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Cough, flu, blood in nose while sneezing, history of 3 surgery for back problem, multiple medication, - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1773 Questions
User :   I am a 38 year old male with a back problem since 1999 (3 surgeries), with multiple medications that I have stopped around a year ago. I have a had a cough for 4-6 months...with about 2-3 weeks off from it. I had been told I had the flu after 2 months. Took 2 XXXXXXXX flu 5 day packs. Flue was gone but not cough. Said it was allergies...took several allergy meds, cough meds, inhaler, spray, ect. I still have the cough and have been noticing an ammonia smell after I take long walks or sweat on my shirts. So strong that last week it finally got my attention when I thought the floors were being was me though. I also show blood from my nose when I tend to sneeze and sometimes I can get it in my flem at that time (that has been lasting for several years after I hit my head from my legs giving out on me from nerves in my back). Other times I can stick a tissue up my nose and it will come out bloody or just a little blood. I am so stressed not being able to find out what is wrong with me.
Doctor :   Hi, Dr AAAAAAA here
User :   hello doctor
Doctor :   Please give em a couple of mins to read the query.
User :   no problem
Doctor :   hi , i just read your query, may i ask you a few relevant questions?
User :   yes
Doctor :   may i know if you have diabetes ?
User :   no
Doctor :   any history of high blood pressure?
User :   I had bloodwork and was told everything was fine
User :   lately yes.....but they figure it was because I am not on any meds for my back...pain related
Doctor :   ok
User :   i also have the sweats a lot...whoch could also be explained by my back i guess
Doctor :   ok , may i know what were the blood pressure readings?
User :   147?/87? around there
Doctor :   ok
Doctor :   did the doctor put you on any medicines for the blood pressure?
User :   no
User :   figured it was because of back
User :   i get tossed around a lot
Doctor :   OK, I would want to tell you that the readings we expect must be around 120/80mm hg
Doctor :   and the Bp you have is a bit more
User :   this was a heart doctor...going in for stress test and heart test
Doctor :   i may consider the back pain and stress as a cause , but this must be brough down
Doctor :   ok , did he suggest you for a stress test?
User :   i unlce had heart related issues and heard about my cough and reccommended I get this done as it could have something to do with my heart
User :   cough starts off slow...but has been escalating the passed 2 almost a weezing cough
Doctor :   yes , as you have a blood pressure on a bit higher range and symtoms like sweating and back ache , i would also suggest you go in for this
Doctor :   as epistaxis, which is bleeding from the nose, may also be due to high blood pressure , though you have a history of trauma
Doctor :   i would suggest you to start with the ECG test, stress test and a 2D echo
User :   that started after the head hard...had a concussion possibly..started soon after
User :   having an echo also
Doctor :   ok
User :   nothing else you can think of that moght cause this...i know its multiple issues...ym doctor says I am a mystery..thinks im crazy too i think
Doctor :   i can think of diabetes as the cause for the acetone smell in sweat
Doctor :   but you said the sugars are under control.
User :   wonderful.....i eat whatever i want really...not the healiest eater...but not a ton of sugars
User :   i go on health kicks....and then fast food..back and fourth
Doctor :   ok , when was the sugar checked
User :   probably when i was checked for flu..everything was good i was told.
User :   she gave my blood a full workup
Doctor :   ok , you have been on tamiflu, one of the side effect of the same is bleeding from nose.
User :   i had this before that
Doctor :   yes , i understand , but im listing out the possibilities here.
Doctor :   we must not ignore these symptoms.
User :   i mind the anoyng patient
Doctor :   since the blood pressure is more than normal, i would expect treatment to be started
Doctor :   no , your not at all annoying.
Doctor :   do not worry about it , you could ask me all your doubts , i will help you
User :   ok..treatment for bp...check blood work...get tests from above done
Doctor :   acetone smelling breath or urine , is very likely to be associated with a condition caled ketosis
User :   urine smells also
Doctor :   yes , urine , breath and sweat
Doctor :   generally acetone / fruity smell as we say indicated ketosis
Doctor :   hence i suggest you to get the tests done again for sugar
Doctor :   it can follow after starving for a long time as well
User :   ok...anything else i should do in the meantime
Doctor :   no , first thing check sugar and act accordingly.
Doctor :   nothing else to be done , follow normal routine
User :   ok...i appreciate you help dr.
Doctor :   i hope i answered your questions
User :   you did
User :   thank you
Doctor :   pleasure here
Doctor :   thanks for consulting me
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