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Dr. Hasan
Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 8630
Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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Can you tell me if every serious lung condition can be ruled

Resolved Question:

Can you tell me if every serious lung condition can be ruled out by a chest x-ray? Or the lack of a cough? I've had troubling symptoms for 17 months. Each time I see my doctor she is very unhelpful. She claims the above but as I have breathlessness/shortness of breath, a lot of mucus (which can't always be coughed up) there was a cough at the start but it went, now it's more like a need to move the mucus than a cough. I also have sinusitis symptoms, which all started after an infection. The nose never stopped being congested/running/needing to be relived every 15-30 minutes (and still like that), tinnitus began soon after in one ear, a year on in both. The shortness of breath was mild when I first went to the doctor in Oct 2013 but she did little to treat it so it's only continued to worsen. Now it is unbearable. I asked for the chest x-ray. She said as it looked normal there is no serious problem but thinks it could be asthma but that doesn't explain most of the symptoms. There is also a lot of pain in the upper back/chest, a bit like when I had pneumonia and also odd breathing noises, from subtle wheezing to the sound of air escaping or being compressed, sometimes a more whistle-like sound. I'm very concerned as know there is more to this than asthma. Please advice. Many thanks.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Hasan replied 2 years ago.
Hi, Thanks for your question. I'm Dr. Hasan and I'll try to help you. Have you had a sinus X ray so far? What is the color of mucus and have they tested it in laboratory? Are you using anything for sinus symptoms? Regards
Customer: replied 2 years ago.

Hi Dr Hasan. No sinus x-ray. The lumps of mucus that I cough up are white and very thick; the nose is either yellow or more clear though generally have both colours every day, thicker yellow and thinner clear. Also has been a bit frothy. When it all began, I coughed up far more and it was a deeper yellow/green but now the cough is less productive and the other symptoms worse. There is also post nasal drip but the white lumps are like nothing I've ever seen. It feels like there is always mucus stuck in my throat if that helps. Whatever is actually going on, whether there's more than one thing, being so short of breath with the constant tinnitus and pain is not easy so was genuinely surprised that nothing was done again when I saw my doctor. Do chest x-rays show everything in terms of lung conditions? Thanks v much for your help doctor.

Expert:  Dr. Hasan replied 2 years ago.
Thanks a lot for your input. I am sorry to hear about your problem. I am going to address your primary concern but later you can ask anything you want. Yes chest x ray is sufficient to detect any lung pathology but in your case after reading your symptoms in detail, I am not suspecting any lung pathology except mild bronchitis which has got aggravated due to your sinus infection. I will not confuse you and will give simple suggestions. Visit your ENT, get nasoendoscopy done and get culture test of your secretions. This will help them to identify the causative organism. Later you can get a targeted antibiotic according to the test. He may order your CT scan of sinuses. You should ask him for steroid nasal spray as well. Till you visit him, you should take steam inhalation with menthol drops twice daily. Also I would like to share a home remedy. Take 250 ml of honey, add one table spoon each of ginger extract and black pepper. Make a solution and take one teaspoon twice daily. It might take 7 days or more but will help you. I reassure you that as per symptoms, I don't suspect anything serious. I wish you good luck and that you get well soon. My goal is to provide you with excellent service – if you feel you have received anything less, please reply back as I am happy to address follow-up questions. Kindly rate me when you are done. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always. Regards
Customer: replied 2 years ago.

Thank you so much for your detailed answer, really appreciate it. I will take all your advice save the nasal spray as find the steroid ones make it worse in the longterm. Thanks also for the home remedy.

Are you saying that I have a sinus infection that is aggravating bronchitis or that the illness 17 months ago lead to a sinus infection that became chronic because of no treatment? Or that it's chronic bronchitis? A bit confused, apologies.

Would you say that all the symptoms are from the original untreated infection 17 months ago that has lead to asthma and bronchitis? Is it normal to have so much pain from that? It actually hurts to breathe now, which it never did when seeing the doctor. I should perhaps mention I am already on pain medication for another condition (fentanyl), so it being this severe while on opioids is partly why it's so concerning.

It's like a bruised feeling all around the chest and upper back, the pain is also throbbing and sometimes sharper but generally is like being pushed/lots of pressure. It's worsened quite dramatically in the last few days and would definitely be described as severe. The x-ray was about 5 months ago.

The wheezing and pain is worsening quickly, sounds a bit like an old man but can sometimes clear it but only briefly when I can cough the mucus, generally it feels very stuck and hard to cough up. The worst thing is being out of breath from just moving around my house. The pain is also obviously horrid too.

The other thing is I'm in the UK so it can take up to 18 weeks to get an appointment with a specialist. Is there nothing I can do to treat the infection in the mean time? I know doctors are not using antibiotics as much as they used to but it's already been 17 months, obviously far worse for no treatment and if it were as simple as a course of antibiotics could actually mean some relief. Naturally pretty desperate after so long being given things like antihistamines that didn't help. Though she did give me an inhaler for asthma.

I will have a steam session this instant. Thanks again for all your help doctor.

Expert:  Dr. Hasan replied 2 years ago.
You are most welcome :). I will address your concerns separately.
Are you saying that I have a sinus infection that is aggravating bronchitis or that the illness 17 months ago lead to a sinus infection that became chronic because of no treatment? Or that it's chronic bronchitis?
I am saying that you are likely to have chronic sinusitis resulting in bronchitis.
Would you say that all the symptoms are from the original untreated infection 17 months ago that has lead to asthma and bronchitis? Is it normal to have so much pain from that?
Yes I would say the same and the pain you have is muscular and due to coughing. Pain killers are sometime not sufficient for such pain and it may need physical therapy.
Is there nothing I can do to treat the infection in the mean time?
The only thing you can do is to use the home remedy. Add over the counter available tab aleve twice daily for pain and take steam inhalation. You can also take over the counter available mucinex twice daily for thinning of mucus.
I wish you good luck and that you get well soon. My goal is to provide you with excellent service – if you feel you have received anything less, please reply back as I am happy to address follow-up questions. Kindly rate me when you are done. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always.
Regards
Dr. Hasan and 2 other Medical Specialists are ready to help you
Customer: replied 2 years ago.
Hi Dr Hasan, I went to the doctor who gave me an inhaler for what she thinks is asthma. Unfortunately she did not refer me to an ENT so still stuck with all the symptoms. She also said that sinusitis is not treated with antibiotics but I had the impression that was acute, not chronic. Either way she would not issue anything for those symptoms. The inhaler actually does nothing for the breathing and as it makes my heart race, I'm not using it. So a little desperate! Would so appreciate any advice. I was told I could have a more accurate spirometry test but don't think that is the problem after reading on asthma, and especially after reading your thoughts and advice. She did give me another type of nasal spray but if the cause is not treated, don't understand how it can improve. One other thing I didn't understand was if the pain is caused my coughing, it would have been worse when the cough was present but as it's been so long since the cough stopped, why would the pain now be worse? Is there any connection with RSD and pleurisy? As that is the kind of pain (I had that with pneumonia), it's not entirely muscular, more bruised and pressure but with nasty sharp shooting type pains. I do see a physical therapist but she thought the back was in good condition so a bit perplexed. It's now 5 months since the x-ray and obviously had no treatment so wondered if as the pain that has appeared since that could be from the condition worsening. Or would you maintain that it is from bronchitis pain? I do daily physical therapy for the RSD (for the whole body not just RSD areas) and have regular massage but without being able to see an ENT specialist, only have the neti pot, steam and your remedy to help. It's already so hard living with RSD so this on top is making it impossible! I would go private if I had an income to do so but a bit out of options. Many thanks for your help doctor.
Customer: replied 2 years ago.

Are you unable to help? Today had blood in the mucus, though only a little. Please let me know as obviously need medical advice.

Expert:  Dr. Hasan replied 2 years ago.
JOa I am sorry but with blood in mucus, you must see a doctor in person as you may need antibiotics after an evaluation. Regards