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Have Inhaled Stone Dust Syndrome. Should I Be Concerned About The Feeling Of Inflammation In The Lower Part?

Posted on Mon, 10 Jun 2013

Question: hey Dr. I left you alone for a bit. i did talk to another Pulmonologist on here. He said, he strongly believes I have acute silicosis symptoms. Not the actual disease but just the symptoms. I am not sure if that is good or bad to hear. he said it is "inhaled stone dust syndrome XXXXXXX and i should heal up in time.

Is it true that maybe Drs just dont want to tell me I have acute silicosis, because it is so bad?

My chest does still feel improvements a little bit everyday. It seems to have ebbs and flows. LIke, it changes daily, the different pains and tightness. But it seems to be getting better overall.

Should I be concerned about the feeling of inflammation in the lower part, under the front of ribcage still?
Also, I had that intense feeling of inflammation in my entire lungs when this all originally happened. Can that just be RADS? It seemed pretty intense.
Also, if I hit my chest in the center a little bit, it has a vibrating feeling for like ten seconds. Do you know what that means?

Thanks

XXXXXX

Answered by Dr. Gyanshankar Mishra (23 minutes later)

Hi,
Thanks for posting your query on XXXXXXX After going through your query, I would like to comment the following:

1. Considering the high amount of silica concentration in the inhalational dust, silicosis is a possibility. But your investigations were completely XXXXXXX I believe that you were symptomatic in the 1st 24 hours of dust exposure but noticed it at a later stage. Since your lung morphology and physiological functions were not affected, the disease will definitely heal within 1 years time.

2. Dust exposure does lead to chest heaviness initially which you describe as "vibrating feeling".

3. You are on your way to healing. All your investigations are normal.

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 : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (49 minutes later)

Yes, I do remember feeling kind of weak and tired the first 24 hours.

I guess only time will tell how this goes. I guess if it is a possibility of silicosis, then i just have to accept that. I was beginning to understand that anways.

Can Rads have a major inflammation in the entire lung region? and even a feelings in the lower lung region now still? It seems its more of an airway disease. Mine seems to have affected my entire lungs.

The vibrating feeling is what I am noticing recently. Its only when I hit my chest, a little hard with my hand. It makes a vibrating feeling in the center of my chest for only like several seconds. I wonder what it could be? It feels like my chest wanting to come back to life after all the dust.

Also, I think i am understanding the dry and whistly sound when i exhale with my chin down. It could be called Stridor? It is getting better but still there.

Answered by Dr. Gyanshankar Mishra (3 hours later)

Hi,
Thanks for the follow up.

1. A dry whistling sound is wheeze and it is seen in more of an airway disease like RADS.

2. You need to take your inhalers regularly and get pft test monitoring at regular intervals. If you feel that these sounds are not controlled on medications then please visit you doctor once again and the dose of inhalers will have to be increased with addition of an oral bronchodilator.

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
3. It will take time to heal. Do wait for 1 year to complete.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (2 days later)

hi Dr.

I think I am feeling better. The heaviness is pretty much gone. I still have the tightness. It feels deep in my lungs around the ribcage and back. My breathing seems like it is getting better. Not really shallow anymore.

It seems if I think week to week, instead of day to day I can notice the improvements. I hope that I am not just getting used to this disease tho.

I talked to a respiratory therapist and he thought I was getting out of the latency period for acute silicosis. He thought because of the shorter exposure, a shorter latency period? Like in the next two months?

Do you think It will heal very slowly like this for the entire year?

Also, It seems to be discomfort when I drink either hot or cold beverages in my upper stomach area. Do you know what that could be?

Thanks,

Answered by Dr. Gyanshankar Mishra (1 hour later)

Hi,
Thanks for the follow up.

1. Its good that the symptoms are resolving.

2. A substantial relief of symptoms will be appreciable at the end of one year.

3. There could be associated Hyperacidity (GERD). You could start an antacid in consultation with your doctor. Avoid too hot or cold food. Avoid staying empty stomach for more than 4 hours in the day.

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
4. One important point. You can conside flu and pneumococcal vaccine in consultation with your doctor.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (9 hours later)

I uploaded the material safety data sheet of the inhalation product.

I probably should have left and researched this thoroughly four months ago. I did call the company after someone warned me of silica. The lady that answered the phone told me it was a small percentage of silica. ha.

We were just a nice couple that wanted new flooring, and never thought this could all happen to us. Now I feel like every Dr. in the country and now even India is watching me to see if it is humanly possible to walk away from this.

Thanks again for everything

Answered by Dr. Gyanshankar Mishra (2 hours later)

Hi,
Thanks for the follow up.
The best that we can do at this moent is regular follow up with inhaled and oral medications. You are on your way to healing.

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (5 hours later)

So what do you think? I still have some chest tightness. and real dry cough but only voluntarily. I do get really tired at times. I am in a constant state of rest it seems. I just nap and lay around, go for short walks once or twice a day. I feel it is best for me now. I do not really want to go out in public now either. I feel ok overall tho.

Do you think I should ask for a bronchoscopy or lung biopsy to confirm silicosis already? Maybe a tb test or skin disease test? Have you ever encountered acute silicosis? It sounds like it is hard to diagnose, different symptoms with different people.

What do you think about the lag time? maybe my exposure was short enough that I will have a shorter lag time like the respiratory therapist told me? He thought another month or two and no other major symptoms, i should be clear.

Thanks

Answered by Dr. Gyanshankar Mishra (6 hours later)

Hi,
Thanks for the followup.

1. You are clinically improving.

2. Bronchoscopy is only required if diagnosis does not explain the clinical feature or if there is no response to treatment. I do not think that it is required at this stage since you are improving.

3. TB test not required but the policies change as per countries.Also clinical features do not support a diagnosis of TB currently.

4. Regarding the lag time, I suggest observation for a period of 2 years and if by the end of 1 year if you are symptomatically improved, then you should be alright.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar