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Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise?

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Pulmonologist
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Hi Dr. I went away for a few days. My lungs seem to feel better. The Dr noticed they sound really dry. I am worried that continues dryness may lead to permanent damage. Also worried about my Nicosia epithelium and if it regenerate s?

Posted Tue, 28 May 2013 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 2 hours later
Hi,
Thanks for posting the query on XXXXXXX After going through the query, I would like to comment the following:

1. Its nice that you are feeling better.

2. I am not sure what it meens by "lungs sound dry" but if there are no adventitious sounds then its ok.

3. Remember all our body part has the ability to heal themselves including mucosal epithelium.

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: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 19 hours later
I feel like I have come a long way from my initial sickness. I had such a tight chest with intense pains. I felt like I was in toxic shock also. then restricted breathing with pains which felt like they were in my kidneys, liver, and spleen.
I just Hope that I continue on this healing path. there was just so much of that respirable dust. I feel like I was breathing it in for days. I could barely see it. It is hard to believe that I can walk away from this and have a normal health again.
I keep reading that xray and PFT can show normal in acute silicosis? Maybe I should get a TB
?test
As of now, a still somewhat restricted chest and ribcage. It feels like the dryness wants to loosen up when I make myself cough. A little dull feeling in the center of the chest when I inhale
 
 
Answered by Dr. Gyanshankar Mishra 5 hours later
Hi,
Thanks for the follow up.

1. In absence of symptoms of TB, a TB test is usually not recommended in such acute cases.

2. Continue incentive spirometry and Inhalers.

3. You symptoms are declining is a good news.

4. Follow up as advised in prevuious posts is required with your doctor.


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: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 45 minutes later
Yes, I feel like my bronchi has cleared itself out for the most part. My lungs feel weak and restricted still. I Hope I continue on the healing path and it improves all the way, and not take a turn for the worse.
 
 
Answered by Dr. Gyanshankar Mishra 4 hours later
Hi,
Thanks for the follow up.

Yes, the natural course of the lesion is to heal itself. Your symptomatic improvement is a good sign.


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: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 12 hours later
I am just trying to understand. When this initially happened, my lungs felt very inflamed and a hollowed out feeling. Then six weeks later I had the CT. The Dr says there was no sign of inflammation. Is it possible for the inflammation to go away in six weeks? It still felt inflamed when I did the CT.
It just bothers me because I feel as if the Dr does not believe my symptoms. And he thinks there's nothing wrong me. Its been over three months and I still have chest pains when I take a deep breath. I guess there is nothing more he can do. I just wish he could understand what I went and going through.
Also, I had blood work done last week, and they said everything looked fine. I am having what seems to be periodic pain where my kidneys should be. Would that show already on the blood work if something was wrong with my other organs?
Also, what do you mean when you said acute silicosis does not manifest in a year, it manifests at the first clinical sign? From what I understand, it can manifest from a few weeks to five Years after the exposure?
I am just worried that my symptoms will go away in the next month or so and then the acute silicosis could start?
 
 
Answered by Dr. Gyanshankar Mishra 9 hours later
Hi,
Thanks for the follow up.
1.     Your normal ct scan is due to the fact that there is no morphological change or damage as a result of the dust exposure episode. Yes in six weeks minor inflammation if any produced as a result of the dust exposure episode , does heal.
2.     Your investigations are fine.
3.     If you have pain in abdomen then it can be investigated in consultation with your doctor. If kidneys are involved then usg abdomen, kft and urine examination should pick it up.
4.     Regarding acute silicosis – in absence of any morphological (normal ct scan) or physiological changes(normal pft), it is unlikely that you are suffering from acute silicosis since any one of them needs to be altered in acute silicosis.
5.     Also your symptoms are on a decline.
6.     You need for 1 year for significant and near complete resolution of symptoms.


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: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 10 hours later
ok, I understand. I just keep reading that it can take up to five years for it to manifest?

Is it possible for these initial symptoms to get better, but I could still be in done sort of latency?

Its been over three months, and it seems like it is moving out my bronchi and even lungs. Do you think it would have passed through my other organs already? The blood work last week said my liver and kidney panel looks fine, but maybe it takes time for it to have affect?

Again, I am sorry that I keep bothering you. I just feel so uncertain with my health. Is it really possible that I could have such heavy exposure to a fine dust, become as sick as I did and not progress to acute silicosis? IM just finally done suffering with my symptoms. I don't want to go back to suffering again
 
 
Answered by Dr. Gyanshankar Mishra 2 hours later
Hi,
Thanks for the follow up.

1. It is extremely unlikely for you to progress to a disease severity that you are worried of.

2. Currently there is no morphological or function damage to lungs or any other organ. It is again unlikely from now onwards for such a lesion to happen.

3. Normally after such a heavy exposure symptoms like your are seen and they gradually subside.

4. Your symptoms have a very unlikely chance of recurrence. So no points for worrying.


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 Pulmonologis
Above answer was peer-reviewed by
 
Follow-up: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 1 hour later
Ok. Thank you so much. I am going to go and get my life back. I still have tight in my back lungs deep. Its just all I read about is how XXXXXXX that stiff is with so many opportunity for disease. I want to live in Asia again and don't want to worry about TB.
I Hope you are right, but you have been so far. I am healing up finally. I can't believe it.

Thank you again for being here for me.
 
 
Answered by Dr. Gyanshankar Mishra 5 hours later
Hi,
Thanks for the follow up.

1.You are feeling better is a good news.
2. You can live in Asia. It does not mean that anyone living in asia gets TB disease.

Wish you a healthy 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 Pulmonologis
Above answer was peer-reviewed by
 
Follow-up: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 23 hours later
Ha! I just meant that I am reading that I am now three times more likely to get TB now because of my exposure. It seems that maybe TB is a little more prevalent in some parts of Asia.

So if I had blood work done two weeks ago, and everything looked normal, including kidneys and liver. Now the last week my kidneys seem sore.
Do you think I should get those additional tests done, or should the blood test have picked it up?

Thanks

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

1. I do not think that you have kidney involvement at present. Yes some local cause like small kidney stone could be there if you are having symptoms. Investigations need to be done in supervision of your treating doctor. Drinking plenty of water will help in flushing toxins out of your kidneys.

2. Yes 1/3 rd of population in India is infected by TB but that is not TB disease.

Wish you a healthy 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 Pulmonologis
Above answer was peer-reviewed by
 
Follow-up: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 21 hours later
Hi Dr.

I just wanted to ask if you think it will be six months to one year from the time of the incident, or from now?

Also, If I do heal up and live longer will the silica dust eventually disolve and be ridden from my body, or will it stay in my lungs, lymph, and other organs for the rest of my life?

I still have that dry cough down deep in my chest. i find myself trying to cough a few times a day to clear it. It feels like it is getting better, but still no mucous or clearance. feels and sounds dry also. Is there anything I can do or take to help clear that out? Should i not be trying to cough?

I do feel like I am healing tho. I can take deep, pretty smooth feeling breaths, even while lying on my back and only an occasional small pain.

Also, How much longer do you think I should wait until my next xray or CT scan? I have the other CT scheduled in September, but maybe I should wait longer?

That is an amazing statistic about one thirid of the population of India having TB. So they are like carriers only of TB?
I have always wanted to go there. It sounds so ancient and mystical.
I also kind of have a pain in the upper chest when i try and cough. And it feels like a vibration in my trachea or something.

Thanks,

XXXXXX

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

1. It will take 1 year from the initial episode of dust exposure so far as significant symptomatic improvement is concerned.

2. A duration of 1 year between the 2 CT scans is usually recommended. In between, If required xray chest can be done.

3. The dust should not have any residual effect on your body after complete healing.

4. You just need to do chest physiotherapy (incentive spirometry) and continue your medications.

5. Population infected with tb means that they have been exposed to infection. It is not the disease. Even after childhood vaccination for TB(BCG) one becomes TB infected as it is an artificially generated acquired infection for protection from TB 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 Pulmonologis
Above answer was peer-reviewed by
 
Follow-up: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 8 minutes later
Ok, thanks Dr.

Do you have any advice for the dry cough? How to loosen and remove?
or just give it time?
Also, should be concerned that the tightness extends to my lower lungs. Like on the base of my ribcage, and around the back?
Hi Dr.

I realize that I have to get a grip with this. I have just always had my health, and I am only 36. Its been really hard for me, as you know. I do not want to lose the opportunity to consult with you on occasion, I realize I have to stop bothering you everyday. This has been the only thing to keep me going and have hope. You know all my details, and regardless what I have been through, you keep telling me that I will be ok again someday.
I have been making progress so I have to be patient and just wait and see.
 
 
Answered by Dr. Gyanshankar Mishra 12 hours later
Hi,
Thanks for the follow up.

1. As I have said regular follow up is very important.
2. For dry cough, a cough suppressant syrup or tablet or cough lozenges can be taken in consultation with your doctor.
3. Do continue the rest of treatment. Inhalers and incentive spirometry along with breathing exercises is required.
4. Also do not take stress. This is not for assurance but is medically important for your quick 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 Pulmonologis
Above answer was peer-reviewed by
 
Follow-up: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 18 hours later
Hi Dr.

So i am reading about the respiratory epitheleum. I really feel like mine has been damaged.
It must be why it is still so dry sounding. Its been over three months. Do i still have a chance for it to repair? And is there any additional treatment? I read about a linoliac acid medicine in a nebulizer? or a type of t cell therapy?

It sounds like i will be hindered as far as defence against disease now?

Thanks

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

1. Respiratory epithelium takes time to heal.

2. There is currently no proven therapy to accelerate it.

3. Continue the inhalers, incentive spirometry and respiratory exercises. You should increase intake of fresh fruits. Anti oxidant- vitamin supplements may be of some help.

4. I would suggest frequent PFT monitoring at regular intervals. If any drop is there at any time then a more aggressive approach can be planned. In severe cases systemic steroids (For anti inflammatory action) can be started for long term but they are not without side 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 Pulmonologis
Above answer was peer-reviewed by
 
Follow-up: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 1 hour later
How much time for the epithelium to heal? Maybe in the year time frame?
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Hi,
Thanks for the follow up.

Yes 1 year is sufficient time.

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 Pulmonologis
Above answer was peer-reviewed by
 
Follow-up: Lungs sound dry, dryness may lead to permanent damage. Have Nicosia epithelium. Advise? 37 minutes later
So, i should not be concerned about those symptoms residing still?
It sounds as if maybe I should be concerned.
I do feel improving week by week tho. I do not know what I want to hear. I guess you already told me many times to not worry. I just read about healing times being shorter in respiratory epithelium.
But, if you still think its RADS, and i have a good chance to heal up?

Thanks,
 
 
Answered by Dr. Gyanshankar Mishra 21 minutes later
Hi,
Thanks for he follow up.

1. If the symptoms are on the decline, then you should not be worried.

2. There is good chance that you will be completely symptomatically releived at the end of 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 Pulmonologis
Above answer was peer-reviewed by
 
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