Dr. Anjali
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,
About a year ago, I had COVID 19 infection and was in the hospital for 30 days, out of which 15 days I was in the intensive care unit (ICU). For three months after hospitalization, I was on an oxygen concentrator. I have been prescribed tablet Nintena for three months post-hospitalization. My oxygen saturation remains at 90 to 94, which reduces to 88 to 90 after physical activity. I also have dizziness in the morning and tiredness after morning walks. What can be the reason for it? Kindly suggest.
Hello,
Welcome to icliniq.com. I understand your concern and would be happy to help. Can you share the discharge summary of the hospital admission? How many liters of oxygen do you use on a concentrator? Are you still on tablet Nintedanib? Do you use any inhalers? Is there a history of Tuberculosis (TB)? Are you a smoker? Do you take any other medications? Is there any recent radiological investigation or pulmonary function test report available? Is there a family history of joint pains or arthritis? Do you do any regular exercises or get physiotherapy sessions at home? I would appreciate your patience in answering the above questions. Thank you.
Patient's Query
Hello doctor,
Thank you for your response. I was on an oxygen concentrator for only three months post-hospitalization. Also, I do not continue using tablet Nitenib or any other medications. There is no history of tuberculosis (TB) or smoking. Also, there is no family history of joint pains or arthritis. I do not do any strenuous exercise; however, I go for a morning and evening walk. My doctor suggests that 95 percent of my lungs have recovered; however, my problem persists. I am sharing my discharge summary and computed tomography (CT) scan reports. Kindly advise.
Hello,
Welcome back to iclinq.com. I have seen your attachments (attachments removed to protect the patient's identity). Oxygen saturation of up to 94 percent is considered good. However, I suggest getting your pulmonary function tests (PFTs) done to check your lung functioning. They will help to decide whether you need inhalers. I also suggest you follow the below treatment plan: Start deep breathing exercises and incentive spirometry to strengthen your lungs. Take multivitamin supplements for 15 days for weakness. Repeat chest x-ray and CT (computerized tomography) chest to check the current status of the lungs. I hope this helps. Kindly revert in case of further questions. Thank you.
Patient's Query
Hello doctor,
I am in a better position now with my health a little better than before my oxygen level is 92 -93 when I am inside the room while it is 94-95 when I am in the open air outside. I have recently few tests which I am attaching. The only problem is I have to breathe heavily while climbing a hill which I did today in an uphill morning walkers mountain just to check my lung capacity. I was inhaling air like anything to keep the tempo up the hill and felt my heart rate on the higher side like it is trying hard to pump air into the system. I climbed 200 meters. Kindly go through my latest report to see how I can improve from here.
Hello,
Welcome back to icliniq.com. I am glad that your saturation has improved over time. Your PFT (pulmonary function test) shows that you have a slight obstruction in your airways because of that you will be out of breath on exertion like walking on a hill. To improve that you can start using inhalers which will improve your airways and your saturation will improve further. You can use inhalers for three months and then can get a repeat PFT done. However next time you get PFT tell them to do it with bronchodilator reversibility. That will give a better estimate of your lung function. And I would still advise you to continue deep breathing exercises and incentive spirometry. I hope it helps. Thanks a lot.
Patient's Query
Hello doctor,
Tried to read on the net about it and found I can go for steam inhalation and steam bath, will it help? Which inhalers can I use? My doctor has given me puff during medication is it the same as inhalers or inhalers are different? Please prescribe which company inhalers to be used. I had send my X-ray and report, what does it suggest? My doctor asked me to walk 4-5 kilometers daily but did not allow gym. Which could be the reason. I get suspicious as if he is trying to hide something for me not being scared. Whereas I want to hit the gym to reduce weight in order to put less stress on my lungs. I have started deep breathing exercises and my spirometry is on the way as kids broke the previous one.
Hello,
Welcome back to icliniq.com. Steam inhalation can help up to some extent but it will not relieve the obstruction completely. For now, you can use Foracort Synchro breathe 200 1 puff morning and evening, and rinse your mouth afterward. You can see on youtube how to take this one. However, this is slightly on the higher range side. You can also use Foracort inhaler 200 1 puff morning and evening but with a spacer. Or you can use an inhaler of any company containing Formoterol (6) and Budesonide (200) combination. Your X-ray shows slight post-COVID changes but overall seems to be normal. Regarding the gym, first, you need to build up your stamina by walking. If you want to go to the gym start with light exercises. And in the gym or during any exercise you have to keep your inhaler with you. I hope it helps. Thanks.
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