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Suggest Treatment For Severe Chest Infection During Winters
Question: I get a chest infection every Winter but this year , it is different and after starting with copious mucus from nose , a burning chest developed and now my lungs are full of liquid and I cannot stay asleep as I am jolted awake by intense pressure ,sweating ,tremors from my lungs and throat. I have tried sleeping upright ....no difference .This last symptom has gone on 5 days. The infection is in the fourth week. I slept three hours last night but have become slightly delirious from lack of sleep. I am 67 and have Behcet's Disease which is controlled by Colchicine . I suspect it is pneumonia and I think I want an Xray to check NHS will not offer it I think at this ( early ? ) point but I am prepared to pay privately but not sure if my NHS GP has to give the go-ahead for that . With Behcet's my body responds differently to infections .I live alone in XXXXXXX Keynes and not prepared to travel out of the area for any help . I have no medical insurance .The Colchicine controls the intensity of the mouth ulcers and my general condition . Several doctors have advised me by telephone and nurse checked my vital organs a week ago . GP came out two days ago and said he could hear some fluid in one lung at the base .I am sleeping on my side . GP wants a mucus and urine test on Monday ....all closed until then .
Brief Answer:
Pneumonia
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history. You probably have an incomplete Bechets which gets better with Colchicine. Considering the chest infection you are having, i would recommend you to continue antibiotics with colchicine. Colchicine being a mild immuno suppressant should not be taken alone especially in an infection state.
As for the Chest infection, Could you please let me know what antibiotics you took? I am not too sure if they were sensitive for the infection you have. Plus you need a combination and a longer course of it. I would recommend you to get an X Ray done along with mucus examination and Complete blood counts( rather than urine). If your current NHS doctor doesn't allow it, I suggest you to get it done privately. It is not early for X Ray as it has already been 3 weeks and if there is fluid in the lungs or some infection, we can easily pick it up. If you want, you can upload it here and i can give you my opinion on it.
But i wont recommend much delay it on it as we don't know what sort of infection we are dealing with. Any infection going on will affect your appetite and cause weight loss as well. My only fear, it should not trigger Bechets.
Do let me know few queries on:
1.Antibiotic used? Duration
2. ANy blood in sputum
3. Any chest pain?
4. Did you have any other manifestations of Bechets other than oral ulcers??
Await your reply
Will try to guide you further
Regards
Dr Naval
Pneumonia
Detailed Answer:
Good evening
Thank you for writing on health care magic
I have gone through your history. You probably have an incomplete Bechets which gets better with Colchicine. Considering the chest infection you are having, i would recommend you to continue antibiotics with colchicine. Colchicine being a mild immuno suppressant should not be taken alone especially in an infection state.
As for the Chest infection, Could you please let me know what antibiotics you took? I am not too sure if they were sensitive for the infection you have. Plus you need a combination and a longer course of it. I would recommend you to get an X Ray done along with mucus examination and Complete blood counts( rather than urine). If your current NHS doctor doesn't allow it, I suggest you to get it done privately. It is not early for X Ray as it has already been 3 weeks and if there is fluid in the lungs or some infection, we can easily pick it up. If you want, you can upload it here and i can give you my opinion on it.
But i wont recommend much delay it on it as we don't know what sort of infection we are dealing with. Any infection going on will affect your appetite and cause weight loss as well. My only fear, it should not trigger Bechets.
Do let me know few queries on:
1.Antibiotic used? Duration
2. ANy blood in sputum
3. Any chest pain?
4. Did you have any other manifestations of Bechets other than oral ulcers??
Await your reply
Will try to guide you further
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Prasad
Thank you . I am feeling sick quite a bit and my instinct tells me I need treatment and fast . I cannot get access to the anti biotic name as I threw away the details and surgery closed til Monday . It began with Clom or something similar....sorry ! No blood coming up . Behcet's symptoms for me are profound exhaustion ,over sensitive body.,.esp head. I need sedation for dental work for example . I have had surgeries for rectal area,thumb joint and Morton's Neuromas - 8 surgeries,three were failures and needed redoing differently .My heart is racing now as I am attempting not to panic :) Behcet's- Tinnitus type sounds which are present 24/7 since this infection took hold. I heal very slowly after surgeries . I teach part time at home to japanese students but think I might stop and work online only as my students bring me new bugs every week . I asked for antibiotics after ten days and was refused( new doctor to me ). I got them from the out of hours service ten days later . I will get the name for you ,Monday ,if that helps at all .no chest pain but I am bringing up lots of wind to my mouth esp when resting....then chest pain .
The antibiotic...I found bottle. Clarythromycin 250 and I took it 5 does over three days . I am contemplating going tonA and E now. I have a carer who can take me which is fortunate . Any advice please is welcome .
The antibiotic...I found bottle. Clarythromycin 250 and I took it 5 does over three days . I am contemplating going tonA and E now. I have a carer who can take me which is fortunate . Any advice please is welcome .
Brief Answer:
?pneumonia
Detailed Answer:
Good evening
Well, you took the right antibiotic but the dosing is a bit inadequate . we normally use 500 mg twice a day and in addition to a broad spectrum antibiotic which takes care of the organism. Since you are already on colchicine you need a better cover of antibiotics. But I will suggest you go to ER. And preferably get admitted for a couple of days. initial course of iv antibiotics will help contain the infection and then you can be switched to oral. I don't know why the doctors are reluctant in getting an x ray done and starting antibiotics. Any patient with autoimmune disease needs to be attended early. I won't suggest waiting for another week of mucus report before starting on a antibiotic.
Hope the information is useful. Do let me know for more queries
Regards.
Dr naval
?pneumonia
Detailed Answer:
Good evening
Well, you took the right antibiotic but the dosing is a bit inadequate . we normally use 500 mg twice a day and in addition to a broad spectrum antibiotic which takes care of the organism. Since you are already on colchicine you need a better cover of antibiotics. But I will suggest you go to ER. And preferably get admitted for a couple of days. initial course of iv antibiotics will help contain the infection and then you can be switched to oral. I don't know why the doctors are reluctant in getting an x ray done and starting antibiotics. Any patient with autoimmune disease needs to be attended early. I won't suggest waiting for another week of mucus report before starting on a antibiotic.
Hope the information is useful. Do let me know for more queries
Regards.
Dr naval
Above answer was peer-reviewed by :
Dr. Shanthi.E
THANKYOU .Now Saturday morning and I slept 7 hours at least :) Just to explain what happens as I wake after the longer sleep - the paracetamol has worn off from last pm and my head aches but my whole system feels strained and my heart is a bit pumping and tinnitus like sounds present . My carer/ friend took me to A and E and a doctor said vital organs ok .I asked for X-ray ...he let me have it but doubted there would be anything. There was not . He said bloods may not help to show up anything. He said to see GP Monday and get tests done . But to come back if things change / get worse before then ,to hospital . My body is under a great strain as I start to wake...is the the Behcet's doing something to my body already ?
I did not eat after lunchtime yesterday as could not face food when I tried .I hope I can manage breakfast .I am trying to eat foods not encouraging mucus .I attend Local hospital for my disease under Dr. XXXXXXX XXXXXXX ...I will leave a message on his secretary's fone . The hospital doctor I saw , thought it was not a good idea to try another antibiotic without more understanding of what is going on; noting the violent reaction my body was having to the one I took for a couple of days .My thought is the Colchicene is maybe some part of the problem.... I appreciate your feedback ...thank you ,Doctor .
I did not eat after lunchtime yesterday as could not face food when I tried .I hope I can manage breakfast .I am trying to eat foods not encouraging mucus .I attend Local hospital for my disease under Dr. XXXXXXX XXXXXXX ...I will leave a message on his secretary's fone . The hospital doctor I saw , thought it was not a good idea to try another antibiotic without more understanding of what is going on; noting the violent reaction my body was having to the one I took for a couple of days .My thought is the Colchicene is maybe some part of the problem.... I appreciate your feedback ...thank you ,Doctor .
Brief Answer:
? Is it Pneumonia
Detailed Answer:
Good evening
Well that is a good sign, considering your vitals are normal and the Chest X Ray not showing any evidence of infection. But yes blood tests are needed, not to show any infection but to rule out any side effects of Colchicine on it.
Bechets itself does not cause mucus production sort of symptoms. If it affects the lungs, it is in a very different way and a much more serious way. Since you have already been examined, it shouldnt be that. But yes, if you experiencing loss of appetite, i feel you should stop colchicine for a couple of days till you meet your GP on monday. It is a very well known drug for causing diarrhea and decreased appetite.
I am still not too convinced regarding chest infection, but yes if the antibiotic is causing a reaction you may consider taking it under supervision. You need more evaluation to rule out what exactly is happening and blood tests will give us a clue along with the sputum examination
Do let me know for more queries. Sorry but the medical system are a bit slow at your place. Here we get things done within few days, weekends also are never an issue
I will be around on the weekend for any help you need till you see your GP
REgards
Dr Naval
? Is it Pneumonia
Detailed Answer:
Good evening
Well that is a good sign, considering your vitals are normal and the Chest X Ray not showing any evidence of infection. But yes blood tests are needed, not to show any infection but to rule out any side effects of Colchicine on it.
Bechets itself does not cause mucus production sort of symptoms. If it affects the lungs, it is in a very different way and a much more serious way. Since you have already been examined, it shouldnt be that. But yes, if you experiencing loss of appetite, i feel you should stop colchicine for a couple of days till you meet your GP on monday. It is a very well known drug for causing diarrhea and decreased appetite.
I am still not too convinced regarding chest infection, but yes if the antibiotic is causing a reaction you may consider taking it under supervision. You need more evaluation to rule out what exactly is happening and blood tests will give us a clue along with the sputum examination
Do let me know for more queries. Sorry but the medical system are a bit slow at your place. Here we get things done within few days, weekends also are never an issue
I will be around on the weekend for any help you need till you see your GP
REgards
Dr Naval
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thanks Doctor Naval . I am on Colchicene for over 20 years and it has not caused me problems re my appetite or motions hardly . Can I try to explain the sensations I wake up to ? My whole upper chest feels as if glowing and I hear my system roaring intensely in my head...very scary as if my chest is about to burst or something .Quickly take two Paracetamol and after 20 minutes or so and getting up ,it subsides.That is what is worrying me ; the doctor last night , did listen but could hear very little from my chest . If my chest could be checked as I wake up , it would be maybe more obvious that I am flared up by Behcet's I suspect .Would an antibiotic I have used in the past safely ,be the right one to chose ? I live alone and am suffering a little with unhappiness / mild depression but generally my life is well ordered and satisfying . I now realise the bad side of living alone . I have some support but I am easily fatigued so unless I had a partner who knew my needs ,I cannot relax in company for more than two hours XXXXXXX .The Behcet's changed my nervous system quite a lot ; I got ill after a year of intense stress and diagnosed five years later which was a great relief....having tried so many things to get well. THANKYOU again for giving me your attention and I ate lunch ok : )
XXXXXXX
XXXXXXX
Brief Answer:
? Is it pNeumonia
Detailed Answer:
Good evening
sorry for the late reply. Was caught up in a few things
Well i guess you can wait one more day before starting the antibiotic. Let your GP examine you once and give you the right one under his guidance before you take something which may give you a reaction. The early morning sputum production is usually a sign of either Asthma or Bronchietasis, which may not be very evident on X Ray but only while auscultation we can appreciate it.
As for colchicine, you should discuss with your Rheumatologist as well. We normally dont continue it for so long. 20 years is quite a long time and one needs to taper it.But if it is controlling your disease and you dont have side effects, i guess it should be ok
i understand. Problems like this, one feels you need a good support system. I understand how you feel at this stage. Things are made so much easier if there is just that one person next to you, just to hold your hand while you sleep. But dont worry, you are gonna get better soon and you will be back to work with full flow.
Do let me know what your GP says and the blood results as well
Hope the information has been useful
Regards
Dr Naval
? Is it pNeumonia
Detailed Answer:
Good evening
sorry for the late reply. Was caught up in a few things
Well i guess you can wait one more day before starting the antibiotic. Let your GP examine you once and give you the right one under his guidance before you take something which may give you a reaction. The early morning sputum production is usually a sign of either Asthma or Bronchietasis, which may not be very evident on X Ray but only while auscultation we can appreciate it.
As for colchicine, you should discuss with your Rheumatologist as well. We normally dont continue it for so long. 20 years is quite a long time and one needs to taper it.But if it is controlling your disease and you dont have side effects, i guess it should be ok
i understand. Problems like this, one feels you need a good support system. I understand how you feel at this stage. Things are made so much easier if there is just that one person next to you, just to hold your hand while you sleep. But dont worry, you are gonna get better soon and you will be back to work with full flow.
Do let me know what your GP says and the blood results as well
Hope the information has been useful
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
It is now Tuesday and I started the 8 capsules of Doxycycline yesterday .Two the first day then one daily . I am not any better with the sleeping problem .Now I am assuming young doctors are dealing these cases....please can you find out what is happening if I try to explain ? Please I mean no disrespect but I am not being comprehended by the medics here in my town or if I am ,I wish I could have explained reassurance ; when I fall asleep within minutes I jolt awake with panic as my lungs feel at bursting point and heart pounding . Last pm I used many pillows to sleep upright completely ...I cannot go to sleep in this position and so do not get the sensations as my lung fluid is not rising . So NO rest in the form of sleep .I try to sleep by turning on my side with upper body still tipped higher but the sleep is stopped almost always within minutes by the fullness and pounding and juddering or tremouring of my chest and windpipe .Please would you research this? Remember I have Behcet's ,am 67 ,sensitive type but not hypochondriac . These symptoms are present a week or more now .I have a friend/ PA sleeping here the last 2 nights and tonight so I am very grateful for that . As many of you as possible dealing with my situation please...the more who can research it .the better .This is fifth week of viral infection .GP says bloods not helpful right now . Can I try a machine to bring up mucus? I am ordering one online today . Or will this disrupt my system negatively ? With Behjet's one's body can over react to stimulus .
Brief Answer:
? Cardiovascular or Respiratory Disease
Detailed Answer:
Good evening
Well XXXXXXX, the sort of symptoms you are describing fit into very few conditions. I totally understand you are not faking anything. It is some process going on which is going un diagnosed. I am not sure if you had it discussed with your GP. I will try to give you differential diagnosis on it and you can further discuss it with your GP
The condition you are describing looks like Paroxysmal Nocturnal Dysponea( PND) i.e., when a person lies down, there is increased blood flow from the lower limbs to the heart and if the heart is not functioning properly, it tends to give rise to the symptoms of decreased oxygenation, so much so that the patient has to gasp for breath. It is mostly due to underlying cardiac problem and patient tends to use more pillows as it gives them a sense of relief.
What is more surprising is, so far your X ray has been ok and the last examination by the ER doctor as well did not show any problem in your lungs. But considering the mucus production, you have been prescribed antibiotics. Some of the lung conditions also cause these symptoms but are very rare. Asthma for example can wake up a person at night but then we need to have some findings in the lung on auscultation.
So what i would suggest is, since your x ray has been ok and they dont find anything on auscultation, you can look up on the net for the Paroxysmal nocturnal dysponea, i just mentioned and see if your symptoms co relate. If it does, discuss it with your GP and get a cardiac evaluation done. Considering Bechets, it is quite common for the pulmonary arteries to get involved as well. If i was your physician, i would have got done a CT for the Chest and a 2 D echo which will help delineate the exact cause.
You can try the mucus thinning machines as well, but i dont think they will help much. We need to attack the exact cause for it, so it stops the overall production.
Hope the information has been useful
Let me know what you think of it
Regards
Dr Naval
? Cardiovascular or Respiratory Disease
Detailed Answer:
Good evening
Well XXXXXXX, the sort of symptoms you are describing fit into very few conditions. I totally understand you are not faking anything. It is some process going on which is going un diagnosed. I am not sure if you had it discussed with your GP. I will try to give you differential diagnosis on it and you can further discuss it with your GP
The condition you are describing looks like Paroxysmal Nocturnal Dysponea( PND) i.e., when a person lies down, there is increased blood flow from the lower limbs to the heart and if the heart is not functioning properly, it tends to give rise to the symptoms of decreased oxygenation, so much so that the patient has to gasp for breath. It is mostly due to underlying cardiac problem and patient tends to use more pillows as it gives them a sense of relief.
What is more surprising is, so far your X ray has been ok and the last examination by the ER doctor as well did not show any problem in your lungs. But considering the mucus production, you have been prescribed antibiotics. Some of the lung conditions also cause these symptoms but are very rare. Asthma for example can wake up a person at night but then we need to have some findings in the lung on auscultation.
So what i would suggest is, since your x ray has been ok and they dont find anything on auscultation, you can look up on the net for the Paroxysmal nocturnal dysponea, i just mentioned and see if your symptoms co relate. If it does, discuss it with your GP and get a cardiac evaluation done. Considering Bechets, it is quite common for the pulmonary arteries to get involved as well. If i was your physician, i would have got done a CT for the Chest and a 2 D echo which will help delineate the exact cause.
You can try the mucus thinning machines as well, but i dont think they will help much. We need to attack the exact cause for it, so it stops the overall production.
Hope the information has been useful
Let me know what you think of it
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you .Is it possible that this antibiotic could get it sorted out ? I have mania a bit this evening as so anxious not being able to sleep after so many days . The night I was at A and E , I walked about a bit and slept after that ( several nights ago ). So should I try a little exercise ? I am not bringing up much mucus .
My Behcet's doctor can see me in two weeks time as no clinic until then .I got a course of Zoplocone from GP today but am not sure they are safe to take .It is the lower dose size .
My Behcet's doctor can see me in two weeks time as no clinic until then .I got a course of Zoplocone from GP today but am not sure they are safe to take .It is the lower dose size .
Brief Answer:
Can have Zoplcone
Detailed Answer:
Good evening
Well the antibiotic can take care of the infection bit. Normally viral infection doesn't last long and the bacterial infection overtakes it. So the antibiotic will help in that part.
As for exercise you can try for a bit, but don’t do over exert yourself. You don’t want to have breathlessness getting exaggerated.
I would still suggest you talk to your GP about these symptoms and get a 2 D Echo done. Zoplcone you can have, 5 mg would suffice. It will relieve the anxiety bit.
Do let me know for more queries and if you read up on the net about the symptom I told you
Regards
Dr Naval
Can have Zoplcone
Detailed Answer:
Good evening
Well the antibiotic can take care of the infection bit. Normally viral infection doesn't last long and the bacterial infection overtakes it. So the antibiotic will help in that part.
As for exercise you can try for a bit, but don’t do over exert yourself. You don’t want to have breathlessness getting exaggerated.
I would still suggest you talk to your GP about these symptoms and get a 2 D Echo done. Zoplcone you can have, 5 mg would suffice. It will relieve the anxiety bit.
Do let me know for more queries and if you read up on the net about the symptom I told you
Regards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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