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Ask Dr. Natasha Your Own Question

Dr. Natasha
Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 11789
Experience:  American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing
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What inhaler works best for emphasima not bronchit

Customer Question

What inhaler works best for emphasima not chronic bronchitis
Submitted: 9 months ago.
Category: Medical
Expert:  Dr. Natasha replied 9 months ago.

Dr. Natasha :

Hello

Dr. Natasha :

You basically need two types of inhalers

Dr. Natasha :

one for rescue which is albuterol

Dr. Natasha :

the other which is a combination medication (long acting bronchodilator + steroid)

Dr. Natasha :

symbicort and advair are good for this

Customer:

What about spiriva

Dr. Natasha :

advair is better

Dr. Natasha :

in a study of COPD patients (which emphysema is included), people who took advair were 1/2 as likely to die

Dr. Natasha :

http://www.webmd.com/lung/copd/news/20071228/advair-vs-spiriva-fewer-copd-deaths

Customer:

Ok I have been having sob for 4 months I had a cxr which showed mild hyperinflted lungs I had a pft which came out normal what do u think

Dr. Natasha :

I think that you should use the medication that I suggested if you need it

Dr. Natasha :

the advair is daily, but the albuterol is as needed

Dr. Natasha :

not spiriva

Dr. Natasha :

and if you smoke, stop!

Customer:

My pulmonologist says I don't have copd

Dr. Natasha :

you have emphysema?

Customer:

I quit smoking

Dr. Natasha :

did your dr say you have emphysema?

Customer:

She said I had mild hyperinflted lungs but my pulmanary fuction test was normal...

Dr. Natasha :

okay, well if you don't have documented lung disease, don't take anything

Dr. Natasha :

but if you have wheezing secondary to lung disease, then you need meds

Dr. Natasha :

you don't want to take anything you don't need! :-)

Customer:

I can't breath get out of breath really easy

Customer:

Aren't hyperinflted lungs a sign of emphasima??

Dr. Natasha :

not necessarily

Dr. Natasha :

hyperinflated means too much air

Dr. Natasha :

Diagnosing emphysema can't be done with an X-ray alone.

Dr. Natasha :

it needs pulmonary function tests, physical exam

Dr. Natasha :

if those are normal, you don't have emphysema

Dr. Natasha :

did you see that

Customer:

Could I have mild emphasima that won't show on pft yet....

Dr. Natasha :

not really, the PFTs are a main part of the diagnosis

Customer:

Would a ct scan pick it up...

Dr. Natasha :

yes, but you need to have PFTs too

Dr. Natasha :

it is not just diagnosis on radiography

Customer:

I have also had a cardio pulmanary exersise test I got to 200 watt power my doc said it was normal...

Dr. Natasha :

that is great

Dr. Natasha :

I would not worry about COPD or emphysema yet then

Customer:

I can also run a mile in 8mins 30 secs and can run five miles in under an hour

Dr. Natasha :

wow

Dr. Natasha :

yeah, your lungs are good

Customer:

Could it be that this could all be from my 20 year smoking history and the lungs need time to repair themselves I have only quit last week

Dr. Natasha :

yes, that can be it

Dr. Natasha :

generally it takes a few years to repair themselvse

Dr. Natasha :

I hope that I provided you with excellent service?

Customer:

It really takes that long

Dr. Natasha :

yes it does- but at least it CAN

Dr. Natasha :

I hope that I provided you with excellent service?

Customer:

Good point so basically with the test I have had emphasima can be ruled out??

Dr. Natasha :

yes

Customer:

Ok thanks doc yes excellent

Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 11789
Experience: American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing
Dr. Natasha and 5 other Medical Specialists are ready to help you
Expert:  Dr. Natasha replied 9 months ago.
Hey Kevin
I was following up to see how you were doing
Customer: replied 9 months ago.

I had a ct that shows emphasima but normal pft what the deal

Expert:  Dr. Natasha replied 9 months ago.
I will get to this tomorrow. Not on computer
Customer: replied 9 months ago.

Ok thx

Expert:  Dr. Natasha replied 9 months ago.
Well, you can have scarring in the lungs and normal PFTs. It means that your lungs are able to function normally despite being damaged. That is a good thing...

Customer: replied 9 months ago.

The doc said mild emphasima changes on the ct scan yes my pft where above normal....the mild emphasima is causing my sob then?

Expert:  Dr. Natasha replied 9 months ago.
Most likely yes
Customer: replied 9 months ago.

Can it be stopped at this early state with the normal pft and the fact I quit smoking?....should I be on meds?

Expert:  Dr. Natasha replied 9 months ago.
Once you have scarring it is permanent. But if you stop smoking it will not get worse.
The medications are for symptom relief
It cannot reverse the scarring
Customer: replied 9 months ago.

Don't the steroids reverse inflamation in the lungs

Expert:  Dr. Natasha replied 9 months ago.
They DO, but they don't reverse SCARRING.
Customer: replied 9 months ago.

So advair would reduce my symtoms and not smoking and exercise will stop the progression?....also I ran a road race on thanksgiving it was 5 miles I did it in 54 mins which is about a 10 min 30 sec mile.....do you think I will ever end up on oxygen I'm 36 years old...

Expert:  Dr. Natasha replied 9 months ago.
Advair will reduce symptoms,
not smoking will reduce progression
exercise is good for overall health
Customer: replied 9 months ago.

My fev 1 is 108% of predicted....do you think I will ever end up on oxygen??

Expert:  Dr. Natasha replied 9 months ago.
Not at the rate you are going :-)
Customer: replied 9 months ago.

What does that mean?

Expert:  Dr. Natasha replied 9 months ago.
It means you are doing well

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