Deciding Between Intubation and Tracheostomy for Elderly Patients
Intubation or not? Dear Dr. Jiang, I would like to seek your advice regarding my grandmother's condition. She is currently 78 years old and has a history of hypertension. Two months ago, she suffered from severe herpes zoster (commonly known as shingles) in her abdomen, whi...
Dr. Jiang Zhenyuan reply Pulmonology
Basically, if a patient has been intubated for more than two weeks, recommending a tracheostomy is a reasonable course of action. The benefits include: 1. It can reduce airway resistance. 2. It facilitates suctioning, which can actually alleviate the patient's suffering. How...[Read More] Deciding Between Intubation and Tracheostomy for Elderly Patients
Understanding Tracheal Repair: Risks, Recovery, and Symptoms to Watch For
Tracheal anastomosis and tracheostomy? Hello Dr. Jiang: 1. I would like to ask if there are any potential complications after undergoing a tracheal suturing surgery due to a work-related injury, and what precautions I should take in my daily life. 2. It has been almost four m...
Dr. Jiang Zhenyuan reply Pulmonology
After tracheal suturing surgery, the healing of the wound is very important. During the healing process, it is common to experience a feeling of tightness or discomfort in the chest. It is essential to have regular follow-up appointments with the surgeon to ensure that the wound ...[Read More] Understanding Tracheal Repair: Risks, Recovery, and Symptoms to Watch For
Understanding Pulmonary Fibrosis: Causes, Treatments, and Transplant Options
Treatment for pulmonary fibrosis? My father sought medical attention in June of this year due to persistent coughing. After undergoing a chest X-ray and biopsy, he was diagnosed with pulmonary fibrosis. Initially, he was able to breathe independently, but gradually he required su...
Dr. Jiang Zhenyuan reply Pulmonology
Mr. Li: Pulmonary fibrosis is often caused by changes resulting from the treatment of other diseases, such as tuberculosis. Some patients may develop pulmonary fibrosis without any obvious contributing factors as they age. Since your father is experiencing respiratory failure and...[Read More] Understanding Pulmonary Fibrosis: Causes, Treatments, and Transplant Options
Navigating Drug-Resistant Tuberculosis: A Family's Struggle for Answers
Pulmonary tuberculosis Dear Dr. Jiang, I have a lot of content to share, and I appreciate your time in reading it, as I am unsure of what to do and need more advice. My father was diagnosed with tuberculosis around March of this year. The doctor mentioned that he has drug-resist...
Dr. Jiang Zhenyuan reply Pulmonology
Dear Ms. Hsiao-Yu, Your letter shows how much you care about your father's condition, which is truly touching. Based on your description, your father's various discomforts are common symptoms seen in patients with pulmonary tuberculosis. I hope that adherence to the pr...[Read More] Navigating Drug-Resistant Tuberculosis: A Family's Struggle for Answers
Understanding Aspiration Pneumonia: Causes, Diagnosis, and Treatment Options
Aspiration pneumonia My father was admitted to the emergency room the day before yesterday due to abnormal breathing caused by choking. He was subsequently diagnosed with aspiration pneumonia, as food was extracted from his trachea. After consulting with the physician, it was det...
Dr. Jiang Zhenyuan reply Pulmonology
1. Dysfunction of the epiglottis is often associated with neurological disorders (such as those caused by stroke) and can be evaluated by an otolaryngologist or a neurologist. If the neurological condition cannot be improved, there is no specific pharmacological treatment availab...[Read More] Understanding Aspiration Pneumonia: Causes, Diagnosis, and Treatment Options
Understanding Asthma Medications: Inhaled Steroids and Their Use
Asthma medication (1) Yes, Beclomet Easyhaler (Beclometasone) is an inhaled corticosteroid. (2) Among the currently available inhaled corticosteroids for asthma treatment, fluticasone and budesonide are commonly considered effective options. Inhaled corticosteroids should be con...
Dr. Jiang Zhenyuan reply Pulmonology
1. Beclomet Easyhaler is an inhaled corticosteroid (Beclomethasone). 2. Currently, there are three commonly available options in the Taiwanese market: Beclomethasone, Budesonide, and Fluticasone, which have minimal differences. The treatment for asthma is divided into two categor...[Read More] Understanding Asthma Medications: Inhaled Steroids and Their Use
Understanding Pneumothorax: Treatment Options and Expert Advice
Pneumothorax I would like to ask about my brother, who is currently serving in the military. Last week, he suddenly experienced chest pain and later underwent an examination in Yilan. The doctor recommended immediate hospitalization for surgery, as the X-ray results indicated bil...
Dr. Jiang Zhenyuan reply Pulmonology
The symptoms of pneumothorax often include sudden chest pain. My brother was diagnosed with bilateral pneumothorax during an examination in Yilan, and the hospital recommended surgery, likely due to clinical judgment indicating that surgery was necessary to prevent potential risk...[Read More] Understanding Pneumothorax: Treatment Options and Expert Advice
Understanding Mild Chest Discomfort: When to Seek Medical Help
Mild chest pain? After maintaining a fixed posture for a long time, there is a slight dull pain in the center of the chest that lasts for about 1 to 2 minutes. What type of problem could this be? Which specialty should I consult?
Dr. Jiang Zhenyuan reply Pulmonology
There are many causes of chest pain, which can arise from different areas within the thoracic cavity and adjacent organs. Although some characteristics of the pain can help infer the cause, in many cases, a correct diagnosis and treatment cannot be made immediately. Paying attent...[Read More] Understanding Mild Chest Discomfort: When to Seek Medical Help
Understanding Infectious Risks of Open Tuberculosis in Patients
None Hello, doctor: The family member is a patient with open pulmonary tuberculosis and is currently undergoing treatment. 1. Is the patient's sputum or oral secretions still infectious? 2. If so, how long can the tuberculosis bacteria survive in the air after being expelled...
Dr. Jiang Zhenyuan reply Pulmonology
1. Patients with open pulmonary tuberculosis indicate that Mycobacterium tuberculosis is still present in their sputum. Typically, the coughing of tuberculosis patients can release droplets containing the bacteria, and patients with tuberculous laryngitis can also spread the bact...[Read More] Understanding Infectious Risks of Open Tuberculosis in Patients
Understanding the Use of 1TU RT-23 Tuberculin Test in Taiwan
tuberculin skin test Dear Director: According to the Department of Health's "Annual Report on Tuberculosis Prevention and Control," the current tuberculin test used by the Bureau of Disease Control is 1TU of the Danish RT-23 strain. However, according to textbooks,...
Dr. Jiang Zhenyuan reply Pulmonology
Dear Brother Chao-Hua: In your letter, you inquired, "Which is biologically equivalent to 5TU PPD-S, the Danish RT-23 1TU or 2TU?" The answer is as follows: According to the current data, the Danish RT-23 2TU has nearly identical sensitivity to 5TU of PPD-S, although ...[Read More] Understanding the Use of 1TU RT-23 Tuberculin Test in Taiwan
Understanding Chest Tightness: Causes and Solutions for Breathing Issues
Chest tightness? During elementary school, I participated in a road running event. While running, I would drink water, and since then, I have often experienced shortness of breath, frequently needing to take deep breaths and pressing on my chest, which can also be painful. In win...
Dr. Jiang Zhenyuan reply Pulmonology
The described symptoms do not rule out the possibility of asthma; however, other cardiopulmonary diseases are also possible. It is recommended to consult a specialist in pulmonary medicine for a detailed evaluation and diagnosis.[Read More] Understanding Chest Tightness: Causes and Solutions for Breathing Issues
Understanding Lung Adenocarcinoma: Diagnosis and X-Ray Limitations
Regarding lung adenocarcinoma? Hello Doctor: I would like to ask you if lung adenocarcinoma is easy to diagnose. If an X-ray shows no issues, does that mean there is no possibility of having lung cancer? Thank you, Doctor.
Dr. Jiang Zhenyuan reply Pulmonology
Lung adenocarcinoma often occurs in the outer lobes of the lungs. In its early stages, lung adenocarcinoma may not present obvious symptoms, but it can often be detected through a chest X-ray. A normal chest X-ray does not rule out the possibility of cancer, but the likelihood is...[Read More] Understanding Lung Adenocarcinoma: Diagnosis and X-Ray Limitations
Understanding Tuberculosis: Diagnosis, Transmission, and Symptoms Explained
Suspicion of pulmonary tuberculosis? Hello, doctor: 1. Can an X-ray definitively determine if someone has tuberculosis (TB) of the lungs? 2. A few months ago, my family member was diagnosed with mild open pulmonary tuberculosis and was hospitalized for treatment. They have now...
Dr. Jiang Zhenyuan reply Pulmonology
Hello, Xiao Xiang: I am glad to receive your letter. 1. X-rays are an important tool for diagnosing tuberculosis (TB). Although X-rays have some limitations, most lesions can be visualized. However, to confirm the diagnosis, sputum tests are still necessary. 2. After treatmen...[Read More] Understanding Tuberculosis: Diagnosis, Transmission, and Symptoms Explained
Understanding Chest Pain: Possible Causes and When to Seek Help
Suspected pneumothorax Hello, doctor: Sometimes I experience pain in my left chest, and I suspect it may not be a heart issue but rather a lung problem. However, I have had an electrocardiogram in the past, which showed no issues! At times, my breathing feels smooth, while at oth...
Dr. Jiang Zhenyuan reply Pulmonology
First, let's explain the mechanics of breathing: During inhalation, the diaphragm descends, and the entire chest wall expands due to muscular effort, allowing air to enter the alveoli for gas exchange. At this time, the diaphragm and chest muscles exert significant force. Du...[Read More] Understanding Chest Pain: Possible Causes and When to Seek Help
Persistent Cough and Yellow-Green Mucus: Is It a Cold?
Is persistent coughing considered a cold? I have been coughing up phlegm and experiencing a runny nose with yellow-green mucus for over a month. I have been taking cold medication, but it hasn't improved.
Dr. Jiang Zhenyuan reply Pulmonology
Yellow-green nasal discharge has persisted for a month, and it is important to consider whether sinusitis is the cause. It is recommended to consult an otolaryngologist for a thorough examination. Additionally, the productive cough may be due to post-nasal drip irritating the thr...[Read More] Persistent Cough and Yellow-Green Mucus: Is It a Cold?
Understanding Delayed Toxicity: Are You at Risk from Hidden Poisons?
I'm sorry Hello, doctor. The other day, I saw a description on the Discovery Channel about a type of poison, which is either a virus or a chemical agent, that can cause chronic illness and death many years later. Does this really exist? If so, how dangerous is it? You could ...
Dr. Jiang Zhenyuan reply Pulmonology
Thank you for your letter. I have not seen the program aired on the Discovery Channel, so I am not familiar with which one refers to a virus or a toxin. The most well-known chronic disease-causing virus that leads to death is Bovine Spongiform Encephalopathy (BSE), commonly known...[Read More] Understanding Delayed Toxicity: Are You at Risk from Hidden Poisons?
Understanding Tuberculosis Risk and Screening After Exposure
Pulmonary tuberculosis Hello, my family member is a patient with open pulmonary tuberculosis and has just returned home after a week of treatment in the hospital. They are still continuing medication for control, and I sleep in the same room as the patient. What is the likelihood...
Dr. Jiang Zhenyuan reply Pulmonology
If your family member tests positive for acid-fast bacilli in sputum smear, their infectiousness is higher, and there is a possibility of transmission if sleeping in the same room as a tuberculosis patient. As long as your family member adheres to their medication regimen, their ...[Read More] Understanding Tuberculosis Risk and Screening After Exposure
How to Determine If You Have Tuberculosis and Find a Doctor
If you are unsure how to determine whether you have tuberculosis (TB), you should seek a healthcare provider? Dr. Jiang: Hello, I was found to have calcifications in my lungs six years ago during a medical outreach program. Since then, I have been getting annual chest X-rays, and...
Dr. Jiang Zhenyuan reply Pulmonology
Hello: 1. There are many causes of hemoptysis, with common causes including bronchiectasis, pneumonia, pulmonary tuberculosis, or lung tumors. Severe coughing due to bronchitis can also lead to the rupture of blood vessels, resulting in hemoptysis. 2. The so-called calcification ...[Read More] How to Determine If You Have Tuberculosis and Find a Doctor
Understanding Adenocarcinoma in Lung Cancer: Treatment Options and Symptoms
Adenocarcinoma of the lung? Are there medications for adenocarcinoma of the lung? Lung cancer has several types, and adenocarcinoma is one of them. Symptoms include pain that radiates from the front of the chest, around the axilla, to the back. Thank you.
Dr. Jiang Zhenyuan reply Pulmonology
Adenocarcinoma is a type of lung cancer, primarily treated through surgical resection. Chemotherapy agents include Cisplatin and Gemcitabine, among others. Please consult a pulmonologist to confirm the diagnosis, and then seek treatment from either a pulmonologist or an oncologis...[Read More] Understanding Adenocarcinoma in Lung Cancer: Treatment Options and Symptoms
Understanding Emphysema: Symptoms, Diagnosis, and Management
Suspected emphysema Hello, Director Jiang: Two months ago, I noticed an unusual knocking sound in my chest during inhalation (after taking a deep breath and holding it briefly), with a frequency that synchronized with my pulse, accompanied by chest tightness. The physician initia...
Dr. Jiang Zhenyuan reply Pulmonology
1. Emphysema and chronic bronchitis combine to form chronic obstructive pulmonary disease (COPD), which is generally diagnosed based on clinical symptoms and pulmonary function tests. 2. It is. 3. Emphysema is not contagious. 4. Please consult a pulmonologist for diagnosis and re...[Read More] Understanding Emphysema: Symptoms, Diagnosis, and Management