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Have Respiratory Problem. Nose Blocked After Medication. Alternate Medicine For Zolfresh?

Posted on Thu, 4 Apr 2013

Question: Dear Doctor; nice learning from the WWW.WWWW.WW about online consultation. I have a query. i am having respiratory problem, besides HT and DM. Accordding to Dr. prescription it is OSA/OAD/hypertemia an he prescribed medicines such as theo-asthalin, formonide inhaler, olmin for BP, zorryl for DM and zolfreh 5mg for sleep. I am somehow feeling very uncomfortable in the morning and als one side of the nostril is invariably blocked even in the night. i wnat to know the medicine I take is alright or I need to change and consult somebody. Would a[appreciatre if you could suggest a good doctor for repiratory problems. Also kindly advise what is the alternative for zolfresh if any as i have totally lost sleep probably due to aftereffect of medines I have been taking for long. if zolfresh is better can it be contibnued for long.
Thanks a ton in advance for a suitable and encouraing answer.
IMy Doctor is k.k.pandey/ashok XXXXXXX According to Pandey it is COPD/DM/ht whereas Dr.
XXXXXXX it is oSA/OAD/hypertemia. Other Doctors say it is allergic problem., I am confused. my problem is short of breath or hyper ventilation.
XXXXXXX

Answered by Dr. Prasad Akole (1 hour later)

Dear friend,

Thanks for your query.

I am Dr. Prasad Akole (Critical care Specialist).

I saw your history.
All your medicines appear appropriate.

Zolfresh is a sleep promoting agent and may need to be used cautiously if you have OSA (Obstructive sleep apnea)/ hypoventilation syndrome.
He must have considered zolfresh safe, hence placed you on the same.

I would like to know some more details like:

What is your carbon dioxide saturation value? If measured.
Do you feel sleepy in the day and difficult to get sleep in the night?
Have you undergone any sleep studies?

It would help, if you tell me your location, height, weight, detailed symptoms.
I can guide you better then.

It would also be a good idea to search for a Pulmonologist in healthcare magic webpage under “find a doctor” service.

I think this gives you some encouragement.

Would be glad to help you further if needed.

You can ask your query at http://bit.ly/Dr-Prasad-Akole
Take care. Thanks.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prasad Akole (17 hours later)

Dear Dr. Thanks for your quick reply and the contents noted. To be XXXXXXX with you I dont have a OSA problem. I havent done my Co2 test so far. I can do it if you say so. I do get sleep with zolfresh but not quiet refreshing. A slight hangover in the morning on getting up. Also couging which is productive. the phlem is whitish latherish. I do taske in the morning and niight Formonide inhaler two puffs. Even trhen when i do some work or exercise, I do become easily tired and breathless.
one side of nosestrill is invariably blocked both at night and sometime during day.

All I need from you is, what type of problem is this and the type of treatment I should follow. I have not gone for PFT for quite some time now. Even gthe earlier PFTs were poor in result. If I know what exactly the problem I have I can accordingly stick to a proper treatment. Which is the best doctor for the same and can you suggest one at a place called Kaushambi area, near XXXXXXX located in Ghaziabad.

Pl advise.

thanks,
XXXXXXX

Answered by Dr. Prasad Akole (3 hours later)

Dear XXXXXXX,
Thanks for the update.

if you are sure you did not have OSA and have no excessive weight (obesity) or daytime drowsiness, then all you have is advanced COPD as per your description.

You may have to see a good pulmonologist or a good physician for the same.
I would advise to repeat the PFT, do an ABG (right heart is pressure overloaded and for pulmonary hypertension from advanced COPD (aka OAD).

I am not familiar with your place, but searching for a pulmonologist on this website under “find a doctor" and searching area and city-wise may find you one near you..

If you get too many exacerbations due to respiratory infections, you better get vaccinated for influenza and pneumococcus (OPD basis).

Detailed management plan is only possible after actual physical examination.
I can just comment on your Xray or reports, if you can upload them here on this site using the uploader or email them to
YYYY@YYYY
with XXXXXXX attn: Dr. Prasad Akole

Hope this answers your query precisely.
Take care and keep me updated.
I would value your review/ feedback on the answers that I gave before you close the query.
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Prasad Akole (19 hours later)

Thanks again for your valuable comments and i wish to say that i have no OSA problem and for vaccinations I have already taken rh vaccinations suggested by you. I have recently taken xray and the chest is Ok as per examination results. the other tests suggsted by you shallbe done shortly. i have recently done a complete blood examination and the result is aboslutely. lipid tests are absolutely normal and so also KFT, LFT, urinogram,hemogram etc. I would like to follow strict medications if there is one for COPD and if you caan suggest, i welcome or if you feel only a pulmonologist can do that kinldy let me kjow.

thanks for your valuable time and examination of the case and i appreciate your views which will be adhered to.

XXXXXXX

Answered by Dr. Prasad Akole (43 minutes later)

Hello sir,
Thanks. I am glad that your most labs are normal so also the X-ray and you are vaccinated.

For your nasal block, I would advise one visit to an ENT specialist, to physically see, if there is any structural obstruction and for any treatment needed. (e.g. DNS, overgrown turbinates etc.)

Also a thorough examination by a good pulmonologist and PFT, CO2, Echo tests together will better define the extent of affection.

Ask if addition of tiotropium puffs will help.
If there is any pulmonary hypertension (heart overload) features on echo, ask if pulmonary vasodilators are needed.
Sleep disturbance is a common part of breathless COPD patients. Exact cause is also determined by examinations as above. One may need extensive pulmonary rehabilitation to lead a better life, especially at such advanced life.

I cannot prescribe you any drug without actually examining you and with incomplete studies.
But my advice will certainly guide you on what to discuss with your doctor and get a good prescription from him/her accordingly.

Take all the puffs through a spacer device for better effect. Rinse throat 15 minutes after taking the puffs.

Please revert if I can offer any other help.
Good luck and take care !

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Shanthi.E