Lung reduction and transfer of gases

[ineedair]

Hi, I'm new to this site and desperately want to understand my condition. I am only 43 but i have bronchiectasis, emphysema ( diagnosed at 30 years old) and have been told i now need lung reduction due to gases not transferring properly. My quality of life is declining quite fast now and I was hoping anyone who is going through the same or who has had this surgery could give me some information. Also i have been told of coils inserted into the airways surgically to kerp them open and stop them collapsing but nhs won't fund it, as anyone else heard of this? Thanks for reading and I look forward to any responses

[stone-UK]

Hi

Bronchiectasis is a condition on it's own.

COPD is a umbrella term for chronic bronchitis and emphysema

Read the following page 39/40 explains spirometer readings.

bronchiectasishelp.org.uk./...

Coils and valves are available on NHS subject to being suitable, they are more for emphysema.

[ineedair in reply to stone-UK]

Thanks

[ineedair in reply to stone-UK]

Thanks for the link.. its so confusing although i have a great consultant i often leave with my mind blank

[Hidden]

A dont think do lrs to help gas trasfer .. Think your lung docs being to kind and not being quite homest with you

The good news is not everone gets offerd lrs so you are lucky

Reason i know do lrs is to cut rotten bits of lungs away so you dont keep getting nasty infection or sepsis ect

But is a plus plus you have been offerd it my own lung doc as told me they cant do that for me as its to dangerious given state of my own lungs

As far as lung coils A dont no much about them but they do lung stents for collasping airwsys

[ineedair in reply to Hidden]

I havent been accepted by the team at leeds yet but im told that by removing the bottom half which has the most damage that this will help. Confused.com

[ineedair in reply to Hidden]

Sorry didnt say thankyou.

[itsBAme]

hospitalpharmacyeurope.com/...

[Hidden in reply to itsBAme]

Thats great news about that nintedanib never new was affective treatment for ipf

[ineedair in reply to Hidden]

It could be that ive come away misunderstanding what i was told, all i know for definite is i have infections all the time, my gases arent transfering and im fed up ! Lol All these big words and terms confuse me even more!!!

[ineedair in reply to itsBAme]

Thankyou, good info

[Hidden in reply to ineedair]

Ad try not to worry to much a no can be hard

But doc was right ya infection rate necrosis will cause all sorts of problems breathing problems

If ya was not suitable for lvrs they would not of said out am sure

[johnwr]

Hello ineedair,

Let's see if I can clear up some of your confusion.

It is likely that your biggest problem re gas transfer is inflammation caused by the persistent infection you have that is described as Bronciectasis. This causes additional mucus which hinders the gas transfer by smothering the membranes in the lungs. It also causes swelling of the tissues, which also hinders gas transfer. Emphysema is a condition where the alveolar (the tiniest part of the airways, where the gas transfer takes place) get damaged either by infection or pollution, and eventually destroyed or taken over by scar tissue. As the damage continues, in time this destruction causes the damage at the alveolar to link up, and cavities appear. These cavities are significant because the surface area where gas transfer takes place is reduced. Also there is usually significant conversion to scar tissue which is not as elastic as healthy tissue.

Now let's look at some of the treatments used.

Stents. There are two major types in use. The first are expandable tubes placed in major airways to reinforce them when the damage is such that they cannot hold themselves open. The second are really a type of grommet that is inserted to keep open a hole that the surgeon may cut to give an escape route for air that persistently becomes trapped. This can happen lung become over expanded due to tissue damage, and when the top part of the lung empties, air becomes trapped in other parts, causing discomfort.

Valves and Coils. these are used to effectively reduce the volume of a lung by closing down a part that is badly damaged, so that the rest of the lung can function more efficiently. Valves is the preferred option of the two, but there is a selection process to determine Yes or No. Coils are becoming more of a considered option, but there is still a selection process, but with different criteria than with valves. One major factor is persistent infection, as this is a cause of failure with these procedures, so surgeons are reluctant to put forward patients with Bronciectasis and some other conditions.

Lung Volume Reduction Surgery. This is the next level of treatment. If a patient has lungs that have overstretched to the point that there is no longer sufficient room in the chest cavity for them to operate properly, then Volume Reduction by surgery is sometimes used. This is a keyhole procedure , done under General Anesthetic. Badly damaged sections of the lung are cut away and removed leaving more room for the healthier parts remaining to work in. Many years ago this was an open chest operation, but is now done using two or three small access holes. This means that now recovery happens in days or perhaps a couple of weeks as opposed to weeks or often months.

Lastly, there is transplant, where one or both lungs are removed and replaced by organs from a donor. This is a big operation, done as a last resort, but often with excellent success rates.

Remember that new drugs and treatments are coming into use all the time, giving us a better chance of improvement.

My experience which I have written about in articles on HU I hope gives others hope, knowledge and a direction to follow. (I had valves implanted in Feb 2012. My FEV1 doubled from 16% to 33%. I have managed to retain most of this improvement.

breathe easy

johnwr

[ineedair in reply to johnwr]

Thankyou thankyou thankyou, you're information is clearly explained and as I have read it in my own time rather than being told in a hospital environment where everything is so scary and confusing has helped greatly.

It is also good to hear from someone who has been through surgery successfully. I would be very pleased if you could send me some links to the articles you have written. The information regarding the cavities and alveoli is sounding very similar to what my consultant said, as well as the mucus problems and blocked airways.

Finally I'd just like to add that you taking the time to explain this to me so clearly has made me feel much better today and for that I am ever so grateful.

[ineedair in reply to ineedair]

Just noticed the links below!!!

[Lyn45 in reply to johnwr]

Thank you so much for explaining all this, it has helped a great deal, the doctors have said I can't have surgery to remove my lungs but they don't really explain why not, but you put it in a way which is not frighting, I would like to know if possible how many stages are there, and what to expect, and I expect it not to be pleasant I just need honest answers and you seem to have that combination to explain, I'm sorry if this is a pretty loaded question, I have chronic Asthma with Bronchiectasis with c.o.p.d. That's what they say and the last year I have gone down hill quite fast I'm on max tablets and nebuliser 4times a day I have a constant wheezy chest, if you could explain some things to me I would appreciate it, thank you

[johnwr]

Here are links to some of my earlier articles which may help you

healthunlocked.com/blf/post....?

healthunlocked.com/blf/post...?

healthunlocked.com/blf/post...........?