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Chest pain and cigarette smoking - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Smoking and Alcohol Addiction
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   Hi
User :   Hello, how are you this evening?
Doctor :   I am Dr AAAAAAA
User :   Nice to meet you, thanks for taking time to help me.
Doctor :   Fine, thank you how can I help you ?
User :   I will summarize my problem, one moment please.
Doctor :   Please proceed.
User :   I'm a 25 year old male. I started smoking cigarettes and marijuana regularly when I was 19-20 years old. Recently, I have been experiencing a dull pain in my chest. The pain is in my left breast. It sometimes hurts when I exhale deeply.
Doctor :   Ok
User :   For several months, I have been coughing up mucus which has brownish black particles in it, particularly in the evening.
User :   I have seen blood on a few rare occassions.
User :   I do not have health insurance nor am I making much money. I am very concerned for my health. Please advise.
Doctor :   Ok.
Doctor :   May I ask you a few questions before I can advise you on this ?
User :   Yes, I will provide any information you need.
User :   I wanted to talk to someone before waiting hours in an ER...
Doctor :   Ok.
Doctor :   Do you have any difficulty in breathing ?
User :   Hmm, it does feel somewhat diminished, but I have never been gasping for air or felt like I couldn't catch my breath.
Doctor :   That is encouraging.
User :   Heh, cool. It feels like my left lung isn't filling up with as much air as my right. I don't know how accurate that sounds, but it's the best way I can summarize.
Doctor :   Ok.
User :   The effected area is sensitive to touch, like it's bruised or something.
Doctor :   How about any swelling on the affected part ?
Doctor :   Do you see any signs of inflammation ?
User :   No, none that I can notice in the shower. Everything appears the same as the other half of my chest.
User :   other side, rather.
Doctor :   Do you see any redness, warmth along with the pain ?
User :   No, just the tenderness to touch and pressure.
Doctor :   Ok
Doctor :   Do you see any small nodular swellings under the armpit , neck or throat ?
User :   No sir, nothing like that.
Doctor :   Ok.
User :   (or ma'am)
Doctor :   Do you have any difficulty in swallowing or drinking ?
User :   Also no, I do consume alcohol regularly as well (about 2-3 beers per night) and I've never had a problem drinking.
Doctor :   Ok.
Doctor :   How about any recent bouts of chronic cough, cold, fever , sneezing or running nose or headaches or light headedness ?
User :   Yes, I have had a chronic cough since the beginning of the season. I figured that was due to my smoking. I haven't been sick in a while, had a runny nose, or any headaches in a while.
Doctor :   Ok.
Doctor :   May I know your good name please ?
User :   The cough has subsided lately since I stopped smoking cigarettes. I think I have smoked 5-6 since Wednesday. I am trying to quit... it is very hard.
User :   ;)
Doctor :   Let me sum up and put them in a nut shell to give you my opinion.
User :   Please.
Doctor :   I can understand the constraint you are in , without an insurance it is very difficult to undergo all these medical tests and treatment but I feel you need to get at least some basic screening done, Hope you understand.
Doctor :   My differential diagnosis would be : Doctor :   1. Emphysema .
Doctor :   2. Any fungal infection.
Doctor :   3. Pneumaonia
Doctor :   4. Viral Bronchitis
Doctor :   5. I would also not rule out a pleurisy as you are complaining of tenderness.
Doctor :   6. Last but not the least Lung Carcinoma.
User :   What is Carcinoma, cancer?
Doctor :   Yes, But I would say that you have a very low chance of being positive for that , but got to rule out before we can zero on a diagnosis.
User :   Alright. What should I do now? What steps can I take to easy the pain or help this go away?
User :   Or should I just head on over to an ER asap?
Doctor :   I want you to take some acute , immediate measures : Doctor :   1. Stop smoking completely, the earlier you quit , the greater is the chance of cure for any of the above diseases.
User :   stop smoking everything I assume?
Doctor :   2. Take Tab.Advil thrice daily to relieve you from the pain and tenderness for next 2 days.
Doctor :   Yes, I mean to say smoking and marijuana.
User :   Understood.
Doctor XXXXXX, you are a young man with lot of years ahead and great future, I know that it is very difficult to quit but I have seen youngsters who, If they once decide to Quit , Quit it for life and Stay healthy ever after. And the most important thing is that Youngsters tend to quit easily than older males in all the research and studies conducted.
Doctor :   3. Need to get an X-Ray Chest PA View done
User :   Yeah. It's been fun, but I'm so scared to be feeling this kinda stuff at my age. I don't want to ... well, you know.
User :   Leave this place early.
User :   Alright, I'll head to an ER and do what you've said. Anything else? I'm pretty damn scared to be honest.
Doctor :   Yes, I undersatnd.
Doctor :   Yes, Please get two more tests done that I shall advise you now.
Doctor :   4. Sputum analysis
Doctor :   5. If necessary CT Scan Chest after the X-Ray if they say , it would be helpful
User :   Ok.
Doctor :   Please visit an ER , And get the follow up done by a Pulmonologist or Chest Physician
Doctor :   Hope I have answered your query and please let me know if I can help you in solving any other query ?
User :   Yeah, you've been spot on. Best 15 bucks I spent in a while. I have no clue how I'm going to pay for everything you've told me to do, but it doesn't seem like I have much of a choice.
Doctor :   I would be really concerned about your diagnosis, Please let me know , If possible the report and the diagnosis.
User :   I will, I'm printing a log of this chat. If you'd like to give me an email I will forward.
Doctor :   YYYY@YYYY is my mail id and you can forward your reports to that mail id.
Doctor :   Wishing you all the best, Thank you for consulting me.
User :   Cool, I got it. My email is YYYY@YYYY if you want to send anything to me or just check in.
User :   Thanks for your time, I really do appreciate it. Take care.
Doctor :   Take care, Bye for now.
User :   I promise I will tomorrow.
User :   have a good evening.
Doctor :   That is really good to hear.Have a nice evening.
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