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Family Medicine (Expert Forum)
Amer. in Saudi Arabia, Fast onset symptoms, no better after nearly 4wks § 3 meds
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
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Amer. in Saudi Arabia, Fast onset symptoms, no better after nearly 4wks § 3 meds
by Carlene, Mar 22, 2003 12:00AM
First symptoms starting March 1: dry,violent cough,chest tightness,chills,general feeling bad progressing to difficulty breathing in hours. March 2nd began taking 100mg each 12hrs of doxycycline. Next 3 days all symptoms cycled from not as bad to really bad again, and 3rd day added symptoms of upper chest pain down center with 'quarter' sized areas of more intense pain on either side of chest bone, and lots of mucus that wouldn't come up,wheezing.
After 5 days felt getting better, went out for day, by evening as bad as before plus fatique. Continued the doxycycline, vitaimins, rest, but very ill with all symptoms. For first time have head cold symtoms added, and flu feelings,little appetite,dizzy.
Finally went to hospital March 12.Doctor changed meds to amoxycillin 875mg+ciavulanate potassium 125mg each 12hrs & Romilar Expectorant. Did chest x-ray they said showed no damage or pneumonia. Said acute bronchitus,drink lots of warm decaf tea,breathe steam if can't breathe. Still unable to sleep lying down or much at all,coughing,burning in chest,hard to breathe, especially at night & mornings. 3 days later have good day, get around, then hits hard again.
Go back to hospital May 19, same Doctor. Changes meds to 582mg ciprofloxacin HCI every 12hrs + small pill not named for encouraging expectorating/loosening mucus. Again in 3 days feeling a bit better, able to sleep, coughing but getting things up, get up and around, then hits hard again last night. Burning in chest after coughing, and burning spreads from center to both sides and remains burning/tight, but able to breathe better than first 3 weeks. No more head cold or flu like body feelings, but deep wheezing,deep mucus cough,always burning in chest after coughing and lasts for hours if no coughing,difficulty sleeping,hot flashes/chills/sweating,strong fatigue.
I have not had even a cold for over 2 1/2 years, I'm 54, female, smoker (cold turkey quit date april 1 - this is scaring me),good shape/weight. Because of being in middle east now,and because will NOT get better, I fear this is something like anthrax or unusual microbe or something. I never mentioned anthrax to doctor, and have taken advice and meds, but it's not going away, and when comes back as bad after feeling like I'm getting better, I get more concerned about diagnosis. Medical care here isn't good, and Doctor doesn't speak English well either.
Does this sound like acute bronchitus? If anthrax, would it go on this long without having killed me already? I feel like I am fighting it, but it keeps coming back as bad like none of the meds are working, and it's something different than I have ever had.
I am to go back to hospital the 26th, and would appreciate any help with questions, tests, etc to ask the doctor about before I go.
Thank you so very much for any help or advice,
Carlene
After 5 days felt getting better, went out for day, by evening as bad as before plus fatique. Continued the doxycycline, vitaimins, rest, but very ill with all symptoms. For first time have head cold symtoms added, and flu feelings,little appetite,dizzy.
Finally went to hospital March 12.Doctor changed meds to amoxycillin 875mg+ciavulanate potassium 125mg each 12hrs & Romilar Expectorant. Did chest x-ray they said showed no damage or pneumonia. Said acute bronchitus,drink lots of warm decaf tea,breathe steam if can't breathe. Still unable to sleep lying down or much at all,coughing,burning in chest,hard to breathe, especially at night & mornings. 3 days later have good day, get around, then hits hard again.
Go back to hospital May 19, same Doctor. Changes meds to 582mg ciprofloxacin HCI every 12hrs + small pill not named for encouraging expectorating/loosening mucus. Again in 3 days feeling a bit better, able to sleep, coughing but getting things up, get up and around, then hits hard again last night. Burning in chest after coughing, and burning spreads from center to both sides and remains burning/tight, but able to breathe better than first 3 weeks. No more head cold or flu like body feelings, but deep wheezing,deep mucus cough,always burning in chest after coughing and lasts for hours if no coughing,difficulty sleeping,hot flashes/chills/sweating,strong fatigue.
I have not had even a cold for over 2 1/2 years, I'm 54, female, smoker (cold turkey quit date april 1 - this is scaring me),good shape/weight. Because of being in middle east now,and because will NOT get better, I fear this is something like anthrax or unusual microbe or something. I never mentioned anthrax to doctor, and have taken advice and meds, but it's not going away, and when comes back as bad after feeling like I'm getting better, I get more concerned about diagnosis. Medical care here isn't good, and Doctor doesn't speak English well either.
Does this sound like acute bronchitus? If anthrax, would it go on this long without having killed me already? I feel like I am fighting it, but it keeps coming back as bad like none of the meds are working, and it's something different than I have ever had.
I am to go back to hospital the 26th, and would appreciate any help with questions, tests, etc to ask the doctor about before I go.
Thank you so very much for any help or advice,
Carlene
Doctor's Answer
by Kevin Pho, MD, Mar 23, 2003 12:00AM
, Mar 23, 2003 12:00AM
Hello - thanks for asking your question.
Please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only. Please see your personal physician for further evaluation.
Inhalational anthrax would be very unlikely. Although the symptoms would mimic a severe pneumonia, you would be much sicker (i.e. hospitalized) if it were true anthrax. A CXR would have a suggestive finding (known as a "widened mediastinum") if anthrax were present.
The medications that you were put on (doxycycline, augmentin, ciprofloxacin) are appropriate for both bronchitis and pneumonia.
If you are not responding to the antibiotics, then further evaluation is required to determine whether you have uncommon conditions that can cause your symptoms. This can include a mass, allergic bronchitis (known as eosinophilic bronchitis), abscesses, airway damage, or rare pathogens. Evaluation with a chest CT and/or fiberoptic brochoscopy would be the next step.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only. Please see your personal physician for further evaluation.
Inhalational anthrax would be very unlikely. Although the symptoms would mimic a severe pneumonia, you would be much sicker (i.e. hospitalized) if it were true anthrax. A CXR would have a suggestive finding (known as a "widened mediastinum") if anthrax were present.
The medications that you were put on (doxycycline, augmentin, ciprofloxacin) are appropriate for both bronchitis and pneumonia.
If you are not responding to the antibiotics, then further evaluation is required to determine whether you have uncommon conditions that can cause your symptoms. This can include a mass, allergic bronchitis (known as eosinophilic bronchitis), abscesses, airway damage, or rare pathogens. Evaluation with a chest CT and/or fiberoptic brochoscopy would be the next step.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
This burning pain is like heartburn pain, but all over, and with a heavy feeling. When I first wake up, no pain... then coughed a bunch, but no pain coughing... then it starts deep in lungs, the spreads outward. Then once it's here, it doesn't go away, but intensifies after more coughing. It is very strong on upper sides of chest under both underarms and armpits. Also occassionally feel like I can't make myself take a deep breath.. it's heavy tingling pins and needles burning feeling mostly like in chest muscles after originating where the cough started moving/loosening mucus.. also dizzy and headache on and off.
I've been finished with Cipro for 24 hours, but could this still be a reaction to that drug? I am now not taking any medication but asprin until/if on wednesday he prescribes more. I wonder if I could have hurt myself, a nerve pinch or something to get this burning? Or could this burning be caused by anxiety and side effects to these meds I've taken for 3 weeks? I'm going to see if I can go to an on compound chiropractor today just to try to rule out neck or spinal nerve pinch, and to some extend anxiety causes.
I go back to hospital wednesday and will ask about CT as you said, and wonder if I should also ask for another xray and for them to let me see a specialist. What specialist should I ask for? This isn't a family, personal doctor.... the health care here isn't like that. Saad medical hospital has all the equipment and awesome facility, but they don't have the reputation for knowing what to do with it all... haha... Our plans as expats are always to just NOT get sick. So any help in giving me specific things to ask them or tests to run, etc will help get them on a diagonostic path, I hope anyway.
I've never had anything like this, nor ever been sick this long with anything... thanks for your advise...
Carlene
If you're still coughing despite antibiotics, you may want to see a pulmonary specialist.
Another consideration may be heartburn. Uncontrolled heartburn can also cause chronic cough. You may ask your physician about treatment for this.
Thanks,
Kevin, M.D.
Last night I drank a hot tea of grated ginger and honey and it was soothing to the burning, although it didn't leave completely, I was able to get to sleep. I'm trying that this morning too, but so far it's not helping me open up my chest.
I've not had antibiotics for two days. The doctor only prescribed me 5 days of cipro since last weeks appointment. Funny, except for the awful burning and coughing often (but getting stuff up and being able to breathe well last couple of days), I was feeling so much better than I am feeing right now. This feels so strong... like these last 4 weeks and I'm right back to beginning again. Hard to breathe deeply. No head cold or nasal symptoms for over 2 weeks though.
I am pretty worried now... just can't seem to shake this or keep building on the gains. My husband is also sicker, and he says to print all this off and take with us to the hospital. I will ask for a pulmanary specialist this time. I've been up about an hour, and now after all the coughing but getting nothing up or loose, the burning is coming back, but localized in the middle of my chest and not radiating all the way to under both arms.
Carlene