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Suggest Treatment For Mild COPD

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Posted on Mon, 6 Oct 2014
Question: For pulmonologist

I have what i thought was mild COPD. This past week i have undergone several events that has my portable hand held spirometer values down to 1.95 L at times. My last readings before the events were up 30-35 points.

I had an exacerbation last week. Went to ER sob and fever. Diagnosed mild patch of pneumonia, given prednisone and antibiotics. Felt ok. Was scheduled for day surgery on bladder a few days later so they took another cxr and it was now a slight patch. Doctor and anesthesiologist cleared me for surgery, all vitals were good. Surgery itself went well for purpose, but i was told that had a bromchospasm during it and oxygen went down to 85. Got it back up to 96 before i was sent home. Myusual oxygen is about 97, sometimes 96-98. This all was very scary to me.

My portable spiromter may not be the most accurate. But i find that i am having a hard time getting a number much higher than 2.11, usually lower. My oxygen earlier was 98 but now fluctuating to 94 at times. I am very concerned that my lung function has been severely damaged by pneumonia and anesthesia, or it is unmasking poor function? I am not sob, i feel ok.

I cannot get into see a pulmo dr for a couple of weeks. In the meantime do you think the pfts will get higher after pneumonia and anesthesia? Should they be better by now? This all started with sob 1 week ago.

Thanks for advice.

doctor
Answered by Dr. Drkaushal85 (3 hours later)
Brief Answer:
exacerbation in COPD decreases FEV1 and FVC.

Detailed Answer:
Hello,

Thanks for your question on HCM.

As a rule , lung fuction tend to decrease especially FEV1 and FVC , with every exacerbation. That is why COPD treatment is mainly focusing on preventing exacerbation , rather than complete cure. And the decrease in FEV1 and FVC are permanent.

Infections are the most common cause for exacerbation. So prevention of infection should be given atmost priority. I suggest you to take adult respiratory vaccines ( pneumococcal and Influenzae) for preventive care, after consulting pulmonologist.

And home spirometer s are not so accurate. So you should not completely rely on it. And lung function takes atleast 1 month to improve. Start chest physiotherapy, Deep breathing exercise and consult your pulmonologist and get done Spirometry. Also ask him about vaccination.

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. Raju A.T
doctor
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Follow up: Dr. Drkaushal85 (11 minutes later)
Please tell me more about bronchospasm. When that heals does it not improve lung function? Dr told me that the fev1 etc should improve after healing. I do not know much about bronchospasm. Also that it occurred during surgery.

I always get the flu shot and getting it this week. I had pneumonia shot about six years ago so perhaps get another soon.
doctor
Answered by Dr. Drkaushal85 (24 minutes later)
Brief Answer:
Bronchospasm is the cause for decrease in FEV1.

Detailed Answer:
Hello Mjmhayes, Bronchospasm is constriction of bronchi due to any cause. It can be due to infection, surgical stress, not taking treatment properly etc. So bronchospasm is the main thing causing decrease in lung function. As I told you, this will take atleast 1 month to improve. But with every exacerbation, lungs are getting weak further and so some decrease in FEV1 is permanent.
And about vaccination, flu vaccine is yearly and pneumococcal is every 5th yearly. So consult your pulmonologist for vaccination schedule.
Hope I have solved your query. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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Suggest Treatment For Mild COPD

Brief Answer: exacerbation in COPD decreases FEV1 and FVC. Detailed Answer: Hello, Thanks for your question on HCM. As a rule , lung fuction tend to decrease especially FEV1 and FVC , with every exacerbation. That is why COPD treatment is mainly focusing on preventing exacerbation , rather than complete cure. And the decrease in FEV1 and FVC are permanent. Infections are the most common cause for exacerbation. So prevention of infection should be given atmost priority. I suggest you to take adult respiratory vaccines ( pneumococcal and Influenzae) for preventive care, after consulting pulmonologist. And home spirometer s are not so accurate. So you should not completely rely on it. And lung function takes atleast 1 month to improve. Start chest physiotherapy, Deep breathing exercise and consult your pulmonologist and get done Spirometry. Also ask him about vaccination. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.