Lung Nodule In CF

[LittleLab4CF]

I believe in miracles but somehow I suspect that the goober they plucked from your lung is one of your MDR (Multiple Drug Resistant) bacteria causing the body to wall in the infection. Cystic Fibrosis is so named because of the fibrose scarring in the pancreas, liver and lungs. You might have caught the infection just in time before too much scar tissue built up around the intractable infection.

If this is the case, and I give it 50-50, the scar tissue is being reabsorbed by your body and hopefully it will be just a bad memory.

Whew!

LL

 

[Printer]

LL

If I were her, I would get second opinions, as stated above.

Bill

 

[LittleLab4CF]

An important point Bill, every now and then someone recommends a specific doctor, myself included. Given the random nature in finding doctors based on advertising and websites, a recommendation from a fellow CFer in the same region is well worth serious consideration.

Anytime something akin to a miracle in medicine happens, a second look is invaluable. Since this is the first nodule in a lung, confirmation via a second opinion. I've got a spot on my lung that is just above the liver on the right side of center. It has been identified as a rosette scar, aspirated barium, calcification, chrysalis and shrapnel, all in the last 10 years. It was on Xray all of my adult life and frankly it could be any one of the possibilities. It is part calcification because it has become more opaque over time and has grown a small amount.

LL

 

[LittleLab4CF]

It's strange to see that the last post on lung nodules was one of mine from May of 2015 but I have a nodule problem of my own now. I am looking for others who have had a similar experience and I am wondering what to do next.

Last Friday night I coughed up something of a surprise. I'm not sure if I had a sinus, chest or abdominal infection but something has been sapping my energy more than usual this last month and my doctor put me on Levaquin and Flagyl was added after ten days of Levaquin had been little help. Antibiotics have the effect of loosening up infections in me, it might have something to do with the surprise I coughed up.

My chest was tight and Friday I noticed that I had a light productive cough. I had the sense something was trying to come up. I finally had to cough hard and I caught something interesting in my mouth that definitely came from the lungs or bronchial structure. Immediately my chest hurt. The chest x-ray and follow up CT scan from when I saw my PCP at the beginning of this particular complaint showed a new cluster of nodules in the upper right lung lobe. The pain corresponded with the general area where the cluster was imaged. I've coughed up big hemoptysises before, up to 6cc, cohesive blob of mostly blood clot and never had any lasting pain.

I coughed up a formed ~5mm diameter solid "nodule". The pain in my chest was sharp and focused the moment it occurred and since if I talk for more than a few minutes or exert myself like taking out the garbage. Not exactly work. The nodule most likely was the shape of what contained it, roughly spherical and not unlike a piece of white cheese, a pink speckling could be seen infiltrating it. I placed it in a sample jar and the lab basically said it was too small. It's lost and I am left wondering if it was one of the nodules.

How often do CFers cough up a nodule in the lung, in the shape of a sac or something that would be recognizable? I'm assuming that what I coughed up was pus and hopefully dead bacteria. What points me in the direction of pus is the report mentioned ground glass scarring around the cluster and indications of inflammation. That and I have seen pus that resembles a couple varieties of cheese, this easily could be. I am vexed by the pain from it coming out. Has anyone coughed up a solid nodule or such and have pain for several days after, either constant or when aggravated?

The cluster of new nodules range from one 7mmx7mm, and several 6, 5, 4, and 3mm nodules. I don't have CF lungs, at least I haven't had the thick horrible mucus and low PFTs. If I have coughed up one and the result is pain, a nasty high fever when it popped and more fatigue, I am not sure if I can make it.

Thanks in advance for any help or thoughts,

LL

 

[LittleLab4CF]

This is a strange twist on the "nodule" I coughed up. It is a yeast, likely Candida. I was kicking myself for not insisting my CF Clinic take the case. I had a long standing appointment with my CF specialist but I needed attention sooner than I could be seen in the CF Clinic. My nodule wasn't large enough for culturing except for molds, yeasts and such but no bacteria. I've seen the respiratory nurse at the CF Clinic pleased when a smear of color shows up in my typically puny sputum and possibly a 5mmx5mm cheese like formed chunk was a diagnostic gold mine. Maybe I should be giving my doctor more credit. After a doubly long course of Levaquin and Flagyl added to the second round of Levaquin, most likely killed all but the most resistant bugs. Well crap, MDR bugs are common in CF and hence the wish my CF specialist would have taken it over. I'm sure if I had asked directly, he would have been pleased to assume the job, my PCP is good and now I know the limitations of a the lab service they use.

I'm now with a prescription for Fluconazole. The last time I took the drug, it was a liquid for thrush. This is a bit of a rant but I am sick and tired, literally, of being a moist, dysfunctional bag of food for everything that wafts past my nose. I'm not hopeful that it is going to be easy on my stomach.

How long does it take to wipe these nodules out? Is this the right medicine and since I just found out that I have cultured MRSA and one other super bug during the last year, what does this mean? I'm pleased to not have CF lungs but it appears that CF can become more virulent with time.

LL