Wednesday, July 17, 2013

Diagnostic Bronchoscopy


Common reasons to perform a bronchoscopy for diagnosis are:
  • Lung growth, lymph node, atelectasis, or other changes seen on an x-ray or other imaging test
  • Suspected interstitial lung disease
  • Coughing up blood (hemoptysis)
  • Possible foreign object in the airway
  • Cough that has lasted more than 3 months without any other explanation
  • Infections in the lungs and bronchi that cannot be diagnosed any other way or need a certain type of diagnosis
  • Inhaled toxic gas or chemical
  • To diagnose a lung rejection after a lung transplant
You may also have a bronchoscopy to treat a lung or airway problem, such as to:
  • Remove fluid or mucus plugs from your airways
  • Remove a foreign object from your airways
  • Widen (dilate) an airway that is blocked or narrowed
  • Drain an abscess
  • Treat cancer using a number of different techniques
  • Wash out an airway (therapeutic lavage)

The main risks from bronchoscopy are:
  • Bleeding from biopsy sites
  • Infection
There is also a small risk of:
  • Arrhythmias
  • Breathing difficulties
  • Fever
  • Heart attack, in people with existing heart disease
  • Low blood oxygen
  • Pneumothorax
  • Sore throat
In the rare instances when general anesthesia is used, there is some risk for:
  • Muscle pain
  • Change in blood pressure
  • Slower heart rate
  • Nausea
  • Vomiting
There is a small risk for:
  • Heart attack
When a biopsy is taken, there is a risk of severe bleeding (hemorrhage). Some bleeding is common. The technician or nurse will monitor the amount of bleeding.
There is a risk of choking if anything (including water) is swallowed before the numbing medicine wears off.

Here is a 7 minute video on diagnostic bronchoscopy.  It shows a tumour being biopsied.  This video is shown to my patients before consent for the procedure is taken.

Warning:  Do not view if you are afraid of blood.


A Chest X-Ray for myself


Went for my yearly chest x-ray today. Thank God the lung fields are normal. A bit of spinal scoliosis for my poor posture. Time to straighten up and exercise more!

A chest x ray is recommended for people who have symptoms such as shortness of breath, chest pain, chronic cough or fever. The test can help find the cause of these symptoms.

Chest x rays may help diagnose pneumonia, heart failure, lung cancer, lung tissue scarring and other conditions. They are also used to check treatment response.

Sometimes, doctors recommend follow up chest x rays within hours, days, or months of an earlier chest x ray.

Chest x-rays are often done before surgery and during medical check-ups. 

NSAID's GI and CV risks



Talk by Dr. Peter Lin yesterday at Tropicana Grand Ballroom.  When choosing a "pain killer" for joint pain we must remember the potential GI side effects like gastric erosions, ulcers and bleeding.  We must also not forget the potential CV risks, like heart attacks and strokes, that come with some COX-2 inhibitors.  Some recommendations are shown in the picture.