
Stomach Pain, Weight-gain And Shortness Of Breath After I Quit Smoking. X-ray Shows De-mineralized Bones And Spine Problems. Advice

All problems are due to effects of chronic smoking
Detailed Answer:
Hi Mr. XXXXXXX
Thanks for your query.
* Firstly, most of your problems- including weight-gain, shortness of breath (due to a condition called Emphysema --> COPD) OR, possible coronary artery disease; smokers' acidity (called Chronic Gastritis) or stomach ulcers; demineralization of bones (called osteoporosis) are due to long-term effects of chronic smoking.
* Further, osteoporosis can partly be due to ageing process.
* I personally feel that Endoscopy- instead of Barium swallow test- should be done to see for any stomach ulcers/growth or, a bacterial (H. pylori) infection, which would be diagnosed by analysis of a scrapping of inner lining of stomach.
* Other investigations, which should be done are:
- Lung function tests to assess the efficacy of lung functions. In chronic smokers, the lungs lose their elasticity (condition called Emphysema), or cause asthma-like problems; both of which culminate into a predominantly-irreversible condition called Chronic Obstructive Airway Disease (COPD).
- Heart functions test, particularly stress ECHO/Thallium test or TMT (which diagnose narrowing of heart vessels- a condition called coronary artery disease). Chronic smoking is the greatest risk factor for this heart disease, which too manifests as shortness of breath on exertion.
- Lipid Profile Test, to see for levels of different types of harmful cholesterols- which invariably occurs in long-standing smokers. These harmful cholesterols get deposited in the blood vessels of heart, brain other organs, and to their narrowing--> reduced blood supply.
- DEXA scan to see the extent of demineralization of bones
- Thyroid hormone levels to exclude/confirm hypothyroidism, in view of weight gain.
Therefore, consult your doctor and discuss my views/opinions/recommendations with him. I am certain that he will agree with me and order all tests as advised. On seeing the tests' reports, he will prescribe treatment which is most appropriate for you.
Hope I have answered your query. I will be only too happy to answer further clarifications, if any.
Fond Regards,
Dr. Rakesh Karanwal


Chest aches/pains are due to muscles' spasm/COPD
Detailed Answer:
Hi Mr. XXXXXXX
Welcome back!
It's a positive sign that your heart is still in excellent shape.
Aches and pains in the chest are usually due to either, spasm of the muscles between the ribs. This occurs due to extra strain imposed on them during breathing effort, as in COPD or Emphysema. A short course of anti-inflammatory pain-killers(such as ibuprofen + paracetamol combination) + muscle relaxants (such as chlorzoxazone) will rid you of pain if due to muscles' spasm.
If due to constant strain due to emphysema or COPD, easing inflow and outflow of air into the lungs (with inhaled bronchodilators and steroids) will relieve undue strain --> reduced chest pains.
Degenerated discs in neck are less likely to cause such chest pains. Nerves emanating from the neck spine, supply mainly arms, shoulders and uppermost part of the chest.
While awaiting appointment with Lung Specialist, consult your treating doctor, who will auscultate your lungs. If he finds narrowing of wind pipes, he will prescribe inhaled bronchodilators + inhaled steroids to ease breathing problem.
Fond regards,
Dr. Rakesh Karanwal


Please give more details and values of proteins
Detailed Answer:
Well, Mr. XXXXXXX
BMD and DEXA are one and the same test.
I am sorry I could not follow where you have extra protein. If it is in urine, would point towards early impairment of kidney function.
If the extra protein is in the blood, well! There are primarily two types of proteins in the blood : albumin (produced in liver); and globulins. Usually, reduced blood albumin may be seen in early liver involvement.
I am afraid I will not be able to comment unless the name AND value of proteins (that you are referring to); and whether they were detected in blood or urine.
Fond regards,
Dr. Rakesh Karanwal


ALL REPORTS ARE NORMAL
Detailed Answer:
Hi Mr. XXXXXXX
Nice to hear from you.
I have gone through all your test-reports carefully. ALL REPORTS- INCLUDING SERUM PROTEINS LEVELS- ARE WITHIN NORMAL LIMITS. The so-called mild abnormality in the band of IgG is ONLY OF ACADEMIC INTEREST and thereby, bears no significance in clinical practice.
Hence, I once again recommend that you follow my advice as given in the previous answers and do NOT be troubled by normal variations.
Fond regards,
Dr. Rakesh Karanwal


Thanks a Lot!
Detailed Answer:
You're most welcome, Mr. XXXXXXX
Wish you a speedy recovery & Good health.
Fond regards,
Dr. Rakesh Karanwal

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