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Suggest Treatment For Breathlessness While Having Emphysema

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Posted on Mon, 17 Oct 2016
Question: treatment for breathlessness caused by emphysema?
doctor
Answered by Dr. Kaushal Bhavsar (9 hours later)
Brief Answer:
You should start pulmonary rehabilitation also.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Sorry to say but your attachment is not opening.
What is this pdf contain?
Your are taking spiriva and advair.
Spiriva is having long acting inhaled bronchodilators and inhaled corticosteroid. Advair is having short acting bronchodilator.
Both are appropriate for emphysema.
If your breathlessness is still uncontrolled then you should discuss with your doctor about starting newer ultra long acting inhaled bronchodilators (indacaterol and glycopyrollium).
Also enroll in pulmonary rehabilitation Center where chest physiotherapy and deep breathing exercises are done.
These will also help you in relieving symptoms.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (15 hours later)
Thanks for the answer.

PT is my father. The un-opened attachment is report of recent CTA showing light emphysema on small region on top of lung. This is a new finding.

At his age, he is already taking various meds for a number of conditions. I do not like to see him getting into more meds unless absolutely necessary (FYI, I'm no doc.) It's my observation that nearly all meds have some side effects. Perhaps if Advir HFA alone can control his symptoms he should stop Spiriva? He is having occasional urinary frequency problem due to his prostate (slightly enlarged,) If he is on one or both meds long term, how badly will his urinary problem be affected according to your opinion?

Thanks.
doctor
Answered by Dr. Kaushal Bhavsar (8 hours later)
Brief Answer:
Better to take spiriva regularly.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, you are right about side effects.
But inhaled treatment is having least side effects. This is because they are devoid of systemic absorption and act directly, locally on lungs.
So no need to worry much for advair and spiriva side effects.
Spiriva is having long acting bronchodilators and inhaled corticosteroid. So they are better ad compare to advair alone.
So it is better to give him spiriva.
And these drugs don't have any side effect of Urinary frequency.
His Urinary frequency is due to prostate only.
So consult urologist for this.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your father. Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Kaushal Bhavsar (11 hours later)
Thanks for the advice. Very useful.

I'd like to know more about pulmonary rehabilitation:

1- His emphysema is moderate, but he is very symptomatic (could be partly attributed to his heart block). Would pulmonary rehab be necessary?

2- He does not drive, neither does he speak English. I have to take time from work to transport him, and act as translator, too. How much time commitment are we talking about for one course of pulmonary rehab?

3- He is one of those people who is not good with body movements, such as a gifted dancer or athlete. How demanding is such rehab on one's abilities to coordinate his/her body movements?
doctor
Answered by Dr. Kaushal Bhavsar (12 hours later)
Brief Answer:
Well, it is very difficult to say this without seeing patient.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Thanks for your kind words.
Well, these questions are difficult to answer because I have not seen and clinically examined the patient.
Pulmonary rehabilitation is not 1 day thing. It needs daily sessions.
So you have to take him daily to rehab center and do all rehab things. This takes almost 2-3 hours per day. And it is continuous process. You have to take him for at least 2-3 months.
So I don't know how much it will be feasible for you.
In my opinion, you should discuss about pulmonary rehabilitation with his pulmonologist or treating physician. I think he will guide you best because he has seen the patient.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (39 hours later)
useful way to gain further info on certain subject . Your own physician seems always rushed.
doctor
Answered by Dr. Kaushal Bhavsar (26 minutes later)
Brief Answer:
Thanks for your kind words.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Thanks for your kind words. I really appreciate this.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your father. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14979 Questions

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Suggest Treatment For Breathlessness While Having Emphysema

Brief Answer: You should start pulmonary rehabilitation also. Detailed Answer: Thanks for your question on Healthcare Magic. I can understand your concern. Sorry to say but your attachment is not opening. What is this pdf contain? Your are taking spiriva and advair. Spiriva is having long acting inhaled bronchodilators and inhaled corticosteroid. Advair is having short acting bronchodilator. Both are appropriate for emphysema. If your breathlessness is still uncontrolled then you should discuss with your doctor about starting newer ultra long acting inhaled bronchodilators (indacaterol and glycopyrollium). Also enroll in pulmonary rehabilitation Center where chest physiotherapy and deep breathing exercises are done. These will also help you in relieving symptoms. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.