How can I tell if my shortness of breath is abnormal?
Ask yourself this question: Are there specific activities that did not cause shortness of breath several months ago now cause breathlessness? If the answer is yes, that is abnormal and should be investigated unless there is an obvious, short-term explanation (for example, a severe cold or other acute illness).
Since heart disease can cause shortness of breath, how should I decide whether to see a heart specialist instead of a lung specialist?
Your primary care physician can be very helpful in making this decision. If for some reason you don’t want to discuss this choice with your primary care physician, or you don’t have a primary care physician, associated symptoms may help. If you have a cough and wheezing, a lung specialist would probably be the best choice. If you have chest pain and risk factors for heart disease, a heart specialist would probably be the best choice.
How long can a cough last after a bad chest cold, bronchitis or pneumonia?
It is not unusual for a cough to last several weeks, even two or three months at times, following a bad case of bronchitis or pneumonia. As long as the cough is gradually improving with time, it is not necessary to see a lung specialist. In cases where the cough is significant and lasts more than three months, further investigation is recommended.
I have seen another physician already about my chronic cough, and he/she tried a couple of medicines that didn’t help. How can you help me?
We cannot make any guarantees that our services will resolve your cough, but our success rate is very high, especially if you have not previously seen a lung specialist for your cough. Our comprehensive evaluation that includes a careful medical history, review of your medicines and Chest Xrays
, along with Lung Function Tests
helps guide our approach to help resolve your cough.
Are there differences between COPD, chronic bronchitis and emphysema?
COPD, which stands for Chronic Obstructive Pulmonary Disease, includes both chronic bronchitis and emphysema. Individuals with the chronic bronchitis form of COPD have a frequent productive cough, and less destruction of lung tissue than with emphysema. The emphysema form of COPD is identified by loss of functional lung tissue, often replaced with empty space within the lungs causing enlarged lung volumes. At this time, both chronic bronchitis and emphysema are treated similarly.
Is there any type of breathing exercise that can help my COPD?
There are some breathing exercises that may offer some small benefit. In terms of exercise, the most important is working to improve overall fitness so that you can do more with the lung function you have. We generally recommend that our COPD patients start a regular walking routine which does not require any special equipment. This walking can be done around the home for severely limited individuals. Pulmonary Rehabilitation is a structured exercise program that can be very helpful for motivated individuals with COPD. For more information, please see Pulmonary Rehabilitation
What is the difference between asthma and COPD?
Asthma is a lung condition that also is defined by obstruction, or limitation of airflowout of the lungs as defined on Lung Function Tests. Asthma is not caused by tobacco smoke, but individuals with asthma will almost always react very strongly to smoking, or even being around a smoker. The mechanisms responsible for the obstruction of airflow in asthma are a combination of airway inflammation leading to airway swelling and abnormal mucus production, along with abnormal constriction of muscle surrounding the airways. In the vast majority of cases, the airway inflammation can be controlled with inhalers and the abnormal airflow completely, or mostly, reversed to normal. Stated differently, unlike COPD, asthma is characterized by a reversibility of airflow obstruction. For more information about asthma, please go to American Lung Association
How long after quitting smoking does the increased risk of lung cancer go away?
Large studies of ex-smokers have shown this is dependent is large part on the amount of tobacco smoke exposure, most commonly expressed as “pack years”. One pack year equals one year of smoking one pack per day. So for example, if one smoked 1 pack per day for 30 years, that is 30 pack years. As a very rough rule of thumb, if one smoked 15 pack years or less, the risk of lung cancer would be that of a nonsmoker several years after quitting (say 5 years). For heavier smokers, the risk decreases over time but will not get back to that of a nonsmoker – and the amount of increased risk is roughly proportionate to the pack years. In other words, if two smokers each quit 10 years earlier, the 60 pack year smoker will have a significantly higher risk of lung cancer than the 30 pack year smoker.
Is lung cancer more common in smokers/ex-smokers with COPD?
Yes. In plain and simple terms, there is growing evidence that individuals who develop COPD from tobacco smoke are also most likely to develop lung cancer for a variety of reasons including genetic tendencies – and more recent evidence suggests that there are changes in the airway lining cells of individuals with COPD that makes them more likely to turn into cancer cells.
I was just told that my chest xray showed some pulmonary fibrosis. How worried should I be?
The radiologist interpreting your chest xray is reporting a pattern on your chest xray, and nothing else. The physician who ordered the chest xray should help you understand whether the amount of fibrosis, or pattern, is of concern. If the physician who ordered the chest xray showing the pulmonary fibrosis is uncertain about the significance, or you remain concerned, a comprehensive evaluation with lung function tests by a lung specialist will be very helpful in determining whether your pulmonary fibrosis requires further evaluation or treatment.
What is “Idiopathic Pulmonary Fibrosis”?
Idiopathic Pulmonary Fibrosis, or IPF, is a progressive form of pulmonary fibrosis that develops without any associated illness or cause. This is a severe problem, usually leading to respiratory failure and death several years after the initial diagnosis. There are two new medications recently approved for the treatment of IPF, and lung transplantation can also be used in selected individuals. However, there are many other forms of pulmonary fibrosis that can have some resemblance to IPF, and this diagnosis always requires an evaluation by a lung specialist.
When someone has a “spot” on their chest xray, what exactly is that?
When we see the word “spot” used to describe an abnormality on a chest xray or chest CT scan, we find this is a word used to describe a large range of abnormalities. In general, a “spot” refers to a round/oval solid tissue with the lungs that shows up because it is more dense than the surrounding lung tissue. A “spot” less than 2-3 centimeters in diameter is medically referred to as a “lung nodule”, whereas a “spot” more than 3 centimeters in diameter is designated a “lung mass”. In general, the concern increases with the size of the “spot” – but there are other features that are often useful in determining the risk of cancer or other serious problems. Typically individuals with an unidentified lung nodule or mass are referred to a lung specialist for further evaluation.