When I cough my chest pain gets worse. Is it something serious?

Question

Hi doctor,

I am a 60-year-old female. I weigh 154.4 pounds, and my height is 5 feet. I am a known diabetic and hypertensive and on regular medications. I have been suffering with dry cough, fever, and chest pain. When I cough, my chest pain gets worse. I am unable to take deep breaths, because if I inhale deeply, then the chest pain increases. I have had no appetite for the last 25 days. I am feeling weak.

Due to my illness, I have visited our local hospital. I have told the doctor about every health issue, and he suggested I do an x-ray of the chest PA view and multiple blood tests. I am attaching the reports for your reference. After the tests I visited the doctor again, and he said everything is alright. But there is a little infection.

And he suggested a few antibiotics for me, namely Azithromycin with Ofloxacin SR tablets for 5 days, a vitamin syrup named fortified vitamin B-complex, L-lysine, Zinc syrup, cough syrup Grilinctus, and a few more tablets. For the past four days, I have been taking all the medicine, but I am not getting well.

Moreover, my chest pain has increased, and I am having stomach upset and going to the washroom frequently. I have some doubts about my x-ray report. Because an X-ray of healthy lungs should be clear, but there is some white appearance in the X-ray.

Can you please check the reports again, including blood test reports? Tell me if there is anything wrong. Also give me a detailed answer in regard to my health condition.

Thank you in advance.

Answer 1

Hello,

Welcome to icliniq.com.

I have read through your query in detail and gone through your reports (attachment removed to protect the patient's identity). Please find my observations below. The chest x-ray shows certain changes that are expected for your age. There are no significant shadows showing any problem in the lungs. There is no sign of serious disease on the chest x-ray. The heart shadow and aorta are mildly prominent.

But, this is seen in many patients at your age. Your random blood sugar RBS appears to be at the upper limit of normal. To get a more accurate status of your sugar control, please get HbA1C (glycated hemoglobin) test done, and this tells the average sugar over three months. It should be less than 6.2 in people with good diabetes control. I suggest you take a tablet. Ofloxacin is a broad-spectrum antibiotic and is recommended for certain infections.

Also, I suggest you take the tablet Azithromycin (Azithromycin dihydrate) is a powerful antibiotic and must be given with caution to people at your age. It can cause an increase in heart problems if you already have any heart problems. Please inform your doctor of any heart problem next time when you are given tablet Azithromycin. Kidney function and urine tests are normal. Calcium levels in blood are low, and you can take foods having high calcium.

White blood cell count is slightly increased. ESR (erythrocyte sedimentation rate) value is also high, and this might indicate a low-intensity infection within you. Hemoglobin is normal, and TSH (thyroid stimulating hormone) in the thyroid function test is also normal. The result in the Widal test BH reactive might indicate a mild stomach infection. However, it is not significant. Since other titers are normal. If you have the infection, then tablet Ofloxacin which you are taking, will treat it completely.

Grilinctus (Dextromethorphan hydrobromide) is a cough preparation and will help soothe your throat. Also, starting to take vitamin syrups can be continued. Please take your diabetes tablets regularly with food. The cough might be due to the flu and weather changes and is persisting probably due to dust pollution and hot weather. Please avoid going outside in hot temperatures and protect yourself from dust and pollution.

Diabetes itself causes patients to have other infections and delays recovery. Kindly observe better control over diabetes and blood pressure. You can allow 15 days' time after medicines for the dry cough to get cured. If you still have a dry cough even after 15 days of taking the above treatment and protecting yourself from dust, then doing a CT scan of the chest might be required to evaluate any changes in smaller airways and lungs that are not clearly seen on the chest x-ray.

The chest pain following repeated dry cough is explained by muscle contractions, and it does not mean that there is any serious problem in the chest. Please eat healthy, home-cooked diabetes food at home and avoid taking outside food for two to four weeks.

Wishing you a quick recovery.

I hope this helps.

Thank you, and take care.