Bad cough causing severe pain in ribs on left side under breast through under the arm into the back.

[Annie_Oh]

Diagnosed with pneumonia a few weeks ago, put on an antibiotic.  Cleared the lungs, but the coughing and choking has been extreme. I get to the point where I can't breath in.  I am on a nebulizer, 4 x's a day.  Gerds and larynx spasm have been mentioned and meds have been given for this.  That was on the a week ago.  The coughing is not making me weeze as much now, but is still extreme and causing a great deal of pain in my ribs and chest.  I also have Scleroderma, so I'm wondering if the esophagus may be involved, since it seems to be coming from the upper area and not the lungs.  Any suggestions?

[Londres70]

You are welcome.  

The Barium Swallow was very prudent to order.  

Keep me posted about the findings.  


Londres :)

[Annie_Oh]

Went to an appointment with my pulmonologist yesterday.  She sent me over to the hospital for blood work (white blood count is a little high), a ct scan of my chest (making sure there is not a blockage in my lungs which, obviously there wasn't otherwise they would have admitted me) and a barium esophogram (because of the scleroderma and the tightening of the organs, etc.) .  Will find out the results either today or tomorrow. No other meds were prescribed.  You pretty well hit on the same thing my pulmonologist was looking for.  See a new rheumy next week.  Have not been happy with the one I have now.  The one I'm seeing comes highly recommended and, I'm not sure of where you are located, but he's with the Virginia Mason Group in Seattle.  Thanks very much for your recommendations and advice.  I take it all very seriously.  

[Londres70]

Sounds like an issue more with the upper airway (Bronchi) vs. the upper GI (esophagus).  In my opinion, sounds like Bronchitis secondary to the recent case of Pneumonia.  

A repeat chest x-ray is warranted.  Ideally, I would recommend obtaining a chest CT given your medical history.  Do you see a Pulmonologist for the Asthma?  

Get the Rheumatologist's opinion and go from there.  Might not be a bad idea to have an Upper GI Endoscopy done to rule out GI issues.  

[Annie_Oh]

Had chest x-rays done two weeks ago.  Meds I'm on are:

OMEPRAZOLE 40 MG – 1 TAB ONCE DAILY BEFORE MEAL FOR 30 DAYS
     To treat gastroesophageal reflux disease (GERD),

PREDNISONE – 10 mg 3 x daily –
       Helps decrease inflammation and suppress an overactive immune system

Zabtac 150 – 1 tablet before meals – no more than 2 daily –
     Ranitidine also treats gastro esophageal reflux disease (GERD) and other conditions in which acid backs up from the stomach into the   esophagus, causing heartburn
                
BENZONATE 100 MG 3 x daily –
      Benzonatate is a medication taken orally to suppress coughs. It has an anesthetic (numbing) action similar to that of benzocaine and "numbs" the stretch sensors in the lungs. It is the stretching of these sensors with breathing that causes the cough.

LORAZEPAN – 1 MG  every 6 hours as needed for anxiety –
          Lorazepam is used to relieve anxiety. Lorazepam is in a class of medications called benzodiazepines. It   works by slowing activity in the brain to allow for relaxation.

CHERATUSSIN AC SYRUP – 1 tsp (5 ml) x 6 to 8 hrs) –
It is a cough suppressant that affects the signals in the brain that trigger cough reflex.Guaifenesin is an expectorant. It helps loosen mucus congestion in your chest and throat, making it easier to cough out through your mouth.The combination of codeine and guaifenesin is used to treat cough and to reduce chest congestion caused by upper respiratory infections or the common cold.Codeine and guaifenesin will not treat a cough that is caused by smoking, asthma, or emphysema

OVAR INHALER – 2 PUFFS TWO TIMES A DAY FOR ASTHMA –

ALBUTEROL INHALER – AS NEEDED FOR ASTHMA  –

ALENDRONATE – 70 MG – 1 TABLET WEEKLY FOR OSTEOPEROSIS -

GABAPENTINE – 300 MG – 1 – 2 capsules 2 x daily and 3 to 4 at 8pm nightly FOR SCLERODERMA


HYDROXYCHOLOROQUINE – 200 MG TWICE DAILY FOR SCLERODERMA –


PRAZOSIN – 5 MG – 2 TABLETS AT NIGHT FOR RAYNAUDS

DICLOFENAC SODIUM – 75 MG 2 x daily –
      inflammation Cervical Spinal surgery

I have an appt to see a new rheumy next week.  Perhaps he can get to the bottom of this.  Thanks much for your response.

[Londres70]

When was your last chest x-ray or chest CT done?

What are all the meds you have been prescribed? (names please)

It is highly possible the Scleroderma could be playing a part in all this.