questions about test results and treatments

[Dawn1214]

Hello Dr.

First I would like to thank you in advance for your time in helping people witht their concerns and questions.

I recently had major surgery to remove a tumor from inside my spinal cord. I also had a small fatty cyst removed from my neck and the surgeon ran a ct scan to check for more lumps. There is a note on the ct scan about my upper lungs which the radiologist could see. Can you please explain what this means as my PCP didn't really explain it to me. I am not sure he completly understood it.

The visualized upper lungs demonstrate som emphysematous change with pleural parenchymal type scarring bilaterally

Conculsion: Pleural parenchymal type scarring associated with the lung apieces with finding of emphysematous type change with small blebs.

I also had a Pulmunary function test and the results were The FEV1 is normal, but the FEV!/FVC ratio and FEF25-75% are reduced. The MVV is within normal limits. The airway resistance is normal. Lung volumes are within normal limits. Conclusion: mild obstructive ventilatory defect. Significant improvement is seen after bronchodilators indicating the prexence of hyperactive airways.

My PCP wants to put me on Flovent 2x a day for what he says is mild asthma. I would like to know if this is the proper treatment?

What does the CT scan results mean? I am very concerned about this as I was a smoker for 27 years. I very recently stopped smoking. I am very concerned about what all these years of smoking have done to my lungs. I have been concentrating on my breathing quite a bit lately and my PCP keeps me telling me I have anxiety. When I have the oxygen monitor on me my SAT levels are alway at 100%. Please tell me if I need further testing on my lungs or if you feel that the testing I have had done is enough to ease my mind about having something more serious going on other than mild asthma.

Again Dr. Thank you so very much for all of your help.

Dawn

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Dawn,
Brown sputum and your other symptoms point towards a respiratory tract infection. Please consult your doctor quickly for a physical examination, some tests, and a prescription of antibiotics.
It may be a good idea to request additional imaging including paranasal sinuses and entire lung.
Flovent may be useful, but currently you also need antibiotics for the infection.
All the best,
Dr Saini

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
THe CT scan has noted some scarring on the upper part of the lung.
There is some damage (called emphysema) in that area. This is perhaps a consequence of your previous smoking.
Overall this may not be of much clinical concern, especially if you have recently had a pulmonary function test and the reports are normal. Also, your clinical examination is normal, and your doctor has attempted to reassure you on this matter.
It is excellent that you have quit smoking.
Now quit worrying. Please lead a regular, healthy lifestyle, and see your pulmonologist at regular intervals. You need not unduly worry about this report.
All the best, and God Bless!
Dr Saini

[jimster2010]

A related discussion, fluid in the lung for the third time was started.

[jimster2010]

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[Dawn1214]

Thank you so much for answering my questions.

Just 3 days ago I started a having a productive cough which brings up a lot of bright yellow and brown mucus/phlegm. It is about the size of a nickel and it is constant. The morning is the worst time and is accompanied by wheezing and rasping. My chest feels heavy.

My right sinus is also congested and I am not getting anything out by blowing my nose but I do feel it draining down my throat. I do not have a pulmonologist (do you feel I need one?) and my pulmonary function test weren't really normal as it showed mild obstructive ventilatory defects. Since the radiologist could only see the top part of my lungs do you think it would be a good idea to get a ct scan of my entire lungs to see if the damage at the top of my lungs is also in other places? Also I wanted you opinion on the Flovent inhaler that my PCP suggested I use.

Thank you again for your help and God Bless you too!
Dawn