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Suggest Remedies For Severe Pneumonia When Diagnosed With Osteoarthritis

Posted on Wed, 4 Jan 2017

Question: I have an autoimmune lung problem. I was hospitalized two times for Pneumonia and one time for respiratory failure during the past year. I go months and months where everything is fine and like the last time all of a sudden I can't breath and have to be rushed to the emergency room. I have been in ICU twice this last time for two days. First they place me on a CPAP machine then as things improve a high flow then a nazel canula, then breathing on my own.

I hate being hospitalized and at this time am unable to follow up with a specialist due to living in a very difficult third floor walk up. Between breathing problems on the stairs and knee problems in both knees.((I have osteoarthritis is both knees). They put me on antibiotics and sterroids and eventually this time after nine days I was well enough to go home. I am extremely scared about not seeing the doctor for follow up. Also being stuck in my apartment. I am married and my husband is very supportive.
i have a nurse practitioner visit me at home once a month. He was here on Friday and put me on a five day treatment of 20 mg. of sterroids. Also gave me antibiotics just in case I need them.

Still i am scared and there are many unanswered questions. I want to get control over this but don't know how?? I feel better now that I am taking the 20 mg. of sterroids. The nurse practitioner said some people need to be on Sterroids continuously. I am not sure in my case.

Is there anyway you can give me some kind of information or advise me on this problem.It's been about five hours now since I asked you the question. Any updates??
Thank You,

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
You are mostly having acute hypersensitivity pneumonia or BOOP.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
By your history and description, possibility of either acute hypersensitivity pneumonia or BOOP (Bronchiolitis Obliterans Organising Pneumonia) is more.
Both these conditions are acute on onset and responds well with steroids.
So better to discuss about these causes with your nurse or doctor.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 days later)

The doctor put me on 20 mg. of steroids. He wants to know how many mg. of Steroid you would suggest that I be on? I have been on a one week course and I have taken my last one today.
Thank You, XXXXXXX Leher

Answered by Dr. Drkaushal85 (7 hours later)

Brief Answer:
Which steroid is given?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry for late reply as it was night in my part of world.
See, dose of steroid depends on your weight and type of steroid given.
So please let me know your result weight and whish steroid is given to you so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 hour later)

20 mg. of Predisone for five days. My height is 5' 4 inches and weight is approximately 200 lbs.How long can I stay on a Steroid without doing to much harm to my body?

Answered by Dr. Drkaushal85 (4 hours later)

Brief Answer:
You are taking lesser dose.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
It was night in my part of world so a bit late in reply.
Your weight is 90kgs approximately.
Initial dose of prednisone is 1 mg/kg. So you are taking lesser dose.
Ideally you should be given 90mg for 1week then taper down to 60 mg for next 1 week then 30 mg for next 1 week then 10 mg for next 1 week then 5 mg for next 1 week.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 hour later)

I use my nebulizer twice a day is that correct?How often should I take the taper down dosage pack? When I finish it how long until the next time I take it?

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Which drugs you are taking via nebulizer?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Please let me know the drugs you are taking via nebulizer so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

I am taking Albuterol with the nebulizer.

Answered by Dr. Drkaushal85 (6 minutes later)

Brief Answer:
Yes, albuterol should be taken at least 4-5 times.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Albuterol I Salbutamol. It is short acting bronchodilator. Its action lasts for a maximum 4-5 hours. So you need more frequent dosing like 4-5 times a day.
So don't take it twice daily, take it 4-5 times a day.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 hours later)

What is the best Inahler to use for my condition? I am currently using ProAir RespiClick, Symbacort, and PROAIR HFA.
Thank You

Answered by Dr. Drkaushal85 (11 hours later)

Brief Answer:
No need to take both proair respiclick and HFA.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No need to take proair respiclick and HFA. You should take either of them as both are having similar active molecule (albuterol).
Symbicort is good drug so continue it.
May I ask you about frequency of dosing of symbicort?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (7 hours later)

I use the Symbicort as needed. How many times a day would you recommend?
Thank You

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
Your should use symbicort twice daily.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Symbicort I having formoterol and budesonide combination. Both are long acting drugs which are useful in control of symptoms.
So you are should take it twice daily regularly despite of symptoms forever better symptomatic relief.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

Thank You so much for your answers. They are helpful to me!!
I know there will be more!!!!

Answered by Dr. Drkaushal85 (14 minutes later)

Brief Answer:
You can ask me directly on bit.ly/askdrkaushalbhavsar.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
It's always encouraging for doctors to hear positive feedback from patients.
And I am Always ready to help you and I welcome all your questions.
You can ask me directly on bit.ly/askdrkaushalbhavsar at any time. I will be glad to hear back from you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 days later)

How often should I repeat the Prednisone Steroid protocol you suggested?
Thank You

Answered by Dr. Drkaushal85 (9 minutes later)

Brief Answer:
Better not to repeat Oral steroids.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
If you need recurrent oral steroids, it is not considered good. Recurrent oral steroids are needed when your disease is Uncontrolled.
So it is better not to take Recurrent steroids.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 minutes later)

Thank You for you answer. What if I take 5 or 10 mg. of Steroids while my disease is controlled? I also have osteoarthritis in both of my knees Steroids help with the pain.
Thank You

Answered by Dr. Drkaushal85 (6 minutes later)

Brief Answer:
No, you should not take long term steroids.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No, no, no. You should not take long term steroids as these can worsen underlying osteoarthritis.
So don't take long term steroids.
Since how long you are suffering from osteoarthritis?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (33 minutes later)

I have has Osteoarthritis for about six years and has gotten progresssively worse.
Should I take the nebulizer 4 - 5 times a day even when my disease is not active?
Thank You

Answered by Dr. Drkaushal85 (8 minutes later)

Brief Answer:
You should take symbicort twice daily and pro air as and when required.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
For lung issues, you should take symbicort twice daily and proair as and when needed.
Better to avoid frequent oral steroids.
You must be taking adequate treatment for osteoarthritis. Are you?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar