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I have a flattened diaphragm. It has been that way for over

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I have a flattened diaphragm. It has been that way for over 3 years and my doctor says it is caused by asthma. However, I do not wheeze or have serious asthma symptoms. I do have an inhaler and use it occasionally. Will the diaphragm ever go back to normal?
Submitted: 2 years ago.
Category: Medical
Expert:  khagihara replied 2 years ago.
The flattened diaphragm is usually due to chronic obstructive pulmonary disease (COPD). It is a group of lung diseases that block airflow as you exhale and make it increasingly difficult for you to breathe. Emphysema and chronic asthmatic bronchitis are the two main conditions that make up COPD. In all cases, damage to your airways eventually interferes with the exchange of oxygen and carbon dioxide in your lungs. COPD is a leading cause of death and illness worldwide. Most COPD is caused by long-term smoking and can be prevented by not smoking or quitting soon after you start. This damage to your lungs can't be reversed, so treatment focuses on controlling symptoms and minimizing further damage.

COPD primarily refers to obstruction in the lungs caused by chronic asthmatic bronchitis and emphysema. Many people with COPD have both.

Chronic asthmatic bronchitis
Chronic asthmatic bronchitis causes inflammation and narrowing of the airways that lead into your lungs. This may cause you to cough and wheeze. Chronic asthmatic bronchitis also increases mucus production, which can further block the narrowed tubes.

Emphysema
Emphysema damages the tiny air sacs in your lungs (alveoli) in two main ways. Alveoli are clustered like grapes and emphysema gradually destroys the inner walls of these clusters, reducing the amount of surface area available to exchange oxygen for carbon dioxide. In addition, emphysema also makes the alveoli walls weaker and less elastic, so they collapse with exhalation — trapping air in the alveoli. Shortness of breath occurs because the chest wall muscles have to work harder to expel the air.

Cigarette smoke and other irritants
COPD is typically caused by long-term exposure to airborne irritants, such as:

Tobacco smoke
Dust
Chemical fumes
Air pollution

SInce you don't have wheezing, your COPD is due to emphysema.

There's no cure for COPD, and you can't undo the damage to your lungs. But COPD treatments can control symptoms, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.

Stop smoking
The most essential step in any treatment plan for smokers with COPD is to stop all smoking. It's the only way to keep COPD from getting worse — which can eventually result in losing your ability to breathe. But quitting smoking is never easy. And this task may seem particularly daunting if you've tried to quit before. Talk to your doctor about nicotine replacement products and medications that might help.

Medications
Doctors use several basic groups of medications to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed:

Bronchodilators. These medications — which usually come in an inhaler — relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day, or both.
Inhaled steroids. Inhaled corticosteroid medications can reduce airway inflammation and help you breathe better. But prolonged use of these medications can weaken your bones and increase your risk of high blood pressure, cataracts and diabetes. They're usually reserved for people with moderate or severe COPD.
Antibiotics. Respiratory infections — such as acute bronchitis, pneumonia and influenza — can aggravate COPD symptoms. Antibiotics can help fight bacterial infections, but are recommended only when necessary.
Therapy

Oxygen therapy. If there isn't enough oxygen in your blood, you may need supplemental oxygen. There are several devices to deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town. Some people with COPD use oxygen only during activities or while sleeping. Others use oxygen all the time.
Pulmonary rehabilitation program. These programs typically combine education, exercise training, nutrition advice and counseling. If you are referred to a program, you'll probably work with a range of health care professionals, including physical therapists, respiratory therapists, exercise specialists and dietitians. These specialists can tailor your rehabilitation program to meet your needs. Exercising regularly can significantly improve the efficiency of your cardiovascular system.
Surgery
Surgery is an option for some people with some forms of severe emphysema who aren't helped sufficiently by medications alone:

Lung volume reduction surgery. In this surgery, your surgeon removes small wedges of damaged lung tissue. This creates extra space in your chest cavity so that the remaining lung tissue and the diaphragm work more efficiently. The surgery has a number of risks, and long-term results may be no better than for nonsurgical approaches.
Lung transplant. Single-lung transplantation may be an option for certain people with severe emphysema who meet specific criteria. Transplantation can improve your ability to breathe and be active, but it doesn't appear to prolong life and you may have to wait for a long time to receive a donated organ. So the decision to undergo lung transplantation is complicated.
Managing exacerbations
Even with ongoing treatment, you may experience times when symptoms suddenly get worse. This is called an acute exacerbation, and it may cause lung failure if you don't receive prompt treatment. Exacerbations may be caused by a respiratory infection, a change in outdoor temperatures or high air pollution levels. Seek medical attention if you notice more coughing or a change in your mucus or if you have a harder time breathing.

(By Mayo clinic)

Any questions?
khagihara, Doctor
Category: Medical
Satisfied Customers: 5608
Experience: Trained in the multiple medical fields for many years.
khagihara and 4 other Medical Specialists are ready to help you
Customer: replied 2 years ago.
My physician says that I do not have COPD. Is there another option with these symptoms?
Expert:  khagihara replied 2 years ago.
Did your doctor say emphysema?
Customer: replied 2 years ago.
No. He did not. He indicated that my lungs were heavy with inflammation. I asked him from what and he just said asthma. I do not wheeze, do not have mucus and do not smoke. I have never smoked. I have been exposed to second-hand smoke a lot as a child. In the '70s I had asthma pretty bad while living in Florida. I moved to Ohio in 1975 and my asthma became so bad that I was told that I had to move to the southwest. I did that and it improved greatly. I do have allergies (environmental). Is it really possible that I could have emphysema?
Expert:  khagihara replied 2 years ago.
Your previous severe asthma seems to have caused permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe. It caused the flattened diaphragm. It is not emphysema.
Customer: replied 2 years ago.
Wow! That is encouraging (I guess). However, I assume there is nothing that can correct that. Is that true?
Expert:  khagihara replied 2 years ago.
Unfortunately it can't be corrected.
Customer: replied 2 years ago.
Thanks so much for your help. My biggest problem right now that seems to contribute to the breathing problem is edema. Lasix doesn't seem to help but I keep taking it anyway. I plan to go back to my family doctor and encourage him to be a little more aggressive about my situation or at least tell me more about my illness. I feel like I am just not getting better and am really home bound at this point (3 years now).

Thanks again for your time and I will pay for your help.

Sincerelly,

Barbara Drawdy
Expert:  khagihara replied 2 years ago.
You are welcome.
Hope you feel better soon.

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