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Suggest Treatment For Irregular Chest Pain
Question: Hi ,
I'm 36 , Male , Social Smoker.
I'm having some chest pain ( irregular ) since a month on the right side and I mostly experience it while eating food , so went to a family doctor. No fever , No cough and No shortness of breath.I do not feel any pain for few days .
She ordered ed an X-ray and found that there is moderate pleural Effusion.
After that , ordered CT and found that there is very less liquid but there is pleural thickening and some lung volume loss on the right side. No issues with left lung. I copied my CT report and attached the X-Ray report as well for your reference.
My Surgeon was telling me that this is a scar tissue and I have a open pleural biospy scheduled in 2 weeks.
He was guessing that the pain I have is due to some thing else.
I went to another surgeon and he was guessing this to be Viral Infection and it will go away. But he also suggested a biopsy.
I took another opinion with a doctor in XXXXXXX and he suggested me with non-TB antibiotics for 2 weeks and then take another X-ray and see if it goes away. I got the same answer from another doctor here in USA as well.
I'm mostly opting to try anti-biotics and then decide if I want to do a bispsy once the infection is ruled out.
Please suggest help me deciding.
Regards.
I'm 36 , Male , Social Smoker.
I'm having some chest pain ( irregular ) since a month on the right side and I mostly experience it while eating food , so went to a family doctor. No fever , No cough and No shortness of breath.I do not feel any pain for few days .
She ordered ed an X-ray and found that there is moderate pleural Effusion.
After that , ordered CT and found that there is very less liquid but there is pleural thickening and some lung volume loss on the right side. No issues with left lung. I copied my CT report and attached the X-Ray report as well for your reference.
My Surgeon was telling me that this is a scar tissue and I have a open pleural biospy scheduled in 2 weeks.
He was guessing that the pain I have is due to some thing else.
I went to another surgeon and he was guessing this to be Viral Infection and it will go away. But he also suggested a biopsy.
I took another opinion with a doctor in XXXXXXX and he suggested me with non-TB antibiotics for 2 weeks and then take another X-ray and see if it goes away. I got the same answer from another doctor here in USA as well.
I'm mostly opting to try anti-biotics and then decide if I want to do a bispsy once the infection is ruled out.
Please suggest help me deciding.
Regards.
Brief Answer:
You should start antibiotic first.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the reports you have attached.
Possibility of old lesion is more.
But at present, you should first try broad spectrum antibiotic for 2 weeks and then get done repeat chest x ray.
If it stays same then you'll have to go forth Biopsy without waiting much.
Please let me know
1. Which antibiotic you have been prescribed?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
You should start antibiotic first.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the reports you have attached.
Possibility of old lesion is more.
But at present, you should first try broad spectrum antibiotic for 2 weeks and then get done repeat chest x ray.
If it stays same then you'll have to go forth Biopsy without waiting much.
Please let me know
1. Which antibiotic you have been prescribed?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr XXXXXXX
I'm prescribed Augmentin and Zifi-Turbo from a doctor in XXXXXXX
I'm trying to ask my primary care to prescribe me similar anti-biotics here in USA.
1. If it's old lesion , will it go away with antibiotics ? If not ... will it cause any problem further ?
2. Do you see any risks in open biopsy procedure ?
3. My surgeon was suspecting that the pleural area is fused and cannot do a VATS procedure and so he wants to do Open Biospy.
Thanks
I'm prescribed Augmentin and Zifi-Turbo from a doctor in XXXXXXX
I'm trying to ask my primary care to prescribe me similar anti-biotics here in USA.
1. If it's old lesion , will it go away with antibiotics ? If not ... will it cause any problem further ?
2. Do you see any risks in open biopsy procedure ?
3. My surgeon was suspecting that the pleural area is fused and cannot do a VATS procedure and so he wants to do Open Biospy.
Thanks
Brief Answer:
If it is old then it will stay forever.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern
Answer to your 1st question.
If it is old then it will stay life long.
But if is not old then we need to treat it as soon as possible otherwise it can cause permanent damage to right lung.
Answer to your 2nd question.
80% of open Biopsy are complications free. 10% develop minor complications like pain, bleeding, swelling etc. Rest of the 10% can develop serious complications like lung injury, infection etc.
Answer to your 3 rd question.
Yes, your surgeon is right. Due fusion of pleural area, there is no operative space in VATS. So it is not possible in your case. So open Biopsy is needed.
Please let me know
1. Do you have any past history of chest trauma or tuberculosis or pleural effusion?
Please reply me answer of above asked question, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks
If it is old then it will stay forever.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern
Answer to your 1st question.
If it is old then it will stay life long.
But if is not old then we need to treat it as soon as possible otherwise it can cause permanent damage to right lung.
Answer to your 2nd question.
80% of open Biopsy are complications free. 10% develop minor complications like pain, bleeding, swelling etc. Rest of the 10% can develop serious complications like lung injury, infection etc.
Answer to your 3 rd question.
Yes, your surgeon is right. Due fusion of pleural area, there is no operative space in VATS. So it is not possible in your case. So open Biopsy is needed.
Please let me know
1. Do you have any past history of chest trauma or tuberculosis or pleural effusion?
Please reply me answer of above asked question, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr,
Reply to your question:
I do not have any past history of chest trauma or TB or pleural effusion.
1. I've mentioned the name of antibiotics in my previous reply . Could you please check them and are they similar to what you suggested ( Broad spectrum anit biotics )
2. And what would be the outcome if the X-ray looks the same even after using the anti biotics ?
3. If it's not infection(bacteria etc) then the only possibility is old lesion ? If so , I guess it will not increase anymore ? Am trying to understand what would be the next guess if the X-ray is the same even after the anti-biotics.
4. If it's a old lesion .... the cause for the pain I'm getting sometimes is not due to the old lesion ?
Thanks
Reply to your question:
I do not have any past history of chest trauma or TB or pleural effusion.
1. I've mentioned the name of antibiotics in my previous reply . Could you please check them and are they similar to what you suggested ( Broad spectrum anit biotics )
2. And what would be the outcome if the X-ray looks the same even after using the anti biotics ?
3. If it's not infection(bacteria etc) then the only possibility is old lesion ? If so , I guess it will not increase anymore ? Am trying to understand what would be the next guess if the X-ray is the same even after the anti-biotics.
4. If it's a old lesion .... the cause for the pain I'm getting sometimes is not due to the old lesion ?
Thanks
Brief Answer:
Yes, these antibiotics are good.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, these drugs are appropriate. You should take them.
If chest x ray remains same after these antibiotics then Biopsy is needed. It will tell you the exact diagnosis. It will also tell if it is benign fibrotic thickening.
If it is negative for infection then possibility of either benign pleural thickening or pleural malignancy is more.
The cause of your chest pain is this lesion only.
Please let me know
1. Do you have weight loss?
2. Do you have decreased appetite?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Yes, these antibiotics are good.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, these drugs are appropriate. You should take them.
If chest x ray remains same after these antibiotics then Biopsy is needed. It will tell you the exact diagnosis. It will also tell if it is benign fibrotic thickening.
If it is negative for infection then possibility of either benign pleural thickening or pleural malignancy is more.
The cause of your chest pain is this lesion only.
Please let me know
1. Do you have weight loss?
2. Do you have decreased appetite?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr ,
My Appetite is normal.
Lost weight after knowing this issue ( may be because of stress ).
Is it too late for me to start the anitbiotics ? It's been almost 2 months since I came to know about this.
If it's TB , am I delaying it for the treatment ?
Thanks
My Appetite is normal.
Lost weight after knowing this issue ( may be because of stress ).
Is it too late for me to start the anitbiotics ? It's been almost 2 months since I came to know about this.
If it's TB , am I delaying it for the treatment ?
Thanks
Brief Answer:
What? Is it since 2 months?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Initially you were saying that you are having this since 1 month. Now you are saying that it is Since 2 months.
See, 2 years time is sufficient enough to produce pleural thickening in case of tubercular pleural effusion.
So you might be having tubercular pleural effusion since 2 months and at present you have developed pleural thickening due to healing.
Please let me know
1. On which date you done your first chest x ray and ultrasound?
2. Before how many days you have done your last chest x ray and ultrasound?
3. Before how many days you have visited India?
4. Do you have any close contact who is suffering from TB or have constant coughing?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
What? Is it since 2 months?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Initially you were saying that you are having this since 1 month. Now you are saying that it is Since 2 months.
See, 2 years time is sufficient enough to produce pleural thickening in case of tubercular pleural effusion.
So you might be having tubercular pleural effusion since 2 months and at present you have developed pleural thickening due to healing.
Please let me know
1. On which date you done your first chest x ray and ultrasound?
2. Before how many days you have done your last chest x ray and ultrasound?
3. Before how many days you have visited India?
4. Do you have any close contact who is suffering from TB or have constant coughing?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr,
My Answers
1. On which date you done your first chest x ray and ultrasound?
First x-ray was done on 5-11-2016. I remember uploading the same in this website.
2. Before how many days you have done your last chest x ray and ultrasound?
5-24-2016 was my last X-ray.
3. Before how many days you have visited India?
1 Year
4. Do you have any close contact who is suffering from TB or have constant coughing?
Not that I know of.
Questions from me:
1 . May I know the reason why you advice anitbiotics when you mostly guessed it as old lesion ?
Thanks
My Answers
1. On which date you done your first chest x ray and ultrasound?
First x-ray was done on 5-11-2016. I remember uploading the same in this website.
2. Before how many days you have done your last chest x ray and ultrasound?
5-24-2016 was my last X-ray.
3. Before how many days you have visited India?
1 Year
4. Do you have any close contact who is suffering from TB or have constant coughing?
Not that I know of.
Questions from me:
1 . May I know the reason why you advice anitbiotics when you mostly guessed it as old lesion ?
Thanks
Brief Answer:
There is still pleural fluid in your CT report.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
See, pleural thickening is old lesion.
But your CT report is suggestive of presence of fluid in the pleural cavity.
And pleural effusion is mostly infective in nature.
So antibiotics are advised to see if they work on pleural effusion and resolve it.
If antibiotics fail in resolving effusion then Biopsy is needed to rule out tuberculosis and cancer.
Why you have not started antibiotics?
On which date you have been prescribed these antibiotics?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
There is still pleural fluid in your CT report.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
See, pleural thickening is old lesion.
But your CT report is suggestive of presence of fluid in the pleural cavity.
And pleural effusion is mostly infective in nature.
So antibiotics are advised to see if they work on pleural effusion and resolve it.
If antibiotics fail in resolving effusion then Biopsy is needed to rule out tuberculosis and cancer.
Why you have not started antibiotics?
On which date you have been prescribed these antibiotics?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Somehow my physicians feel that antibiotics will not do any good in my case. So they did not prescribe me any.
There is very less fluid even to aspire it.Pleural Thickening is what they are after.
Antibiotics prescribed for me are from a doctor in XXXXXXX ( 4days ago ). I had them courier and I have them with me. So thinking if I should really go with Antibiotics or not.
Thanks
There is very less fluid even to aspire it.Pleural Thickening is what they are after.
Antibiotics prescribed for me are from a doctor in XXXXXXX ( 4days ago ). I had them courier and I have them with me. So thinking if I should really go with Antibiotics or not.
Thanks
Brief Answer:
Yes, you should definitely take antibiotics.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should definitely take these antibiotics and see if they are effective or not.
If they are not effective then Biopsy is mandatory to identify the cause.
So in my opinion, you should start these antibiotics and complete the course.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.
Yes, you should definitely take antibiotics.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should definitely take these antibiotics and see if they are effective or not.
If they are not effective then Biopsy is mandatory to identify the cause.
So in my opinion, you should start these antibiotics and complete the course.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Raju A.T
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