Day +1017 : Follow-up : Asthma Clinic - All is not well in the lung

I am fine today.

I have my Asthma Clinic appointment today. The appointment was scheduled 2:00pm on first time first serve basis. Because I needed to take a chest x-ray in the radiology department, I went to UH as early as 11:30am. The traffic was quite clear and I managed to reach UH at 12:00am.

I got a general queue number in the general clinic first before rushing to the radiology department to take x-ray. After registering at the radiology counter, I rushed for my lunch. When I came back about half an hour later, it hadn’t reached my turn yet.

The registration for Asthma Clinic opened at 1:00pm, but the problem was that I wasn’t called for chest x-ray. In order to get an earlier queue number to see lung specialist, I rushed to the general clinic to register for Asthma Clinic based on the earlier general queue number. I got a queue number 8006, which was quite an early queue number.

After that, I went back to the radiology depart for my x-ray. I managed to get the chest x-ray done at 1:40pm.

The chest x-ray taken today was basically the same as the previous one. The right pleural effusion remained. After asking a series of questions and then analyzing the chest x-ray, the lung specialist pointed out the right costophrenic obliteration (right lower tip of the lung was blunted) might not be due to the pleural effusion (fluid retention). It might be due to pleural thickening.

Due to the way I cough, the doctor said that I might have bronchiectasis.

Bronchiectasis is a disease that causes localized, irreversible dilation of part of the bronchial tree. It is classified as an obstructive lung disease, along with bronchitis and cystic fibrosis. Involved bronchi are dilated, inflamed, and easily collapsible, resulting in airflow obstruction and impaired clearance of secretions. Bronchiectasis is associated with a wide range of disorders, but it usually results from necrotizing bacterial infections, such as infections caused by the Staphylococcus or Klebsiella species or Bordetella pertussis. [Wikipedia]

He saw some dilation of the bronchial tree on the chest x-ray and even on the last thorax CRT scan that was done middle of last year.

The dilation of the bronchi tree causes the sputum to be accumulated easily in the lung which results in the blocking of airway. The accumulation of the sputum also increases the change of lung infection. The blockage of the airway might be the reason why I always felt short of breath :-(

The doctor asked me to do a spirometry test to measure the lung function. The test result ruled out the possibility that I have asthma. So the diagnosis that I have bronchiectasis is now more firmed.

However, to confirm the diagnosis, I still need to have a thorax CRT to see the condition of the lung.

Instead of giving me cough syrup to stop the cough, he asked me to cough as much as possible to discharge the sputum in the lung. In order to soften the sputum to increase its mobility so that it can be coughed out easily, he prescribed me an antibiotic called erythromycin for three months.
Therefore, in addition to penicillin, I need to take additional drug from now onwards.

Another measure to loosen the sputum is to use an instrument called Acapella which cost about RM300. It is a type of oscillating positive expiratory pressure devices that once blew will create oscillating pressure that would loosen the sputum. Doctor prescribed the instrument but I have yet to decide if I want to acquire the instrument.

To prevent infection due to bronchiectasis, doctor advised me to undergo two types of vaccinations: Pneumovaccine and Fluvaccine to protect me against pneumonia and flu. The Pneumovaccine has to be done 5 yearly while the fluvaccine has to be done annually.
The cost for Pneumovaccine is RM148 and the cost for Fluvaccine is RM45. However, I will be able to claim back the cost from government.

I will consult my haematologist first before doing the vaccinations.

My appointment for CRT is on the 18 June which is two months from now :-( And I will be seeing the lung specialist two weeks after the CRT.

Erythromycin
Acapella

See you next post :-)