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Dr. Andrew Rynne

Family Physician

Exp 18 years

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Had sever cough and bronchitis. Took z pack. Have nasal congestion and a mild headache. Chances of lung cancer?

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Practicing since : 1979
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I have some questions regarding lung scarring, lung cancer and a respiratory illness that I have right now. I have been treated for bronchitis over the past month and although I am not getting any worse, I am not over it yet. I am very worried about the possibility of lung cancer because I had a chest x-ray and a chest CT one year ago and it showed a small area of lung scarring. At the time, my doctor told me that it was probably due to a previous respiratory illness that I had. The problem I have now started with what I thought was a cold. I had a sore throat, temperature of 99.2 and a runny nose. A fe days later I developed a cough. The cough got increasingly worse and I would have violent coughing episodes especially during the night, so I was not sleeping well. I would cough so hard that I would gag and a couple of times I actually vomited. The doctor said it was probably bronchitis and put me Z-pak and a cough syrup with codeine (to be used at bedtime). After a couple of days on the antibiotic, I felt a little better and the cough was not as bad. The cough syrup kept me from coughing at night and I was able to sleep. A few days after finishing the antibiotic, the cough seemed to get a little worse and felt like it was mainly in my throat. I also had more nasal congestion and a mild headache. When I coughed it would feel like I was trying to suck in air and sometimes it would be hard to catch my breath after coughing. It also felt like I had a lot of mucus in my throat and I am constantly clearing my throat. I also sound like I have a mild case of laryngitis. My voice will be strong one minute and cracking the next minute. Went back to the doctor and he said that my lungs sounded clear and that I probably had a sinus infection. So he put me on omnicef and ProAir inhaler every 4 hours as needed for cough. I haven't noticed much improvement, except that I don't cough at all during the night. But I had a scare yesterday morning. I actually woke up gasping for air. I tried to cough, but kept gasping for air. It only lasted about 5-10 seconds, but I was a little short of breath afterwards. VERY SCARY! I called the doctor again and he told me to stop the inhaler and he was giving me a nebulizer to use 4 times a day. I have used the nebulizer now for 4 days and have not seen much improvement. I still cough and have that hard to catch your breath feeling and sometimes a gagging/choking feeling also.
I have never smoked although both of my parents smoked and I was exposed to second hand smoke as a child growing up. I have been away from second hand smoke for the last 32 years.
Here are my questions:
1. What is the chance that this could be lung cancer? I am so scared that it is lung cancer.
2. Is this how bronchitis acts?
3. Should it take this long to get over bronchitis?
4. Could the lung scarring I had a year ago, be lung cancer instead?
5. Could this be due to an autoimmune disorder? I see a Rheumatologist for joint pain and he has diagnosed me with osteoarthritis, he is monitoring me for other signs of RA. The last sedrate I had done in October 2012 was minimally elevated according to the Rheumatologist and I know that the sedrate can be an indicator of inflammation. Could this be lung inflammation?
6. I have had episodes of a dry cough off and on for the last few years, but I also have issues with seasonal allergy symptoms throughout the year. Should I be concerned about cancer, emphysema or COPD since I have had a dry cough off and on for the past few years?
7. What is causing the feeling of mucus in my throat?
8. What is happening to my voice?
9. What causes the constant throat clearing?
10. Should I be worried about something more serious than bronchitis?
Here is my medical history:
osteoarthritis, high blood pressure, herniated cervical discs, peri-menopause
Medications include:
toprol, gapapentin, prilosec, naproxen, tylenol, omnicef, albuterol sulfate(nebulizer)
I have asked questions regarding this problem before,, but I am very concerned and scared. I don't want to die of lung cancer. I don't know where to turn or what to do. Any help you could give me would be greatly appreciated.

Wed, 23 Jan 2013 in Lung and Chest disorders
Answered by Dr. Shashi Dangwal 3 hours later

I`ve gone through your query and your medical history in detail. Here are the answers to your queries:

No your symptoms do not appear to be due to lung cancer. You have had a bout of respiratory infection and you are coming out of it. Yes, sometimes it may take a long time to recover from bronchitis, especially the cough may linger.

Your lingering cough and bouts of shortness of breath may be because of a condition called hypereactive airway disease. In this condition, airways become hyper reactive after a bout of respiratory infection and go into spasm on exposure to any irritants or cold and dry air resulting in cough and shortness of breath. Continue nebulization with levolin and budecot 2 to 3 times a day. Take a montair lc at night, aerocort inhaler 2 puffs 2 to 3 times a day and a pan 40, twenty minutes before breakfast. I`m sure you will feel better.

Lungs may be affected in some autoimmune diseases but in your case it appears to be unlikely.

From the description, the lung scar in your case does`nt appear to be lung cancer and may be the result of some old infection which may get reinfected from time to time and may cause symptoms.

Answers to query 6 to 10 are hypereactive airways as mentioned by me above. you are also giving history of having seasonal allergy which reinforces the diagnosis of hypereactive airways.

I would like to advise that do`nt be over anxious. Be under care of your family physician or a pulmonologist.

Take care.
Above answer was peer-reviewed by
Follow-up: Had sever cough and bronchitis. Took z pack. Have nasal congestion and a mild headache. Chances of lung cancer? 6 hours later

I just read your answer. Thank You. I have a couple of more questions.

So, if I understand correctly, this is probably just the bronchitis and I am possibly in the recovery stage of it, even though I still have a cough that makes me feel like I can't catch my breath and I am trying to suck in air. If that is the case, how long will that last? Shouldn't I have seen some improvement by now with the nebulizer (albuterol sulfate) I am using? Also, after I use the nebulizer, I can feel my heart rate increase. Is that a side effect of the nebulizer breathing treatments? After I have a coughing episode, I feel OK until the next coughing episode.

I am sorry. I probably seem nervous. I guess I am. My mom had serious lung disease because of smoking (COPD, lung cancer and eventually heart failure), and I guess I am scared because I was exposed to second hand smoke for such a long time growing up. I have a question about lung cancer in non-smokers. Since I was exposed to second hand smoke for many years, but have been away from it for 32 years, am I still at risk for lung cancer, or does the risk decrease the longer a person is away from it?

I really appreciate all your help!
Answered by Dr. Shashi Dangwal 52 minutes later

Your symptoms do seem like an attack of bronchitis from which you are recovering. Continue nebulization and other medicines that i`ve suggested. You may add another inhaler by the name of seroflo 250, two puffs twice a day. You will improve in due course of time but it is difficult to give an exact time frame. Yes increase in heart beat may be a side effect of albuterol inhalation.

Coming to your second query, i can well understand your apprehensions but presently there does`nt appear to be any cause for concern. The risk of COPD and lung cancer increase proportionately to the no. of cigarettes smoked and the duration of smoking. Keeping that equation in mind, your chances are almost negligible. But it`s not an absolute fact because lung cancers do occur in non smokers as well. However i`ll again say that at present there does`nt appear to be a possibility of lung cancer in your case.
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