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Complains for cough. Pulmonary function tests showed asthama and given medicine but no help. Suggest?

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Pulmonologist
Practicing since : 2003
Answered : 593 Questions
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Hi Dr.
My wife medical history reports is attached. She was complaint for cough (2 year back).we consulted the doctor we did PFT and told there is initial phase for asthma. and start the medicine more than one year. and after is suggestion we stop the medicine. again she was facing the same problem we again consult the same dr. he again did PFT and start the medicine. the told you should take tha patiecnce during treatment and told PFT report os normal. we really frusted this long term medication and having doubt with docot for treating us like commercial purpose.. please go through the attache medical reports and history and suggest.
Posted Thu, 5 Sep 2013 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 18 hours later
Brief Answer:
She needs to be evaluated.

Detailed Answer:
Hi,
Thanks for posting the query on XXXXXXX After going through your query, I would like to comment the following:

1. The PFT report attached shows hyperresponsiveness of the small airways which is seen in Asthma. t could be cough variant asthma. If last episode 2 yrs back had responded to asthma medications then that is one more point in favour of asthma.

2. However supportive evidences like sputum cytology, serum IgE levels and chest xray will also be required.

3. Currently you need to take the medication for a minimum of 3 months and then get reevaluated. Maintenence inhaler therapy for 2 symptom free years is generally recommneded prior to stopping the thearapy.

4. Avoid possible alleregens and triggers.

5. She may also consider the flu and pneumococcal vaccination in counsultation with her doctor.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: Complains for cough. Pulmonary function tests showed asthama and given medicine but no help. Suggest? 38 minutes later
Hello..
Thanks for your reply..

I have more questions.

1.)As per your reply i feel that there is any stable treatment for problem. She need to take the medication regularly (through out the life.) and this symptoms arise any time.
2.) She had already took the vaccination by doctor ( please check the report-1).
3.) Dr suggested us sputum cytology, and chest xray,but the reports are normal ( as told by doctor).
4.) please suggest us how long she took the medicine.i cant understand ur point no -3, please can u explain this.
5.) medication given by dr is good, coz some time i feel that he is pllaning for make money with us. coz i already spend more than 75 thousand during the treatment, but i feel the result is nill. Even during medication is has no complaint.

dear Doctor please suggest me , i am really very frusted, with the issue.

Thanks in advance for your support & suggestion.

Regards
XXXXX XXXXXXX

 
 
Answered by Dr. Gyanshankar Mishra 10 hours later
Brief Answer:
Medications need to be continued

Detailed Answer:
Hi,
Thanks for the follow up. After going through your followup query, I would like to comment the following:

1. If it is Asthma the the treatment aim is to keep the asthma under control and by means of step sown treatment reduce the treatment to the minimum required. If the medications are taken regularly then the chances of exacerbations is quiet low.

2. Its good that she has already taken the vaccination.

3. If sputum cytology and chest xray reports are apparenly normal then the asthma seems to be under control.

4. The follow up visits in asthma should be every 3 months to your doctor. Hence currently you need to continue the medications for a minimum of 3 months. As far as stopping the medications is concerned please do not do it yourself but wait for your doctor to do so. Once the asthma is under control and the patient is symptom free on maintenance inhalers for 2 consecutive years, then the doctor may consider stopping the treatment but that does not mean that your asthma is cured, depending on the circumstances and allergen triggers the symptoms may resurface later in life.

5. I can understand your feelings but regular medications is the key to keep asthma under control. The initial hard part of diagnosis and stabilisation is over and it may at times cost dearly. Now just the continuation of medications is required.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
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