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56 Yrs old man started coughing blood heavily & vocal chord was completely choked and what all precaution need to take ?

My Father is 56 Yrs old. He was a chain smoker and an alcoholic till the day it was discovered that his vocal chord was completely choked and was hardly able to speak. We immediately got him admitted in hospital in the month Nov- 2010. Later on after the diagnosis it was found that he has got tuberculosis in Categor-1, wherein they suggested starting with the DOT medicines. After 5 days in the hospital he got discharged and he was brought home. His weight was by then 50Kg. He was on healthy diet since then and completely stopped smoking and drinking. After a week when we started with the DOT after 2 days he started coughing blood heavily. He was then again rushed to hospital and was admitted there for at least a week. After he got discharged, after a week again he started coughing blood in medical term he had Hemoptysis. Though this time as it was suggested by the doctor in the hospital to be given at the time of emergency, injection “TRANEXA” was given to him. My queries are: 1. Do we need to admit my father again, if yes then for how long? 2. As told by the doctors that coughing blood is recurring, can we give the injection regularly ? a. When all do we need to give him Injection? b. Do we need to start with giving the other vitamins and Glucose doses? 3. In such a case how long does it take a patient to recover ? 4. What all precaution we need to take with such a patient
Asked On : Thu, 30 Dec 2010
Answers:  2 Views:  183
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Pulmonologist 's  Response
Thanks for visiting HCM.
I went through your father's history and can feel the problem. Bleeding in tuberculosis can happen due to many things like rasmussen aneurysm in cavity, aspergilloma, bronchiectasis etc. since it is recurrent bleeding, it is important to know the site from where the blood comes. One ct scan of thorax is advised at this juncture to localise the lesion and to know if he has some other concomitant problem like cancer.
If such episode happens again just make him lie with diseased side of the lung downward, so that blood do not spills in opposite healthy lung. Give the trenexa injection stat. and once the patient is stable go for pulmonary angiography, so that bleeding vessel is detected and if facility exist go for pulmonary artery embolisation to block that vessel. This is simple procedure done by interventional radiologist. Even if bleeding is there get that bleeding part of the lung removed.

Best wishes
Answered: Fri, 26 Apr 2013
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  User's Response
1. If these is Hemoptysis again, he may require hospital admision and if the hemorrhage is heavy, Tranexa will be required too.

2. He is under treatment, so his physicain will guide you regarding diet, vitamins etc. Do not give him any medication without his doctors permission.

3. Recovery of the patient depends on his age, his immunity , and also his will & attitude. So be patient for a few months , atleast.

4. TB is infectitious illness. So patients clothing, bedding, utesils and objects used by him should be seperate from rest of family members , esp children.
Healthy and balanced diet , fresh air , little activity like walking and a positive attitude is very helpful.
Answered: Thu, 30 Dec 2010
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