Asthma/Cough

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Question
QUESTION: Hello Doctor,
My chest X-Ray report mentions the following:
"Prominent bronchovascular markings seen in both lung fields are due to changes of bronchitis. No evidence of pulmonary infiltration or pleural effusion is seen on either side of the chest.
The cardiac shadow is with normal limits of size and shape.
Opinion: Bronchitis."
I want to know what does this mean in plain english.
Let me mention my symptoms. For the past two weeks I have had repeated cough and phlegm production as well as sore throat. It was more intense in the first few days but now it has reduced but is still there. I have visited the doctor 3 times so far. Each time he prescribed a different set of medicines. The first time was an antibiotic and I dont know about the later times. My symptoms right now are that I get cough occasionally and also whenever I eat or drink something. There is a slight ache in the head and sinus areas. There is a bit of sputum production probably a couple of times a day.
Earlier(before this occurence), I used to frequently sneeze. I don't know what is the trigger but I feel it could have either been dust from construction activity in a nearby building or the gaseous mosquito repellant that I use. Right now however, I dont fact this problem of sneezing.
I am awaiting results of blood tests and have also been asked by my doctor to give the sputum for test.
Do let me know your opinion on this.

ANSWER: Hello Ajit,
  Bronchitis is an inflammation of the airways, generally due (90% of the time) to a viral infection. I just got over it myself earlier this week after a 3 week run if it. Antibiotics are generally of no value, since they are ineffective for viral infections. Often the treatment is similar to that of an asthma or emphysema. Commonly using an airway relaxer (salbuterol) and an inhalation steroid to reduce the swelling.  This ailment typically takes 3 to 5 weeks to resolve...very frustrating.
   It's great that you keep following up with your doctor. That helps to minimize risk of something changing where an antibiotic would be needed.
   Sadly, you just have to be patient.

Get well soon!

Sincerely,

Marc

---------- FOLLOW-UP ----------

QUESTION: Hello Doctor,
Thank you for your response. Right now my doctor has given me a syrup (to be taken 3 times a day) 'Expectorant' and a tablet called 'montemac'(once a day) which is because I mentioned the allergy to him. These are to be continued for 15-20 days. Blood test results were normal.
I still often get cough whenever I eat or drink something. Also sitting upright gives me greater relief than lying down. These have never happened to me before. I wonder how much more time it will take to get back to normal or are these medicines going to be effective?

Answer
Hello Ajit,

The medications "may" be effective. I would think that the doctor is doing a blood test to help determine what you may be allergic to. Skin scratch testing for allergic response is also used to pinpoint if there are allergen problems.

Yo have not indicated your height/weight situation. If one is overweight, the added belly mass restricts breathing when laying down, which could help explain those issues.

I'm surprised that your doctor didn't give you any medications by inhaler device to help ease your breathing and coughing. If these symptoms have not resolved, you may want to ask him about possibly using salbuterol to help you breath when it is more difficult, or have a severe bout of coughing. When your airways are narrowed due to inflammation, coughing is more easily set of by mucus in the lungs, and this medication opens the airways much wider, improving airflow.

If it is bronchitis, as I've said earlier, it sometakes takes 5 weeks to resolve. Every day you wake up and wonder, "Is it over yet?"!

Hope this helps you.

Sincerely,

Marc

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Marc Rubin, RPh Asthma Educator

Expertise

I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.

Experience

Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

Organizations
American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

Publications
AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

Education/Credentials
BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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