Dr. Chandra Shekhar
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,
I am 31 years old. I am suffering from high BP and I am currently on medication. I have no thyroid issues, no diabetes, and normal lipids. Electrocardiogram (ECG) and echo both are normal. But, the main problem is a little breathing difficulty. The X-ray of the chest is clear normal but the high resolution computed tomography (HRCT) of the chest revealed early bronchiectatic changes. The question is what is the difference between early bronchiectatic changes and bronchiectasis? Is there any difference in the degrees? What is the treatment? I have a son with whom I am emotionally very attached. Can I at least live anormal lifespanwith treatment or is there any specific life expectancy of five years or so? Please help me out how long can I live? Secondly, I want to expel mucus from inside. Can I try Guaifenesin alone or in combination with what? Can you please provide a drug to expel mucus.
Hello,
Welcome to icliniq.com. I saw your all reports (attachment removed to protect patient identity) and want to say something. Your probable diagnosis is bronchiectasis. Early bronchiectasis does not mean you are a patient of bronchiectasis. Also, you have atelectasis. So, send me a picture of the CT (computed tomography) scan and X-ray of the chest. You can try Aerodil (Guaifenesin and Ambroxol) syrup and tablet Acebrophylline SR 200 mg OD. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You also can trypostural drainage of the sputum. Online information about this is available. Another thing I want to say is you go for sputum Gram staining, AFB (acid-fast bacilli) staining, and fungal staining. Your survival can be more than 70 years.
Patient's Query
Thank you doctor,
Definitely, I will send the images to you. I read that gravity-dependent atelectasis is just because of some position while on CT. If we change the position, it vanishes. Is it so? Some say gravity-dependent atelectasis is benign. I need your opinion on this. Secondly, Aerodil syrup contains Salbutamol also along with Guaifenesin and Ambroxol. Can I take that or onlyAmbroxol with Guaifenesinis recommended? Can I take Budesonide/Formoterol inhaler along with Acebrophylline tablet as you mentioned? Canboth be taken? Can third generation beta-blocker like Nebivolol be taken for blood pressure (BP) in bronchiectasis? Can I take the medicine prescribed until the symptoms subside? Or is there any other duration?
Hello,
Welcome back to icliniq.com. No, there is nothing like gravity-dependent atelectasis. But when you send me your film of CT (computed tomography) scan and X-ray then I will clearly say. I suggest you syrup Aerodil (Ambroxol, Guaifenesin, Terbutaline) 10 mL thrice a day. Yes, you can take the MDI (metered-dose inhaler) Foracort (Formoterol and Budesonide) 200 one puff twice a day with Zerostat VT Spacer in proper technique. Third generation beta-blocker likeNebivololcan be taken for blood pressure regulation in bronchiectasis. It is not contraindicated. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Send me the CT film and then I will tell you the severity of your disease.
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Pulmonology (Asthma Doctors)
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