Overview
A pneumothorax is a fairly common
complication of CF. It happens when a small area of the lung bursts, letting air
leak into the pleural space (a thin space between a lining that cover the lungs
and the chest cavity). This creates pressure around the lung, making the lung
collapse. Between 10-25% of people with CF will develop a pneumothorax. Regular
physiotherapy and taking your medication may help prevent lung damage that may
lead to developing a pneumothorax.
What are the symptoms of a pneumothorax?
Patients who experience a pneumothorax generally describe it as a sudden, sharp pain in the chest and/or shoulder, with increased shortness of breath. Sometimes, these symptoms occur with lower saturation (oxygen in the blood) and increased heart rate. Often, the two sides of the chest are inflating unevenly.
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What should I do if I think I have a pneumothorax?
A pneumothorax requires immediate medical attention. You need to go to the hospital at once. It is
a serious condition. A chest X-ray will be done along with a doctor's examination. If you think you
have a pneumothorax, don't do your breathing test until your chest X-ray is done, as this test might worsen the pneumothorax.
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What are the treatments for a pneumothorax?
The treatment of pneumothorax depends on its size. If it's minor, treatment may
only be observation with or without the use of oxygen. If it's more serious, you
may need a chest tube in order to remove the air from the pleural space and give
your lung a chance to heal itself.
Am I at risk of having another pneumothorax after I had a first one?
Unfortunately, yes. Studies have shown that people who have had a pneumothorax are at a higher risk of having a second one, especially within six months. If this happens, your physician will discuss further treatment options with you and your family.
Can I go back to my normal life after a pneumothorax?
Yes. It might be wise to avoid certain activities such as scuba diving and flying in a depressurized aircraft. Activities such as these may increase the risk of developing a pneumothorax.
What is hemoptysis?
Hemoptysis is a condition where people
cough up blood from their lungs. It is a common complication of CF -- in fact,
some studies state that 60% of the patients with CF will experience
hemoptysis.
Hemoptysis can be very stressful,
especially when it happens for the first time. There are three types: minor,
major and massive hemoptysis.
- Minor hemoptysis usually involves only
a small amount of bleeding. An inflammation or infection in the lungs generally
causes this type of hemoptysis. The amount of blood can vary from streaks of
blood in your mucous to a few teaspoons of blood during the day.
- Major hemoptysis is harder to define,
but it usually involves patients coughing up a few teaspoons of blood over a
period of 24 hours.
- Massive hemoptysis is a very serious
condition, with patients coughing up more than a few teaspoons and up to two
cups of blood over 24 hours. If you have either major or massive hemoptysis, you
must go to the hospital immediately.
What happens in my lungs when I have hemoptysis?
Sometimes, CF patients will develop bronchiectasis - or enlarged
bronchi and bronchioles (airway tubes) -- in their lungs. These enlarged
areas have more blood vessels close to the surface, so they are more prone
to leaking or rupturing during an infection. During massive hemoptysis, a
bronchiectatic area of the lungs will burst, and the blood in this infected
area is coughed up. Mucous can either be streaked or bloody.
What should I do if I have hemoptysis?
Hemoptysis can make people very anxious, so try to remain calm. If you are coughing up bright red blood, go to the hospital immediately. If the bleeding is minor, contact your CF clinic, as you will certainly want to be evaluated. Every time you have hemoptysis, try to take note of how much blood you are coughing up since the doctor will ask you for a rough estimate of the amount.
What are the treatments of hemoptysis?
Treatment depends on the severity of the hemoptysis and where it's located. It can vary from:
- observation (with or without antibiotics)
- embolization – a procedure that consists of blocking the blood vessels that are causing the bleeding.
- surgery
Your doctor will discuss these treatments with you in greater detail.
Am I at risk for other episodes of hemoptysis after I had it once?
Since hemoptysis is common, you are still
at risk of having another episode. There is no way to prevent a massive
hemoptysis but sticking to your medical treatment certainly cuts down the chance
of further lung damage from occurring. Preventing lung damage can prevent
bronchiectasis.
Can I resume a normal life after hemoptysis?
Yes, definitely! However, if you're
experiencing major or massive hemoptysis, don't do physiotherapy or breathing
tests as they might trigger another episode. Contact your CF clinic if you're
uncertain.
