Nodule on lung, could be atelectasis??

[katie01]

If you've seen my posts about my influenza ordeal, I came down with influenza about a month ago, it turned to bronchitis, I started on antibitocs, then it started having rib pain, that lasted well over a week, then this Saturday I coughed and felt a "pop" in the sore rib area, then I was in so much pain I was crying. DH took me to Urgent Care, the dr there looked over a chest ray they took there, said nothing was fractured, sent me home with Rx for pain meds. This morning I got a call from the nurse at Urgent Care saying I should follow up with my primary dr to get a chest CT, that they saw a nodule on my lung, I believe she said it was 4mm, and I can't remember how she worded this again, something about how it could be related to atelectasis. Even though I work in the medical field (physical therapy) I had forgotten what atelectasis means so I had to look it up, it said it was related to a partial collapse of the lung.

I don't expect anyone to have to be my online doctor, but when I called my primary the receptionist didn't have any of my info from Urgent Care in front of her, and said next Monday is the soonest I can get in for an appointment. I'd kind of like to not worry that long, does anyone have words of wisdom or experience with this? I know nodules can be seen on lungs quite often and are only very rarely cancerous. I'm a non-smoker and I'm only 42 so I'm not so worried about cancer (well maybe a bit), but mainly wondering about the atelectasis part.

 

[phorsenuf]

If you've seen my posts about my influenza ordeal, I came down with influenza about a month ago, it turned to bronchitis, I started on antibitocs, then it started having rib pain, that lasted well over a week, then this Saturday I coughed and felt a "pop" in the sore rib area, then I was in so much pain I was crying. DH took me to Urgent Care, the dr there looked over a chest ray they took there, said nothing was fractured, sent me home with Rx for pain meds. This morning I got a call from the nurse at Urgent Care saying I should follow up with my primary dr to get a chest CT, that they saw a nodule on my lung, I believe she said it was 4mm, and I can't remember how she worded this again, something about how it could be related to atelectasis. Even though I work in the medical field (physical therapy) I had forgotten what atelectasis means so I had to look it up, it said it was related to a partial collapse of the lung.

I don't expect anyone to have to be my online doctor, but when I called my primary the receptionist didn't have any of my info from Urgent Care in front of her, and said next Monday is the soonest I can get in for an appointment. I'd kind of like to not worry that long, does anyone have words of wisdom or experience with this? I know nodules can be seen on lungs quite often and are only very rarely cancerous. I'm a non-smoker and I'm only 42 so I'm not so worried about cancer (well maybe a bit), but mainly wondering about the atelectasis part.

About 4 years back I had nodules detected in my lungs. They attributed it to some scarring, perhaps from an infection in the past. They decided to just monitor it through ct scans to make sure they don't change. All subsequent scans hadn't changed so all was good.
Fast forward to January when I ended up in the ER for a suspected blood clot. I offhandedly mentioned to the doctor that I'd been getting out of breath easier lately with activity. She decided to do a ct of the lungs to make sure all was well since I'd had a PE in the past. Well, when the Dr came back with the results it turns out my lungs were filled with nodules and the larger ones that they had been monitoring over the years had grown in size. Since I was a year out from having cancer they said it was consistent with the cancer metastasizing to my lungs. Had a PET scan and it pointed to that as well.
Had a lung biopsy of several of the nodes and they were all benign (thank God!), and I was diagnosed with sarcoidisis. I had never heard of that and after reading about it, everything added up in regards to other problems I'd been having but was dismissing. I've been on prednisone and an daily inhalant to help combat it and later this month I will have another ct scan to see if it is helping. It is something that may clear up, or may not. It's a crap shoot I guess. But, it's not cancer so that's a plus!

It was a scary time no doubt while we waited on the biopsy and results. It's hard not to have your mind run away from you. Just think positive and try not too worry too much.

 

[katie01]

About 4 years back I had nodules detected in my lungs. They attributed it to some scarring, perhaps from an infection in the past. They decided to just monitor it through ct scans to make sure they don't change. All subsequent scans hadn't changed so all was good.
Fast forward to January when I ended up in the ER for a suspected blood clot. I offhandedly mentioned to the doctor that I'd been getting out of breath easier lately with activity. She decided to do a ct of the lungs to make sure all was well since I'd had a PE in the past. Well, when the Dr came back with the results it turns out my lungs were filled with nodules and the larger ones that they had been monitoring over the years had grown in size. Since I was a year out from having cancer they said it was consistent with the cancer metastasizing to my lungs. Had a PET scan and it pointed to that as well.
Had a lung biopsy of several of the nodes and they were all benign (thank God!), and I was diagnosed with sarcoidisis. I had never heard of that and after reading about it, everything added up in regards to other problems I'd been having but was dismissing. I've been on prednisone and an daily inhalant to help combat it and later this month I will have another ct scan to see if it is helping. It is something that may clear up, or may not. It's a crap shoot I guess. But, it's not cancer so that's a plus!

It was a scary time no doubt while we waited on the biopsy and results. It's hard not to have your mind run away from you. Just think positive and try not too worry too much.

That is very scary! I pray that your sarcoidosis clears up and doesn't cause you pain or other disability. Keep us posted on how you are doing, and thank you for sharing your story.

 

[strat68]

Nodules can also be cause by rheumatoid arthritis.

 

[Pea-n-Me]

Who was treating your bronchitis? Who did you speak to on the phone at your PCP's office?

 

[mjkacmom]

About 4 years back I had nodules detected in my lungs. They attributed it to some scarring, perhaps from an infection in the past. They decided to just monitor it through ct scans to make sure they don't change. All subsequent scans hadn't changed so all was good.
Fast forward to January when I ended up in the ER for a suspected blood clot. I offhandedly mentioned to the doctor that I'd been getting out of breath easier lately with activity. She decided to do a ct of the lungs to make sure all was well since I'd had a PE in the past. Well, when the Dr came back with the results it turns out my lungs were filled with nodules and the larger ones that they had been monitoring over the years had grown in size. Since I was a year out from having cancer they said it was consistent with the cancer metastasizing to my lungs. Had a PET scan and it pointed to that as well.
Had a lung biopsy of several of the nodes and they were all benign (thank God!), and I was diagnosed with sarcoidisis. I had never heard of that and after reading about it, everything added up in regards to other problems I'd been having but was dismissing. I've been on prednisone and an daily inhalant to help combat it and later this month I will have another ct scan to see if it is helping. It is something that may clear up, or may not. It's a crap shoot I guess. But, it's not cancer so that's a plus!

It was a scary time no doubt while we waited on the biopsy and results. It's hard not to have your mind run away from you. Just think positive and try not too worry too much.

I have it too, diagnosed 10 years ago. Knock on wood, no issues.

 

[katie01]

Nodules can also be cause by rheumatoid arthritis.

. I didn't think of that. Hopefully it's not RA, but still better than cancer.



I have only gone to Urgent Care for all of these visits. At one point in the whole illness, I did try to get in to see my primary, but there was nothing available (this is when I was on Day 9 of fever from influenza, so I went to UC for that, and that dr diagnosed bronchitis. I also would have gone to my PCP for this increased pain (to put it mildly) from the rib, but that happened on a Saturday (I'd had the pain for over a week but it got much worse on Saturday).

When I called the PCP today to follow up in the call I'd had from the UC nurse, I at first talked to a secretary, then I believe a nurse. When the nurse told me the soonest appt was next Monday, I said, "Do you think (my doctor) might want to send me for a CT now, before the appt, so we might have the results of that for the appt next week? The nurse at Urgent Care said I'd need a chest CT". The nurse said she'd leave a message for the dr about it, and if the doctor wants to do that or see me sooner she'll call. So far I haven't heard anything. Supposedly all the results from my walk in visit should be in the system for my PCP to see, since it's the same network, but I know it doesn't always happen (my mom has run across this problem with the same network and other specialists not getting reports)

Who was treating your bronchitis? Who did you speak to on the phone at your PCP's office?

 

[VandVsmama]

Other things than cancer can cause lung nodules to appear. Valley fever, for example (it's a fungal infection in the lungs and is common in central California and the southwestern US). A bad case of pneumonia can cause it, too.

 

[lifesavacation]

My son had a very serious hospitalization for pneumonia. They told his his chest X-ray would show scar tissue for 6 mos+.

 

[katie01]

Other things than cancer can cause lung nodules to appear. Valley fever, for example (it's a fungal infection in the lungs and is common in central California and the southwestern US). A bad case of pneumonia can cause it, too.

I wonder if I actually had pneumonia and the doctor just couldn't hear it with the stethescope? When he diagnosed me with bronchitis, he said, "You have very, very bad bronchitis. I'm surprised you are functioning as well as you are". Then he said something about how he thought my bronchitis was right on the verge of pneumonia based on where he was hearing the sounds in my lungs or something. I wouldn't be surprised if it was pneumonia, any case of bronchitis I've had has never been this bad. This is the sickest I can remember feeling in my life. I had pneumonia as a small child and my mom loves to tell the story of how the dr thought my lungs sounded clear but she requested a chest x ray, and sure enough, it was pneumonia (a favorite example of hers she likes to share about mother's instincts lol)

 

[katie01]

My son had a very serious hospitalization for pneumonia. They told his his chest X-ray would show scar tissue for 6 mos+.

I hope your son is doing well now

 

[Pea-n-Me]

. I didn't think of that. Hopefully it's not RA, but still better than cancer.

Nodules can be a lot of things. No sense in listing them all.

What you have is an "incidental finding", i.e. something found when looking for something else. Many of us are walking around with things we know nothing about, but most don't mean much. My mother had an incidental finding of a lesion on her pancreas a few years back. Getting that phone call took my breath away, let me tell you. We had it worked up, and it turned out to be nothing, and here she is still going strong at almost 91. So keep that in perspective. A lung finding during the course of, or after, a serious respiratory illness would not be unusual. I doubt a lot would be done without watching it first, as you heal. (Since something like a biopsy could have risks.) A baseline CT would probably be prudent, but it's really not emergent.

I have only gone to Urgent Care for all of these visits. At one point in the whole illness, I did try to get in to see my primary, but there was nothing available (this is when I was on Day 9 of fever from influenza, so I went to UC for that, and that dr diagnosed bronchitis. I also would have gone to my PCP for this increased pain (to put it mildly) from the rib, but that happened on a Saturday (I'd had the pain for over a week but it got much worse on Saturday).

When I called the PCP today to follow up in the call I'd had from the UC nurse, I at first talked to a secretary, then I believe a nurse. When the nurse told me the soonest appt was next Monday, I said, "Do you think (my doctor) might want to send me for a CT now, before the appt, so we might have the results of that for the appt next week? The nurse at Urgent Care said I'd need a chest CT". The nurse said she'd leave a message for the dr about it, and if the doctor wants to do that or see me sooner she'll call. So far I haven't heard anything. Supposedly all the results from my walk in visit should be in the system for my PCP to see, since it's the same network, but I know it doesn't always happen (my mom has run across this problem with the same network and other specialists not getting reports)

Ok, time to step back a bit. You are a PT so you know this, but I know you're super nervous. (That happens when it's yourself or someone you care about; helps give us perspective on what our patients go through!)

First, if you can't get in to see your PCP during a health crisis, then it's time to get a new PCP where they can see you in reasonable time. Urgent care centers aren't the best places to go for good, consistent care. I think an ER at a good hospital would've been a better choice - if you couldn't see your PCP - when you heard the pop. (Better yet, seeing your PCP before that, as advised by people on your older thread, would've been the best choice. Your PCP knows you and will follow up with you. You know the quality of care since you selected him or her and the office, etc.)

So where to go from here? IMO you need to get in to see your PCP. Make it happen - that is what they are there for. Call the clinical practice manager if you have to, but they should have an RN who triages calls. "Not sure" if it was a nurse you were speaking to is just not ok. You have to know your practice and how it operates for "emergencies". I would be shocked if they didn't have a process in place for that. (Not that this is an emergency, necessarily, but seeing that this has been going on for a while, and you are now almost in a panic about it, as well as still in severe pain, warrants an urgent visit with your OWN PCP.)

Your doctor will not order a CT based on hearsay. That would not be the standard of care. He will order a CT based on the details of your case, when he sees you. Your doctor is accountable for how he treats you - this includes actually seeing you when you need him, and ordering tests when and if they're indicated. He'll make that decision when he sees you. Now get on the phone, or go there in person, and get an appointment for today or sometime early this week. Stay calm, don't threaten or anything, just be firm. If you absolutely can't be seen, then I'd say an ER visit is warranted, mainly for the pain issue. Don't expect a CT unless they find something that causes it to be warranted - the pain alone may do it, I doubt they'd do it based on the "lesion" seen at UC. Good luck.

 

[Pea-n-Me]

I wonder if I actually had pneumonia and the doctor just couldn't hear it with the stethescope? When he diagnosed me with bronchitis, he said, "You have very, very bad bronchitis. I'm surprised you are functioning as well as you are". Then he said something about how he thought my bronchitis was right on the verge of pneumonia based on where he was hearing the sounds in my lungs or something. I wouldn't be surprised if it was pneumonia, any case of bronchitis I've had has never been this bad. This is the sickest I can remember feeling in my life. I had pneumonia as a small child and my mom loves to tell the story of how the dr thought my lungs sounded clear but she requested a chest x ray, and sure enough, it was pneumonia (a favorite example of hers she likes to share about mother's instincts lol)

Of course you had pneumonia!

 

[katie01]

Thank you Pea-n-Me, very helpful info! Yes, I'm not thinking clearly today. My dad was undergoing scheduled surgery this morning so I was waiting to hear on that, not expecting to hear anything further on my own health, so it threw me for a loop this morning. I know that these incidental findings do show up and the great majority don't turn out to be anything serious, so I'm not near panic stage, just wanting to proceed as soon as possible and not have worry at the back of my mind

 

[Pea-n-Me]

I was thinking of all these "flu" threads when I was caring for someone last week recovering from Influenza A. He was lucky to be alive, frankly. I was thinking, "Now I understand how people are dying" from these recent strains. His lungs were not only severely compromised, so much so that he needed a ventilator and even then it was touch and go, but it also affected some of his major organs. Here was a healthy young man who, a week or so into it, could barely move, talk, eat or drink. Scary stuff.

 

[phorsenuf]

I have it too, diagnosed 10 years ago. Knock on wood, no issues.

That's great you haven't had any issues! How were you diagnosed with it?

 

[Pea-n-Me]

Thank you Pea-n-Me, very helpful info! Yes, I'm not thinking clearly today. My dad was undergoing scheduled surgery this morning so I was waiting to hear on that, not expecting to hear anything further on my own health, so it threw me for a loop this morning. I know that these incidental findings do show up and the great majority don't turn out to be anything serious, so I'm not near panic stage, just wanting to proceed as soon as possible and not have worry at the back of my mind

Thanks for taking my rather firm post as it was intended. Just a little virtual "shake", haha.

 

[Pea-n-Me]

Oh, and when you call your PCPs office, just focus on the pain and respiratory issues. Leave the discussion about the XRay finding till you see the doc, as right now it only waters down the real issue.

Also call the UC center and make sure they fax all records of your visits over to your PCPs office asap, so they know what's going on. Go there yourself if you have to.

It's understandable you're run down after such a battle. Be sure to rest and take care of yourself.

 

[Gary M]

Other things than cancer can cause lung nodules to appear. Valley fever, for example (it's a fungal infection in the lungs and is common in central California and the southwestern US). A bad case of pneumonia can cause it, too.

I'm a non smoker. About 10 years ago an x ray showed a nodule on my lung. The doctor had me come back in a few weeks for another x ray and the nodule was gone. I live in Indiana, he said it was most likely a fungal infection, which is common in our area.

 

[Pea-n-Me]

I had a breast needle core biopsy based on a spot on my mammogram - which was done during that time of the month - and my history (BC). Came back negative. Surgeon still wanted to make sure, so I was scheduled for an excisional biopsy, where they take out the whole area of the spot and biopsy it. Radiologist at the hospital couldn't find the spot to place a guide wire. Gone. When he looked at the original films he said he never would've done a biopsy based on that finding; he would have repeated and waited and watched, etc. We still watched it, and it never returned. He thought it was just fluid. Things can come and go in the body based on what's going on at the time. It doesn't mean they shouldn't be watched, but it also doesn't mean we should necessarily do all kinds of invasive procedures on them right away, either.