Pneumonia and underlying lung disease (asthma or copd)? Worried.

[verybookish]

I am 40 year old, healthy and very active woman. As long as I can remember my lungs have not been great. I had whooping cough and pneumonia as a toddler. As a young adult I was told that I had some scarring on my lungs due to that by my doctor in my European home country.

I never get any breathing or lung problems when I am well. I cycle 1h a day 3 days a week, I walk long- distances, run up and down our 3-floor house after the kids. Never short of breath or coughing or tight chested. I was never even short of breath in my three pregnancies.

However, for as long as I can remember sometimes when I get a cold I get a dry cough that just takes 1-2 weeks to go (happens 1-2 times in a winter season). It’s not continuously coughing but getting these cough attacks. The doctor in my home country explained that I have hyperreactive lungs due to what happened as a toddler (I was also premature). I was once prescribed an inhaler to help with that but it was a one off.

Fast-forward to now. I got a virus, then a cough which was different from my usual cough in the sense that it was productive (white, transparent). Dragged on for 5 days before I finally got a 5 and then 2 additional days of antibiotics. Was feeling better but then after 3 days cough started again any my blood oxygen levels were not good (dropping down to 88 intermittently before picking back to 93 to 95). GP bundles me up to AE where I am am diagnosed with pneumonia at the hospital yesterday.

They can’t find evidence of ongoing serious infection (though still waiting for sputum and swap results) and listen to my lungs and note that I am wheezy and very tight. They are very interested in my history if whooping cough and pneumonia as a child and ask a lot about the scan that supposedly showed some scarring about 15 years ago. They then go and treat me as if I had an asthma attack (I recognise the protocol because my son has asthma). I get nebulised which makes a big difference to my lungs and am sent home with 4 day course of steroids and inhaler.

Thank you for making it this far. My letter says that gp should refer me to lung specialist for underlying respiratory disease. This is worrying me. I think my general symptoms sound more like some sort of virus-triggered cough variant asthma. But google also tells me that lung scarring is bad. Though I don’t recognise myself in the COPD.

I am also super perplexed as the extremely thorough doctor in the European country I am from (a very highly developed, known for fantastic health care) who once sent me to have an MRI because I had slightly twisted my ankle (we had private insurance so tests were enthusiastically given), delivered the news about lung-scarring as kind of oh just FYI rather than this needs further investigation or care etc. My mum also told me that she also has scarring on her lungs from pneumonia as a child and again there no special medical care following in from that. She is 75, very healthy and is very on top of preventative health care tests, screenings (again due to private health care and the way the system works back home)

So my questions are

• what respiratory disease might they think I have. Asthma or Copd or something else?
• is scarring on the lungs always linked to a respiratory disease or can some people have scarring but be ok with it?

I am going to talk with my GP on Monday but I am really quite worried at the moment and any personal stories of people in similar situations might help tie me over until then.

I have asthma and what you have sounds like what my DD, who also has asthma, gets for a while after a cold - the asthma nurse put her on a different inhaler as she said she thought her asthma was not controlled well whereas I think mine is. And since then the dry coughing fits have all but stopped.

My DH does not have asthma but was told following a scan after Covid that he has some ‘bubbles’ on his lungs. I was frantically googling about that but they seemed quite casual about it. He is very fit and has stopped worrying about it.

Have you not been given more antibiotics for your pneumonia?

Hi @LoreleiG thanks for responding. Yes, I asked about the antibiotics. I was given some intravenous antibiotics as they were still figuring stuff out but apparently my blood showed infection markers that weren’t high enough to warrant more antibiotics. They really went fully with the ‘this is your bad lungs not being able to clear the fluid’ route after they listened to my chest and nebulised me.

Reassuring to hear about your husband. Thank you. I just could not imagine the doctor back at home letting something slide like that. A) because he is very thorough and well- regarded and B) because essentially due to our private insurance status we were a cash cow.

There is a very wide range in severity and the type of scarring that can happen in the lungs. If they did not give you an MRI with contrast they won’t know the degree of scarring and what it looks like and if this may have been a contributing factor.

I suspect they are sending you home because you are no longer urgent, so don’t need hospital care.

I sympathise with your worry and know how it feels, but if you are now on the mend you are very likely to recover back to your baseline with time.

some things to consider and may not be applicable to your situation… but a recent COVID infection increases your risk of contracting RSV and bacterial infections that you would normally have avoided, so it might be that.

Anyone who does have some degree of prior lung damage might be wise to avoid catching any respiratory infection not only because they are difficult to budge but also to avoid any further lung damage. We are all different in how our lungs will react and heal.

If I was in your position I would ask your gp for an MRI (contrast) and full lung function testing, plus referral to a respiratory consultant so you can understand your current lung health status.

@Yorkshirelass123 thank you! That’s very sound advice. Will do as you say with gp.

I have had covid twice (confirmed) and funnily enough in never went to my lungs. I get the flu (and now the Covid) jab annually. This will definitely make me more cautious going forward in avoiding people with coughs and colds. Though easier said than done with three small children.