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Breathing problem started after spinal surgery. Diagnosed with COPD. Started gaining weight. Treatment?

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Practicing since : 2009
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I am having an issue with a breathing problem which I acquired 5 - 6 months after having spinal surgery for a crushed spine. I had quit smoking as well. I came home from the hospital in a shell(upper body cast) to get well and wasn't feeling well one day. Went to the ER at hospital and while sleeping had an episode of respiratory failure. They decided to keep me overnight and then found that my oxygen would drop down sometimes and decided to send me home with oxygen for at night while sleeping. I did that and then I ended up as time went by withine a couple of months needing the O2 at all times. I don't seem to need the O2 while at rest or when sitting though. Only if I am walking or busy. I know that I have lost 6 inches due to my spinal surgery as I had osteosporosis severly and between that and the spinal injury lost the 6 inches in height. Like I said, I am doing well, walking well, eating well, and getting back to my old self which is great however, now I am needing this O2 which is not making me very happy but full of anxiety which is awful. I love life and living and would like to get back to my good ole self which I am doing all except for this breathing thing.They did diagnose me as having COPD after having the surgery but I wasn't having any problems at all before the surgery either. I could get breathless at times but not like this now. I have to have an inhaler of Albuterol and use it every 3-4 hours or I am gasping for air. It is awful. I did noticc that when I came home and from my injury and all that I had gotten down to 100 pounds and was 100 pounds when I came home from the hospital. It seemed as if I noticed that this problem started to occur when I had finally put some weight back on. Could it be that from loosing the 6 inches in height and then finally gaining some weight back that my lungs got pretty tightened up in there and now the lungs cant expand the way they are supposed to? Could this also be the reason for the wheezing at times? I am desperate for help. I have grandchildren and would like to get back to doing some of the things I love to do with them if it will ever be possible again. Thank you for your help, I hope you can help. I gave up smoking in hopes of a better life but it doesn't seem as if I am being rewarded very kindly.
Posted Sun, 5 May 2013 in Asthma and Allergy
Answered by Dr. Arnab Maji 6 hours later
Thanks for your query
See you are suffering from exertional dyspnea. You were a smoker. You have wheezing. Wheezing is always suggestive of obstructive airway diseases like asthma or COPD. Asthma is rare possibility because you dont have such symptoms previously though there is an entity called adult onset asthma. The chance of having COPD is more in your case because you were a smoker and you have dyspnea along with wheezing. You didnt mention about your cough and expectoration. You need to have a spirometry with bronchodialator reversibility dont to diagnose COPD conclusively.
Another possibilty is there. Because of your spinal surgery you may have some nerve injury which are causing weakness of your respiratory muscles that is causing exertional dyspnea and most notably it can be unilateral diaphragmatic palsy or paresis. You need to have undergone measurement of maximum inspiratory pressure and fluoroscopy or USG-B scan of your thorax to visualise diaphragmatic movement to diagnose repiratory muscular problem.
So visit an eminent chest specialist, get yourself locally examined and go through the investigations mentioned by me to have a diagnosis because proper diagnosis and management can give you relief.
Hope, my information will be of help to you. If you have further queries you can write back to me.
Wishing you a quick recovery.
Dr Arnab Maji
Above answer was peer-reviewed by
Follow-up: Breathing problem started after spinal surgery. Diagnosed with COPD. Started gaining weight. Treatment? 35 hours later
I am pleased with your answers to my questions, you have given light to some of my thoughts as well as eased some of my fears. I was having severe anxiety just about going to the doctor out of fear that they were going to just tell me that I was going to die. You mentioned that with proper diagnosis and management I could possibly find some relief. That didn't seem so CRUCIAL! I guess I was thinking the worse. Maybe it is because I found out the worse when it came to my spinal condition after my accident. I avoided the doctor then as well out of fear and it cost me a bit. I feel good mentally and would like to continue to live positively like I have in the past but am finding out with age that you start to realize that time gets shorter and that is scary as I enjoy so much the "art" of living as they put it, lol! Seriously tho, on another note now that I have quit smoking is it possible to get better and do well or should I fear the worst with this breathing problem? When you refer to seeing a chest specialist are you referring to a pulmonologist? Are these tests that you mentioned invasive tests?
I have been avoiding going on this Zoloft medication for anxiety just to get to the pulmonologist/chest doctor out of fear. I occassionally have a serious anxiety attack in regards to this and the wondering of what it is that is wrong but I don't want to take any drugs if I can help it. I am trying to be strong about it and deal with it because I have learned that this is more of a fear thing than anything. Do you think it is necessary to get through this? This may be a hard question to answer and I respect any advice you may give. Thank you so much for your time and answers. I very much enjoyed your response and quick reply. My regards, I was very pleased. I would like to eventually let you know the outcome if you would like after seeking help for this problem. I also wanted to comment to your comment in regards to the fact you mentioned to me that I didn't mention anything about a cough or expectoration or coughing up stuff. I do not have a cough and never really ever did have a cough and I also very rarely coughed up anything when I did smoke nor do I now cough or otherwise cough up anything much. What I do cough up now is very very little sputum that is yellowish and very very sticky, so sticky that it is indeed hard to get it coughed up. I relate it to the Albuterol that I inhale by an inhaler. I don't do this if I don't use the inhaler but when using it occassionally but very little do this cough up sputum and not much either. I also have to use my inhaler every 3-4 hours as I said now and am scared what would happen if I didn't have it. I have to have it. If at rest though I don't need it like i SAID JUST like the O2. Thanks so much Dr. Maji I look forward to your response.
Answered by Dr. Arnab Maji 29 hours later
Thank you a lot for your queries.
I am referring you to a pulmonologist. All the tests prescribed by me are non-invasive.
If your diagnosis is proved to be COPD then yes, effective treatment is there to control your disease. You need to have then not only albuterol rather long-acting bronchodialator, inhaled corticosteroids and anticholinergics by inhalers in a proper dosage schedule along with pulmonary rehabilitation and non-invasive ventilation if needed to enhance your quality of life.
Again if its the disorder of respiratory muscles there are pulmonary rehabilitation programmes and several other means which are usually available in a good pulmonology set-up to improve your daily living standard undoubtedly.
Therefore you should not be afraid, rather you should go for these investigations first followed by appropriate treatment to enhance quality of life.
If you have futher queries dont hesitate to write back to me. If you are happy with my answer then kindly write a review on this answer.
Wishing you quick recovery.
Dr Arnab Maji
Above answer was peer-reviewed by
Follow-up: Breathing problem started after spinal surgery. Diagnosed with COPD. Started gaining weight. Treatment? 9 days later
Hello Dr. Maji, I was most pleased at your recent reply. Each and every time you have made me feel more confident about reaaching out to a pulmonologist and if anything this has been the hardest thing for me to do as a result of the anxiety that it was causing me. I thank-you for that! I was automatically assuming the worst and the starting to think of nothing but my death and dying a horrible one at that!
I am setting an appointment up with a pulmonologist to seek medical help for my problems. You have made it seem as if there is definitley some help available for my condition. I have never been a person who suffered from any kind of depression until this problem and all awhile I was feeling so full of life yet on the other hand I was becoming so depressed at the thought that there was no hope for my condition and that I was facing a downhill struggle for the rest of my life. Basically the negative feeling was killing any positivity that I was having and that downright saddened me. I am glad that I sought you out and paid for this review as your advice has certainly given me so much more hope. I will if you would like me to get back with you to let you know of what it is that I learn from my experience as I feel when working together with others there is much more communication involved this way and much more to be learned or something learned by someone that may be beneficial to someone else who is experiencing similiar problems or such. COMMUNICATION is KEY! I am a firm believer in this!
I feel confident enough to seek out the pulmonologist now and in time will get back with you with word of my journey and findings. Thank-you I am most grateful for your help. Good day.
Answered by Dr. Arnab Maji 46 hours later

Thanks for your appreciation.

Yes, communication is the key.

Keep me posted and let me know about the Pulmonologist's consultation and about anything that you wish to discuss here with me.

Wish you good health.

Above answer was peer-reviewed by
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