British Lung Foundation
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9mm nodule

Soooo, in addition to hyperinflation and a flattened diaphragm, my husband's CXR also shows a 9mm dense nodule in the left lung. The radiologist made no recommendation for follow-up and stated in his report it is from "previous granulomatous disease". There is no mention of whether it is calcified or not. Now I am back freaking out about lung cancer. SIGH. I want off this merry-go-round. I don't wanna play anymore :(

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Hi Mel, is it up to the Radiologist to ask for further investigation? If you have a Consultant ring their Secretary and explain the results and your worries and ask for further tests and an explanation. Surely results are sent to your Consultant and GP.

Or have a word with your GP.

Don't sit worrying.

Love Suzyxxx

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Suzy, I am in the US but from Australia. I've also lived in the UK for several years. The way it works over here ain't the NHS unfortunately. It's dog eat dog and I don't trust it.

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Also my GP is not a GP. They have a thing called "physician assistant" here and it seems like it is one step up from a first aid certificate (but with less common sense).

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Oh my goodness. my grandsons live in the States and their Mum is a nurse in a teaching hospital. Her Mum has respiratory problems too - though she is in her late 70's so different situation. However, I have been quite horrified by some of the things they have said to her. I feel glad that her daughter is a nurse and her daughter-in-law is now a Dr as they have been able to help.

xSianx

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Oh Goodness! This is all so worrying. Like Suzy6 I think you should talk to your consultant and GP. That is what they are there for.

All the best

Sian xxx

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Hopefully the pulmonologist will set things straight for me. The not knowing is wrecking my brain. Consultant = specialist, yes?

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yes. xSx best of luck

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A normal FEV1 ( in your husbands case above normal ) means he is not Hyperinflated. There are loads of references to this on the net.

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He hasn't had the lung tests yet. The FEV1 measure I am going off is from a device I bought online. I do hope it is accurate!

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Hi Mel

I am in usa also. Wondering which device you have to ck. Fev 1?

Rubyxx 😊

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Have you tried it yourself? I have that one also. The mouthpiece is so small.

Rubyxx 😊

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Yes, I had a play with it. Do you find it accurate?

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I have a microlife and it's like 8 numbers higher! Did it say what you should be when you did It? ☺ xx

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I just looked up what I should be online. What do you mean it was eight numbers higher?

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On piko I was 154 and on other one I was 167.

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Oh, I have the Microlife too. How do you find they compare to spirometry?

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Don't know. Do you yourself get the same reading on both of them? What should you be? I'm going by you as you don't have copd.

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Ah, OK. I can't remember my exact results, but they were in the right range for my age and height and gender.

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Also, both my husband and I had higher results on the Pico.

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Hyperinflation on an x-ray is a subjective measure, as I understand. I'm not sure whether the flattened diaphragm and large retrosternal space is part of that or an additional finding. The spirometry tests will reveal more.

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Sorry, I should have mentioned I am in the US. I do now have - after a lot of foot stamping - a referral to a pulmonologist. I'm used to the system in Australia, which I guess is more aligned with the NHS than with this free market BS over here. It's a steep learning curve!

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Best of Luck Mel07. It all seems very confusing. I do hope you get things sorted. IF you have medical insurance there do they not have an advice line you could call?

Sian

xxx

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I have good insurance (thankfully). I don't find them very helpful though. They are kind of antagonists, not advocates, in my experience :/

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Yes, afraid that may be the case. Until we know a little more about the system in the US we tend to think that you can get everything immediately because you have private insurance - not exactly like that is it? All the different companies have their own different rules and it can be as hard to get the treatment you want there as it is on the NHS - sometimes harder from what I have read on other health websites.

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Yes, they will challenge and deny where possible. I recently had to have big ugly orthotics made - and they knocked it back because it was "cosmetic". Jeez.

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Oh for goodness sake!

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I know! Exactly like a boob job.

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Different forces at play. In the US, it's all about profit. In the UK and Australia (to a degree), it's more about minimising cost.

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All adds up to the same thing really doesn't it? As little money as possible spent on the patient - unless you pay a fortune for your insurance and then if you are poorly they tend to up the costs or deny insurance. I remember on one of the other forums I am on that one of the girls couldn't get the procedure she wanted done so decided to pay completely out of pocket and found that if the insurance company paid for the procedure and one night in hospital it cost $28,000 to the insurance company but her payment for the same thing upfront was less than $10,000. I can't remember the exact sum but remember it worked out that the insurance company charged about two thirds more for the same procedure in the same hospital. No wonder insurance costs so much eh?

Hope you get things sorted as quickly as possible.

Sian

xxxx

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Thanks, Sian. You're right. It's terrible how our health is reduced to the level of a business transaction. Still, I live in hope there are still doctors out there who abide by the Hippocratic oath :)

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Oh I really do think all Docs want to do the very best they can. It is the insurance companies and the administrators ( and I hate to say this sometimes the secretaries and receptionists) who get in the way.

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Just got back from the pulmonologist. He was great. Spent an hour with us. He says the nodule is 99.9% benign, likely an old histo scar. For peace of mind, he said we could do an X-ray in year, but that in his opinion it wasn't necessary. He said the flattened diaphragm, hyperinflated lungs were not diagnostic of COPD, merely suggestive, and that nothing else in the work-up was indicative of it. My husband's O2 sats were 99%, BP and heart rate both low, all blood work within normal limits, and there was no wheezing. He said if he does have COPD, it is likely mild. PFT testing is on Monday :)

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