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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Asthma And Rheumatoid Arthritis, Pain In Ribs, Severe Pain Attacks And Feel Breathlessness While Walking. On Heavy Pain Killers

hi i had MRSA back in march i have severe asthma and RA since march i have had severe pain in my ribs it moves around my chest the pain is constant but i also get severe pain attacks that take my breath away i am breathless on walking i am having a cat scan tonight and i am on heavy pain killers that dont do much i am so tired and now scared of theses attacks i feel like i am drowning when they happen and i cant breath in properly can you help
Mon, 18 Jun 2012
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Pulmonologist,  's  Response
hi maddie
thanks for ur query
u had MRSA
u have severe asthma and RA
consult pulmonologist for ur asthma control
have a spirometry done and stage up ur asthma control level on the basis of symptoms and pft finding as per GINA guideline
ur treatment needs to be stepped up
RA usually not involving axial skeleton but ur pain involvs ribs as per ur version
so u need to search for something else
severe rib pain refractory to heavy anlgesics is indicative of multiple myeloma
so follow the steps---------
1. chest x-ray to look for rib osteolytic lesion
2. urinary bence-jones protein
3. serum immunoelectrophoresis
u need to discard cardiac diseases also b/c what u r thinking a rib pain it may be a pain of cardiac origin also
so u must have a stress ECG, lipid profile and further inv if needed atall
thank u
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Allergist and Immunologist,  Dr. Sujoy Khan's  Response
Hi,
The chest pain & breathlessness with underlying asthma and RA combination suggests the CT scan is
important to exclude cardiopulmonary complications. Calcium score on coronary CT can inform of your heart status; while it is important to exclude several lung complications associated with RA.

I am sure you are getting the right investigations and please get in touch if you need any specific advice.
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Have Asthma And Rheumatoid Arthritis, Pain In Ribs, Severe Pain Attacks And Feel Breathlessness While Walking. On Heavy Pain Killers

hi maddie thanks for ur query u had MRSA u have severe asthma and RA consult pulmonologist for ur asthma control have a spirometry done and stage up ur asthma control level on the basis of symptoms and pft finding as per GINA guideline ur treatment needs to be stepped up RA usually not involving axial skeleton but ur pain involvs ribs as per ur version so u need to search for something else severe rib pain refractory to heavy anlgesics is indicative of multiple myeloma so follow the steps--------- 1. chest x-ray to look for rib osteolytic lesion 2. urinary bence-jones protein 3. serum immunoelectrophoresis u need to discard cardiac diseases also b/c what u r thinking a rib pain it may be a pain of cardiac origin also so u must have a stress ECG, lipid profile and further inv if needed atall thank u