walking 6 miles a day.

[David Tinkelman, M.D.]

You may or may not have emphysema but the presence of lung nodules is not characteristic of that disease.  However, a pulmonologist would be the person most qualified to make that diagnosis.  Whatever lung condition you might have, the  markedly reduced lung function, a low oxygen level and polycythemia suggest that it is severe and the marked reduction in your walking capacity, in less than a year suggests that it is rapidly progressive.  I cannot, just on the basis of your report, provide any estimate of life expectancy or the diagnosis.

You might want to ask your lung specialist about the significance of the “multiple lung nodules” and if you still have concern about what is going on, request a second opinion.

Good luck