Does needle biopsy damage lung?

[Jane1]

Hi



2 years ago I was diagnosed with Pulmonary Sarc through needle biopsy to investigate finger nail size scar on right lung.  I am asthmatic, my asthma is controlled and I haven't had an attack in 3 years. However after 1 year the sarcoid had completely gone and the Consultant said it is unlikely to return, my last xray was clear.  I find now though that my breathing really affects me on exercise - cycling now to reduce weight gain after years of steriod treatment for asthma ( previous to Sarc) and kicking smoking - I often get a sharp pain in my chest that weakens my arms and makes me feel light headed with nausea - this passes after a few minutes -

When I had the needle biopsy I bled a lot and had to be hospitalised after losing blood, could the biopsy have damaged my lung, therefore causing pain and SOB when exercising?

I have been recently dxg with Reflux and do suffer indigestion -

I have Pernicious Anemia and get shots every 3 months - my peak flow best is 400 litres - but rarely goes above 320 since biopsy.

Any thoughts would be appreciated - because I need to lose the weight but find I am in a catch 22 with the exercice being so difficult.



Jane

[National Jewish]

The consultant is correct that once the sarcoidosis is completely gone it is unlikely to return.  It is possible that the biopsy might have damaged your lung but unlikely to have caused much damage.  During the biopsy, you might also have had bleeding in the pleural space and this could be the cause of the sharp pain in your chest.  But, unless the pain is pretty bad, this should not cause you to have shortness of breath when exercising.  And the clear chest x-ray probably excludes this.  However, it is still possible to have pleurisy with a normal chest x-ray and no sign of what we call pleural thickening.  You might want to get a second opinion on your chest x-ray, with special attention to the area where you experience the sharp pain.



Since your peak flow is less than your best of 400 this suggests that your asthma may be more of a problem than you suspect.  This may be responsible for your shortness of breath when exercising.  Wheezing and coughing are certainly common symptoms of asthma.  However for some people shortness of breath is their only symptom of asthma.  Exercise is a common trigger for asthma.  For some people it is the only thing that causes asthma symptoms.



You should have pulmonary function tests and an exercise challenge.  An exercise challenge is a test used to determine whether or not exercise-induced asthma (EIA) is the problem.  You will walk or run on a treadmill or ride an exercise bicycle.  Before and after this exercise spirometry is checked.  Spirometry is a simple breathing test that provides detailed information about how your lungs are working.  If the spirometry drops by 20% after exercising the test is positive for EIA.  If your doctor determines that you have EIA, a prescribed bronchodilator inhaler can be used 10 to 15 minutes before cycling.  This pre-treating will quickly open your airways and prevent your shortness of breath during exercise.  Please read our Exercise-Induced Asthma MedFact at http://www.nationaljewish.org/medfacts/induced.html for more information.  It is important for you to be evaluated by a doctor to determine your problem and the best treatment.



Good luck with weight loss and your exercise program.

[Jane1]

Thank you



I do have 6 monthly full PFT check-ups ( they never show sarcoid, but the respiratory nurse showed some concern about the Asthma) I take asthma meds - Seretide 250 ( Advair?) and ventolin. But taking the ventolin before I exercise may be key to helping me cope, I will look into the pluersy and am due for another X Ray soon, I will check out the links.

Many thanks for the detailed reply.

Best regards

Jane