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My husband has emphysema & bronchiectasis, takes two

inhalers in AM, one to...
My husband has emphysema & bronchiectasis, takes two inhalers in AM, one to two resp. Tx;s daily, and carries a rescue inhaler. No Oxygen yet. Was dx'd in Jan. '10, but is diffuse.
Often sounds "hoarse" or voice sounds "weak". Hasn't called MD. What do you think is causing this? How long before he'll be on Oxygen? Die?
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Answered in 2 minutes by:
6/26/2010
Dr.tiwari
Dr.tiwari, Doctor
Category: Medical
Satisfied Customers: 5,256
Experience: M.D.
Verified
Chat Conversation Started
Dr.tiwari :

Hello,

Customer:

Hi. It appears you are not a medical doctor, right? I thought I would be talking to someone with a medical degree/

Dr.tiwari :

What is the reason to think that?

Customer:

Because that is what I was shown prior to agreeing to pay.

Dr.tiwari :

May i know about the medicines he is takingor other treatments?

Dr.tiwari :

Should i work with you to help you or opt out so that your question can be assesed by others?

Customer:

He takes Symbicort inhaler, Albuterol is his 'rescue' inhaler, nebulizer tx's with albuterol and one other inhaler in once in the AM - I'll check. He also has high blood pressure and takes Adalat 30 mg QD. The other inhaler is Pro-Air metered spray QD. Also, Prevacid QD for GERD.

Customer:

Are you a medical MD? I think I need to be in conference with a medical person. That is what the site indicated when I agreed to pay? I'm quite confused.

Dr.tiwari :

Thanks ,It looks from your details that he is presently taking the anticholinergic medicine & steroid inhalers for control of his symptoms.As you know in emphysema there is loss of basic unit of respiration that is alveoli with decrease of the surface of area of the lung 7 distortion of the shape of the lung,

Dr.tiwari :

Even after this your husband has maintained a good partial pressure of O2 in his circulation,

Dr.tiwari :

That is really good.

Dr.tiwari :

At this stage a good lung physiotherapy with effective positioning like high fowlers position & oxygen supplementation for support 7 decrease the effort can be very useful for him.

Customer:

I am a nurse, so I know what happens with emphysema. I don't know why he is able to maintain such a good O2. The pulmonologist feels it's because he does some walking to & from work. But how long is this going to last? Why does he sound hoarse so frequently?

Customer:

The MD hasn't recommende O2 yet and that would TOTALLY FREAK OUT MY HUSBAND. He thinks that is WAY down the road. He is due to retire this August 27th and I'm terrified for him and myself!

Dr.tiwari :

That's good,If there is no associated enlargement of cervical lymph nodes without unexplained weight loss & clear CT then you should not worry in this reference.

Customer:

He has had three CT scans and they are all clear.

Dr.tiwari :

For more clarity you may have a cytopathological examination of lung aspirate which can be taken by bronchoscope.

Customer:

Well, they haven't recommended that yet. Are you referring to his "hoarseness"? They have done sputum cultures secondary to his bronchiectasis but found no "really ugly" bugs.

Dr.tiwari :

That's good.

Dr.tiwari :

The hoarseness & weakness of the voice may appear in the emphysema due to decreased collapsibility of the lung leading increased pulmonary work & extra working of the accessary muscles of the neck & voice box.

Dr.tiwari :

They have to do more work to expell air from the lung to produce voice so that voice is weak & hoarse.

Customer:

Oh God, I never thought of that. Then I probably should call the MD and have him seen, right? Maybe he already needs O2, at least at nite. Is that what you are thinking? When I mention it to him, he always says: "it feels like there is something 'stuck' in my throat. Sometimes he can clear it & other times, not. He dosen't 'sound' "Juicy" - like he has phlegym in his lungs ( of course I know he does); but he doesn't sound like he usually does when he has an infection.

Customer:

OK. I'll call Monday to make an appt. What do you think re: time left? What do you think about his platelets? Do you think there is any correlation between the two?

Dr.tiwari :

The paltelets are elevated in the inflammation & connective tissue disorder.The present elevation looks to be due to lung condition.

Dr.tiwari :

As this is a inflammatory disorder associated with insult of lung tissue by irritants.

Dr.tiwari :

Hope this will help you.

Customer:

The hematologist KNOWS he has emphysema; yet, she never seems to indicate that that is the probable reason for his elevated platelets. Neither does his pulmonologist.

Dr.tiwari :

Look at this(Chronic inflammatory condition)-

http://emedicine.medscape.com/article/206811-overview

Customer:

OK. I'll check that out. Thank you. You really did help explain a possible reason for his hoarseness. He denies being SOB. It's so very difficult. Do you think if he starts using O2 at nite, it might improve his condition? I know there isn't any 'cure' for emphysema; but I want him to have some time to relax. some time to 'be retired'. He was in the Navy and they used asbetos sheets to cover parts of the boat in drydock when they were working on it. He does NOT have asbestosis, but he did smoke for many, many years and that was another irritant to his lungs.

Customer:

Are you still there?

Dr.tiwari :

Yes.

Dr.tiwari :

Is there any other query?

Dr.tiwari :

If you ares atisfied with my answer then please PRESS GREEN ACCEPT.

Customer:

Are you still there?

Dr.tiwari :

Do you want to know any more?

Customer:

No. Thank You.

Dr.tiwari :

I have not received any response.

Dr.tiwari
Dr.tiwari, Doctor
Category: Medical
Satisfied Customers: 5,256
Experience: M.D.
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