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Treatment other than surgery for copd with collapsed lung - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Lung and Chest disorders
Answered by

General & Family Physician
Practicing since : 2009
Answered : 634 Questions

Doctor :   hello
Doctor :  
how can i help u?
User :   Sir is there any alternative for chest surgery
Doctor :  
can i ask u few questions?
User :   yes
Doctor :   why do u wanna go for chest surgery?
User :   It is for my father
User :   He has undergone ICD
User :   his right lung is collasped.
Doctor :  
ok
User :   he is also treated on angioplasty
Doctor :  
why it was collapsed?
User :   The Dr now reccomends surgery
Doctor :  
ok
User :   nut his age is 70 yrs
Doctor :  
ok
User :   Collapsed due to extensive smoking
Doctor :  
surgery for collapsed lung?
Doctor :  
he was diagnosed as copd?
User :   Yes
Doctor :  
ok
User :  
Doctor :  
even after surgey survival rates are low at this age

Doctor :   hiii
User :   yes Dr
User :   We have done CT scan for him also
Doctor :  
ok
User :   How can I send you the report for your reference?
Doctor :  
u try to type the report..
Doctor :  
r u there?
User :   Yes
User :   I am trying to type the report
Doctor :   ok
User :   First heading of the report
Doctor :  
ok
User :   Both lung fields and pleurae: Doctor :  
ok
User :   Multiple large cystic areas with imperceptible walls S/O large emphysematous bullae are seen in subpleural location in whole of the right lung with partial collapse adjacent lung parenchyma and in apico-posterior segment of left upper lobe.
Doctor :  
ok
User :   Dense fibrosis is noted in right upper lobe with emphysematous bullae within the parenchyma.
Doctor :  
ok
User :   Right & left hila are normal.
Doctor :  
ok
User :   No focal mass or calcification is seen.
Doctor :  
ok
User :   There is no evidence of any pleural reaction or fluid in the both the pleural cavities.
User :   Second heading of the report: User :   Mediastinum: Doctor :  
ok
User :   Trachea is central in position
Doctor :  
ok
User :   Esophagus is normal. The lumen is normal diameter & appearance. No abnormal dilatation is seen.
User :   Heart and pericardium are normal. No evidence if pericardial effusion.
Doctor :  
ok
User :   Aortopulmonary window and azygo-esophageal recess are normal.
User :   No significant mediastinal lymphadenopathy is seen.
Doctor :   ok
User :   Third heading of the report: User :   Diagnosis: User :   Multiple emphysematous bullae in subpleural location in whole of the right lung with partial collapse of adjacent lung parenchyma and in apico-posterior segment of left upper lobe with dense fibrosis in right upper lobe.
Doctor :  
ok
Doctor :  
according ur history his ur dads major problem is emphymatous bullae
Doctor :   what surrgery did the doctor suggest?
User :   I can't say much in medical terms.
User :   we are visiting the Drs in Cardiothoracic department and they are saying chest surgery.
Doctor :  
ok
Doctor :  
did he tell any name of surgery?
User :   thoracic surgery
Doctor :  
ok
Doctor :  
i think the DR whom u are seing wants to go for videothoracoscopic bullectomy
Doctor :   emphysematous bullae is dangerous may get ruptured any time
Doctor :  
so that is the reason he have suggested u operation
User :   On the treatment slip it is written CECT thorax
Doctor :   cect thorax means contrast enhanced ct scan
Doctor :  
it is not a surgery
Doctor :  
it is an investigation
User :   ok
Doctor :  
ur father is having severe breathlesness?
User :   Now what should I do
User :   Back to a week he is very very serious.
Doctor :  
ok
User :   he was making noises while breathing
Doctor :  
u can go for surgery as u dont have anyother option left
User :   but now he is some what better in this respect.
User :   He can sleep in night.
Doctor :   yes

Doctor :  
but bullae may rupture anytime...
Doctor :  
one more thing as jis situation is very serious we cannot guarantee 100 percent improvement after surgery
User :   Can you describe me in general term what is wrong with him and what was going to be done.
User :   As I am unable to understand the report of CT scan
Doctor :   some parts of his lung has become dead and later converted into structures simlar to gas bubbles called as bullae ..this part of lung is not usefull
User :   ok
Doctor :  
the basic function of lung is exchange of gases like oxygen
Doctor :  
once enough oxygen is not reaching lungs he will feel breathless
Doctor :  
so the structure similar to gas bubbles can burst anytime which is very dangerous
Doctor :  
but he is not ideal candidate for surgery also as his age is 70 yeasr
Doctor :  
and even after surgery if it is sucessfull he will be free of disease for 3 to 4 years
Doctor :  
and again there are evry chances of he devoloping bullae once again
User :   ok.
User :   What they will do in the surgery?
Doctor :   yes i will explain
Doctor :  
they will remove the bullae first
Doctor :  
with a video endoscope
Doctor :  
At the end of the procedure particular attention is paid to the presence of air leaks. If they are observed, surgical sealants may be applied to cover the holes and reduce or eliminate this complication
User :   ok
User :   And could you plz suggest me any other Dr in Lucknow city as the one we are visiting is from a government hospital and it will become very tough to handle for me as only me and my mother are there and she is of age 65 Yrs.
Doctor :   Instead of resecting the bulla, it can be rolled or folded and plicated over itself placing a stapler at the base. This technique is better performed through an open approach and has the potential advantage of allowing reinforcement of the staple line with the bulla itself
Doctor :   ok
Doctor :  
we will find a good doctor and fix an appointment
Doctor :  
0000
Doctor :  
is this ur mobile no.?
User :   Yes.
User :   But before fixing an appointment kindly let me know bcoz I am not always in the town.
Doctor :  
we will get u back tomorrow morning and we will try to fix an appointment or else atleast we will guide u to which doctor u should meet in lucknow
Doctor :  
is there anything else i can help u?
Doctor :  
are u there?
User :   Can you tell me the estimates for the surgery and the time duration as I will have to take a leave from my company.
Doctor :  
that will be fixed by the cardiothoracic surgeon
User :   ok
Doctor :  
have u filled the feed back form?
User :   yes
Doctor :  
thanku
Doctor :   what time is ok for u so that we can u call u back regarding appointment
User :   Anytime
Doctor :  
ok
Doctor :  
we will get back to u tommorow
Doctor :  
Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to ur service.
User :   Thank you very much Dr.
Doctor :   u are always welcome
User :   Good Night
Doctor :  
bye good night
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