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Suggest treatment for pleurisy

Answered by
Dr.
Dr. Muhammad Ali Rauf

General & Family Physician

Practicing since :2013

Answered : 1313 Questions

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Posted on Fri, 13 Mar 2015 in Mental Health
Question: Hello,

I need your help, i have been to see my doctor and i feel i have not got anywhere.

in november, out of nowhere i were sat down and suddenly could not get my breath, i went to a and e and they gave me an xray eventually and said that it could be pleurisy.

been to see my doctors a couple of days later and she said that it could be anxiety.
she gave me omeprazole and fluoxetine and they made my symptoms worse.

i went back to a and e and they gave me an inhaler which saw some improvement.

However recently im back to sqaure one, i struggle for breath and do get into a situation where i panic, my jaw aches and i have a jittery sensation around my elbow, my sternum hurts when you apply pressure and this is really affecting my quality of life, what can i do?

I cannot go a day or even a minute without this being on my mind and i feel no one is listening to me or telling me im fine when i really believe im not.

I am also suffering from back pain and up until November i had not seen a GP for years.
, please help as this is really getting me down.

Yours in faith,

XXXX
doctor
Answered by Dr. Muhammad Ali Rauf 2 hours later
Brief Answer:
need some details to guide you better

Detailed Answer:
Hello

My name is Dr Muhammad Ali Rauf & i will look into your problem.

I have gone through your query and would try to help you in the best possible way. First of all i'm sorry that you are suffering that much. There could be a number of causes for your symptoms. I would be in a better position to guide you anything if you answer following questions please:

1. When did this problem start at first? Was it after some incident or disease? like some sad event in family,etc or some trauma?
2. do you have diabetes, hypertension, depression, asthma or any other illness?
3. any family history of any illness including depression?
4. i could see a long list of your medicines. Which one of them are you taking at the moment?
5. have you undergone ECG or any tests other than chest xray? If yes then please share results.
6. is there any history of pain in chest? if yes then does it occur all the time or at a particular time and how is it relieved?
7. any symptom other than shortness of breath that you would like to share?


I will be looking forward for the answers to conclude the discussion in the best interest of yours.
Thank You
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Muhammad Ali Rauf 40 minutes later
Good evening Dr XXXXXXX XXXXXXX Rauf,

Thank you very much for looking into this problem I am having.
It makes a lot trust me.

The answers to your following questions are:
. When did this problem start at first? Was it after some incident or disease? like some sad event in family,etc or some trauma?
A: This problem first occurred November 5th, the previous night me and my family were out burning some fire and It could be attributed possibly to breathing in the smoke, which is why A and E first suggested pleurisy.

2. do you have diabetes, hypertension, depression, asthma or any other illness?
A: No, my blood pressure is fine and I do not have any problems suggested above, and up until November I were living a fairly reasonable healthy life, I had not seen a doctor for quite some time.
3. any family history of any illness including depression?
A: believe my mother had been treated for depression a few years ago yes.
4. i could see a long list of your medicines. Which one of them are you taking at the moment?
A: At the moment I am using an inhaler but only rarely where I feel I need to get some more air in my lungs. I find it helps knowing I have something that in the short term can help me when it comes to getting out of breath etc.
5. have you undergone ECG or any tests other than chest xray? If yes then please share results.
A: Yes, the first time I felt out of breath an ECG was done and a couple of weeks later where I felt unwell and tight chested at work, a paramedic came out to me and did an ECG - on both counts the ECG was fine, no murmurs were found and my heart beat and blood pressure seemed to be at normal levels.

6. is there any history of pain in chest? if yes then does it occur all the time or at a particular time and how is it relieved?
A: No history with me or my family although my granddad suffered a heart attack during old age, which worries me a lot.
This pain can occur at any moment but I feel it creeping upon me before it happens, it mostly occurs at work when I am sat, I do have bad posty posture in truth and my back does hurt, I didn't have back pain before this incident in November, however.
It is usually relieved either by taking an inhaler or standing up and walking about , the standing up is only a short term measure however.
7. any symptom other than shortness of breath that you would like to share?i
Yes, I suffer from 1-2 second flashes/dizziness which does subside and then comes back at random times.
My hands lately have been spasming, mostly on the muscle where my palm is, nearest to my pinkie. This is unsettling, I have also been getting like a fluttering/pulsating sensation on my elbow. These do not hurt but cause me more emotional distress and worry rather than physical pain.

Any ideas Doctor, please I just worry as my current doctors seem to change their mind as I have seen them 3 times over the last 3 months.

Thank you for your help, it is much appreciated.
doctor
Answered by Dr. Muhammad Ali Rauf 6 hours later
Brief Answer:
Most probably stress/panic attack induced

Detailed Answer:
Hello

Thank you for the answers. I have gone through them.

First and MOST important thing that you need to take care is STRESS/ANXIETY. You are absolutely fine. You need to keep this in your mind. Your history is suggesting that you have NO apparent cause of shortness of breath other than stress/anxiety.
Stress causes constriction of bronchioles(conducting airway). As a result reduced air enters into the lungs. When air is reduced then obviously less oxygen would be supplied to brain.As a result dizziness occurs. Salbutamol inhaler produces slight improvement because it causes the relaxation of bronchioles. As a result air can pass easily BUT inhaler is not treating the cause so your problem is reoccurring. Spasm in hand/fingers can be due to electrolyte imbalance.

Suggestion:

1. If you are unable to deal with stress/anxiety then i would suggest you to get an appointment with a psychiatrist. He is specialized in dealing with such conditions. He will advise some stress relieving therapies and medications. Both if taken properly will show dramatic improvement in your current state.

2. As i mentioned, sometimes electrolyte imbalance may causes spasm of hands. You can visit a local doctor to get serum electrolytes done. IF particular electrolyte level is below normal then he will advise supplements.


Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!
Above answer was peer-reviewed by : Dr. Yogesh D
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