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Dr. Andrew Rynne

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Pain below armpit, back, ribs. Taken Biaxin for bronchitis. Difficulty breathing after exertion. Taking Dulera

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Dr. Prasad Akole

Internal Medicine Specialist

Practicing since :1996

Answered : 961 Questions

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Posted on Wed, 10 Apr 2013 in Asthma and Allergy
Question: I'm having infrequent pain approx 2-4 inches below my left armpit and aching in my right upper back and right side under my ribs. I had bronchitis a few weeks ago and took Biaxin 500mg daily for 7 days. I get shortness of breath when I exert myself. I received a Dulera inhaler to use two puffs twice a day but I'm still not feeling like I'm getting enough air. It hurts a little when I inhale on the right. I'm taking care of my daughter who has mono. I'm 49 years old and I am used to being active I'm concerned about this aching pain.
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Answered by Dr. Prasad Akole 44 minutes later
Dear friend,

Welcome and thanks for entrusting your query here at XXXXXXX

I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.

Since you had an attack of bronchitis needing antibiotics and inhaled bronchodilators, your pain is most likely a pleuritic pain.

It is the pain from the rubbing pleurae (lung coverings) during inspiration. It is secondary to underlying lung infection (pneumonia).

I fear you could still be having some residual lung infection causing the pain and dyspnea (shortness of breath). You must still be having bronchospasm (wheezing), so you feel unable to get enough air.

I would like to know some more details to advice you better.
Was an Xray chest done that time?
Do you have any fever, cough, expectoration now?
What other symptoms do you have?
Are you on any other medicines?
Are you wheezing still? Do you get a catch in breath on inhaling deep?

I can tell you more specifically if you can provide this information and any other info and can even upload any reports/ Xrays here (using the uploader on the right side of this page) or do mail them to
YYYY@YYYY
with subject : attention Dr Prasad Akol.

Waiting for your response,

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Prasad Akole 39 minutes later
Thank you for your reply, Dr. I am having a chest X-ray done tomorrow. I don't feel like I have any wheezing and the doctor never acted like I had abnormal lung sounds. I was given Lortab liquid to take for my cough. I only took it at night because it makes me sleepy and I go to school some nights and I needed to be clearheaded to study. But the cough went away for almost a week so I haven't taken it in a while. The cough was nonproductive at the time. Now the cough is back and I have yellow come up sometimes. I have low grade fever (around 99 or 99.5) when I run any.Right now it's 99. No catches on inhaling but it aches more when I do inhale deep. I have a sore throat now and I'm having to clear my throat a lot. When I had the bronchitis I coughed a lot and I could feel congestion in my chest. I feel tired and sleepy and almost too tired to cough now. I started taking musinex 400mg yesterday.
doctor
Answered by Dr. Prasad Akole 7 hours later
Thanks for the information requested!

I was right in thinking that you would have all these symptoms pointing to a possible lung infection (pneumonia).

The pain is pleuritic. The fever, cough with yellow expectoration, pain, sore throat, tiredness, shortness of breath is all explained by it.

I would advise you to be re-evaluated by your treating doctor for a possible new/ worsening infection in the lungs. (As your non-productive cough is now productive of yellow sputum). The earlier the better.

You would need a physical examination, Xray chest, sputum examination (gram stain and culture), haemogram to begin with. You will have to take an appropriate antibiotic on evaluation.

Mucinex will help you loosen secretions. Take paracetamol for pain and fever until then.

Watch for any rising fever, breathlessness, giddiness.

Wish you get well soon. Please your age, weight etc.
It would greatly help if you could upload any reports/ Xrays here using the uploading service available on this query page just below the text box. You can email the reports / images to
YYYY@YYYY
with subject- (Attn: Dr. Prasad Akole)

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Please ask for any clarifications before closing and rating this answer.
Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole
Thank you. Good luck !!

Above answer was peer-reviewed by : Dr. Shanthi.E
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