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Chest infection and pain management - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Lung and Chest disorders
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3316 Questions
User :   It's been three weeks that I have chest pain. What is wrong with me?
Doctor :   hi
Doctor :   Dr. XXXXXXXX here
User :   hello Dr.XXXXX
Doctor :   please explain/describe your symptom in detail
User :   the first time i experience chest pain was 6 months ago...i went to hospital..the doctor said i have viral respiratory infection...i did what he said...then i got well
User :   however...
User :   3 weeks ago..i started to have chest pain again...i was in vacation living in the same house with my friend who is a doctor...he gave me naprosxyn and prilosec..he said take those and observe
User :   however...i wast getting better for about a week
Doctor :   ok
Doctor :   did you continue those medications?
User :   yes i continued taking those medication...after a week, i experience fatigue, still have chest pain, tightness on my chest, and i noticed that im starting to have rashes on my arm (armpit side)...i was sent to the hospital, then they found out that my TSH is they gave me levothyroxin
Doctor :   ok
User :   then after
User :   still there dr. xxxxx?
Doctor :   yes please proceed
User :   i got disconnected
Doctor :   I am here
User :   ok
User :   they gave me levothyroxin enough for 1 week
User :   im having trouble with my net connection..anyway
User :   last week
User :   i visited my regular doctor here in Los Angeles...she prescribed me levothyroxin too...
Doctor :   ok. are you feeling better after starting with levothyroxin?
User :   no..
User :   chestpain is still there
User :   and the rashes on my arm are getting more and more
User :   arms
Doctor :   ok. are there any other associated symptoms apart from chest pain?
Doctor :   does the pain come with chest tightness, palpitation, breathing difficulty?
User :   4 days ago, i noticed that everytime i wake up in the morning, my throat is dry
Doctor :   is it centrally located or left sided?
User :   left side
User :   sometimes central
User :   but more on left side
User :   sometimes my back hurts too
User :   last night the pain went to my shoulder,just below the clavicle,left side
User :   right now im thirsty
User :   but i just drunk water
Doctor :   ok. do you have have belching, flatulence, burping, chest burning sensation?
Doctor :   do you have excessive mucus sensation in throat?
Doctor :   are you there?
User :   still here..having trouble with my net connection
User :   i dont know what belching,flatulence are...but no burping....chest burning sensation sometimes
User :   no excessive mucus sensation
Doctor :   ok. try to log out, and log in again after 10 minutes. your internet problem might get solved
Doctor :   which browser are you using at present?
User :   what do you mean browser?
Doctor :   yes
User :   lets just continue...i will do that when i get disconnected again
Doctor :   ok
Doctor :   have you had ECG and other tests done?
Doctor :   if yes please mention the test results and their outcome
User :   when i went to the hospital, they also took says: this individual breaths to 8 1/2 ribs where 9+ are full inspiratory effort (here is some uplifting of cardiac apex and bronchovascular crowding at the lung base, as a result). THe heart is not enlarged. The lung fields are otherwise clear.
User :   conclusions: normal heart and lungs
Doctor :   ok
User :   6 months ago, they did EKG everything is normal
User :   why do i have uplifting of cardiac apex?
Doctor :   it is usually seen in cases of people with cardiac problems
Doctor :   and with congenital anomalies involving heart
Doctor :   you should consider meeting a cardiologist and discussing your symptoms
Doctor :   alsong with ECG and ECHO tests
Doctor :   *along
User :   how come my doctor did not mention that to me
User :   if i have uplifting of cardiac apex, how come the conclusion is my heart is normal
Doctor :   I do not know, as per symptoms and the x-ray results described by you, I have suggested you the probability
Doctor :   get ECHOCARDIOGRAM done to confirm the exact cause
User :   also i have on and off low grade fever
Doctor :   if your symptoms are cardiac related or not
Doctor :   do you have exaggeration of symptoms when having fever episodes?
User :   usually i have tightness on my chest when i get low grade fever...but the low grade fever usually last for about an hour or two and that's it
Doctor :   ok. is there palpitation, shortness of breath associated?
Doctor :   during these episodes?
User :   shortness of breath, yes
User :   but it goes away, wont last for 30 mins
Doctor :   ok. then I would recommend you not to delay your visit to cardiologist for complete analysis of your symptoms and exact cause
User :   is related to my thyroid too?
User :   when they found out that i have high TSH, they said that i have hypothyrodism
Doctor :   no it may not be related to thyroid if your thyroid levels are controlled with taking levothyroxine.
User :   is it really hypothyrodism if my TSH is high but my T4 and T3 are normal?
Doctor :   yes, TSH is thyroid stimulating hormone produced by brain (pituitary gland) to tell thyroid gland to produce T3, T4
Doctor :   if it is high, that mean sthat there is abnormality
Doctor :   get free T3, and Free T4 analysis done along with repeat TSH levels to see the exact status
Doctor :   if teh free T3, and T4 are also normal, with TSH being high, then it is hypothyroidism
User :   how about the rashes on my arm?
User :   they are itchy
Doctor :   please describe them in detail (about appearance)
User :   like a bunch of petichia
Doctor :   ok. are they at skin level or raised than skin level?
Doctor :   are they in clusters or isolated?
User :   raised than skin level
Doctor :   is it possible for you to send a picture of them for me to understand them better?
Doctor :   if yes please send it at YYYY@YYYY
User :   i can send it to you but not right now
Doctor :   and address it to DR. AAAAAAA
Doctor :   ok. you can send it later and come back to chat with me.
User :   can i do it tomorrow..i have 30 day subscription to this site
User :   why is throat dry when i wake up in the morning?
Doctor :   yes you can do it. I am available between 9Am-4PM (IST). In my absence my colleagues too can help you with your query
User :   why is my throat dry when i wake up in the morning?
User :   still there/
User :   ?
Doctor :   yes..I am chatting with other patients too, please bear with me for a reply
User :   oh sure
Doctor :   please describe the dryness that you feel. i sit like a painful feeling or just dryness?
Doctor :   is it associated with altered sensation in nose
User :   just dryness...when i drink water, i feel the roughness on my throat
User :   that happens when i wake up in the morning only
Doctor :   ok. try with having warm water at night before sleeping
Doctor :   and avid direct blow of air on face
Doctor :   when sleeping. try with gargling with warm salt water on waking up
User :   ok i will
Doctor :   is there anything else I can help you with?
User :   im thirsty right now and i feel the burning sensation again on my chest, also my left back shoulder hurts
Doctor :   ok. try to eat something
Doctor :   have something mild
Doctor :   avoid leaving stomach empty for more than 3 hours except when you sleep
User :   ok...i will go to sleep after our chat..should i still eat something?
Doctor :   yes, you sould. it will help you to get sound sleep
Doctor :   and without problems of throat dryness and chest discomfort
User :   but my friend who's a doctor told me that i should only eat 3 hours before going to sleep
Doctor :   since you are having symptoms at present you should eat something mild
User :   oh ok...anything?
Doctor :   avoid having heavy meal just before sleeping, have atleast 2 hours before sleeping
Doctor :   something mild like 2 biscuits or some small serving of salad
Doctor :   or some juice (not citrus like lemon, orange).
User :   oh ok...i will try a slice of bread
Doctor :   ok. that is fine.
Doctor :   is there anything else you would like to ask me?
Doctor :   are you there?
User :   still here
User :   im having difficulty breathing
Doctor :   i sit associated with sweating , palpitations?
Doctor :   *is it?
User :   no
Doctor :   is there chest pain, discomfort associated?
User :   i have low grade fever
User :   discomfort on my back
User :   on and off chest pain
Doctor :   ok. have you taken any medication?
User :   just tylenol like 4 hours ago
User :   beacuse i have low grade fever
Doctor :   ok. if 4 hours are over you can repeat the dosage
User :   i think ive been taking tylenol almost everyday everytime i have low grade fever...why do i have on and off low grade fever almost everyday
Doctor :   if it is du eto cardiac related problem like anomalie with mild endocarditis, you might have on and off fever
Doctor :   with back pain and shortness of breath
Doctor :   hence I suggested you not to delay your visit to a cardiologist
Doctor :   have you followed what I have said?
User :   yes....
Doctor :   go ahead with the suggestions as above and get back to me for a follow-up once you finish your further investigations and cardiology consultations.
User :   when should i go to emergency?
Doctor :   it will be more helpful
Doctor :   if breathing trouble in not yet controlled then visit ER (emergency room)
Doctor :   or if you develop palpitations, sweating chest pain radiating to jaw, shoulder and causing breathing trouble
User :   now i feel pain on my left side from armpit to waist
Doctor :   ok. are you having stomach distension, or discomfort?
Doctor :   is there belching, burping sensation?
User :   no
Doctor :   is there burning sensation in chest?
User :   no
User :   on and off burning sensation in chest
Doctor :   then it should subside in sometime. continue to take Tab Prilosec daily 2 times a day before food
Doctor :   and avpid taking spicy, oily food
Doctor :   keep diet bland and do not leave stomach empty for more than 3 hours
Doctor :   avoid citrus foods, potatoes, cabbage, cauliflower
User :   that's what my friend doctor told me..i took those for about 9 days...chest pain kinna subside for a day..but came back again
Doctor :   if the pain is severe, then visit ER
Doctor :   you need to continue on them for 2-3 months to see complete and long lasting benefit
Doctor :   along with diet changes
User :   the pain on my left side is kinna subsiding now..
Doctor :   as listed above
Doctor :   that is good
Doctor :   it should subside down
User :   its always like...on and off
User :   then the pain will move to other parts of my body
Doctor :   ok. please provide your age
User :   im 25
Doctor :   ok.
Doctor :   follow the recommendations as above, you will have relief.
User :   so i have to continue for 2-3 months?
Doctor :   yes
Doctor :   along with diet changes.
User :   last night i felt pain on my left lower rib (part of it)
User :   and i went away didnt last for more than 3 or mins
User :   3 or 4 mins
Doctor :   ok
User :   i breath a bit better now..
Doctor :   ok
User :   i still have back pain
Doctor :   repeat the dosage of Tylenol since it is over 4 hours since your last dose
Doctor :   and take rest, try to sleep after having something light
Doctor :   you will have your symptoms controlled
Doctor :   you can come back for follow-up chat with me
Doctor :   later with all your further investigation repeats
Doctor :   *reports
User :   sure...also...ive been taking tylenol almost eveyday for i guess 10 to 11 days i still safe with tylenol?
Doctor :   it will help me to give you interpretations and tell you what is going on with you.
Doctor :   taking it 2-3 times a day is safe , but continuous use over longer periods are harmful
Doctor :   stop self medications
Doctor :   focus on getting to the root cause and get it rectified.
Doctor :   have you followed what I have said?
User :   yes..but how long is that "over longer periods"?
Doctor :   longer than 2 weeks
User :   i forgot to mention...when i stretch my chest, move my arm (like shampooing my hair), press my chest (like left side of my sternum) i also feel pain in chest
Doctor :   such pain could be muscular pain
Doctor :   a consultation with cardiologist and examination will help you to figure out is it muscular or gastric related or cardiac related chest pain
Doctor :   maintain diet as advised
Doctor :   and continue with Tab Prilosec
User :   do you know any cardiologist here in XXXXX by any chance?
User :   i mean would you recommend someone?
Doctor :   I am based in India, however I recommend you to search on WWW.WWWW.WW or WWW.WWWW.WW to find the best cardiologist in your location
User :   oh ok...
User :   my backpain is kinna subsiding now,but im sure it will go back again later or tomorrow as it always does
Doctor :   ok.
User :   i think this is it for now...thanks for answering all my questions...i will try to see a cardiologist tomorrow...
Doctor :   sure.
Doctor :   do get back to me after your consultation if you have further queries
Doctor :   thanks for consulting now. bye for now.
User :   thanks a lot..bye
Doctor :   bye.
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