
Suggest Treatment For Bronchiectasis

Recent times it is observed that the frequency of getting infected and subsequent usage of antibiotics is increased. Last April (2014), it is observed that some blood strains came along with the sputum for about three times in a single day. He has used Tenexa and Zurosis(cough syrup) as per the advice of Dr. Jayachandra of AKJ Chest Hospital, Himayatnagar, XXXXXXX along with other medication (prescription is attached). In between he also got the spondylitis problem for which he is taking the medicine. Present problem is unbearable and almost persistent pain at the back i.e., from spine to left lung area. This is apart from the spondylitis pain. We were thinking that it is also due to spondylitis. But Orthopedic doctor Dr. Kamaraju of Kamineni hospitals, XXXXXXX checked the x-rays reports and told that the pain is mostly not due to spondylitis and could be due to lungs problem only. He is also having Homeo medicine for spondylitis and Ayurvedic medicine for lungs problem. He used to get chest pain earlier quiet rarely and for a small time. But now the pain is quiet acute and it is much more during night time. Recently i.e., on 28th Aug 2014, he again omitted blood (in small quantity may be 5ml) for three times along with sputum and he was advised by doctors to repeat the usage of Tenexa for five to eight days. We also got done ECG and 2D Echo as per the doctor’s advice to check for any heart related complications, but the report is good.
Please go through the discussion below
Detailed Answer:
Hi
Thanks for your query.
I have gone through thoroughly all the prescriptions attached here and come to know that he is suffering from bronchiectasis. It is indeed a chronic disease and sometimes has acute episodes for which he is suffering from infections and hemoptysis. In fact it is the natural course of the disease. I found Dr Jayachandra's prescription more ethical. You need to have some bronchoscopic studies and also microbial analysis of broncho-alveolar lavage. Inhalers prescribed by him are rightly needed to clear off the secretions and also to have symptomatic relief. Also you need postural drainage of lung secretions. Vaccinations against pneumococci and influenza may be of great help in your scenario. Pulmonary rehabilitation will be definitely of help. Discuss these issues with Dr Jayachandra.
If you have further queries you can write back tome.
Thanking you.
Regards,
Dr Arnab Maji
MBBS (Hons), MD (Chest Med)
Consultant Pulmonologist


Also, As I already mentioned my grandfather is facing severe pain at a particular spot near the left rib radiating towards the backbone. This is too severe for him that he is unable to sleep during night or day times. He is using ULTRACET tablet, but even that's not providing him much relief. The pain is concentrated around a particular semi circular part of the left rib. I have also observed slight swelling around that part.
Also, Dr. Bansal doubted of some Hairline crack and discussed the same with the radiologist along the CT Scan Images and informed that the pain is due to some unknown reasons and told to visit again if the problem persists still. Also, we visited another pulmologist who too doubted of Hairline crack. Is there any possibility of hair line fracture in that area.. If so, what is the method of identification of the same and the treatment for the same? Also, in genral does the sensitivity to pains increase with age?? Can we use any medicine in the night for getting peaceful sleep?
Answers of each of your questions are given below
Detailed Answer:
Hi
Thanks for writing back.
There may be a hair-line fracture which will be revealed by a CT scan. Practically even if there is a confirmed hair line fracture, there is in-deed no definite treatment other than pain relief. For pain relief he has already been given ultracet tablet. Morphine may be of help. In case of incapacitating pain you can consult an anesthetist and may go for intercostal nerve block or epidural analgesia to have some relief. Sensitivity to the pain actually decreases with ageing. But it's a slow process. you may have diclofenac potassium with paracetamol combination or tramadol or even morphine injection along with some aort of sedation to have a peaceful sleep at night.
If you have further queries I am always here to help you as much as I can.
If you are satisfied with my answer you can write a review for me.
Thanking you.
Regards,
Dr Arnab Maji
MBBS (Hons), MD (Chest Med)
Consultant Pulmonologist

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