Lung Disease

Are there any good surgical options to treat emphysema?

DEAR DOCTOR K: My mother has severe emphysema. Medication and oxygen therapy aren't helping much anymore. Are there any good surgical options?

DEAR READER: Emphysema is a long-term lung problem that makes it harder and harder to breathe as the disease progresses. It is often grouped together with chronic bronchitis under the label of chronic obstructive pulmonary disease (COPD).

I have COPD, how can I improve the quality of life?

DEAR DOCTOR K: I have COPD. My doctor is great about prescribing medication, but he doesn't give me much other advice. So I'll ask you: What can I do to improve my quality of life?

DEAR READER: There's a lot you can do. And I have to admit that not all doctors are very good about telling you how your actions can protect your health. First, some basics. Chronic obstructive pulmonary disease (COPD) refers to a group of disorders that damage the lungs and make breathing increasingly difficult. Common symptoms include a mucus-producing cough, breathlessness, rapid breathing, wheezing, tightness in the chest and fatigue.

Why do I need to have another pneumonia vaccine?

DEAR DOCTOR K: I'm 70 years old. I already had a pneumonia vaccine, back when I was 65. At my checkup last week, my doctor said I need to get another one. Why?

DEAR READER: I always like to hear that adults are staying up to date with their vaccinations, as you did when you received a dose of the PPSV23 (Pneumovax) vaccine at age 65. Pneumovax helps protect against pneumonia caused by one common type of bacteria, called pneumococcus.

What does pulmonary rehabilitation involve?

DEAR DOCTOR K: My doctor has recommended pulmonary rehabilitation for my COPD. What will this involve?

DEAR READER: COPD stands for "chronic obstructive pulmonary disease." This group of disorders damages the lungs and makes it increasingly difficult to breathe. Common symptoms include a mucus-producing cough, breathlessness, rapid breathing, wheezing, tightness in the chest and fatigue.

What are pulmonary nodules — can they cause lung cancer?

DEAR DOCTOR K:I saw my doctor because I've been getting short of breath. He did an X-ray and CT scan that found three small "pulmonary nodules." Do I have lung cancer?

DEAR READER: There are few things more frustrating, for both you and your doctor, than when the doctor says: "Well, it's almost surely nothing to worry about ... but there is a small possibility that it's bad." How often does that happen? Pretty much every day, in my experience.

What does positive reading on a Mantoux test mean?

DEAR DOCTOR K: My 6-year-old just had a positive reading on her Mantoux test. What does this mean?

DEAR READER: Doctors perform a Mantoux test to see if someone may have been exposed to bacteria that cause tuberculosis (TB). TB is a bacterial infection that typically infects the lungs. Fortunately, in most people exposed to the bacteria, TB never develops.

As a longtime smoker should I be screened for lung cancer?

DEAR DOCTOR K: I'm a longtime smoker. Do I need to be screened for lung cancer even if I don't have any symptoms?

DEAR READER: Until recently, my answer would have been "no." In the not-too-distant past, screening of people without symptoms -- even smokers who were at high risk -- was judged useless for lung cancer. That's because screening for lung cancer involved using standard chest X-rays, and they produced too many "false positive" results: They identified "spots" in the lungs that were harmless.

What are the health effects of secondhand smoke?

DEAR DOCTOR K: My husband smokes. Is secondhand smoke really as dangerous for me as I've heard?

DEAR READER: When I first became a doctor, very few people thought that secondhand smoke affected your health. I was one of the skeptics. It just seemed like the amount of smoke you take into your lungs when you smoke is so much more than when you are with a smoker.

What is a pulmonary function test?

DEAR DOCTOR K: My doctor thinks I may have asthma. He wants to do a pulmonary function test. What can I expect?

DEAR READER: Pulmonary function testing examines different aspects of how your lungs function. During the test, you will breathe in and out through a tube that is connected to various machines. A test called spirometry measures how forcefully you can inhale and exhale while taking as large a breath as possible. Give this test your best effort. You can skew the results by not trying hard.