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Complains of cough, told to have asthma and got treated. Again have problem and did PFT. Suggestion?

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Pulmonologist
Practicing since : 1979
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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. I take ine more suggestion from one cosultant with reports,he told i dont knpw why he he giving this medicine now, when asthma is cured in PFT reports. Please suggest
Posted Wed, 18 Sep 2013 in Lung and Chest disorders
 
 
Answered by Dr. Shashi Dangwal 26 hours later
Brief Answer:
Continue inhalers and then taper off.

Detailed Answer:
Hello XXXXXXX

Having gone through your query, i would like to know little more about your wife`s cough:

Is it dry cough or with phlegm?

does she have breathlessness?

Is she alleregic to dust and smoke?

Is their any family history(her parents or siblings) of allergy?

From your description it appears to be a form of asthma called `cough variant asthma`.

Both the PFTs appear normal except for slight decrease in PEF.

In initial phases of asthma or in mild asthma, PFT may be normal. It will also be normal if it is done when patient has no symptoms.

I suggest that she takes inhalers like seroflo regularly and once her symptoms are completely cured, they should be tapered off rather than stopped abruptly. She may also take an antiinflammatory agent like monteleukast and cetrizine combination after consulting your treating physician.

I hope this satisfies your query.
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Follow-up: Complains of cough, told to have asthma and got treated. Again have problem and did PFT. Suggestion? 21 minutes later

Is it dry cough or with phlegm?



does she have breathlessness?



Hi doctor,
Thanks for your reply

Please find the reply of ue question.

Ques : Is it dry cough or with phlegm?
Ans : Earlier it is type of dry cough, But few days back she suffered with cold , after that sputum ( white) is there. Today again we consult with tahe same doctor. he checked throughly and prescribed the medicine :1.)Tab sonirab 20mg (2.)Tab predmet 8mg (3) tab telekast-L (4.) Foracort 200R/C and give the vacination for pnenmococcal& influenza, immunisation. After taht he told you need to take the medication aprox 2 years.

Ques: does she have breathlessness?
Ans: never,only cought.

Ques : Is she alleregic to dust and smoke?
Ans : We never notice that she is alergic with dust, may be some time she cant bear the smoking fumes. But never notice the cought system.

Ques : Is their any family history(her parents or siblings) of allergy?
Ans : Yes, her mother had this problem, Bur never required for asthma pump.

I am relally very frusted, he told such long to take the medication. i dont know whwther it is so much serious problem.
Such cough was alredy faced during wife pregnency (during April 2012) but the gyna docotor suggest 2-3 medicine and cought cured very quickly. after that she faced again this time.

Please suggest whether current docoor suggesting good ( i am currently not satisfied). or you may suggest some medicine with taking sedchdule.

Request you to please sugget, which is best for current situation.

regards
XXXXX
.
 
 
Answered by Dr. Shashi Dangwal 55 minutes later
Brief Answer:
Continue all medicines except Predmet.

Detailed Answer:
Hi XXXXXXX

Thanks for further inputs.

I`m still of the opinion that your wife is suffering from allergy in the form of cough variant asthma.

She can take all the medicines prescribed by your doctor except Predmet which may not be required at this stage and going by the symptoms described by you.

As i told earlier, she should continue the inhalers and other medicines till her symptoms are well controlled which may take 12 to 16 weeks. After this an attempt can be made to gradually reduce the medicines.

If she is still symptomatic, i suggest you consult a pulmonologist. I hope that her chest x XXXXXXX has been done and it was normal so that we are sure that she has no other pathology.

Bye.
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Follow-up: Complains of cough, told to have asthma and got treated. Again have problem and did PFT. Suggestion? 1 hour later
Hello Dr, XXXXXXX

As per attached medical reports & history she had alredy taken the medicine by more than one year & we always consult the pulmonologist regarding this matter. earlier he told that you should take the medicine by aprox 1 year and required the vacination. we always follow his prescription by more than one year.
But again the symptom raised it means no value of doctor tongue. dsnt matter but again he is saying the same line and today give again the vaccination. so that i am totally confused the way of treatment,.
yes you are right, her chest x XXXXXXX has been done and it was normal so that we are sure that she has no other pathology. even sputu , CBC, montox has done but all are normal.
Only some problem with PFT test. but noe the PFT is normal , then why6 is started the medication for same.

After 12-16 weeks medicxation she need not to take the medicine. plz suggest coz my docotr told to take thr madicine by more than one year and need the vacination continious by three years.

regards
XXXXX

 
 
Answered by Dr. Shashi Dangwal 39 hours later
Brief Answer:
It`s allergy and can only be controlled not cured.

Detailed Answer:
Dear XXXXXXX

Sorry for the delay in replying to your query as i was held up with some important work.

I have gone through your further inputs.

It seems that you expect that she will be cured of her allegy/asthma once she completes a course of treatment for a certain duration. No, it`s not like that.
You must understand that she is not suffering from some infection which will be cured after a course of antibiotics.

She has allergy and she will always have it. Symptoms arising as a result of allergy can only be controlled with the help of medicines that she is taking. She may require it for a short or a long term. She can have recurrence of symptoms, esp if exposed to allergens like dust and smoke even after having been free of them for some duration.

The treatment may be completely stopped once she is better but then will have to be restarted if symptoms recurr.

The vaccination is to prevent her from getting pneumonia and common cold because they can aggravate the symptoms of asthma. It is not a cure for asthma.

I suggest you should not get unnecessarily worked up because in my opinion she is getting correct line of treatment.

Bye.
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