Dr. Kaushal Bhavsar
Pulmonology (Asthma Doctors)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My father is 76 years old. He often complains of breathlessness and uses nebulizer every day. He has chronic gastric and digestion issues as well. His other health issues include diabetes, blood pressure (BP), spondylitis, and back pain. I got an x-ray done recently. Please advice.
Hello,
Welcome to icliniq.com. I can understand your concern. Can you send me the x-ray report? And also tell me which Nebulization he is using? I will be happy to help him further with medicines and investigations.
Patient's Query
Thank you doctor,
My father uses NS once or twice daily, and Levolin 0.63 once or twice a week, depending on the intensity of the issue. I am sending other blood reports along with the x-rays for your review.
Hi,
Welcome back to icliniq.com. I can understand your concern. I have gone through the reports you have attached. (attachment removed to protect patient identity). His diabetes is uncontrolled. There are better drugs available for breathing difficulty other than Levolin nebulization. I want to know a few more things. Who advised saline nebulization? Since how long he is using Levolin nebulization? Has he ever consulted a pulmonologist?
Patient's Query
Thank you doctor,
I bought a nebulizer for my daughter when she had pneumonia a couple of years ago, but my father uses it whenever he feels breathlessness. Actually, no doctor advised nebulization, but my father uses it on his own. He has been using it for the past three to four months. He never consulted a pulmonologist. Does the x-ray report suggest any problem?
Hi,
Welcome back to icliniq.com. I can understand your concern. Chest x-ray is not much of problem. (attachment removed to protect patient identity). It is showing prominent bronchovascular markings. This is commonly seen with bronchitis and pulmonary edema. Bronchitis is common in smokers and pulmonary edema is commonly seen with diabetes and hypertension. So we need to rule out bronchitis and pulmonary edema. Both can cause breathing difficulty. Please let me know is he a current or past smoker? Does his blood pressure under control? Is he having edema infection of feet or around eyes?
Patient's Query
Thank you doctor,
No, he does not smoke or drink. He used to smoke around 30 years ago, but not a daily smoker at that time. Maybe two or three cigarettes a week, as I checked with him. His blood pressure is under control. He takes medicine with a combination of Telmisartan + Amlodipine + Hydrochlorothiazide. He does not have any infection in his eyes or feet.
Hi,
Welcome back to icliniq.com. I can understand your concern. In my opinion, you should give him Duolin inhaler with a spacer. Better to stop nebulization. Also, give Acebrophyllin tablet (oral bronchodilator). I hope this helps.
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Pulmonology (Asthma Doctors)
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