Brief Answer:
Your medications require to be titrated.

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

1. You seem to have been diagnosed with COPD / Emphysema.

2. Investigations supportive to above diagnosis are - chest xray, sputum examination, pulmonary function test and /or CT scan thorax. I guess you would have had some of these tests.

3. Management of COPD depends on the severity of disease based on above investigations/ symptomatology.

4. Currently you are taking only reliever medication with no controlers (long acting inhalers). The management is according to the staging of obstruction on pft.

5. You need to get yourself evaluated by a pulmonologist and most probably you require to be started on add on therapy along with oral bronchodilator medications. Also pulmonary rehabilitation and vaccinations needs to be looked into by you in consultation with your treating physician.

6. Current coughing may be due to inadequate control as mentioned above requiring add on therapy or due to associated secondary infection in which case a course of antibiotic may be required. Use of repeated nebulisations is generally not recommended.

7. Yearly flu and 5 yearly pneumococcal vaccine will definitely help.

8. Having said this it is being assumed that you do not smoke at present and you need to protect yourself from any inhalation dust/ fume exposure.

9. Thus a detailed clinical evaluation with Pulmonologist is required at present.

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

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