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I Have Asked Dr. XXXXXXX Banerjee Three Question Previously. I

Posted on Fri, 26 Oct 2018

Question: I have asked Dr. XXXXXXX Banerjee three question previously. I have brrn off the medication for over a werk andf still have yellow thivk sputum. I called and sasked my doctor if I can get a Flue shot and she said yes but nothing about thr yellow putum that has not gone away. What is your opinion please. Dolly

Answered by Dr. Dr.Arnab (1 hour later)

Brief Answer:
please see the detailed answer below...

Detailed Answer:
Welcome back Mrs. Dolly,
Thanks for getting back with the details...

If you recall our last discussion, I've explained that the yellow color of the sputum possibly depicting the underlying infection along with the stagnation of secretions.

Now, the stagnation of sputum, internal cell debris, and secretions take a really complex process to produce this color, which is why it may take a long period to clear off also. Please note, that Emphysema of the lungs itself takes several years to develop.

Do make sure that the Sputum is analyzed and cultured (sputum culture and sensitivity), if not done yet, better to get a fresh one as infection needs to be ruled out already discussed.

Once the infection is ruled out and the antibiotic course is completed, continuing routine and maintenance dose of steroids(Methylprednisolone in this scenario), daily round the clock nebulizers, deep breathing exercises, steam inhalation with routine daily chest physiotherapy will further help in what we term as lung-toileting thus help in clearing out of that debris.

It's a day by day process, can take even several months, so please don't worry in case it doesn't clear off quickly.

Coming to the flu-shot, please note, an infection-free period of at least a week is required to yield the most benefits out of it. Yes, if it is, then you can certainly go for it.

Please feel free to discuss further...

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.Arnab (19 hours later)

Thank you for your quick reply. I have one more question. My doctor wants to put me on a three day arithamyacin (not sure of spelling)medication for the rest of my life to help stop flare-ups. I am not comfortable with that. What if I become immune to the drug and I need it later? I would also have to have a electrocardiogram after one week. That also scares me. I have never taken any drugs previously and now I am on too many and I worry about interaction with these drugs. She (doctor) doesn't seem to be the least bit concerned.

Answered by Dr. Dr.Arnab (3 hours later)

Brief Answer:
please see the detailed answer below...

Detailed Answer:
Welcome back,
Thanks for sharing this details...

I think you meant Azithromycin...It seems that yours is an advanced case, which is why your doctor is perhaps considering long-term protection. However, the documented recommendation is, in that case, three times a week for a total duration of 12 months (not lifelong).

The Electrocardiogram is recommended for monitoring purpose in patients who are on Azithromycin therapy for such duration. Although, chances for developing any untoward side effects are quite unlikely. Please note that this monitoring is generally done a bit frequent only at the beginning, then only once in a while.

It's a novel approach as the chances of developing side effects are actually higher in patients receiving the therapy in the short course. Moreover, it's been observed that the incidence of flare-ups actually got reduced after this. So, you can consider this and give it a go for the 12month period (definitely not lifelong though).

Let me know if I can assist you further...

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee