Hi I am Dr.V.K.Shrivastava from Chhindwara M.P.My wife is a case of Type 2 D M with Hypertention with C O P D with Corpulmonale with chronic respiratory failure.she is kept on 02 for 2hrs then rest for 1hr by o2 concentrator.with medicines (1)T.DYTIDE 1/2 OD(2)T.DOXILLINE 400(3)T.AB FLOW 100 MG(4)T.CAVETRA 25 MG (5)INHALER -FOMTIDE 400 MG (6)INHALER-AEROTOP; All Bid. Please suggest thebest.
I have emphysema which has caused right side ventricular heart failure with cor-pulmonale, I have mild twinges on the left side of chest, they are stronger with exertion, but can feel movement when sitting still. I become short of breath with very little exertion, tire easly
I would like to discuss my mother who is currently 74 years old with h/o bronchial asthma for the last 35 years. She is a nondiabetic, non hypertensive with no history of previous CAD. She first presented with Atrial fibrillation 2 years back which was controlled on Diltiazem, initially on 120 mg bd but later on 90 bd. Her respiratory status also decompensated and she started regular requirement for oral bronchodilators, antibiotics as indicated, regular Inhaled corticosteroids which were at times given upto 4000 Ug/day. Rescue therapy with oral steroids were also given off & on. Her sudden decompensation started in December of 2009, when her nebulization requirements increased and she was initially started on Augmentin for a 10- day period. She then became oxygen dependant . Her work up for Tuberculosis was noncontributory and her autoimmune profile in the form of ANA, pANCA were also normal. Based on the picture of rising oxygen requirements, antibiotics were given as follows: Antibiotic history Early Nov, 2009 - Piperacillin + Tazobactum (10 days) Late Nov, 2009 - Tab Azithromycin (7 days) Jan 16, 2010 - Injection Clindamycin (7 days) + injection Moxifloxacin (till Mar 8, 2010) Jan 22, 2010 - injection Moxifloxacin (till Mar 8, 2010) + Tab Faropenem (6 days) Jan 31, 2010 - tab Moxiflox + Isoniazid + Ethambutol This was empirically stated by the Pulmonologist along with Pulse methylprednisolone CT Scan of her chest revealed picture of Interstitial Lung Disease. She showed some response and her oxygen requirements decreased from 2 l/min to 0.5 l/min. Her general condition stabilized for a few days. Feb 28, 2010 - tab Moxiflox + Isoniazid + Ethambutol + Injection Ertapenem (1 gm OD up to Mar 8th, 2010) She showed deterioration at this time with pedal oedema which gradually increased to anasarca. Her LFTâ??s were normal but her total protein fell to 6.2 gm. She was started on sidenafil for her Pulmonary artery hypertension and torsemide for her Congestive heart failure which was interpreted as Cor pulmonale. The cardiologist at this point of time reduced steroids as she developed leucocytosis, raised CRP, bandemia on peripheral smear and altered GTT. On stoppage of steroids she slumbered to CO2 narcosis which reached 100 torr and she had to be put on BIPAP. Her counts at admission to the Respiratory ICU were 18, 800 and she was initiated on Mar 8, 2010 - Inj Imipenem + Inj Cilastatin + Injection Teicoplanin (400 mg OD) for 4 days. The counts increased progressively to reach 26,900 with mainly polymorphic response upto 89%. Her procalcitonin levels were high but galactomannan were negative. She was initiated on Mar 10, 2010 - Injection Tazobactum + Piperacillin TDS for 3 days, + Injection Tigecycline 50 mg BD + Inj Voriconazole. Her counts stabilized for 48 hours but are again showing a rise. Her general condition is improving, her cognition has improved, her blood gases show normoxemia with permissible hypercapnia (50-60) Till date cultures sent every day have been sterile. We would like your advice on further antibiotic therapy and supportive measures. Thanks in advance for anticipatory guidance.
conclusion of a regular medical check is that I need an echocardigraphic evaluation. examining physician says chest X-ray indicated moderate cardiomegaly. electrocardiogram indicated inferior wall ischemia. my blood pressure was 120/80. he thought this may be accounting for the moderate cardiomegaly and the inferior wall ischemia. i exercise regularly (walk 3 to 6 km three times a week; 1 hour gym 2 times a week). enjoy 3 glasses of beer after walking exercise; or red wine with food after gym. do not smoke. weighing 85 kg (recently reduced from 87kg; usually keep weight 82-85kg). 174 cm tall.
I was severely constipated 2 days ago and i was pushing for hours trying to get it out cause the pain was so bad. I did finally poop but now my whole body hurts kind of where both kidneys are and my stomach. i cant even speak loudly or it hurts. could it be muscles cause i was straining for so long? i am female 32 years old and weigh 245 lbs. and have left ventricular hypertrophy.
I have two leaky heart valves and mild cardiomegaly, along with Fibromyalgia and Chronic fatigue. I did have Sleep Apenia, but I lost some weight. So I am told I no longer have the sleep problem. My cardiologist tells me my heart issues are not that serious and I should not worry and to just lose a little more weight and keep my BP under control ( I am on med for that). My question is the fact that I remain constantly tired and sleepy, so much to the point I can barely work my full time job. I can t even bathe myself at times. I have no energy to do basic stuff like my house work and I am afraid to drive for falling asleep. I have Asthma as well, but none of the treatments for the Asthma is working or has ever worked for me. To make matters worse I have problems breathing all the time, and constant pain in my chest on the left side, fluttering from time to time, stomach bloated. My cardiologist insist that it is not my heart that is causing these problems. When I go to places like Walmart I can no longer walk around the store I must ride one of the scooters. He insist it is the Fibromyalgia causing these problems or the Asthma. Yet the ashtma medication does not healp. He also think it maybe the Acid reflex, so I see a Castro fir that. I don t want to wait until things get worse and then I find out later that maybe my heart problems were more serious than he or I thought and not treated earlier on. I had a aunt that had heart problems and it was not treated in a timely manner and she passed away. Also have a good friend that has the same problems and her first doctor failed to treat her problems and her second doctor jumped right on it, right away and was so upset that her problem was not addressed earlier. She has since had surgery and many complications as a result of not having her problem treated early on. Although she is 10 years older than I. I will turn 58 this Saturday. I just want to feel better, I have no life outside of work. I go to work and barley make it through the day and come home and try to sleep or just sit and read and write and watch TV. I have attempted to excercise, but my energy level will not allow it. I am now weighing 171, I have lost 10 lbs. I even had my tonsils and uvala removed to health with the breathing. It did not help much. I do not go anywhere, because I am just to tired and not feeling well. I attempt to rest to get my strenght back to return to work on Monday. Today is Monday and I am still not feeling well enough to go to work. I am giving a lot of thought to changing my cardiologist. First he told me my heart was not enlarged and then he told me it was. Then he told me I didn t have any blockage and when I continued to complain about the chest discomfort , he admitted I did have a slight blockage (20%) and it was not that bad.Thanks for your time.
I was told several years ago (three or so) that I had a very small hemangioma on my T5 vertebrae. It was an incidental finding and I was told it would probably never grow or do anything. I am just curious if it's visible in any of these xrays. I...
Hi Doctor my mother 56 years of age is suffering from congestion in chest and short of breath ... today doctor has advised following medicine and blood test . attaching report and medicine he has suggested. is treatment ok. please advise.