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Suggest Treatment For Dry Cough And Wheezing

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Posted on Wed, 18 Mar 2015
Question: I am a 53 year old female NON smoker. I have had a cough....sometimes dry, but mostly productive....for going on 9 weeks. Wheezing (sometimes crackling) often accompanies the cough and seems to be worse upon inhaling. Seem to cough more if exhale deeply (causes tickling sensation that brings it on) I have been to the doctor4 times during this period. I have had 4 rounds of antibiotics (Ceftin, Amoxicillin, and Levoquin and now a Zpak), a cortisone shot and 5 days of oral prednisone. Nothing has really worked. I have been given two x-rays, as pneumonia was suspected, but they came back negative. I was also give an inhaler. I will occasionally have a day when the cough/wheezing seem to be better, but then it just comes back the next day. I have seen a pulmonary specialist who put me on an antihistamine for a week to see if that helps (thinking allergies?) , but it hasn't made a difference. I go back to him tomorrow . However, I'm just at a point where I'm confused as to what's going on and what the possible problem could be. I'm actually getting very worried. Any insight at all?
doctor
Answered by Dr. Muhammad Ahmad (1 hour later)
Brief Answer:
Hi , need you to answer a few questions.

Detailed Answer:
Hi,

Thanks for writing to Health care Magic,

I am Dr Muhammad Ahmad , Resident M.D.

I have read your question and will try to come up with a comprehensive answer to it, I would like you to answer a few questions of mine which i feld deficient in your description.

1) When was the first time these symptoms started?

2) Did the incidence increase with time?

3) Is there any specific allergic substance related to it?

4) Is there any fever?

5) Did the doctor do your respiratory function test if chest CT scan?

6) Is there any specific thing which improves your symptoms a bit?

7) Do you have ANY other medical issues?

8) Does your breathlessness worsen if you lie down flat ?

i am waiting for your input.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad (15 hours later)
1. First symptoms were about 9-10 weeks ago
2. I would say the coughing has been about the same over this period, some days are better than others. Wheezing started about 3 or 4 weeks ago.
3. I have seasonal allergies , but cortisone injections usually work and they didn't this time
4. No fever
5. Only x-ray (normal), but possibly will be having CT scan
6. Nothing specific that improves symptoms, although I tend to ease up on coughing towards the end of the day and I sleep fine
7. High blood pressure (No ACE-inhibitor), high cholesterol . I am 5'5.5 inches tall and weigh 141 lbs.
8. Do not really have breathlessness, so no does not worsen when lying down

Also forgot to mention that I was diagnosed with early onset rheumatoid arthritis about 1.5 years ago.
doctor
Answered by Dr. Muhammad Ahmad (6 hours later)
Brief Answer:
Some other possibilities are there.

Detailed Answer:
Hi,

Thanks for writing back,

Your answers were really helpful.

Here i would come up with close possibilities it might help you making a discussion with your Pulmonologist.

Any doctor would most probably go for allergy treatment with your symptoms and history of allergies, but as you have told me antihistamines and steroids didn't really work, now a doctor can go for two things

A) Go with heavy duty anti allergy meds like more steroid dose, mast cell stabilizers and etc

B) Consider it an infection and suggest antibiotics.

Now in your case you have used antibiotics as well though pneumonia didn't seem to be a close possibility because you didn't have any fever but still your doctors didn't take chance and gave you antibiotics which didn't work.

Now after that most common cause is heart but as you don't have shortness of breath with no real change on lying down it almost rules out heart being the cause.

So now a doctor will consider checking for less common diagnoses which are refractory to drugs and are concerns for a doctor,

these are structural / parenchymal lung issues for this your pulmonary function tests (PFT'S) and CT scan should be done this will tell if there is any fibrosis or other structural disease in the lungs, a doctor after CT scan might wanna do a biopsy of lungs, as you happen to have arthritis too so in autoimmune settings this cause should be ruled out. Specially if symptoms are gradually getting worse one has to think about parenchymal issues.

You might wanna discuss all these possibilities with your pulmonologist. Because fibrosis is a serious issue i hope this isn't there in your case but if it's there it can be dealt with , as early as possible.


Hope this answers your question. If you have additional questions or follow
up questions then please do not hesitate in writing to us.
Wishing you good health



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Muhammad Ahmad

General & Family Physician

Practicing since :2012

Answered : 1308 Questions

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Suggest Treatment For Dry Cough And Wheezing

Brief Answer: Hi , need you to answer a few questions. Detailed Answer: Hi, Thanks for writing to Health care Magic, I am Dr Muhammad Ahmad , Resident M.D. I have read your question and will try to come up with a comprehensive answer to it, I would like you to answer a few questions of mine which i feld deficient in your description. 1) When was the first time these symptoms started? 2) Did the incidence increase with time? 3) Is there any specific allergic substance related to it? 4) Is there any fever? 5) Did the doctor do your respiratory function test if chest CT scan? 6) Is there any specific thing which improves your symptoms a bit? 7) Do you have ANY other medical issues? 8) Does your breathlessness worsen if you lie down flat ? i am waiting for your input.