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CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness

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i had a ct scan and it said i have a few spots of infiltrates on upper right lung. I had a really bad experience two months ago, in which someone installed porcelain tile floors in my home, and they cut a bunch of them in the basement. a lot of the dust came upstairs and i was trying to clean it up over a few day period. It was alot of dust in the air and it got so cold out, i could not hardly open the windows. i am afraid i breathed in a lot of it over that time. i did not even know anything about silica or anything.
My chest is still somewhat tight after two months, with some pain deep in my chest when i take a really deep breath.

Do the infiltrates mean pnemonaicosis? and could it turn to silicosis in the future?
The doctor wants me to return in six months for another ct scan and pft test. i have not had a chance to talk to him, only the nurse relayed the results to me.
Posted Sun, 5 May 2013 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 54 minutes later
Hi,
Thanks for posting the query on XXXXXXX After going through the query, I would like to comment the following:

1. You seem to be suffering from chest tightness. You had a histoy of porcelain dust exposure 2 months back. You CT thorax shows right upper lobe infiltrates.

2. If you do not have any symptoms other than chest tightness like cough, breathlessness or fever then please do not worry much.

3. The right upper lobe infiltrates could be due to a variety of causes which could be either infective or non infective.

4. Such short term exposure does not lead to pneumoconiosis/ silicosis. Rather the possibility of hypersensitive pneumonitis is there. In absence of any other symptom observation needs to be done.

5. Additional investigations that may be of help are bonchoscopy and PFT along with blood counts.

6. I suggest that you get yourself evaluated in detail with a Pulmonologist.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 1 hour later
ok. They gave me Budesonide inhaler, and it does seem to help. I did take a pft test and it showed only slight lower on the exhale. The doctor said a bronchoscopy was not necessary last week, but may change his mind after the CT scan is now showing infiltrates.

How much more time can the chest tightness last for?

what does infective or non infective mean, with the infiltrates?

Could all that dust give me COPD now in life?

It was so stupid of me to try and clean up that dust by myself, and my girlfriend was not willing to leave the house. She says she is fine, but my exposure time was more and we even slept in the bedroom thinking that it was not in there also.

The dust did not bother me for the first two days, but after the third day my chest felt full with a very bad dry crystal sounding cough. But it only seemed to be a voluntary cough. I kept trying to cough, thinking that i was helping it come up.
 
 
Answered by Dr. Gyanshankar Mishra 7 hours later
Hi,
Thanks for the follow up.

1. Budesonide inhaler will help reduce any associated airway inflammation in your case which could have been caused by the dust exposure.

2. If the chest tightness is due to the recent episode of dust exposure then by 6 to 8 months it should subside.

3. The causes of right upper lobe infiltrates could be infective or non infective. Infective causes include infections by bacteria, TB, etc. Non infective causes include RADS (Reactive airway dysfunction syndrome), Hypersensitive pneumonitis, etc.

4. Such short term exposure is not likely to give rise to COPD.

If your doctor is not insisting on bronchoscopy then he is probably thinking on lines of non infective causes.

Please do not worry.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 17 hours later
ok, this will be my last query. thank you for being very helpful.

The reason I am worried is just the amount of dust that was in the house, and the length of time we spent it there. I kept thinking that the dust was almost gone. It was almost one week before i finally left. It was not bothering me for the first three days, and then I felt like my chest was full of crystals, and then it felt hollow after maybe one week. That lasted a week or two and then I felt like i was in toxic shock. I felt like I almost died, and should have been hospitalized. I am still afraid to return to my home even though my girlfriend says it is all gone now.

1. will this tile dust eventually clear itself out of my lungs? and what happens to the silica that it is in there?

2. It has been two months, and when I do cough, it is dry and non productive. should this be a concern?

3. What about the dust that was ingested otherwise, and my other organs like my liver and spleen? could they be at risk now for some sort of cancer?

4. Is there treatment available for lung regeneration. Like stem cells or injecting t cells?


I want to think that I am getting a little bit better everyday. I hope this becomes only a bad chapter in my life. It is funny that you are from India because all the medicine that i acquired on my own for this is Jaggery sugar and tulusi in a pill. I hope they are helping also.
one last thing. What about scarring in my mucosa epithelium? it sounds hollow still when i exhale.
 
 
Answered by Dr. Gyanshankar Mishra 6 hours later
Hi, Thanks for the follow up query. After going through the query, I would like to comment the following:

1. will this tile dust eventually clear itself out of my lungs? and what happens to the silica that it is in there?

- At this moment it cannot be predicted if the infiltrates are the dust particles or the body's response to the dust inhalation. However such lesions due to acute exposure do reduce with time.

2. It has been two months, and when I do cough, it is dry and non productive. should this be a concern?

- In cases of reactive airway dysfunction syndrome such features are seen. They should normally resolve by 6 months to 1 year.

3. What about the dust that was ingested otherwise, and my other organs like my liver and spleen? could they be at risk now for some sort of cancer?

- Such acute exposure is not a proven risk factor for malignancy. Generally long term exposure is associated with malignancy.

4. Is there treatment available for lung regeneration. Like stem cells or injecting t cells?

- Currently stem cell therapy is in its very early stages and not proven in such situations.

5. What about scarring in my mucosa epithelium?

- In cases of acute dust inhalation some amount of mucosal injury of the airways does happen. It heals with time. You need to take the prescribed inhaled therapy regularly to help with its anti inflammatory effect.


I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 24 hours later
ok, i promise this will be my very last query. I appreciate your feedback very much, and promise to give you a great review either way.

ok, so lets say i was in the house for 16 hours a day for a full week, with alot of tile dust for almost the entire time as cleaning it proved to be more then i expected. We then left for one week. I then went back for almost one more week and some residual dust still in the house. I felt I was not going to get better, but worse and left for good. I mentioned before that we did sleep there too. I know i was breathing it in when i was asleep. I dont know how this all happened. i thought it was like sand and knew nothing about silica and kept thinking i could clean it up. My ignorance is now haunting me.


I just want to know if there is, even a small chance that these three patches of infiltrates could turn into nodules or silicosis in the future? like honestly, 1%, 5%, or more % of a chance? Please be honest if it is possible. six months for my next ct scan is a long time. and then five years or more until the possibility diminishes is even longer for me to worry. but i want to know so i can live life honestly and plan for my future.

Thank you for everything. I will choose you in the future if i use XXXXXXX again.


 
 
Answered by Dr. Gyanshankar Mishra 3 hours later
Hi,
Thanks for the follow up query. After going through the query, I would likes to comment the following:

1. You seem to have had a short term heavy exposure of dust.

2. For the development of pneumoconiosis it normally takes years of exposure.

3. If your infiltrates are due to RADS (Reactive airway dysfunction syndrome), then they should subside by 1 year. The chances of them persisting for a long time is somewhere about 5 to 10% i.e. there is 90 % chances of them subsiding.

4. Please avoid any further dust exposure and continue the medications as advised by your doctor. Inhaled medication definitely help.

It was nice interacting with you.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 45 hours later
Hi Doctor, I suppose i have some more questions. Im depressed on how my life has become. This is the only thing that is helping me feel better. I suppose I should tell you, that i am 36 year old male and pretty healthy otherwise. I did smoke for several years, but quit 10 years ago, but just occasionally smoked until this happened to me about 2 months ago now.

My pulmonologist here says that I should expect a full recovery. Does that sound realistic? You mentioned one year symptoms with the RADs?

My breath feels hollow and dry feeling. I also noticed that when i breath in steam or cold air it seems to stay in my lungs for some time until i really blow it out.

I do feel like I am getting better everyday, but it is so small, it is hard to tell if i am actually getting better or my body is just getting used to this condition. Which is the tight chest and back of lungs. And hollow breath with feeling of dust deep when I cough.

How long shoiuld i use the Budesonide inhaler? My xyphoid process seems enlarged and sore to the touch also?

thanks



 
 
Answered by Dr. Gyanshankar Mishra 8 hours later
Hi,
Thanks for the follow up query. After going through the query, I would likes to comment the following:

1. Keeping all the issues aside the most important facet is psychological health. Please DO NOT feel down under any circumstance. If required please do not hesitate in taking help of a Psychologist/Psychiatrist for his assistance in letting you feel good at all times.

2. Your Pulmonologist is expecting a full recovery and that's very good news since he is the one who has examined and evaluated you clinically and since your diagnosis is linked to a temporary dust exposure, there are all chances that the lesions should be reversible.

3. Budesonide needs to be taken till you get completely better.

4. If there is some inflammation on your xiphoid process please get it examined by your Pulmonologist. A simple inflammation should respond to anti inflammatory medications. Also sometimes sleeping in prone position leads to such symptoms.

5. If every day you are feeling better then that again is a good news. That you have left smoking speaks a lot about your moral character as it is not easy to quit smoking.You need to continue abstinence of smoking in the future.


There is no reason that you need to feel down.
Wish you a speedy recovery.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 13 hours later
Well, i am worried because my doctor did not really even examine or evaluate me much, besides listening to my breathing briefly. I do not think they appreciate how much dust i breathed in over that week.
Any sane or rational person would have just left, checked into a motel and reevaluated the situation. My girlfriend would not leave, and i did not want to leave her. Now I am sick and I am afraid my dog is too. She said she is fine, but i was the one trying to clean it up. It seemed like it was getting cleaner after the first two or three days, but i dont know. It was just so fine dust and seemed to be more.

I am worried also that the original doctors only gave me a rescue inhaler and pensodine. and it took six weeks for them to let me see a pulmonologist and get a steroid inhaler.
Maybe I passed a time window that would have helped me heal better if i could have gotten a better steriod inhaler in the beginning?

Also, do you know why my exhale seems shallow and hollow? and should that get better with time?

Do I have much to worry now about this and the effects on my heart, or my overall health for the rest of my life? If my lungs heal up, will they be ok when i get older.

I have a friend in thailand that wants me to move there next year and teach english. i want to drive to india from there if i move. what an adventure!

 
 
Answered by Dr. Gyanshankar Mishra 11 minutes later
Hi,
Thanks for the follow up query. After going through the follow up query, I would like to comment the following:

1.You had received a course of systemic steroid and are currently on inhaled steroid. That should not worry you much as they will help in relieving the inflammation.

2. That you were an ex smoker seems to be causing the slight decline in lung functions as ex smokers do have a slightly lower lung function than healthy individuals.

3. Right now there is no reason for you to worry regarding possible systemic effects including the ones on your heart since your lung involvement is not that huge to cause such such effects.

4. A change of environment is a nice plan.


I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 36 minutes later
I am an ex smoker, but my breathing was never this bad before this incident. Do yo u think it can return to normal still? or at least get better? People on the phone say i sound asthmatic. you said six months to a year for the chest tightness and six to eight months on the for the dry cough? So in about six months I should feel normal? or close to normal?

Is there any type of vitamins or herbs or other medicines that i can take to help my lungs?
 
 
Answered by Dr. Gyanshankar Mishra 4 hours later
Hi,

Thanks for the follow up. After going through the follow up query, I would like to comment the following:

1. As an ex-smoker you are definitely at a risk of having a decreased lung function as compared to a non smoker of your age. You can search online and have a look at fletcher peto chart which helps in understanding this concept.


2. If the lung infiltrates are related to RADS, then by 6 moths to 1 year you should be symptomatically alright.

3. There are no scientifically proven supplements. All though you may take multivitamin and anti oxidant supplements which are supposed to boost the immunity.

4. Rather chest physiotherapy in consultation with you Pulmonologist should help you.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 21 hours later
HI, Doctor. sorry to keep bothering you.

So if i am symptomatically alright, that means no symptoms, but I could still have underlying affects?

I still dont understand why my breathing seems dry and hollow on the exhale?
Would the CT scan show if my mucosol epithelium was damaged?

So what if some silica entered my lungs? can my lungs handle some of it? i heard it dissolves with time?

Do you know how long it takes for fibrosis to occur after a heavy exposure to that sort of dust? If my next CT scan is in six months and it looks good or even better, and I am feeling better, then does that mean i am in the clear?
 
 
Answered by Dr. Gyanshankar Mishra 4 hours later
Hi,
Thanks for the follow up query. After going through the query, I would likes to comment the following:

1. If you are symptomatically alright then you are on a way to recovery. Since your Ct scan has lesions, it will take time to heal.

2. Mucosal injury / airway injury is not usually visualized in detail on CT scan. Bronchoscopy is the investigation to visualize these defects. Breathing problems are mostly due to airway injury in RADS.

3. Yes the lung macrophages try to drive these particles out.

4. Fibrosis may develop in 6 moths to 1 year at the minimum.

5. If there is resolution on next CT scan it definitely means that you are improving.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 18 hours later
hi Doctor,

It seems my outlook was better at the beginning of our dialog.

So do you think i have a chance of having fibrosis? would that be the interstital fibrosis?

I just hope I have Rads and six months to a year i should be normai, but i am worried about chronic conditions.
 
 
Answered by Dr. Gyanshankar Mishra 3 hours later
Hi,
Thanks for posting the follow up query. After going through the query, I would likes to comment the following:

1. If at all you have fibrosis it will be localised fibrosis and NOT interstitial fibrosis. It might be a simple fibrotic scar.

2. The chances of you developing fibrosis are very low and hence please do not be worried about chronic conditions at this stage.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 16 hours later
HI Doctor,

So it takes six months to a year minimum to develop fibrosis? Do I need to have chest x rays or ct scans for the rest of my life to keep an eye on it, even if my symptoms go away?

What about all the dust that I inhaled. Does it find a way out of my system? or eventually cause tissue damage? Can the macrophages do anything with inorganic matter?

My chest felt like it was on fire and hollowed out at like the second week. I just wonder if it is still tight chest now or lack of lung function?

I started using a nebulizer about two weeks ago, and it is helping more so then just the inhaler. I dont know how long I can afford to keep using it but im going to try for awhile longer, and then just the inhaler.

I am sorry to keep asking questions. I just want to know these things. I feel so much shame, guilt, and anger everyday for what happened. I just want this to be a bad chapter in my life and hopefully get better and have a normal life again.

Hopefully I can move to Thailand, drive to India someday and you can give me my final clean XXXXXXX of health in person. I would like that very much.

Thanks,
XXXXXX
 
 
Answered by Dr. Gyanshankar Mishra 3 hours later
Hi,
Thanks for posting the follow up query. After going through the query, I would likes to comment the following:

So it takes six months to a year minimum to develop fibrosis? Do I need to have chest x rays or ct scans for the rest of my life to keep an eye on it, even if my symptoms go away?

ans: Yes on an average a minimum of 6 months to 1 year are required for fibrosis to dvelop. Medical observation and follow up for an initial period of 2 years should suffice.

What about all the dust that I inhaled. Does it find a way out of my system? or eventually cause tissue damage? Can the macrophages do anything with inorganic matter?

Ans: Short term dust exposure gradually heals with time. It is only the long term exposures which leave a long lasting impression. Macriphages are defence cells and their function is to remove any organic or inorganic foreign molecules form the lung tissues. Also the particles are gradually removed via respiration route over a period of time.

My chest felt like it was on fire and hollowed out at like the second week. I just wonder if it is still tight chest now or lack of lung function?
Ans: If your Pulmonary function tests were almost normal and the CT showed only localised disease then please do not worry.
You have suffered from RADS and it is very less likely to lead to long term effects.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 46 hours later
Hi Doctor,

I am feeling a little better everyday it seems. the tightness seems to be much less. i do have a little dull pain in the center of my chest when i take deep breaths. my chest also feels like it is more expansive since this happened. Like maybe its all swelled up on the inside.
My airway seems hollow and dry. Should i try and convince the doctor here to do a bronchoscopy? i am worried about scarring in my airway and maybe i should know what i have going on? i dont know if there is even anything they can do now but?
 
 
Answered by Dr. Gyanshankar Mishra 37 minutes later
Hi,
Thanks for the follow up. After going through the query, I would likes to comment the following:

1. Please trust your doctor since he has clinically evaluated you.

2. The management of inhaled therapy has already been initiated for anti inflammatory action. Also pulmonary function tests have been done.

3. Since you are feeling better, that's a good sign.

4. Let your doctor make the decisions. You should relax and please do not worry. Things seem to be on the healing path.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 1 hour later
I just feel like you know more then he does about me. and he really did not evaluate me much. Im also afraid they are holding back treatment because i do not have insurance.

So you really think I could heal up back to normal? People with RADs end up healing like it never happened?

I guess you are right. i have no choice but to try and be optimistic. I just dont want to give my self a false sense of hope. do you see situations like this? workers that work long days around this kind of things and then quite and heal up? or other lung healings?

ok, ill let it rest for awhile after this query.



 
 
Answered by Dr. Gyanshankar Mishra 3 hours later
Hi,
Thanks for the follow up query. After going through the query, I would like to comment the following:

1. RADS patient do heal very well. Recently I had 4 patients from a factory with few hours of exposure and they were asymptomatic after 4 days.

2. There is very less chance of developing fibrosis and even if it develops it will be localised. So even the least possible possibility is not that severe.

3. Ethically No doctor should hold back on treatment whatever be the cause.

4. I will once again advice you to please not to worry.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 3 days later
Hi Doctor,

I just wanted to followup and ask about the bronchoscopy? Can they remove particulate matter using this, and is it too late now to do that, with it being over two months?

I am going back to another pulmologist on tuesday and trying to convince them to give me a bronchoscopy. I just want to know what to expect and not get my hopes up if it is too late to remove and debris in my bronchi.
 
 
Answered by Dr. Gyanshankar Mishra 35 minutes later
Hi,
Thanks for the follow up.

Bronchoscopy is not for therapeutic indication. It may diagnose any associated bronchial inflammation. It is the reason I have said before that - The treatment recieved by you is optimal. At most another bronchodilator or oral steroid may be added.

You seem to be worrying a lot.
Please do not worry and relax.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 12 hours later
ok, i will try not to worry so much. Its just I feel like i had such a unique experience. Even ppl that work around the stuff for years, are smart enough not to sleep in the house with it. I feel like i was so traumatized from the experience. It hurt to breath for the first six weeks, until I got the steroid inhaler. When I initially left the house my body felt like it was in toxic shock so bad, my face was twitching.

And then to make matters worse. My dog seems very ill. I took him to the vet initially and he tested positive for lymes disease. They gave him an antibiotic for that, and said it would help for particulate matter regarding the dust. So he never got oral steroids until about a week ago. I have been giving him my steroid inhaler for the last few weeks tho.
He feels so tight in his chest and back and breathing seems deep when he sleeps. He doesnt seem the same, and i hate watching him suffer. I hope their is still a chance for him to get back to being healthy.

Do you really think that crystal sound when i try and cough will go away someday?
And then It sounds like Darth Vader with asthma when I have a deep exhale?

Other then that, I feel like I am maybe 85% back to normal. It feels like it is a little heavy in my lungs when i lay down.

 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Hi,
Thanks for the follow up.

You seem to be on the road to improvement. The breathing problems should subside by 6 month s to 1 year if RADS is the etiology. 6 monthly monitoring of PFT should also help.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 2 days later
hi Doctor, I was just wondering a couple more things.

I heard there is metals in the tile dust i inhaled. Does that also cause scarring in the lungs?
Does that get into the blood and make its way through the brain and have an effect on it?

thanks,
XXXXXXX
 
 
Answered by Dr. Gyanshankar Mishra 4 hours later
Hi,

The main content is silica. Metals are present in very miniscule amount. The main potential content for fibrosing lungs is slica. Brain damage with such short term exposure is not expected.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 15 hours later

Hi Doctor,

The company that make the tile told me its a small amount of silica in it. i am not sure tho. The person must have used a type of grinder cutter to make such a large amount of small dust particles.
I seen a another pulmonologist today, and he said I will be fine. He looked at my xyphoid but did not say anything about it. They took another xray and pft test. Said the xray looked good and did not tell me about the pft yet. I felt better today when i woke up, but i think it was that pft test that tired me out, and my lungs are pretty tight again.
I want to ask how long the dust can be in my respiratory system before it turns to fibrosis? Like in my bronchi?
The pulmonologist does not think i need a bronchoscopy. I am still worried about scarring because of my dry cough and hollow feeling exhale. I hope it can heal with time and return to normal.
I am also worried that maybe everyone is telling me i will be fine because there is nothing really else they can do or say.
I took my dog to the University of Wisconsin Veterinary yesterday and they took an xray and said it looks like his Bronchi has inflammation. Can the Doctor see that on a human Xray? They made an appointment for him to get a bronchoscopy tomorrow morning. I can not believe it is so easy for him to get one but nobody wants to give me one?
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Hi,
Thanks for the follow up.

1. Now after clinical opinion from a 2nd Pulmonologist you should be assured.

2. Xray was normal is a good sign.

3. By 6months to 1 year your symptoms should subside.

4. Bronchoscopy may not be required after your clinical examination since it was only for diagnostic purpose and there seems to be no other differential diagnosis than RADS at present.

5. Veternary health quality care and human health quality care do differ a lot.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 6 hours later
So how can I tell if the tightness is from the alkaline or turning into lack of lung function and becoming chronic?
 
 
Answered by Dr. Gyanshankar Mishra 17 minutes later
Hi,
Thanks for the follow up,
At this moment, you just need to follow up and medical observation is the best medical strategy.
You need to continue your medications.

Only follow up scans along with symptomatic improvement will help us know the resolution of the disease.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 10 hours later
Hi Doctor,

I am sorry to keep bothering you but, I am now more research on the dust, and it seems that what they used was a grinding tool that creates particles 100 nano meters or .1 micron in size. That means that it was very respirable and all went down to my lung sacs? I keep talking to concrete guys, but that is not as small of substance. concrete dust is 10 microns.
I think my lungs are damaged badly for life. I am afraid that i can never have a normal life again.
Does this change everything? all my prognosis?
 
 
Answered by Dr. Gyanshankar Mishra 7 hours later
Hi,
Thanks for the follow up.

The inspired dust was definitely respirable dust. But a single short term exposure will not lead to severe pulmonary function damage as you are thinking. The chances of developing fibrosis in near future is minimal. Remeber fibrosis is one of the body's ways of healing.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 53 minutes later

I was there for week with most of the dust been cleaned up after maybe after the third or fourth day. Is that still considered single short term? Everyone else accept for the idiot i hired does it outside.
I am reading that concrete particles can get very fine also, and I talk to guys that say they spent hours in rooms with it all over in the air so maybe i will be ok.
So this contintued tightness in my chest and in my back. It almost feels like it is in my lower back. This is because of the alkaline still or my lungs healing? I can imagine i inhaled millions and milliions or those particles. At what point does the avioli just get overwhelmed? And maybe now i have only a fraction of avioli that i used to have? The rest are filled with metals, clay and silica and dead?



 
 
Answered by Dr. Gyanshankar Mishra 3 hours later
Hi,
Thanks for the follow up.

Exposures less than 2 weeks are generally considered short term. Do not worry about you alveoli throughout life time they are exposed to numerous dust particles. If there was any abnormality, then the lung function tests shouls have picked it up i.e major obstruction of either the major or the small airways.

You do not have any major symptoms at present is a good indicator of your prognosis.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 16 hours later
Hi Doctor,

I am sorry that I am dragging this querry on. Its just now that i know about fine particles vs course particles. I feel like whatever little hope I had is now dissapearing. I was in there breathing that fine dust for days. I thought maybe it was like construction dust that would settle and maybe i would cough some up later. Now i know why it was not settling and why I have never coughed up any.

So does this change my prognosis? Can i still get better in six to twelve months? Is there still a chance that I can get back to normal and have a somewhat healthy life?
I do want to feel like I am getting a little bit better everyday. But my chest and back is still tight. Maybe I am just getting used to feeling this way....
Now I know that the fine dust did make it deep into my lungs. The cilia can not move it out?
What happens to it in the lungs?
I am guessing there are probably trillions of the particles in my lungs.
The likelihood of all sorts of cancers and heart disease?
thanks,
XXXXXX
 
 
Answered by Dr. Gyanshankar Mishra 2 hours later
Hi,
Thanks for the follow up.
The dust particles are slowly removed with time by ventilation or by other biological process. You do not have any major chance of developing lung cancer or heart disease due to such short exposure.

In all probability, you will get better within 6 months to 1 year.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: CT scan showed few spots of infiltrates on lung. History of porcelain dust exposure. Experiencing chest tightness 13 hours later
Hi Doctor,

I keep reading fine particles have no way of being removed from the body or lungs.
I know you are the Doctor, but I am so worried and losing all hope about my situation.
They said that i passed my pft test, but i was trying so hard to blow and it hurt at the same time. My lungs and my lower back are still so tight. It gets tighter after i try and take a few deep breaths.
Do you honestly think that I can heal from this?

ok, I will leave you alone for 3 months after this.

thanks,
XXXXXX
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Hi,

There are 90% chances of healing at the end of 6 months to 1 year. Do remember that chest xray did not pick up any infiltrates , it is only the ct that showed infiltrates. This means that infiltrates are less. PFT is normal. PFT normally takes the maximum effort out of a person, hence normally you do feel a tired after pft.

Please do not think that all the 100% dust that you inhaled went into your air sacs and your body has no process of expiration!

Most of the fine particles that are capable of settling in lower airways are the smallest in size and hence the lightest of all the particles due to their smallest size hence only few of them are deposited in a short duration of time. Being so fine they continue to float in air on inspiration as well as expiration. Dust particles that have bypassed your defence system including nasal conditioning, hairs, moisture of respiratory tract, cilia of respiratory system and finally the macrophages, it is only a minute proportion of the dusts that can breach all these defences and still be heavy enough to be deposited in the small alveoli and also be the smallest ones!

Why do we cough after dust exposure? It is because of chemoreceptors in the airways and the moisture and cilia that have entrapped the dust particles cough them out with expectoration! Nature's protection!

At present, I see chances of you healing are more and realistic.

Even if a local fibrous scar XXXXXXX comes in the upper lobe, it shouldn't make much of a difference since the XXXXXXX should be very localised if at all it appears and should not hamper your lung functions.

Even if any normal individual undergoes a ct scan there is a fair chance of a fibrous XXXXXXX on his ct , most of the times as a result of some previous healed lung infections.

Do not think that you will have extensive lung fibrosis to the extent that your lung functions will be severely affected and influence your breathing.

Thus you need not worry.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist

Above answer was peer-reviewed by
 
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