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Suggest Treatment For Mild Asthma

Posted on Tue, 5 Sep 2017

Question: I was diagnosed with very mild asthma 3 years ago. In the last few weeks my asthma (or so I thought) has been acting up. I had my pulmonologist appointment and overall, the news was good. My breathing is normal and I have no wheezing. However, he sees something on the chest xray and wants me to have chest CT to rule out bronchietasis. He didn't want to discuss it in detail. But if I had bromchietasis, wouldn't I be wheezing or have somewhat below normal breathing? What are the symptoms? I do have clubbed nails. Could something else be involved? Lung cancer? What are the lung cancer symptoms? He did not seem very concerned. He seems to think my recent problems has to do with allergies and I am now on Flonase

Answered by Dr. Dr. Jolanda (1 hour later)

Brief Answer:
please do the chest CT

Detailed Answer:
Hello and welcome to HealthcareMagic,

I can understand your concern,

Sometimes in bronchiectasis especially in localized one, there is no specific sign and symptom and a normal lung function too. It might be your case

In bilateral bronchiectasis, the patient has a chronic wet cough with or without breathlessness, sometimes bloody sputum and in most cases low lung function.

In lung cancer, the signs and symptoms vary from chronic dry cough, blood in the sputum when the cancer is localized in the airways. If it is away from them than chest pain might be a symptom. However, there are patients free of symptoms too.

Clubbing is a sign of chronic usually lung diseases that should be screened with chest CT. But cardiac problems cause clubbing too.

So I'd recommend you to do the chest CT with contrast and after having the result we can discuss again on it further.

Regards and feel free to ask me again

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Jolanda (22 hours later)

My doctor said the clubbing might be inherited. Does that mean the shape of the finger nail is inherited and there is no potential disease, or did he mean clubbing is inherited and and where there is clubbing is a disease? That is, I inherited the disease?

Answered by Dr. Dr. Jolanda (9 minutes later)

Brief Answer:
Continue discussion

Detailed Answer:
Hi again,

If we exclude by examinations all other diseases which may cause finger clubbing then the last one is the inherited clubbing.

We cannot say it is inherited without prior evaluate several diseases.

I mean if you don't have any other causative factor for clubbing than you may have inherited it

Hope this info helps you. Feel free to ask further.

Regards

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Jolanda (33 minutes later)

Thank you for the fast answer and your help. He told me to take Flonase, since he thinks most of my problems seem to be allergy related. But that is a steroidal inhaler, and if possible I want to stay from it. But instead I want to use Mypurmist, a rather advanced steam inhalation device that is said to be very effective against allergies. I used it 3 years ago after an extended bout of bronchitis and it seemed to do wonders. Do you have any reservations about using a steroidal inhaler?

Also, about an hour after I lay down to go to sleep, I choke on and then spit up a great deal of mucus. (Not every night, but frequently.) Is that a symptom of some kind of bronchial problem (i.e, bronchiectasis) or could it be allergy related? (which is what my dr. seems to think) Hi Dr. J.
Although my fingers are clubbed, my pulse ox is 98% (read from a fingertip pulse oximeter). Is that a good sign? (I need some good news.) Thank you.

Answered by Dr. Dr. Jolanda (24 hours later)

Brief Answer:
continue discussion

Detailed Answer:
Hi again,

Yes, this is a good sign for the lungs.

However, if your doctor has said that nothing problem with your lungs don't worry so much because he knows your clinical picture better.

And the clubbing you most likely have inherited it.

Regards
Dr.Jolanda

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Jolanda (2 hours later)

Thank you for your quick reply. I really appreciate your help. I took the chest CT today and I am very nervous as I might have had asbestos exposure doing a home project 8 years ago.

But one more question about clubbing. After researching the tests for clubbing online, I see that when I do one of the tests, I still have the XXXXXXX window between my index fingers. Does that potentially mean I do not have clubbing, and all of the worrying has been for naught?

Answered by Dr. Dr. Jolanda (5 hours later)

Brief Answer:
continue discussion

Detailed Answer:
Hi

Usually asbestosis appears after 20-30 years of exposure.

There are three grades of digital clubbing.

It depends on what grade is your clubbing.

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Jolanda (13 hours later)

Hello again. One last clubbing question. I did some more research, it looks like my nail can be moved indicating advanced clubbing. Can advanced clubbing be inherited? Or does an indicate a serious health issue and I should be prepared for a bad report?

Answered by Dr. Dr. Jolanda (3 hours later)

Brief Answer:
continue discussion

Detailed Answer:
Hi again,

Yes, a severe(advanced) clubbing might be inherited.

But the severity of clubbing may or may not be directly related to the severity of the health issue.

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Arnab Banerjee