Fall/Winter 2015-2016 FAQs

Amber Porter, MSN, FNP-BC is a family nurse practitioner at Banner - University Medical Center Phoenix Advanced Lung Disease Clinic. Amber’s primary focus is outpatient care, but she also has over 16 years of clinical research experience. Amber is asked dozens of questions in the exam room every day. On this page, she's sharing those questions and her answers. Have a question for Amber? Email us here and be sure to include "FAQs in the Exam Room" in the subject line.

Fall/Winter 2015-2016 FAQs

Question: If my dad had emphysema and my sister had emphysema and was diagnosed with Alpha 1 Antitrypsin Deficiency (A1ATD), do I need to be concerned that I might have A1ATD?

Answer: Yes. Early diagnosis is important for disease prevention even if there are no current symptoms and for stability if symptoms are present and you are deficient in Alpha 1 Antitrypsin (AAT). A1ATD is genetic, a protein which is found in the blood to protect the lungs from irritants such as smoke. The fact that your father and your sister both had emphysema and your sister was confirmed to have A1ATD means that you should be tested. When levels are low of this protein (AAT), the liver can be affected from the inability to release the AAT or the lungs can be affected due to the lack of protectant (Alpha- 1 Foundation, 2015). Early detection can guide life choices such as smoking cessation that can help to keep you healthy.

Question: If I have periods of time that my cough is not as productive do I still need to use my inhalers and airway clearance device?

Answer: Bronchiectasis can have periods where your mucous production appears to be under better control. During these periods it is still recommended to continue using the regimen recommended by your pulmonary provider. This regimen is likely why you are doing well.

Question: I have daily uncontrolled reflux. Do you think this is something to be concerned about?

Answer: Yes! Reflux (GERD), commonly called “heart burn”, is more than an uncomfortable feeling when you eat something spicy, particularly as we discuss the potential effect on the lungs. Some people with GERD may have experienced injury to the lungs from particles of stomach acid that came from stomach into the lungs. Controlling the GERD might help prevent further lung damage.

Question: How will I know I am “listed” for a lung transplant and what is that process?

Answer: The evaluation process is designed to rule out any other health concern that might be present. You will take a lot of medication after your transplant to prevent rejection and these medications decrease your immunity. We need to rule out any medical concerns that would be worsened by the medication you will need to take. The evaluation period is numerous tests which may include testing such as heart catheterizations, dermatology exam, endoscopies looking at your colon and stomach, and ultrasounds. You will meet members of the transplant team such as financial coordinator, social worker, RN coordinator, and surgeon. If everyone is in agreement with proceeding and there are no other medical concerns that would be prohibitive, the team would make you aware that you are “listed” and available for transplantation.

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