Brief Answer:
you need to get investigated as well as examined thoroughly ..

Detailed Answer:
Dear xxxxxxx, Welcome to HCM..

I've gone through your query and understand your concern..

Your previous symptoms were suggestive of allergic bronchitis..but a detailed examination was definitely needed to confirm it which i believe the pulmonologist must've already done..

Now please let know what all tests have you already done and share the reports(you can simply upload them in the reports section) so that I can guide you more specifically..

Does the pain only happening during swallowing ?

Any fever lately ?

What relieves/worsens the pain ?

Do you have any history of smoking ? any history of asthma ?

Any other relevant past/present medical/surgical history ?


As per your description, it can be due to GERD but less likely as the sharp pain on right chest while swallowing can be due to several other causes (muscular strain, hiatus hernia, tonsillits, allergic response, pneumonia, globus and several others.)..

So to confirm the exact diagnosis, you need to get a fresh Chest X-Ray(PA and lateral view) done along with a clinical examination either by your pulmonologist or any other internal medicine specialist..

Please let me know the details..

Take Care
Kind Regards

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Brief Answer:
too many investigations without proper direction already, please follow the advises below..

Detailed Answer:
Dear xxxxxxxxx, Welcome back,

Thanks for following up, i can understand all these doubts you're going through , but please be systematic while following up (please try to answer those questions asked already without any hurry as without proper clarification, specific guidance will also be hampered)..

However, from your descriptions, it seems that you've undergone a lot of investigations already (some of which are unnecessary too).. so even though you haven't shared any of those results of those investigations for my assessment, I'd still advice you not to go for any further testing (MRI Chest may not be a sensitive investigation at all in this case)..

Mantoux test doesn't carry much significance now a days (in aspect of tuberculosis as almost everyone of us are heavily exposed)..

First of all, just take whatever you've done so far and simply schedule the appointment and go to the Pulmonologist for a detailed clinical evaluation, while any further investigations can only be planned after a thorough check-up and complete evaluation of your history..

No need to go to the internal medicine specialist as of now, neither there's any need of MRI (as per your description so far), just get yourself checked in details at first by the Pulmonologist for further course of action..

HRCT thorax along with chest X-ray and those other tests (including serum IgE) is enough for the time being for any pulmonologist's opinion and diagnosis, so no more test till the consultation..

I've tried to make it as simple as possible for you to understand in this small window, please feel free to ask if there's any further doubts..

Let me know how you stay in the due course..

Take Care
Kind Regards

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Brief Answer:
It's EBUS-TBNA not EBNS..

Detailed Answer:
Dear xxxxxxxx, Welcome back,
Sorry for the delay in my response due to work schedule,

I've gone through all the details, and reviewed the HRCT reports along with the prescription..

First of all, let me tell you that every standard medical procedure carries some risk but here the benefit outweighs the risk, that's why they are needed to be done..

EBUS-TBNA (Endobronchial Ultrasound- Transbronchial Needle Aspiration) is the gold standard investigation for this type of mass/lesion, however there are alternatives available i.e. the conventional Bronchoscopy which is also mentioned by your Pulmonologist.. don't worry, you'll be given some form of anesthesia during the procedure, so that you don't feel any pain/discomfort..

Well, all the antiallergics are prone for causing some sedation/dizziness, however Allegra is one of the newer generation drug having really less chance of it..

So you can start Allegra once a day, see how your feeling, and then can make it twice a day after 2-3 days..also continue the Asthalin, it's for long term benefit so you may not feel it immediately, also you need to use it properly, if not delivered into your respiratory tract,the medicine won't be effective..

Here, check this link of youtube, it'll demonstrate you about the proper use-
https://www.youtube.com/watch?v=ma_cmlU9DxU

Those are just, some of the possibilities written there by your Pulmonologist, doesn't mean that your having cancer.. in fact, chances of having cancer is really less, compared to the other possibilities, and the first suspicion is Tuberculosis which your chest physician will definitely agree with..

However, it's only after this confirmatory investigation, the exact nature of the lesion/mass will be confirmed, and those other investigations (Na/K/Urea/Creatinine/PT/INR) are necessary pre-requisite for Bronchoscopy/EBUS-TBNA..

So please, be brave and go ahead with this, don't worry, you'll be fine..

Let me know how it goes in the due course, any queries you have, feel free to share..

Take Care
Kind Regards

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Brief Answer:
please discuss with your pulmonologist reg. getting a fresh PFT later on..

Detailed Answer:
Dear Sulagna, Welcome back ,

Thanks for following up..

I've gone through the details, well the primary aim with Asthalin treatment is to keep the 4 to 6 hrly interval intact, timing varies from person to person.

So, you can simply start taking the first puff at 6 am based on the severity of symptoms, followed by 10 am, in b/n 2-3 pm then observe for next few days, if you feel breathless anywhere in b/n 7-9:30pm then only take the last puff in that period, otherwise take it in b/n 9:30-10pm only, no problem, only thing is to observe and meet the need at the time of your body's need(every human being's body system is unique, thus changes and responses are also dynamic)..and if there's any sudden onset breathlessness you can always take one rescue puff.. most importantly, remember to wash and rinse your mouth pref. with chlorhexidine mouthwash afterwards..

Yes, smoke and fumes from cooking is definitely aggravating the overall process..so if possible try to avoid it, you can also use exhaust fan/high speed turbo-chimney while cooking, but those are off-course not that full proof method..

Due to chronic cough and infection, the respiratory passages (mostly the vocal cords as well as the larynx get inflammed, as well as over-sensitive), so when there's another act like laughing or crying, there's excessive stimulation of them mistaken as a protective reflex called caugh, it'll take some time to go away, but before this the main symptoms and the disease process has to controlled..taking deep breaths, holding them for a while(few seconds, pref. a set timer on a stop watch/mobile) and them slowly exhaling will help you.. practice it several times a day, you'll feel better..

Let all these primary concerns get over with, and later on(after few months) discuss with your pulmonologist regarding doing a repeat PFT with and without Bronchodilator..

Main aim is to avoid direct exposure to A.C. or even any strong cold wind, as the cold dry air quickly sensitizes your respiratory mucosa and causing discomfort..

Don't sit directly in front or underneath them..Keep a face mask with you(sounds and looks uncomfortable but really helpful) and put it on in those unavoidable situations..

Avoid over crowded places, where there's always a high chance of contracting pathogens from other atmosphere/people..

Take steam inhalation three to four times a day, it'll provide a soothing effect..

Yes follow the same during winter also, additionally covering the the face and throat with scarf etc.

Let Me know how you stay in the due course..

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041


Take Care
Kind Regards

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