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Suggest Treatment To Cure Bilateral Lung Shadows With High ESR

Posted on Mon, 5 May 2014

Question: A diabetic male 42 yrs. suffering from tb patches in both the lungs, Esr 256. My physician adviced me to take Forecox 150 ,4 tablets empty stomach, 1 tablet livomore 500 after breakfast, 1 tablet lycopen after lunch , 1 tablet monorin 150 after breakfast and lunch. My present weight is 86 kegs and I take glyciphase and z oral m2 for sugar also. Pls advice if I m adviced with right medicines as I feel uneasy after taking medicines. I hv low grade fever every day and pain in my feet which is not bearable. I hv lost 10 kegs of weight in last 3 months and my tb treatment has started 2 days back only as it couldn't get diagnosed earlier. Pls reply soon.

Answered by Dr. Kavita Paul (48 minutes later)

Brief Answer: continue ATT Detailed Answer: Hi, I appreciate your concern . Since you are are Diabetic and you have bilateral lung shadows with high ESR, first possibility would be Tuberculosis. Since your doctor have already started antitubercular drugs( Tab Forecox), I would advisce you continue it . If i see such i patient i get Sputum Analysis prior to starting treatment . I would advisce that you take following precautions:- 1. Antitubercular drugs are associated with side effects like nausea, vomiting , abdominal pain , jaundice, numbness of limbs etc. Kindly watch for any new symptoms and report to your treating physician in case of any .Antitubercular drugs leads to orange discolouration of urine and other body secretions . So dont worry if you see change in colour of your urine. 2. You might experience loss of appetite with drugs, So kindly monitor your Blood Sugar levels regularly and accordingly you might need alteration in dosage of Oral Hypoglycemic/ anti diabetic drugs. 3.Watch for any fever esp. in evening and monitor your weight. 4. Take frequent small meals and plenty of fluids , to maintain good hydration. 5.In case you feel nausea or vomiting with drugs , then try taking Proton Pump Inhibitors alongwith antiemetics to ease the symptoms. In case symptoms persists , then get your Liver Function Tests. Hope it helps Dr. Kavita Paul

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Kavita Paul (6 hours later)

After how lung do I need to get my x-ray done again to check if the medicines r working and after how many days I'll be feeling a bit better then the present condition. the tb tablet forecox 150 has to be eaten empty stomach only ? The quantity would be 4 tablets till the whole treatment of many months? Please answer.

Answered by Dr. Kavita Paul (10 minutes later)

Brief Answer: it might take 3-4 weeks Detailed Answer: Hi, Chest X Ray resolution with antitubercular drugs might take longer time ( upto 6 weeks ), but to look for treatment response we look for other parameters. In case you afebrile with treatment and gradually gaining your lost appetite and weight , then you dont need to worry . For the full effect of antitubercular drugs , you need to continue your treatment for atleast 3-4 weeks . Initially we give combination of four drugs (i.e. Tab Forcox ) then we step down to combination of two drugs only . So please dont worry and relax . Take adequate rest and diet as advisced . Hopefully you will respond to treatment. Hope it helps

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Kavita Paul (38 hours later)

Hello doc, I want to know what precautions I should take at home as I hv two small kids of 9 and 6 yrs. old. Also after I hv started my medicines, my whole body has started painting. What should I do regarding that and also can I eat some cold beverages like lasso juice etc, I hope it won't increase my cough . Pls reply.

Answered by Dr. Kavita Paul (14 hours later)

Brief Answer: it better you take warm liquids Detailed Answer: Hi, Tubercular bacilli spread by droplet infection which is produced during coughing .With 3-4 weeks of treatment your chances of spreading infection to others decrease. While coughing take precautions like use a hankerchief to cover your mouth. So dont worry , you will be fine . Try taking more of hot/ warm liquids to sothen your throat . Use Cough Lozenges in case of cough. In case you feel uncomfortable taking four tablets of Forcox together , take them one by one at gap of few minutes. hope it helps

Above answer was peer-reviewed by : Dr. Yogesh D