I have just had a troubling chest x-ray after experiencing ongoing coughing and a nagging pain in the center of my chest for the past year. Doctor kept passing it off as allergies or mild asthma, but I persisted for a pulmonary consult. Now, no one will follow up with me for a minimum of 2 months because they want me to take a pulmonary function test and a CT before they give me a clue what is wrong.
I’m a non-smoker, 56 year old female, and aside from breathing in a heavily polluted city, I exercise regularly have no unhealthy habits. Two years ago I had Covid and I coughed up blood once. It has never happened since. My chest x-ray results state:
No pleural effusion, or pneumothorax. Hazy opacities in the upper lobes. Mild nodular areas possible. Mild upward retraction of the hila. Right perihilar bronchial wall thickening. Lung hyperinflation.
Ill-defined hazy opacities upper lobes, uncertain etiology. Inhalational disease is a possibility in addition to infection. Comparison with any prior imaging/history would be helpful. Further evaluation with chest CT recommended.
I’m thinking COPD, especially with the lung hyperinflation. Anyone have a similar diagnosis? I’m afraid to even think what the nodules are. The hazy upper lobes make me think lung cancer though, and I can’t believe they’re making me wait 2 months to shed any light on this. I’m very afraid.
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SmogDweller
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First I should like to welcome you to this forum. It is friendly, funny and hugely supportive but none of us are doctors. So we cannot offer diagnoses. However, we are curious and usually well-informed. I am very interested in your case. Now, I am about to go out on a limb: I noted that you have had Covid. And coughed blood. Hmmm…. I really shouldn’t say this but I think your medical team should be looking at the long term effects of that.
I think you may need a CTPA scan to look at any vascular damage and a MRI, possibly with Xenon gas, to assess the airways damage. Your profile does not say where you are. US? I am happy to continue the discussion on the private messaging system.
Thank you so much for your reply. I realize that no one can offer a diagnosis, just wondered if anyone had a similar finding on their tests. The doctors won’t tell me a thing and it seems that doesn’t bode well. I’m in lower Manhattan, came here for my husband’s work 20 years ago and was always worried about the health effects of living here, especially after the Twin owners came down. There’s so much cancer and lung disease here.
When I went to my GP he made light of my symptoms and kept assuring me that it was probably allergies or mild asthma. I had to go to a new doctor to get a referral to a pulmonologist, but even he was in doubt that anything was wrong. They were both surprised by the positive chest x-ray, but still I have to wait a month to take a pulmonary function test and a CT. Meanwhile, I’m afraid to go outside and breathe in more pollution. I’m afraid to exercise. I wish they could give me at least a little guidance. I understand that they’re likely afraid of being sued for saying the wrong thing (malpractice insurance is sky high gets), but still, it seems like they could at least tell me what to avoid doing.
Thank you for getting back to me. I guessed you were in America. Pulmonologist is a dead giveaway. We in the UK call them respiratory consultants. How interesting to live in Manhattan. I have a friend who is married to a BBC correspondent. She loved the time they had in New York. Culturally very vibrant. Please keep us informed about how things develop with you.
Welcome to the forum. I am sorry you are being left in suspense, but it sounds as if they are giving you a very thorough once-over. Try not to worry too much. There are a lot of conditions which could cause your symptoms, some of which can be managed and lived with. I hope if they suspected cancer they would have called you in for testing a lot sooner. Best of luck.
Thank you so much for your encouraging words. I know. It could be anything. Unfortunately, I spent two years as my parents end of life nurse and I watched both succumb - my mother to ALS, COPD and thyroid cancer, then finally an aortic aneurism. My father died from COPD and an aortic aneurism. It was the most heartbreaking experience of my life to watch them lose the ability to breathe. Now, I find that there’s such a thing as genetic COPD. My mother was a heavy smoker and I went to the opposite extreme - non-smoker, vegetarian, enthusiastic exerciser. But, I guess it wasn’t enough. Moving to a highly polluted city has taken its toll, as had Covid, which had me coughing up blood. I’m pushing my husband to move us to a place with healthier air.
I'm sure your life style must be helpful. Moving to a cleaner area would certainly make a big difference. I get asthma type attacks by busy roads, even in our small town, so I sympathise. I hope you won't have to wait much longer.
There are several lung diseases SmogDweller including a genetic deficiency which can predispose a person to COPD. When I was under investigation I would have bitten off the hand of whoever offered me a full LFT and CT scan. The scan can show so much more than an x-ray. Pollution does play a part in lung health as I know to my cost (brought up in West London, pipe smoke constantly in the home, London smogs & I had undiagnosed asthma). Working environment can play a part too. It can take a while to get a diagnosis - especially in UK- so its very frustrating I know. You will get there. Let us know what the CT scan shows & results of - and a warm welcome to you.
Thanks for replying to my post. I was so emotional when I wrote it. The craziest thing was, as I sat in the hospital waiting for my chest x-ray I was reading a magazine in the lobby. The article was about the singer Donna Summer, who had lived three blocks away from me in lower Manhattan before she died of lung cancer in 2012. She blamed her cancer on living here on 9/11. My husband When I got my chest x-ray results it gave me chills - the article had detailed “hazy opacities in her upper lungs” - the exact wording on my x-ray.
My husband and I bought our condo here, right down the street from the World Trade Center, a month before 9/11. He had a new job and no where else to go here, so even though we lived next to a giant pit (the former World Trade Center), which proceeded to burn toxic chemicals non-stop for the next two months, at least. We were dumb. We should have left.
I have found something that really helps me breathe better, even so far - I make smoothies with a bunch of vegetables and fruit. It really seems to bring down the inflammation. Green tea, too. I hope you will be able to quit the pipe smoking - I know, it’s very hard. It does make it very difficult for your lungs to regenerate, though. I hope it all works out well for you.
Heck what a story SmogDweller, the twin towers must have been a pretty emotional place to live near as well as toxic. I cant wait to hear what the consultant says on Saturday. Good luck(ps 🤣 it wasn't me smoking a pipe, it was my my stepfather. He used to blow smoke into our faces to watch us choke thinking it funny. I was three. It put my sisters & I off smoking for life).
Thank you so much! I didn’t think it would make me feel much better, but I have been surprised how much better posting here has made me feel. It’s so scary, especially when waiting for a full diagnosis, when you’re not sure what will make your condition better or worse.
Thank you very much, Izb1. It’s so nice to have a place to get medical feedback and just plain emotional support during a health scare. I hope things are going well for you!
I have opacity, several nodules as well as hyperinflation. They have been doing follow up CT scans for the last three years and so far these have all been stable. Apparently nodules are fairly common and can be caused by infections/previous infections. They are also apparently common among ex-smokers and most of the time are not serious. If they grow over time then they need to be further investigated. The CT scan may provide more on the nodules. At least they are doing additional tests to investigate these issues. It may be associated with COVID, the pollution you have dealt with for years or something else
Thanks for replying to my post! Do you know what’s meant by opacity? I guess I jumped to conclusions that it was cancer. My mother smoked three packs a day, indoors, when I was growing up. I stupidly continued the family tradition, smoking a pack a day from ages 16-21. I quit at 21 and completely changed my life by moving to the country, becoming a vegetarian and exercising every day. I assume the lung nodules are from my stint of committing suicide by cigarette. The rest is from living in highly polluted NYC.
What brought you to request your first CT? Did you have heart pain or breathing problems? The very first thing I noticed was in January 2021, when the doctors here were refusing to see anyone who didn’t have active Covid. I woke up in the middle of the night spitting up blood and was afraid, since both my parents died of aneurisms, that this was what I had. I was afraid I was going to die in my sleep, and it was six months before I could get a single doctor to see me. He dismissed it as nothing.
I have since learned that the sars cov-2 virus itself can cause myocarditis, which can manifest as viral-initiated congestive heart failure and water on the lung. I wonder. But, I’ve scared myself so badly by pouring through radiology websites and comparing chest x-rays, so I guess I will leave it alone for now, for my own mental well-being. I hope all remains stable with you and hopefully, the lungs will begin to mend themselves.
I’m not really sure what is meant by the term opacity. I specifically asked but didn’t really get a direct answer, just that there is opacity. It is just the way it is is kind of how he answered the question which really didn’t tell me much of anything. It didn’t really seem to be of any concern and was just a comment that that is what was seen. I know there have been others that have had the same issue and have opposed here over the years. I honestly don’t recall what prompted the first CT scan, or if it was a routine screening given my history of COPD, but given the findings they said they would do follow up CT scans every six months to monitor the nodules, but so far so good after I believe 3 years of scans things have remained stable.
I hope your situation will be similar and stable.
Take care and let us know when you have had additional testing or appointments. If you get a better explanation of the opacity or nodules I’ll hope you’ll share it with us.
I still haven't a diagnosis from the pulmonologist, but my family doctor read my last CT report and said it was pulmonary fibrosis. I don't know why the pulmonologist hasn't given me any actual diagnosis yet, but imagine she is just being really careful. I only see her every 6 months and have an appointment coming up in June. I've been seeing the pul. doctors for a year and a half and have been told I needed oxygen from two other doctors for about 2 years now. Just got my oxygen in March for night time only. That's when my sats go down to the lower 80's. It's lower 90's during the day without exertion.
Thank you so much for responding to my post. It seems you are the same limbo as me, not really sure what the full problem is. It’s so scary. It seems premature for your doctor to assume it’s fibrosis - do you have a family history of this disease? Doctors are so careful now, afraid of malpractice. Have you had a full pulmonary function test yet? That is the next step for me. Do you do any type of breathing therapy or just the oxygen? Do you see a respiratory therapist? I keep flashing back to when I was taking care of my parents with COPD. The hardest part is the not knowing. I hope that you are able to get a firm diagnosis and good care. Best of luck.
I have COPD emphysema, this showed up in a CT scan, I also have chronic pulmonary Aspergillosis and aspergillioma ( mass in lung). Opacity in X-ray is common and very often just indicates an infection, bronchial thickening and coughing blood are symptoms of Aspergillosis. This is a rare disease and often overlooked by doctors who very often never see a case. Normally diagnosed after lung cancer and TB have been ruled out, I think most people in the US have to see an infectious disease doctor before they get a diagnosis. Possibly some to raise with your doctor if other diagnosis not forthcoming, for good reliable info there is the website Aspergillosis.org.
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