AboutNeal Okerson Expertise I should be able to answer most questions about anatomy and physiology of heart and lungs. I also enjoy answering questions about understanding diseases. I should also be able to explain the goals and objectives of various pulmonary related treatments. Not an M.D., but worked in the field (Certified Respiratory Therapy Technician) since 1990. Registered Respiratory Therapist since 1995. B.S. degree in Health Education (1987). Currently working (since 1993) as the Director of Clinical Education in an AMA approved Respiratory Care Program in Western KY.
Question Hello. I am a 32 y/o female with a hx of smoking for 17 years (1 pack/day). Recently I had severe pleuritic pain on my left side that hurt tremendously to lie down especially or to sit. I was given a D-dimer and my score was 67 which made the Dr concerned that I may have a pulmonary emobolism. I was sent that day for a CT w/ w/o contrast. That showed LLL pleural effusion and atelectasis. I am not ill, I have not had a fever and I don't have a bad cough. I do have a slight cough (probably from smoking I presume) and SOB. I read the radiology report and it stated of unknown etilogy. No masses, no pulmonary embolism no nodules etc. What could've caused this? It's been a week since I got the initial stabbing pain under my ribs and then the overall lung pain and shoulder pain began and wouldn't let up, unless I was moving about. They have put me on Vicodin and Ceftin. I am feeling better as I can now breath deeply w/out much pain and I can sleep and lie on my back and left side w/little less pain. What happened to me? Do you think this is directly related to smoking? They didn't see anything else in my lungs? I'm worried and am quitting smoking for good NOW. My father died of emphysema from smoking at the age of 52. He was dx w/it in his early 40's. I do NOT want to follow in his footsteps. Please give me some guideance if you can. My Dr stated that it appears to be due to localized infection since there is both atelectasis and pleural effustion. I don't have pneumonia or bronchitis and only feel weak a little. Also I have SVT which I take Toprol for.
Answer Christine,
A pleural effusion is when you have inflammation of one or both pleural layers. The pleural layers (There are 2) line the outside of the lungs and the inside of the chest cavity. The two layers are in contact with each other with a thin layer of fluid between them. The fluid acts as a lubricant. This allows the two layers to slide against the inside of the chest cavity as the lungs inflate and deflate. If one of more layer(s) gets irritated it can cause a great deal of pain (As you know). Just like a sore on your skin, irritation of the pleura can cause fluid to accumulate. This is the pleural effusion. A larger effusion can compress a lung making you feel short of breath. I would say that smoking is a contributing factor in that smoking affects the immune system and slows the healing process. You are making a good choice to stop. It will save you a lot of grief and $$$. Be aware that after a week or two of not smoking, you may have an increase in your coughing. This shows that the cilia, which normally sweep up debris in the lungs, are starting to work again after 17 years of being paralyzed.
It sounds like your dad may have had a genetic tendency to develop emphysema. This should motivate you - you may have the same genetic tendency. It is called Alpha-1 Antitrypsin Deficiency.
Don't give up! It takes 2 to 3 tries for most people to quit smoking.
