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Have post nasal drip, persistent cough, frequent chest infections and urine infections. Remedy?

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Practicing since : 1979
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My mum is a fit, active and usually healthy 75 year old. She had her Gallbladder removed a couple of years ago which did have some complications, including a bile leak which required a drain for several weeks. CRP was in the 400's unfortunately she was discharged home, still feeling very ill, as none of the medical staff noticed this????? Last year she had a hernia op. Last year she became very hoarse with a post nasal drip and persistant cough. She saw the ENT specialist and had a cyst removed from her larynx and made a good recovery. She has paroxysmal AF and was on Amiodarone for a few years (discontinued about a year ago), she can't take Beta Blockers due to slight bronchitis for which she is on no treatment as it is very mild. Over the past few years she has had more frequent chest infections but has had regular chest x-rays to ensure she hadn't developed any pulmonary fibrosis which were all unremarkable. Then she started developing frequent urine infections and she often passed blood in her urine. This hasn't happened for a while. She went for her yearly check and the medical staff said that she had haematuria but no infection and to hand in weekly urine samples. They kept saying there was 'something' which I know is all that can be said at this point until they know for definite exactly what is going on. The symptoms of the laryngeal cyst seemed to be coming back so she had another chest x-rays, the ENT specialist didn't have the report in front of her, it hadn't been reported yet. This was on the Wednesday and on the Friday her gp phoned her and told her that something suspicious (opacity) had shown up on her chest x-rays and that they were going to organise a battery of tests for next week. She warned her to be prepared for them to "turn her inside out". Usually in the uk test results take forever to come back unless there is something potentially serious. This sense of urgency really worries me as well as everything else. Obviously I am thinking of cancer but would appreciate any input you can give whether it is good or bad. Sorry for the rant, I just wanted to give you all the details so you have a clear picture hopefully.
Posted Fri, 12 Jul 2013 in Lung and Chest disorders
Answered by Dr. Shashi Dangwal 45 minutes later

Thanks for posting your query on XXXXXXX

At the outset i must say that your description is very scattered but i can understand your state of mind as you are naturally concerned about your mother`s well being. Since you have chosen lung and chest disorder i will comment on her x XXXXXXX chest.

Any opacity in the lung especially in the elderly age group is taken seriously as it may turn out to be malignant. But lets not draw conclusions before she has been investigated thoroughly.

Has she been a smoker? She needs to be subjected to a complete work up which should also include a CT scan, a bronchoscopy and a biopsy which can be done during bronchoscopy or even during CT scan depending on location of the opacity.

Another aspect which needs to be explored is haematuria that she has had. Has a cause been found for the haematuria? Pl discuss this with her doctor.

The post nasal drip can be responsible for her cough and even hoarseness of voice. She may take an antiallergic like cetrzine, a nasal spray containing fluticasone and an inhaler like forair or seroflo. Consult a pulmonologist who can advise you accordingly.

Only after she has been investigsted, further course of action will be decided. If you have any more queries, do post them on XXXXXXX and i will try and answer them
Above answer was peer-reviewed by
Follow-up: Have post nasal drip, persistent cough, frequent chest infections and urine infections. Remedy? 4 hours later
The laryngeal cyst doesn't concern me as the pathology results came back as non malignant, merely a cyst. It's the opacity on the chest x-rays that concerns me and the haematuria without any infection present and, as the medical staff have said, it shows something else. What ever this is, I do not know but I can guess. I am fully aware that if, but or maybe diagnoses cannot be made but through my job I do have some experience of what these results mean, although it is very different when it comes to close family. Never the less, I am one of these people who needs to know whether I should look on the positive side or not and what ever I find out I am not going to repeat any of it, she was a nurse for her full career so she has much insight herself also. I just want someone with the required knowledge to give me as much information and be honest, with me and tell me what they think the most likely scenario is. I am better knowing what we may be dealing with and preparing myself. Please just give me an honest opinion, i'm desperate and would like to know what the most likely meanings of these tests results are. 1 cannot speak to any of the medical staff in work because I am on maternity leave and I would never put them in that position regardless. I would really appreciate some straight talking here and no sugar coating, I just need to know. Especially about what can cause haematuria with no infection but 'something suspicious' showing up! I know you domnot have a crystal ball but please do your best to help me prepare for what may be coming. Thank you so much.x
Answered by Dr. Shashi Dangwal 17 minutes later

I have already very clearly mentioned that any opacity in the lungs especially in this age group has to be investigated thoroughly to rule out malignancy. There cannot be more straight talking than this. The opacity in the lung and haematuria may or may not be related. However, there can be other non malignant causes for the opacity. The best bet for you is to subject her to the investigations advised as soon as possible and try to arrive at a diagnosis. You have to be positive till a diagnosis is arrived at. I have already said that lets not draw conclusions prematurely.

Take care.
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