Question: I have a viral infection and apparently it has triggerd a wheezing cough and a nonproductive cough. I was put on Z-pack last Friday b/c I was running a temp and I guess the PAC thought it was bacterial, but I was still running a temp up until today. 100.5, 100.4, 99.8. Clear drainage from my nose. I was seen Monday by my family phys. and put me on Xoponex nebulizer treatment and Mucinex, 1200 mgs. in the AM and 600 in PM along with Mucinex DM. Yesterday I was in to see him again, and he decided to put me on Medrol Dose pack to try to help the wheezing and see if I could break up this cough to be more productive. I know it takes about 2 days for the steroids to kick in, but wish I knew why the larynx seems so tight. I do have asthma in the past. I completed the Z-pack yesterday and I know it stays in your body for 5 more days. I can see why the CDC wants medical professionals to be cautious with giving antibiotics. I don't know why the PAC did not wait until 7 to 10 days. My daughter is an epidemiologist in VT, and is always annoyed b/c you should wait 7 to 10 days before giving antibiotics. Can you please also give me your opinion. Much appreciated. XXXX

Thank you for answering my inquiry. I am still concerned why my cough still is not productive even using the xoponex inhalation therapy, muscinex and muscinex DM. The z-pack should be in my body until Monday. I am also taking the Medrol dose pack until this Monday. What else can be done or do I have to wait to see if another antibiotic has to be given?

Thank you Dr. XXXXXXX once again. Just to update you, I cannot take Albuterol as it increased my heart rate to 98, and my BP went up to 188/94. Therefore, I was switchen over to Xoponex 1.25 in the nebulizer. I also have the inhaler to carry in my purse if I need to take it q 4 hrs. as needed. I am on the Medrol Dose Pack, Mucinex 1200 mgs. in the AM and 600 mgs in the PM and Mucinex DM in the PM if I need to quiet cough. I too wondered if my tight cough is more of an allergic bronchitis, as I am allergic to mold also. I rec'd the injection the day before all my symptoms started which is a week ago today 3/14/14. But because I had temps running from 99.4 to 100.5 for nearly 5 days, could this still be viral? Any mucus from my nasal passges are clear. I am also using the sinus rinse twice a day with distilled water to keep the nasal passages clean. Z-pack should be in my system until Monday 3/17/14 and I will have completed the Medrol Dose pack on Monday also. If you feel all what I am doing is fine, please let me know. Do you think after all this, I would have to be tried on another antibiotic? Especially if there is no discolored mucus? XXXX

Hi Dr. ViveK; I just want you to know I appreciate your taking time to answer my questions. The Z-pack should be out of my system on Monday, and the Medrol Dose Pack I will have also completed by Monday. I continue to use the Xoponex inhalation therapy q 4hrs. I plan to go back to work, as I work for St. Luke's Hospital in Bethlehem PA, the St. Luke's Physician Group. I work in the business office and we do all the billing for the physicians owned by the hospital. Is it a good idea to use my Xoponex inhaler q 4 hrs. while at work? I still wonder if getting the mold shot a day before I came down with this infection, made things worse? But who knows. My allergist did ask me to call him on Monday if my cough is still not breaking up, as he might have to increase the steroids. I hope not, as I don't like being on steroids too long of a time, but with allergy pts. and asthma pts. sometimes you have to until this corrects itself. I am not taking any Claritin or Coricidin HBP because I think the antihistimine might make my cough drier if I am correct. Can steroids produce a ringing in the ears and fluid retention? I suffer from Meniere's Disease periodically and watch caffeine, salt as I am on a HBP XXXXXXX with diuretic. But I don't want to get an episode of the vertigo, but I read that that could be a side effect of Medrol. How long can allergic bronchitis last? Should I continue with the amount of Mucinex I am taking? I don't know if you heard of the Doctors Program nightly? They are starting this being able to call a dr. on our Iphone and get advice, treatment, and prescriptions. I guess this is the new trend also. I think this program that you are involved in will help many people. I will be waiting for your answer. I worked in Neurosurgery for almost 30 yrs. and attended nursing school in the past years ago, but had to drop out 6 mos before graduation as my mother became very ill and I had to stay home and take care of her. I worked in ICU 2 1/2 yrs. also in the past. So I have been in the medical field since 1963. Worked in the OB/GYN residency program for the chief and director also at St. Luke's. Did consulting for ENT, Neurosurgery, Nephrology also. Help start up a surgi-center in Bethlehem Twsp. I know I have an extensive background, and am always trying to learn more, but when I myself get ill, you worry more because you are use to helping others. But now I have to worry about myself a little too. Thank you once again. XXXX

Dear Dr. Chail: So good to hear from you again. And thanks for reassuring me I am getting better. I wondered if I could use my inhaler of Xoponex while I am at work? I will use the nebulizer before work and when I get home and before bedtime. But thought during the day as long as it is 4 hrs. from when I used the inhalation, I could use the inhaler (which I will always carry in my purse). Yes, I will only use 1200 Mucinex in the AM and only 600 at night. I haven't been using the DM anymore, as I am not coughing during the nite, unless I get up to go to the bathroom. I'm trying to drink as much liquid as I can to stay hydrated. I'll keep you informed. I have (2) more steroid pills to take, one tonight and one tomorrow morning than I am done. I still feel run down, but it will be 10 days tomorrow all this started. Maybe if the weather warms up a bit, everyone will feel a little better. Thanks again. XXXX

Dear Dr. Vivek: Thank you once again for giving me your medical expertise. It was good to get back to work, even though I am still not 100% myself. But I'm use to being a very energetivc 68 yr. old and am not once to just sit. I like to keep active. But I will have to let my body get a little stronger. Lower back hurts and feels sore, probably b/c I am sitting at my desk in a week. Even though I have been getting up and down. I will continue the use of my nebulizer this week yet and see how well I do. Also completed the steroid pack today. Will continue on the mucinex. Only taking 1200 in the AM and 600 in the PM. Maybe I really don't have much mucus to bring up, as I don't seem to bring any mucus up. It sounds a little more loose, but maybe as you said in the beginning, it could be the irritation in the airway and larynx. I just hope I am not infected as my grandchildren are coming from Vt next Thursday, a week away. I'll keep you informed my progress. thank you again. XXXX