###Input :Upper respiratory culture came back and the results are confusing.I am a 33 year old female. Weight: 160 Height: 53 Medications: Modafinil Smoking: Yes, about a pack a day.Was seen at walk in clinic on the 9th of October for what appears to be a Virus. Swollen lymph node on the left side of my face, under my jaw and just to the left of my chin. Sore throat, dry cough, lethargy, headache, muscle pain, and fever that sticks around 101 and comes down occasionally. OTC wasnt really helping. On the fourth day of this now. Chest discomfort started today.Covid pcr came back negative. Rapid strep test came back negative.My upper respiratory culture came back today and these results are what is confusing me. I cannot get a hold of anyone at the clinic who can tell me something so attempting to get an idea of if I should continue to call or if its nothing.This is the only information on the culture.TEST: Upper Respiratory Culture1COLLECTED DATE/TIME: 10/9/22 8:30 PMFINAL REPORT: MANY MIXED RESPIRATORY FLORAINTERPRETIVE DATA: 1ALI Microbiology uses MALDI-TOF mass spectrometry on the Bruker Microflex as its primary method for identifying bacteria and yeast. This test was developed and its performance characteristics determined by ALI. It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research. ###Output :Usual disclaimer: no one can provide specific medical advice for a person or condition without an in-person interview and physical examination, and a review of the available medical records and recent and past testing. This comment is for general information purposes only, and not intended to provide medical advice. No physician-patient relationship is implied or established.MANY MIXED RESPIRATORY FLORAThis simply means that the bacteria found in your culture are typical bacteria found in everyone. No predominant pathogen (disease-causing organism) was found.Generally speaking, respiratory cultures of outpatients are not useful. Rarely do they produce actionable information.


###Input :My asthma is so badly controlled and my specialist isnt giving me other options, is there anything else I can try?Im 28F and Ive tried so many different asthma treatments and I constantly sound like this https://imgur.com/a/RkAF2MC , right now Im having no real bad coughing fits or terrible difficulty breathing, it gets worse but I really dont know what else I can do to just breath normal. This is what Ive tried with my pulmonologistVentolin Symbicort Spirivia Montelukast Xolair (stopped this bc side effects were bad) Dupixent (taking bi weekly)I take prednisone probably once a month at this stage.Ive seen an allergist and use all hypoallergenic products/bedding etc. I have an air purifier in my room. I wear a mask out doors because of air pollution in the city. Ive tried taking anti histamines and they dont make any difference.I dont or never haved smoked. I try to keep active and live a healthy lifestyle for the most part.What else can I do? My doctors not really giving me any more optionsHonestly all tips or advice is welcome. ###Output :Asthma mimics need to be ruled out (vocal cord dysfunction, tracheobronchomalacia, ABPA, etc). If all else fails there may be some benefit from bronchial thermoplasty (but the overall benefit is somewhat unclear).


###Input :Add Chrug strauss syndrome to the list too ###Output :Sarcoidosis as well. Basically needs a full cardiac, pulmonary, and upper airway workup if youre failing this many treatments. I presume they had one if an allergist got Xolair approved, but you never know.


###Input :How does diaphragmatic breathing differ from typical respiration in an individual without underlying respiratory conditions?To my understanding, the lungs expand and contract as a function of the diaphragm/transverse abdominals contracting, as well as the contracting of the inner/outer intercostal muscles. As a musician who plays brass instruments, there is this phrase, "Breathe with your diaphragm" that gets passed around quite often, but I never really felt like I fully understood what that means from an anatomical standpoint, because wouldn't that imply that it's possible to breathe without the diaphragm, or that an otherwise normal breath is done without the diaphragm?I am aware of diaphragmatic breathing as a form of physical therapy for individuals with chronic obstructive pulmonary disease, but what benefits, if any, would it offer for an individual without such medical issues?Follow-up, would such exercises expand an individual's vital capacity/is it possible? I believe a person's TLC cannot be changed. All in all, there is a lot of information about breathing in the world of music education that is shared and taught without citation or concrete scientific basis and I wanted to get to the bottom of it all. Thanks! ###Output :I am not in the world of music but you are correct. Inhalation is done with the diaphragm and accessory muscles as needed. I would guess that breathing with your diaphragm is more of a cue to take a solid expanded chest, stomach out breath as opposed to a weak, chest only inhalation. Again, basically a cue to get maximal amount of air in your lungs.And yeah I think it would be a stretch to say that exercising can increase total lung capacity. Maybe, but I cant imagine it is in any appreciable way.


###Input :Does routine respiratory flora mean Im strep free?Age: 48Sex: femaleHeight: 5 8Weight: 150Race: whiteDuration of complaint: weekLocation: throatAny existing relevant medical issues: StrepCurrent medications: noneInclude a photo if relevantI was treated for strep but still felt a little sick so I asked for a other culture. The results came back routine respiratory flora. I cant get anyone at One Medical to respond/explain so I thought Id check here and see if that means Im ok or if something else is going on. ###Output :It means you have the normal bacteria that grow in your mouth. As for whether or not you are improving from strep throat, the culture has no bearing on that.


###Input :please help, ive been having weird respiratory problems for 10 days and idk whats going on.25f smoker hi, for 10 days ive been coughing up THICK GREEN phelgm and/or blowing it out of my nose, especially at night. i wake up every 2 hours unable to breath until i clear it out. my throat is also sore at night but just from the phelgm irritation. its so much phelgm i go through 2 boxes of tissues a day. the first day i was sneezing a lot and then my nose was running for a few days and now the last couple days it seems worse, as its turned into a lot more coughing/occasional wheezing even in the day time. i have a post nasal drip too. sometimes my nose feels clogged and sometimes it feels dry. the mucus production has only increased with time. during the day its not very bad but at night its hell and the mucus is much darker and thicker. im only relatively comfortable if im completely standing. weirdly enough i have no other symptoms like fever or pain. just various respiratory issues. im worried i may have a bacterial infection because it has only gotten worse. what could this be? please helpEDIT: went to urgent care, had bacterial infection, on antibiotics now ###Output :You are having a bad cold my friend, sounds like it might have progressed to sinusitis. This will get better on its own, use decongestants at night, aspirin and lozenges for throat pain.


###Input :Can anyone recommend some blood pressure medicines that dont cause respiratory issues?Im 25, Male, 6 and weigh 180lbs. Ive been taking Metoprolol since I was 13. I wasnt overweight, no heart defects or anything, just a genetic issue. My usual blood pressure without medication is 150/100. 25mg of Metoprolol ER brings it down to 120/80, and when Ive taken it in the past, 10mg of Lisinopril brings it down to 110/70.Ive always had bad allergies and congestion issues, and recently theyve been getting worse. Im seeing an ENT soon, but before then, I also have an appointment with my primary doctor. I suffer from pretty bad post-nasal drip which causes me to constantly clear my throat. Through research, Ive found that Beta blockers, as well as ACE inhibitors, are prone to cause asthma symptoms, congestion issues, and dry cough. Since my congestion and post nasal drip have become more problematic, Im looking to eliminate anything that might be contributing. Since there are so many different blood pressure medicines, I thought Id ask for some recommendations that are less prone to cause those side effects. So far Im leaning toward Losartan, and Ill be discussing these changes with my doctor this week. Thanks! ###Output :Beta blockers can cause bronchoconstriction in people with asthma. You havent mentioned asthma, just congestion. Those are unrelated problems.ACE inhibitors like lisinopril increase bradykinin, which can produce a dry cough. Again, unrelated to post-nasal drip or congestion.Calcium channel blockers like amlodipine are often first line and dont have any respiratory effects, and ARBs like losartan dont increase bradykinin, so thats reasonable, but it doesnt sound too likely that your problems are related to medications.


###Input :I previously had an inhaler because I was waking up in the middle of the night not breathing. Did a sleep study and no apnea. I also go through episodes where I feel like theres so much mucus in my throat I cant breathe, but I always attributed that to anxiety. ###Output :At that dose, metoprolol specifically is selective for the receptors in the heart and should not affect your lungs at all. At doses above 100mg/day is when I'd be concerned. (Other beta-blockers vary in their effect on asthma but metoprolol is a better one).As for Lisinopril I echo what the physician above said. It only causes dry cough and that would usually appear very early on when you take it. No effect on congestion.I personally had bad post nasal drip and congestion. Seeing a specialist helped so I'd suggest waiting for the ENT appointment.


###Input :Can someone be more prone to respiratory infections?Almost every year without fail, I get an upper respiratory infection. Every spring it starts out seemingly as allergies, an itchy nose and throat, sneezing, etc. then it slowly makes its way down and I get a respiratory infection. I dont know why but it just always happens without fail. One year it got so bad that I started to have fluid buildup in my lungs and had to have a lot of antibiotics. This year its quickly getting bad but I just moved recently so I dont have a doctor, barely productive cough that tastes like blood/nasty and some chest heaviness along with fatigue and a hoarse voice/white spots on tonsils.No one else seems to have problems like this, so I was wondering if some people are just more prone to stuff like this? Ive gotten them constantly no matter what environment Im in, and it always quickly gets really bad. Even during my childhood I got them really bad, and I had RSV as a kid. Usually I dont get any answers, its just yeah you have an infection, heres antibiotics.Other than this Im a completely healthy 21 year old female, no existing conditions and no medications other than melatonin. ###Output :Note: I am not a pulmonologist.Having had pneumonia in the past, you are more vulnerable to getting pneumonia recurrently. You might want to consult a pulmonologist to see if there's something else going on. Asthma, chronic bronchitis, reactive airways disease, and a few other less common causes of seasonal/recurrent respiratory illness might underlie your problem. Also, because you've had recurrent respiratory illnesses, you should get annual flushots and update other immunizations. If you smoke or vape, the best thing you could do is quit. Inhaled substances are not prudent if you are prone to respiratory illnesses.


###Input :Morphine and breastfeeding21f, in Ontario Canada, breastfeeding a 8 month old. Is there any safe amount of morphine I can take for pain while breastfeeding? ###Output :Morphine is generally safe and has low transfer through breast milk.However, make sure youve maxed out your Tylenol first. 650 mg every six hours can go a long way towards pain relief.


###Input :Thank you for this! Is 650every six hours the max dose for Tylenol? I do not want to take narcotics but sometimes it seems like the only wait to get the pain to a point I can function. ###Output :Max dose is 1000 mg every six hours, but I think you have diminishing returns after 650 mg. Plus, wouldnt go too much higher with breast feeding.


###Input :Can I wait this out? I dont want to go to urgent care35F 140lbs. Been having what I assume is an upper respiratory type infection for like 3 days. Coughing up green mucus, from sinuses too. Its thick and sticky. Taking mucinex daily and drinking a lot of water. No fever.My husband insists I go to urgent care because of the green thick mucus situation. I have no fever, can I just wait this out and see if it gets worse in a few days? I dont want to be put on antibiotics by a doctor if its just a virus. ###Output :If only 3 days in and not having fever or really bad facial pain, I have no reason to think that you have a sinus infection instead of just a viral upper respiratory infection. I don't think urgent care is warranted in this situation.


###Input :No bad facial pain. Just coughing up mucus from the chest. Im assuming from dripping down my throat ###Output :Yep, sounds like a nasty virus. Hydration is going to be key.


###Input :Ongoing respiratory issuesLast week I started coming down with what felt like a cold. But my chest was aching very bad (under left breast and into back) and was having a hard time breathing. Gave it a few days to sort itself out but it got worse, ended up in the urgent care with a fever, cough , chest pains. Was coughing up brown, green and blood tinged mucus. Did X-ray.. doctor said they saw bronchial cuffing but radiologist stayed X-ray was all clear (confusing..) doc put me on a zpac and Im on day 3 of 5. Im still having chest pain, low grade fever and coughing up blood, and green mucous. I am a smoker and noticed after I smoke I feel horrible with chest pains and sweating.. going to ride it out another day if I am still unwell tomorrow should I go to er for another chest X-ray? Nervous about lung issues/as a ct scan awhile back showed partially collapsed lung and lung nodules. I dont feel that the antibiotic has been helping Much. Im a 27yo female so I feel Im sort of young for any serious issues ###Output :Another chest x-ray this soon is probably not going to show anything different. Infections take time to clear, at this point I would recommend continuing the antibiotic and waiting. If your symptoms haven't started to improve after the last day of the antibiotic, then consider going back in for a reassessment. Also, smoking really diminishes the lungs ability to fight infections. I would recommend quitting smoking.


###Input :My neighbor (36M) dropped dead in front of me. I failed to resuscitate him. Hoping to get better understanding of his cause of death.This happened a month ago and Im sorry if this isnt the right place but it was a traumatic event for me and I think having some potential logical explanations might help me move on.My neighbor (who I didnt know at all really) was a 36 year old male, slightly overweight. He worked construction I believe. I was out front of my house when his truck drove down and he kind of pulled into his parking space a bit erratically but I didnt think much of it and was busy with my daughters. After what felt like a couple minutes (but was actually 12 mins according to my security camera), another neighbor screamed and said hes not breathing and asked me for help. I called 911 and immediately helped get him out of his truck and onto his back. He was blue. Me and another man took turns doing chest compressions until rescue arrived. They were able to get a pulse back but he ended up dying a week later.He and his wife had a brand new baby. They dont speak English and so when I asked her what had happened she told me as best she could that it was not a heart attack. That it was respiratory arrest. That he had a form of syncope.I actually have syncope myself (neurocardiogenic syncope and take beta blockers) and didnt want to ask any further questions. Just wondering how such a young guy can go from driving one second to just not breathing the next. As far as I know, my doctors have never told me I might just faint one day and stop breathing as a result. Im guessing this is a different kind of syncope. Just wondering if anyone knows of any possible reasons?Edit: I wasnt expecting so many responses and am so grateful. There are so many potential causes of death I hadnt thought of. Its really moving hearing so many doctors and paramedics share their own stories of losing patients and the emotional ramifications. Thank you. Im going to absolutely pursue counseling.Ive had a couple people message me about his widow and baby. I wanted to update that Ive been doing my best to help them. I got a fair amount of baby gear donated and my husband and I bought her enough groceries for a month as well as a $200 gift card to the grocery store. I also printed photos (which I got from her sister) of him and his baby on archival quality paper and framed them as a gift for them. They were already struggling before he died and both out of work. It seems like since his death, a lot of family has arrived to help her out too.And lastly, it wasnt covid (luckily). Its been a month and I already tested negative. ###Output :Just chiming in to reinforce what has been said. We can't tell you exactly what happened, because we can't know without a lot more information. However, we can say a few things.Seeing someone die is always a hard thing to deal with. The first death we all saw in our careers stay with us, even when doing CPR becomes a routine thing, and if you ask the majority of us we'll be able to tell you what happened in detail, even after quite a few years. It does get easier though, once you realise that the person you were trying to resuscitate needed resuscitation in the first place; they were dying without your intervention and you did all you could to try and change the outcome from what was already going on. In your specific case, the fact that you kept pumping his blood for him well enough for paramedics to get a return to circulation means you did a good job of it.You should consider talking to a counselor about this. It is definitely a big thing to process, and it's normal to struggle with it. We usually get a debrief from our seniors after a death, and getting to talk it over with someone who can help you unpack it all is quite helpful.Also, know that there are various different kinds of syncope, and the kind you have doesn't cause an increase in your risk of sudden death.


###Input :I cant like this enough.I havent been authorized by the mods of this sub, but I want you to know that every death is a tragedy to medical professionals. Regardless if youre prepared for it or not, its hard to deal with losing someone. Even if you know your patient is terminal, it still hurts to have it end in death.You did everything you could, and MORE than most would do.Im so sorry you had this experience, but please know that you reacted stronger and better than a huge majority of people would. ###Output :every death is a tragedy to medical professionals. Regardless if youre prepared for it or not, its hard to deal with losing someone. Even if you know your patient is terminal, it still hurts to have it end in death.Truth. As an oncologist, I have just grown numb to losing a patient. It still feels like a stab in my heart every time.


###Input :Hey man, just wanted to let you know that youre a great person for venturing into such a difficult field. Take care of yourself. ###Output :Thank you


###Input :That's totally how I felt reading this. OP, you did amazing. I knocked myself out at work last year and all people could do was run around screaming. You were nervous but composed and did an amazing thing keeping him as best as you could until the paramedics arrived.OP, I am really proud of you, not only for your quick action but also for your caring. We can't save everyone but the people who try make me proud to be human. ###Output :Know that you did everything that you could. Don't feel guilty. He might've had cardiac issues that resulted in cardiac arrest. Likewise, things such as OD cannot be ruled out either.When I was a resident, events like this often triggered me to have a meltdown. I'd feel guilty. Why couldn't I have saved that man or woman during that code blue? At the end of the day, we have to realize that death is a part of life. Of course, I learned this over time as a young doctor. Sometimes we cannot resuscitate an individual no matter how hard we try even if there is a crash cart with all the emergency supplies right next to us.


###Input :I go to therapy once a week for a different reason, but the one thing that helps with closure with traumatic instances is EMDR. Its like what op said, but instead of writing the event out, you work with a therapist and say the event until you feel safer. I always hold these things in my hand, as we go through the event little by little, hell ask me one to ten how do I feel (about what I just talked about) and tell me to just focus on that and well do a set. The thing in my hand (dont know what its called) will start vibrating in my hands (think like hand held massagers that were popular in the 90s ish. Its not big, but it buzzes and vibrates in your hand. Does that make sense?) Its so soothing, and I always feel like I am slightly floating and turning. Absolutely not in a way you would high. Then he would stop and ask what I notice now? I would explain the next part and repeat. When we had to stop for the day (or week, depending how often you went) he would ask 1-10 how I was feeling, do a set and I would gently open my eyes. We would do this until I felt comfortable enough to feel like the incident was more safe in my mind.ETA: I forgot to mention, in the beginning of the session, he would show me a list of emotions and ask which one could best describe my feelings of the event at that moment. Then ask 1-10 of my emotion. We would then do a set before he asked me what I noticed from the event.Every appointment, he would ask if I felt like processing that session. Sometimes you need a break, and thats okay. You still have someone to share anything you feel comfortable sharing who is a third party. He also started the processesing session showing me emotions, asking how I felt 1-10 and I could share starting with the beginning from last session, or where I left off. The whole point is to talk about the event on your terms and process how you need to. ###Output :Realized I havent let myself process what happened.It will take time; don't be afraid to seek help from a therapist. Just know that you did everything right. Thank you.I just wanted to thank you for doing CPR on this guy. You did a good job, it's so important that people try to resuscitate a patient in this situation. Sometimes it wont work depending on the underlying disease. But that's not your fault. You guys did the right thing!


###Input :NAD, Im a 911 dispatcher. The fact that EMS was able to get a pulse back means you and your neighbor did the right things and did your absolute best to give him a fighting chance. Unfortunately, sometimes no matter what you do, its not enough and its too late. So many times, cardiac arrest calls we take end with EMS doing CPR until getting to the hospital, and the hospital calling it shortly after. Perhaps your quick action gave his family time to see him a last time and say goodbye. I hope you find peace and comfort... and even just a few sessions of therapy can provide such a huge benefit toward professing things like this. ###Output :Echoing all that was said here.First off, thank you for trying to help. These kind acts keep society alive despite political posturing and divisiveness in social media.As hard as it is to imagine and as difficult it is to go about your routine, inaction would be far more paralyzing. You did everything that you could in his time of need. I have had similar instances in my career in the ED and this same message was relayed to me early in my career: We can only do everything we can do and nothing more. At the end of the day, you gave him a chance. If no one did anything, he would have died. You gave him a chance.I cant speak to exactly what happened, but respiratory arrest is essentially saying that he stopped breathing. That could imply severe asthma, anaphylaxis/allergic reaction or even cardiac arrest (eg, I had a 42 yo MI in a patient just today). Or pulmonary hypertension.I wouldnt rule out overdose. Narcotic addiction has almost never been higher and is one of the leading cause of death of young people. I pulled someone out of their car unresponsive, cyanotic last week for the exact same reason.I trained in one of the most severe areas of narcotics in the US, Kensington in Philly. Its everywhere and a daily occurance. An opioid addicts life has been replaced with daily struggle to obtain narcotics or suffer debilitating withdrawal that few ever want to experience in their lives ever again. Its said that alcohol withdrawal can kill you; narcotic withdrawal makes you wish you were dead.Fortunately, there is help. Suboxone and other treatments can help to replace their addiction with an extremely safe and effective alternative. Its unfortunate that this happened and likely could have been well known by the family. I have had this converation far too often in my career. Parents who performed CPR on their child as they were holding their grandchild in their lap on christmas morning, the daughter who could no longer struggle and overdosed on every pill in the house and the 15 year old who is going to gift of life after found in the rear of the bus. Family are expecting that someday that they will get a phonecall - they just dont know when.The carfentanyl that is used in place of heroin is deadly for anyone who cant fight their addiction and relapse, only to find that the ford taurus of narcotics was replaced with a tractor-trailer. And its often too late. Methadone can be used, and maybe used by some on the street or for pain control, but its hallmark is that your breathing is stopped often before pain control. And it has some of these cardiac effects that were mentioned regarding hydroxychloroquine.Narcan is a medication that is widely utilized. It reverses their apnea (lack of breathing/respiratory arrest). But its temporary. Sometimes ingestions can rebound and the effects can wear offI trust that you did everything you can.If this continues to haunt you, in addition to asking your family doctor for a referral to someone to speak to regarding your experience, ask for a prescription for narcan. Even our local libraries carry some. Keep some in your bag. Speak out, see if there are groups in your area that you can support financially or otherwise. Reach out to the family that was involved. Addiction is often a genetic process. Finally, if you have your own kids, be aware that opioid addiction can happen...especially those with addiction tendencies. It can happen with as few as 12 pills.Best of luck. And again - thank you for all that you do!


###Input :Its said that alcohol withdrawal can kill youHow can it kill you? That's insane!It can happen with as few as 12 pills.It's seriously that addictive? I was on codeine cough syrup for three months and I had no problem putting the bottle away when my cough was gone. Maybe it helped that I genuinely hated every single thing about it except for the cough relief. ###Output :How can it kill you? That's insane!Since you don't appear to have gotten an answer. Two main ways. Alcohol withdrawal can cause seizures, which can be deadly, and alcohol withdrawal can cause something called delirium tremens. Delirium tremens is more of a form of withdrawal characterized by quick and varying changes in someones heart rate and blood pressure in such a way that it can kill (through irregular heart rate called arrhythmias) or a person can become unable to "protect their airway" so to speak and choke.Alcohol withdrawal isn't a pretty thing. BUT the good and bad news is that it varies a lot from person to person.https://emedicine.medscape.com/article/166032-overview


###Input :I'm not a doctor so I can't say much on what happened but I went through something similar.An elderly man that walked past my house every day to go to church collapsed in front of my house. I have no idea how long he was there. But I heard a woman screaming for help so I went outside to look. He had no pulse. I gave him chest compressions until ambulance arrived but i knew he was already gone. I could hear air going in and out of his lungs from the chest compressions. I'll never forget that sound and how sad I felt doing it to him when I knew he was gone and feeling his ribs crack. This was 5+ years ago and I still remember it like it was yesterday. I still wonder if i had looked out my window sooner if he would have survived and wonder how long he was there before the woman saw him. I also remember how the fire fighters arrived first and stood around me and told me to keep going rather than take over. It was definitely traumatic.I feel so sorry for your neighbors family. So young and so much life ahead to live.Life really sucks sometimes.I will always remember the experience and it was hard to process at the time but it did get better as time went on. ###Output :This probably doesnt really add anything, but I just want to reiterate, THANK YOU. You did something that is incredibly hard both physically and emotionally. You kept your cool and did what needed to be done, and what each of us hope that someone would do for us or our loved ones. The causes of suddenly death make a long list, and include things like congenital or acquired arrhythmias, vascular issues including aneurysm rupture or clot in the brain or lungs, and among many many others drug overdose which is sadly probably the leading cause in this age group these days. Im sorry that we cant really give you an answer here. As others have said, please seek help if you need it to process this event. Its a trauma and not something that many people have experienced. Remember that you did everything right, there is likely little that would have changed the outcome, and that you helped give his family a week to say goodbye.


###Input :To respiratory physicians: is length of time of holding breath an indication of lung capacity?Im a 24M, light smoker, on no meds, weighing 71kg at 175cm.For a smoker who is hypersensitive to the effects of smoking on his body, I am often testing my lungs, usually while exercising (swimming), to see how long I am able to hold my breath. Am I making a false conclusion when I see that my ability to hold a longer/shorter breath correlates to better/worse lung health?Side note: Ive heard that lung capacity can only deteriorate, and is rather stubborn in improving, or all together impossible.. so what gives?Ps: if there is a better sub to ask this question, please do suggest it! ###Output :The other comments here are correct that breath holding time is not an accurate reflection of total lung capacity (TLC).But to unpack your question a little further, TLC is just one of many variables important in lung health. Chronic lung disease from smoking is predominantly obstructive (COPD), which is measured by a decrease in the forced expiratory volume in 1 second (FEV1), often also expressed as a ratio to the forced vital capacity (FVC), or the total amount of air you can blow out at once.If anything, smokers tend to increase their total lung capacity as their disease progresses because they are trapping air, unable to blow it out.


###Input :Respiratory sinus arrhythmia or sinus pause ?? EKG (sorta) included20M, 52, 150lbs, hypothyroidism, anxiety disorder, depression, .5mg Xanax, 25mgc levothyroxine, 12.5mg metoprolol 2x dailyHi again !! So I have one of those at home 1-lead ekgs and whenever I do one and take a deep breath I notice my heart rate slows down and it looks like it skips a beat...... can anyone tell me what this is ?? I have a lot of anxiety around my heart and bought the ekg to monitor my heart rate and I know these things arent 100% accurate but this is worrying me. Sorry if this is asking a lot but im not seeing my cardiologist for a couple weeks so could someone tell me what this looks like ? https://imgur.com/gallery/wjuAjvy ###Output :100% normal - this is respiratory sinus arrhythmia. Stop checking.


###Input :Update to Previous Post Regarding Cough Up Blood After Workout. Results Were SurprisingAge: 31Sex: MHeight: 6'6"Weight: 250 AthleticRace: White/CaucasianDuration: 4 1/2 MonthsLocation: Lungs/Upper Respiratory, Upper G/ICurrent Diagnosis: Stage 4 Aggressive Gastro-Intestinal CancerCurrent Meds: Pain Killers, DiureticsAs needed Meds: Lidocaine Patches, Anti-Nausea, Melatonin sleep aidOriginal: https://www.reddit.com/r/AskDocs/comments/c2ls61/chronic_cough_and_now_coughing_up_blood_after/?utm_medium=android_app&utm_source=shareSo after spending some time at an Urgent Care, getting some scans lined up and trying to be patient, I woke up one morning to pain and compression over my chest. Urgent Care Docs had advised me that any escalation of symptoms should mean I go to the Emergency Room. Once there they almost immediately checked me into the ICU for observation and began running every test you could name. For the next 4/5 days I did just an unreal number of scans, 2 biopsies, and they drew enough blood to fill a small pool. Pain escalated daily while there so finding a solution was a running theme. So after a lot of trails here's what they found:Current: Stage 4 Aggressive Metastatic Gastrointestinal Cancer ( Adenocarcinoma )Previous: Disseminated Intravascular CoagulationAfter doing a Lymph Node & Bone Marrow Biopsy they found my marrow filled to capacity with dead cancer cells. This pointed them in the right direction. My platelets were crashing daily (20,000 at admission) and I've got inflamed lymph nodes throughout my chest cavity which is one source of my (significant and at time escalating) pain. Its infiltrated my lungs and several vertebrae along my spine (causing vertebrae to show signs of Osteopenia) . Weirdly enough there's no noticeable tumor/mass/lump they can trace it back to. It's kind of just spread throughout (described as Adenocarcinoma) , though they were finally able to locate a small ulcer in my stomach that allowed them to finally be able to classify it. I've currently just completed my 3rd (now weekly) round of chemo (we started asap when other options such as clinical trials were deemed a non-option) and we've been able to stabilize a number of things (blood factors such as platelets, hemoglobin and the like) along the way. Many of my blood counts are still in the trash so clinical trails are not currently an option. In early stages of my 3 weeks hospital visit I was in a state called **DIC (**Disseminated Intravascular Coagulation) which caused me to act like something akin to a blood squirt gun if i bled. Essentialy it screws with you clotting factors and any bleeding event is an issue. Any procedure became an issue and many my numbers were artifically raised in order to attempt anything that would cause me to bleed. Fortunately after a week of treatments and what felt like several wheel barrows of infusions we kicked my body out of D.I.C and am more or less clotting normally. Fun story: early one morning after the vampires took their daily does of my blood a CNA came in to do a routine vitals check. This particular morning they took 2 unique sets of blood samples plus a rather large sample for testing against infectious disease. This was also kind of at the height of my "he's not clotting" phase. During the blood pressure check it popped open all the fresh holes in my arm, causing them to bleed and freaked/surprised the CNA. Made me laugh. (end of story). Immunotherapy is what my Oncologist are banking on right now so crossing my fingers. Chemo is causing reasonable progress (numbers are low but stable) so we're staying the course for now. My personal mid->long term goal is to find an alternative to opiates for pain management (who the hell knows why a person tolerates opiates for a buzz cause constipation sucks!!!) so looking at alternatives (THC pills potentially or preferably resolving the issue that's causing me pain) I've been discharged from the hospital after 3 weeks so now I'm working to find a routine that works. Losing weight so a short term goal is stopping that (I'm rather tall and (was) muscular so my bodies nuking whatever calories I put in and I'm not putting in a lot due to general nausea, but smoothies have been my friend. Please let me know if you have any questions or advice.. I'll answer what I can and absorb what reasonable advice I read. ###Output :Man, that was not high on my list of possibilities after your original description. Sorry to hear. Give it hell.


###Input :Fortunately I do, and they've been a tremendous help. Would have been very difficult without their aid. However , things have mellowed out enough, now that I've been discharged, that most everyone has been able to return to their routines, which is nice. Their support was invaluable but I was eager to get everyone back to their normal lives as well for their own sakes and health. ###Output :Thanks for the update, OP, though I wish it were better news.I will leave this up for now as OP has a specific follow up question regarding pain and symptom management. However, if this thread becomes off topic (including an excess of well wishing in relation to actual advice being given), we will lock it.We all want OP to do well. Stay on topic so we don't bury good advice that may come forward.


###Input :My significant other's health has sharply deteriorated and after months we have no idea what it is.Hello. My (24F) boyfriend, Paul (29M), and I are fairly active. We go on road trips every year with our main stops being prime hiking spots. Paul is 5'7'' and 230 pounds. Due to his southeast asian/pacific genetics, his entire family is on the heavier side, but Paul is just as active as I am and eats well.Recently, we have gone long distance. Paul returned to live with his parents due to the pandemic while I stayed where I was. I visited him in June 2021. At this point, Paul had few symptoms, but some new minor health issues. We went hiking around Lake Tahoe and Paul was a little more out of breath than usual. He hasn't needed to use his inhaler since he was a kid, and he had to use it on this trip. We attributed this to recent wildfires in the area and poor air quality.However, Paul's health continued to sharply deteriorate. We went to Edinburgh, Scotland, in July. While hiking Arthur's Seat, Paul had to use his inhaler so many times he emptied it out. He could not get it refilled as we were out of the country. Until the end of the trip, Paul's breathing became more and more labored and he developed a persistent cough.I did not visit Paul August-November 2021. We spoke on the phone and Skyped regularly. During this time, Paul would sometimes leave the call or mute for a few minutes. He'd come back and apologize, saying he'd had to cough pretty violently and didn't want me to hear. I was concerned. I overheard one wracking, moaning coughing session and knew it was not just asthma or an irritated throat. By October 2021, the air quality in his area had greatly improved.I persuaded Paul to visit his general practitioner. His GP dismissed all of his concerns and cited Paul's being fat and asthmatic as the source of his issues, and that the issues would disappear with rest and exercise. I had to fight doctors for years to get them to take my chronic pelvic pain seriously, and was finally diagnosed with an ovarian cyst that was 8mm long and about to burst, so I have experience with self advocacy in the medical space. I helped Paul see new doctors.In mid-October 2021, Paul developed abdominal edema. Paul's feet, legs, and lower stomach were swelling up like crazy. He gained 40 pounds. He could barely move at all, even to go to the bathroom. He couldn't sleep lying down without suffocating, which only worsened his exhaustion. He went to the doctor again and was prescribed diuretics. The diuretics helped with the swelling and extra weight and within 2 weeks he was back to his regular weight, but the coughing and weakness persisted.About a month after regularly taking diuretics (November), Paul started feeling intense nausea on a weekly basis. This nausea would prompt coughing fits. Paul couldn't eat or focus while nauseated. Our calls became more and more infrequent as Paul's nausea and headaches grew. He told me sometimes the nausea would get so bad that he would vomit. There were no patterns to the vomiting--it didn't happen at a certain time of day or after meals. Sometimes it was foamy. He got a CT scan to look at his gall bladder and all results were within normal ranges. Blood tests, including labs for liver function, all came back normal. His doctor referred him to a gastroenterologist for more testing, but due to increases in COVID-19 cases, they haven't even processed his file, let alone scheduled appointments, which would be months out. A nurse anticipated he wouldn't be able to go in until February 2022, but at his rate of decline, this has me concerned for his mental wellbeing and life quality.This week, in late December 2021, I visited him and his family for Christmas. I had heard from Paul about his issues and was following closely with his medical updates, but seeing it firsthand was another thing altogether. I have never seen human suffering and sickness like this up close or cared for another human being in such an intimate way.Every single day, he has intense coughing fits and bouts of nausea where he makes vocalizations and gags, usually every few hours. At least once a day, these coughing fits are so bad that he spends 5-30 minutes vomiting in the sink. The vomiting has increased drastically. After this, the nausea alleviates, but Paul feels exhausted and has migraines. He barely eats. He barely sleeps.Today, he had three different nausea/coughing bouts that induced vomiting. One developed rapidly and he threw up in a restaurant bathroom. The last one, which just happened this evening as of writing this post, also caught him by surprise, and he vomited in the kitchen sink. The vomiting was so physically taxing that his nose bled profusely and he lost control of his bowels and peed himself. He was not strong enough to make it down the hall to the bathroom. Eventually, I assisted him into the shower. I am writing this before bed, and he is still coughing, and has a migraine. He hasn't gotten up from where he sat after taking the shower.I would appreciate any medical advice about what might be causing what Paul is going through, as well as tips for how to navigate the medical system to ensure this gets treated in the best way possible. I would like to reiterate that while neither of us are marathon running body builders, Paul (before all of this) was physically active and monitored his eating habits. He was also mentally active and had returned to school to pursue a degree in a new field. We both have families that are reasonably well off and are good support systems.Paul is one tough puppy, and reassures me that it "isn't so bad," but after seeing it firsthand, I know this is not something that can continue the way it is. I am extremely worried, and caring for him is beginning to wear on me mentally. Sometimes I feel sympathy nausea when I hear the noises he makes in the bathroom.Please help in any way possible. I appreciate any and every tip, and can provide additional information if needed. Thank you very much.UPDATE 12/26:We went to the ER at 4 AM right after Christmas. Luckily, it was almost completely empty. I was not allowed to go back with him, so for the entire five hours I was sitting in the waiting room, I was only ever accompanied by one or two other people at a time.Paul's shortness of breath, fatigue, and wracking coughs got him seen quickly. He texted me updates as things progressed. He got every test I wrote down from these comments--BNP test, pulmonary work, chest x rays, GI work. An echocardigram is scheduled for next week.They found out right away that Paul's BNP results were seven times higher than usual. They said this was indicative of heart failure. They also tested Paul for COVID 19. He tested negative, but did test indicating he had some kind of viral illness.Paul's doctor concluded that he was suffering from chronic RSV that was made worse by poor genetics, asthma, and obesity. Paul did confirm he had what felt like a respiratory illness in Scotland in June, then after going to a wedding in October, then this week when he got severely ill and we found out his mother had a cold.There is no cure for RSV, but a vaccine has reached human trials. The only things Paul can do to alleviate his own suffering and avoid a heart attack is to make significant lifestyle changes and live like an immunocompromised person. I believe in his ability to achieve the former, but the latter is more difficult because of his emotionally overattached mother who brings the entire extended family out for lunches, movie nights, shopping, etc. several times a week. I'm concerned she won't take it seriously or will be in denial to avoid feeling responsible and will therefore continue to expose Paul to colds that could kill him.Paul is currently resting. He was given medication for his nausea and a new inhaler. He is doing better but still coughing. We have already started on his new food regimen. I am hoping for the best, but the pandemic has proved that people rarely take precautions for others' goodwill. Thank you for all your support. Paul might never have gone to the ER if I hadn't visited and reached out to this community. ###Output :He needs to go to the emergency department. It sounds like he has some sort of heart failure causing the shortness of breath and swelling. The nausea and vomiting could be anything, though Id be concerned about electrolyte abnormalities or increased intracranial pressure. Heart failure can cause it too but not this severe Id imagineDont have a great answer tying them together thoughThis was pretty much exactly my thought process as well. Hard to tie all of these symptoms together until we start a work up, which should definitely include an Echocardiogram. Go to the emergency department to get started, then will probably need to stay in the hospital until a diagnosis and care plan is made, as well as symptomatic improvement.


###Input :What about ruling out lung cancer? You dont have to be a smoker or old to get lung cancer and unfortunately Asian/Pacific islanders are at higher risk? ###Output :Lung cancer is almost unheard of in your 20s. Also none of the symptoms other than cough fit


###Input :Disclaimer: Not a doctor.With Paul's history of being active outdoors(I also wonder if he has any pets?), I also wonder if the hospital should be checking for Lyme Disease? Depending on his other symptoms not sure how high up it would be on the differential?I know that coughing is pretty rare in it, but from the sounds of it whatever he's had has been going on for a prolonged period of time, and it kind of sounds similar to this patients story, but also maybe not entirely?I guess it could be something for the OP to ask the doctor about that they're talking with. ###Output :It is something I thought about though I dont know Lyme prevalence in the UK and more importantly Lyme is more associated with heart block than with heart failure. Something worth thinking about though


###Input :When you look at intracranial pressure, how does that affect how someone breathes?I know it makes you work harder to breathe but not why. ###Output :Theres the Cushing reflex which makes you breathe shallower but Im not 100% sure the nausea/vomiting and breathing troubles are relatedGood lord this is a hospital visit.As a physician these symptoms would spark a large battery of tests in my primary care office, but it sounds late for that. He needs to try a hospital. Make sure he tells them exactly what you wrote here.


###Input :I dont mean to be rude with this question but I know as someone with chronic illnesses I am generally reluctant to go to the ED when they flare up because of the whole history of being told theres nothing doctors can do for me, or its just because Im fat, anxious, whatever. If hes been dismissed by doctors before what should he say now to make sure he actually gets the care he needs? ###Output :Its always hard to say what another doctor saw or thought when someone got care. Miscommunication between providers and patients are extremely common with chronic illness. With flares of chronic illnesses there is often not much that can be done outside of the norm, and brief emergency care is frequently not enough to solve the flare but hospital care is frequently not indicated, which can make one feel very much dismissed.In this case, OPs BF has several huge red flags that suggest he should go to the emergency room for evaluation.Severe worsening nausea and headachesLoss of bowel/bladder controlProgressive coughing and shortness of breathFluid buildup requiring diuretics (this is VERY unusual and requires a significant evaluation that I dont see written about here)


###Input :How can we determine which ER around us is the best/most advanced? Paul's insurance is considered good (Kaiser Permanente) but his doctors barely listen to him, infrequently order tests, and weren't overly concerned/in emergency mode over the fluid buildup. ###Output :If he is a Kaiser insured patient he will only be able to seek care at Kaiser facilities. This is a situation of the squeaky wheel getting the grease. He needs to go to the biggest Kaiser in the area and be on his doctors ass every single day until he gets help.


###Input :There is a Kaiser ER near us. Hopefully they listen. ###Output :Kaiser is generally a good system, but weird things can be harder to diagnose in the system because they are much more conservative in general with testing


###Input :Ideally it should be an academic / teaching hospital. They're more used to seeing unusual cases and thinking outside of the box. ###Output :This will not be possible with Kaiser insurance, they will simply send him to a Kaiser hospital from the academic hospital ER, and he will get a large bill for it


###Input :Im with Kaiser and Ive gone directly to the ER for an emergency by ambulance. I just paid my co pay. ###Output :It can happen, but you cannot be admitted to a non-Kaiser hospital unless you are too unstable for transfer or the Kaiser is on diversion for some reason.


###Input :I agree. He should go straight to the most advanced ER/hospital local to him. A lot of things are probably going on.Once the more acute and scary things are sorted out I'd look into a sleep study to find out if he has sleep apnea since it can cause a cascade of serious problems.Also I do not mean to sound insensitive (and of course doing this is a very personal decision) but if obesity is a big problem for him he may want to consider weight loss surgery after he recovers from whatever is going on now. I was obese my entire life, once my health started failing I had gastric bypass surgery and I can't tell you how much it has helped me and probably saved my life. ###Output :I agree he needs urgent evaluation with his worsening symptoms. The differential is broad for his various symptoms and will likely need cardiac, pulmonary and GI workup.


###Input :The most important part is that - while you may have a list and such, an ER visit isnt going to find the exact diagnosis right there and perform all those tests at your request. The goal of this visit is going to be to assess for any acute abnormalities OR to get him admitted to an internal medicine team that can take the time to work these things out. ###Output :Posts by unflaired users that claim or strongly imply legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification.


###Input :As the physicians here have responded, go to ERnow. And please update! Very curious to hear his outcomes. Best of luck to you ###Output :Does he use drugs, specifically marijuana?Food allergies? It would be a bit drastic, and may not explain the swelling, but you can develop them at any time.A bit young for cancers, but maybe he is genetically predisposed, getting at least a CT scan with contrast of his abdomen would be good.This is concerning for his heart too, as mentioned.He needs quick workup, as mentioned. Worrisome is not eating and what his electrolytes are like.Not that being obese is the sole cause of his symptoms, but he should lose weight. Almost every physician you will run into will say this as it is important for his health, just as they would tell him to stop smoking if he was smoking.


###Input :He doesn't use drugs and has no known food allergies. He was able to eat breakfast today, and so far it hasn't come back up, though he is coughing. I feel overwhelmed by these responses but appreciative. I'm worried about going to the ER because our area is having a huge COVID surge and hospitals are at capacity. Is it safe to wait? Where is best to go? ###Output :As tough as it is right now, you might have to take him for emergency care. If he is coughing/vomiting so much that he loses control of bodily functions and is unable to eat and generally take care of himself, he should be seen sooner rather than later.Are the headaches coming before or just after the other symptoms? Bad migraines can present with nausea and vomiting, and sometimes neurological complaints, as well.It's hard to tell more without seeing full labs and imaging, again, pointing to getting some answers quicker by going to an ER.


###Input :They were probably wondering if cannabis hypermesis syndrome could be contributing to ten vomiting ###Output :Yes, cannabis hyperemesis syndrome, or cyclical vomiting syndrome, as mentioned. Usually people who have been smoking daily for while, 10-15 years, but can happen with less.


###Input :[25m 175lb 61] Post-Concussion Respiratory IssueI suffered a mild to severe concussion on Dec 10th after flipping my car. Jan 13th I began to get sick. I mention this because I know it affects the immune system.So, 1/13; It started with a sore throat & a lump by my adams apple. For the first week It progressed to wheezing, headaches, extreme fatigue and as much mucus and snot that the body can produce. By Jan 22nd I felt better, but the mucus and sinus pressure was still there. Today is Jan 28th. The past 4 days Ive had mucus that began as lime green color the first two days, and the past 2 days (including today) has been the color of an egg yolk. I also coughed up blood a little while ago today. I have never had a sickness last me this long. Not even covid. Im concerned. What should I do? ###Output :It sounds like you have an upper respiratory tract infection.It could be that your symptoms resolved and you got a second infection.It could be that you've got a bit of congestion or post nasal drip. You can treat this with a mucolytic agent that can help the body break down and clear the mucous.It could be that you've developed a bacterial infection that is taking longer to clear and may require some antibiotics.It is likely that these symptoms have nothing to do with your car accident.Given how long your symptoms have been going for, I'd suggest seeing your GP or PCP for further treatment options.


###Input :Undiagnosed respiratory illness.32M177cm77kgEuropean whiteI've had an ongoing illness with no diagnosis for 2 years. Main symptoms are respiratory; sore chest, flu-like symptoms, no energy, coughing up blood and mucous, shortness of breath, exhaustion at the slightest of exertion. Numb nose, inflammation all in nose.I've had a CT scan abdominal and there was nothing too abnormal. One thing stated was large lung volume, but no signs of COPD, fibrosis. I also did genetic test with Ancestry which stated I have a significantly increased risk (although stated it could be a mistake) for lung diseases. I would like to know is there any clinical significance to increased lung volumes with no other symptoms? It's just something I am curious of but can't find answers online, like is it a precursor to getting COPD or something. Can someone explain if it means anything?At this stage due to the CT abdo scan coming back mostly normal, I am beginning to suspect some sort of nasal infection, but I would like someone explain to me what increased lung volume could mean, so I can move forward and narrow down my illness and eliminate all other possibilities whilst also understanding what it means. ###Output :There's honestly no real clinical significance to just noting large lung volumes.


###Input :For 19 days, My wife has had fever and muscle soreness to where I have to help her stand up and get out of bed. She is convinced she is dying. Please help.We have been to the clinic twice since this started but since she has no respiratory problems they did not test for covid. She had a chest x-rayMe and our 1 year old are fine. Wife did not get the flu shot this year so we think it might be related but for 19 days seems outrageous.She has been prescribed antibiotics and tamiflu which she finished two days ago.She gets fevers around 2pm and closer to bed time around 9pm. They've been around 102 on average and peaking at 102.9 a few days ago.We're scared because this hasn't let up for 19 days. Are there side effects if your body stays at fever temperature for long periods of time?Is 19 days unheard of for the flu?? Is it likely something else?31 F 5'9 188 lbs. Caucasian.Taking Tylenol regularly to fight fever and achesUpdate: Wife is in hospital. Thank you for the help.I can't be with her yet. All of our normal sitters and family are either out of town, unavailable or also sick.They would not let us bring the baby in so I'm just home waiting for info. She is at least in good hands. ###Output :She'd almost certainly have a headache though and I see no mention of that.


###Input :Headache can sometimes manifest as neck pain if its referred pain, I just wouldnt rule out. ###Output :Right, but I've never heard of neck pain without headache. It's referred from the meninges so it'd be very strange to present like that. It's always possible but the likelihood is maybe < 1%? Additionally, symptoms typically start improving within 7-10 days.Any answer on the mono testing? If shes never had mono it can be pretty brutal. Comes with neck pain and fevers for sure.


###Input :How severe is the neck pain? Look up Kernigs sign. Its a maneuver you can do to test for meningitis. Meningitis is the inflammation of the lining of the spinal cord and meninges in the brain. It can be caused by both virus or bacteria. Shed be positive if she has extreme pain and cant extend past 90. If thats positive, you need to call the doctor/ED. Also, meningitis can cause a pinpoint rash. If shes darker skinned, you could see it more easily on the palms and soles of the feet. Rashes May also appear with prolonged fever. You can do the tumbler test where you take a clear glass and press it against the rash. If redness goes away when pressed, then its negative. If you can see the rash still through the glass, then its positive. Its sounding more like Mono. If possible, see if the doctor can test. Mono needs to run its course, but it can have some complications. One of them in enlarged spleen, so no sports and if she has sudden upper left abdominal pain go straight to the ER. It also can cause liver issues, so watch out for jaundice which is yellowing if the skin. I hope she starts feeling better soon OP! ###Output :I'd be careful about posting medical advice like you are without fact checking.Kernig's is actually a pretty bad test for meningitis. It has a sensitivity of only 5% and a PPV of 27%. That's pretty awful. I also wouldn't recommend for untrained people to test it on themselves or their loved ones.Not all types of meningitis causes a rash. I believe you're referring to meningococcemia. I think this diagnosis is extremely unlikely as she has been having symptoms for 19 days. She would be dead by now. Symptoms of meningococcemia progress very rapidly. Also, the tumbler test is also a pretty bad test and all it does it to be able to differentiate petechiae from other blanchable rashes. It's not specific to meningococcemia and can also just be done with a finger."Prolonged fever" do not cause rash. I am not sure what you are referring to here. Yes, a lot of diseases that can cause fever are also associated with rashes but it's not the fever itself that leads to a rash.I don't think Mono is likely here. While some of the symptoms would match, it would be unlikely to have persistent fevers for 19 days with simple mono.OP, I believe that at this point a visit to the hospital is warranted if your wife is as impaired as you are describing it.


###Input :THIS. NAD but same symptoms I had and it was sepsis. I was also sent home from doctor/ER twice before they realized it. Need to have blood taken for dx (in my case anyway). ###Output :Please read our rule on claiming credentials


###Input :I wouldnt worry about COVID right now. As your wife is probably septic and requires urgent care to live and prevent death.Spesis KillsSorry to sound blunt please update us ###Output :This is your final warning on claiming credentials without verification.


###Input :Ok. Can you please send me the information so I can send through my information. Kind regards Rachelle. Sorry I have never done this before. ###Output :Posts by unflaired users that claim legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification.


###Input :Exactly. Ive seen a couple cases like this. Id still recommend for OP to have her checked in the ED. Would rather not miss another explanation such as underlying infection and like others have mentioned possibly sepsis. Id suspect an infectious source will need to be ruled out first as it can then be treated with antibiotics and is more lethal. If nothing is identified from labs/imaging maybe further pursue labs to rule out rheumatoid arthritis. ###Output :This sounds like it could be mono. It's possible she's septic from various sources but I'd think they would have been ruled out by the clinic you went to.Has she been getting worse or does it seem like she was bad at first and has stayed at that level?What does she doe for work? Has she had any sick contacts?


###Input :Can the flu be misdiagnosed as an upper respiratory infection?M14Height: 5'3"Weight: 145 lbsRace: WhiteComplaint: Very flu like symptoms; fever, aching body, being hot cold hot cold, chills, dry cough, the whole nine yards. Doctor did 15 minute flu test (nose swab) that came back negative and prescribed an inhaler and cough syrup for an upper respiratory infection.Existing medical issues: None to my knowledgeCurrent medicine and doses: Prescribed Fluticasone nasal spray; 2 sprays in each nostril and Poly-tussin liquidSmoke? No but secondhand smoke from parentsDrink? NoRecreational Drugs? NoAny help is greatly appreciated. I am happy to answer any questions.tl;dr Flu symtoms, got diagnosed with upper respiratory infection. Doesn't sound right. ###Output :Flu technically is an upper respiratory infection (in general, though it can cause lower respiratory infections). The false negative rates of the rapid flu swab are pretty low, so while it is theoretically possible, I would just assume that it's true that you do not have the flu. The flu is just one of many, many related illnesses that all act similarly. Our rapid nasal swabs only test for that one specific virus (influenza), but there are tons of other viruses that we cannot rapidly test for and which could cause similar symptoms. You could have parainfluenza, human metapneumovirus, RSV, etc.The treatment is the same for all of them, inhaler, cough syrup, Tylenol/ibuprofen/naproxen and time.


###Input :Ok. Thank you for answering! I do have a question though. How long should I stay out of school? I was planning to not go tomorrow, and have a doctors excuse to go back on the 5th. Is that good or should I stay out longer. A lot of kids have influenza but go anyway and the school won't shut down to prevent infections. On a sort of related note, I had RSV as a baby and have had bad lung function ever since I can remember. ###Output :Just stay out of school until you're feeling better. The 5th sounds reasonable to return. Ideally people would not be in school when they're sick, but the reality is if you're in school you're going to get sick in the winter. Lots of babies have RSV, I don't know that it predisposes you to having it more as a teenager.


###Input :My dad had an upper respiratory infection and now I am nervous from being around him.Age: 44Sex: MHeight: 6'3Weight: 202lbsRace: WhiteDuration of complaint: NALocation: TennesseeAny existing relevant medical issues: NoCurrent medications: NAMy dad and sister went on a vacation trip to Peru roughly two weeks ago. About a week after returning from the trip he developed runny nose, chest congestion, probably a fever (never took his temp), and a bad cough. He is in his late 60s and already has a weakened immune system from a bone marrow transplant he had a few years ago, so he just chalked it up to the common rhinovirus cold that he seems to get every year. I went to visit him this past weekend (about a week after his symptoms started). He didn't have a fever or anything, but had a pretty bad cough the entire time I was there. All in all, he was healthy and out doing stuff the entire weekend. However, with so much coronavirus in the news, now I find myself contemplating whether or not its POSSIBLE he had it (I havent seen Peru in the news, but ya never know) and if I now possibly have it (I am currently observing no symptoms and was at his house from Friday to Sunday morning). He was not observing very good hygiene protocol with his coughs, and I had to chastise him numerous times for coughing into his hands or not covering up at all. Again, he had zero symptoms at time of visit other than a lingering cough. I guess my question is, should I be dedicating any real estate in my mind right now to worrying about this corona virus? It should be noted that my sister was in close proximity with my dad the entirety of the trip as well as a week after the trip when he started getting symptoms, and she has shown zero signs of anything. With all this panic in the news, I just find myself silently listening or observing my body for the onset of symptoms and its interfering with my daily life. ###Output :You do not need to worry about 2019-nCov at all. There have only been 2 imported cases in Brazil and 1 imported case in Ecuador in all of Latin America. Even if there had been cases in Peru, the odds of him coming into contact with it would be very slim, and the Futher odds of you being at any sort of risk would be neglegible.Stop panicking about this, and get your flu shot every year.


###Input :81 y/o female- respiratory distressMy grandmother got pneumonia this time last year. Currently she is achy, having trouble speaking, her throat hurts very bad. We went to the Doctor a few days ago, they took an X-ray of her lungs and said there was one area with fluid they wanted to keep an eye on but werent too worrisome. Today I call her and she can barely speak and is wheezing while breathing. Do we need to go to the emergency room? ###Output :Yup


###Input :Post-Respiratory Illness - Cardio -- persistent elevated heart rateI have been sick with a respiratory illness for several weeks. I tested negative for the flu, the doc didn't think it was COVID-19 and would not test me. I have been on several antibiotics and I take the last dose tomorrow. It was mostly chest tightness and inflammation. I felt better today so I went for a run. I shortened the distance and intensity by half.About an hour after my run, my heart rate spiked to 99 bpm and my hands began trembling . It's varied this evening between 80-120 bpm all night at rest. My baseline is around 66 bpm. I have tested my temperature several times - no fever.Could this be something serious? It has me a bit concerned. Thank you41M5"10180 lbsSmoke (occasionally)Duration - 6 hours ###Output :No way for us on here to tell you wholeheartedly whether this is serious or not. If it is bothering you then it is serious. Does this typically happen when you run? Cause I know for a fact when I run my heart rate shoots up as well. Very normal for this during physical activity. I would recommend stopping smoking if you are worried of respiratory illness.


###Input :Acute Respiratory Failure from strong scentsAge27SexMaleHeight194cmWeight104kg 14% BodyfatRaceCaucasian, Irish/DanishDuration of complaintLifelongLocation (Geographic and on body)Ontario Canada. Lungs, esophagus?Any existing relevant medical issues (if any)AsthmaticCurrent medications (if any)Salbutamol Turbuhaler, Ventolin, FloventInclude a photo if relevant (skin condition for example)N/AThis question is going to be short, and concise; with examples.When a strong smell is present, my airway cuts out completely. I have theorized that it it may have something to do with what I call "thick air".Examples: Diesel exhaust scent, frying greasy or oily things, the smell of certain algae (like near a pond), occasionally with foul smells (this will seem odd, but it's innocent in my exposure((a day old corpse, animal or otherwise)).It's not particularly tied to smoke, cigarette smoke does not bother me, and I use an E-Cigarette. This has been something I've dealt with my entire life. It is quite painful when my airways suddenly close, and I can only breathe again when I place a cloth over my mouth (if the scent is still present) or move to fresh air. My doctor has told me he thinks it's something called laryngospasm, but this doesn't seem exclusively correct, as from my understanding, this is caused by your vocal chords... and that doesn't quite make sense to me.Edit: I should mention that once I am able to breathe, I typically uncontrollably cough, and sometimes vomit because of my coughs. ###Output :Throat tension, hoarseness, and/or voice changes shortly before, during, or shortly after these episodes?My first thought is along the lines of your docs. Look up vocal cord dysfunction or paradoxical vocal cord motion and see how well that matches your experience.(Edit: also, Id not consider this acute respiratory failure unless you became hypoxemic/needed supplemental oxygen or needed to be mechanically ventilated in some way. These things can happen due to vocal cord dysfunction in fairly severe cases of it)


###Input :Tension and Hoarseness, definitely. My voice becomes gravely and it tends to hurt to speak.Only one instance a few weeks ago, I couldn't get fresh air and from what I've been told, I blacked out. That was strangely because of some smells from a Kernels popcorn stand.I apologize for the mis-identified title. I understand the difference now. Thank you for your response! ###Output :I see laryngospasm occasionally in my clinical practice, and one is usually unable to breath to the point of turning blue. It occurs when a physical substance tickles your vocal cords: saliva, blood, water while drowning, etc.. not generally fumes. Rarely lasts more then a minute.What you're describing sounds closer to bronchospasm for which you're at high risk: asthma, smoker (yes I know it's e-cig... It doesn't make it harmless : https://www.ncbi.nlm.nih.gov/m/pubmed/29847989/). My advise is to get better control of your asthma depending on the frequency of these symptoms and, well, you know this is coming: stop smoking. For standard cigarettes smokers, it can take 2 months for your body hyperreactivity to return to normal, not sure what the data says for e-cigs.


###Input :How can I avoid respiratory problems with the flu shot?I know the importance of getting my flu shot, so I intend to get it. However, I always get breathing problems accompanied by dizziness and fatigue for a couple days after getting my shot. It presents the day after the shot, not the day of, so I don't think it's an allergic reaction. I guess it's just my immune system freaking out. Anyways, is there a way to avoid the respiratory issues, or should I just get my shot on a Friday so I can let everything play out over the weekend?22F, 5'2, 120lbs, no meds, generally healthyThanks! ###Output :This could be an allergic reaction, although it doesn't sound typical. It's worth discussing with your doctor before getting the shot. Some people shouldn't get the flu shot, it's possible you're one of them.If it's not an allergic reaction then I don't have a good alternative explanation. I would suggest Tylenol and rest.


###Input :If it's an allergic reaction, do you think taking Benadryl would work? ###Output :Maybe, but then you would be even more tired. Better to know for sure than guess.


###Input :UPDATE: [26F] recommended for termination of pregnancy in a country where I don't speak the languageOriginal post here: https://www.reddit.com/r/AskDocs/comments/ici7ez/26f_recommended_for_termination_of_pregnancy_in_a/First of all I want to say thank you, thank you, thank you not only to the physicians who responded but also to everyone who upvoted and comment-bumped me for visibility. Obviously the physician responses helped on the medical end, but the simple comment bumps helped so much emotionally. I'm in this country without family (except for my husband and toddler) and sometimes it honestly gets really lonely so having even the tiniest bit of online support meant the world to me. I even want to thank the user who posted anti-semitic comments because your comment specifically helped this hella Jewish woman connect with other Jewish women on this forum who offered hands-on support, validation, and rescoures.I had a meeting with the specialists in the termination committee today and they diagnosed the pregnancy with cystic hygroma in addition to other serious physical (nasal, respiratory, heart) malformations that would make the fetus 100% incompatible with life. They made it pretty dang clear that I could basically miscarry at any moment, which sounds about right to me as a layman given all this info. We asked about genetic testing/probability of this happening again and they said it's very unlikely, the occurrence of this situation is less than one percent overall. So I've decided to forgo any additional testing like CVS or amniocentesis as a chromosomal defect would just be another issue on the list and not a defining factor in my choice.So unless nature takes it course, I'm scheduled for an inpatient termination this coming Monday. I can't really find anything online about inpatient terminations, but they gave me the choice and explained that the outpatient procedure would be started with dilation by osmotic dilators and move quickly while the inpatient procedure would use slow, supervised dilation with less trauma over 48 hours. I'm not 100% sure if they meant physical trauma or emotional trauma, as they mentioned some people find it very uncomfortable and impeding (especially with childcare) to do the outpatient dilation and return to the hospital for the procedure. I'd read about osmotic dilation earlier and it really freaked me out so I was super happy to have this previously unknown option offered.I'm feeling a lot more secure after hearing from everyone in this community, my doctor, and today's specialists. I never in a million years thought I'd be terminating a wanted pregnancy for any reason but I still have thousands and thousands of chances to have another baby just waiting in my ovaries so I'm going to focus on that and also on my toddler who is already my whole world. And I'm thankful in that I've experienced this and can hopefully help women who are in this situation in the future. Thanks everybody!*Edit just to add that all the doctors and social workers on the committee and at the hospital we went to spoke near perfect English which was a great relief for me and we did not have to spend money we don't have on an interpreter.*Later edit to update that the genetic blood test came back early and indicated 1:5 for down syndrome and trisomy 18. ###Output :I'm glad you got the answers you needed.Regarding the inpatient termination if you are wanting clarification I think it would be which route are you going:will you receive osmotic and/or chemical dilators and then go on to have an evacuation procedure?will you receive osmotic and/or chemical dilators and then go on to have an induced delivery? Just an fyi with this, people not infrequently require manual removal of the placenta, so they end up having the 'evacuation' portion anyhow (but it would just be the placenta).Both are safe. Some "feel better" about the second option because they feel like they are just inducing labor rather than actually "terminating". Fetuses in general, but especially a compromised one, have high rates of passing before delivery anyhow though.Also, you could choose to have genetic testing of any remains (and not do CVS or amniocentesis). But it is one of those things where it's optional and it may not truly change anything for you. This being said, many people like having a more solid answer.Good luck with everything. You have very good odds of having normal babies in the future.


###Input :From what I understand, I'd be going route 1 with chemical dilators and then the evac. The chemical dilators seems to be their reason for inpatient treatment though and honestly I'm fine with 1 or 2 in that case. Something about the osmotic course just innately makes me uncomfortable. Buuuut if I'm being super duper honest, I'm fine with anything inpatient because I just want the time and space to decompress about it all without the stress of toddler, chores, work, etc. But yes we asked about genetic testing of the remains too but the specialists said they'd only show "academic" results and nothing impactful after the fact or for the future. My husband and I are both just really onwards and upwards kind of people so if the doctors don't need it after the fact and say everything's okay, then it's okay for us. I wish I had the rescoures to gild your posts for the rest of forever, you really deserve it! I'm so truly thankful for all of your responses you have no idea.*Edit to add that I did however have the basic chromosomal blood test done that goes hand in hand with the nuchal translucency, so if anything comes back abnormal with that I will of course satisfy any curiosity with an update here! ###Output :I did however have the basic chromosomal blood test doneThat test is pretty accurate so that should likely give you the information you need. Good luck with everything.


###Input :NAD, but a nurse and in general was worried for you! Glad to see your update! Im sorry you are feeling so isolated, but glad you found resources! Hang in there. ###Output :I'm locking your thread since you don't seem to have additional questions. Thank you for the update though, and we wish you all the best.


###Input :30F, 55kg, 160cm, Asian, Singapore, upper respiratory tract infectionLong story short, somebody i know was diagnosed with upper respiratory tract infection bu a licensed doctor, 2 night ago. Her symptoms were cough, fever (38 degrees), headache and muscle aches. No runny nose. She refused all the medication provided by the doctor. The doctor gave her 1 day sick leave.Last night, about 24hrs after the initial diagnosis, she claimed that she has been hospitalised for her illness. Is this possible? Isn't "upper respiratory infection" just a fancy term for a common cold? ###Output :We will not be able to tell you if your acquaintance was hospitalized, as that seems to be your question.


###Input :Alkaline "medicine water" healing reflux, colitis and upper respiratory infections.In my country (Hungary) we have this medicine water called Salvus which is drawn from a thermal bath. It has bold claim such as healing GERD, colitis, upper respiratory infections while also treating diabetes and peptic ulcers.I 31M have GERD and my doctor switched me off of PPI's to Salvus water and a low dose of famotidine. Since then I have pretty much non-stop diarrhea and my heartburn got much worse.My question, based on the ingredients, is this medicine water bullshit?Ingredients (mg/l):- Sodium: 5800- Lithium: 2.0- Chlorid: 2020- Bromide: 13.9- Iodide: 2.08- Fluoride: 3.0- Hydrogen-carbonate: 12810 ###Output :Surprised a doctor is scamming you. Is it a real doctor? Alkaline water is a scam. Go back on the PPI.


###Input :Heart rate increases every time I inhale. Respiratory sinus arrhythmia.Male, 27. 70kg. Relatively healthy, I do running and hit the gym.Is it normal? Does everyone have this? ###Output :Very normal. Nothing to worry about.


###Input :Respiratory restrictive pattern, unknown cause please help.I am 21 years old male.I have started having bad shortness of breath the past 4 months. I have seen so many doctors and this is the results so far.The originally test to prove there is something going on is the respiratory function test, I cant interpret all the results but the pulmologist said my breathing shows a restrictive pattern with 65% of expected lung capacity and velocity. This test has been repeated every month with similar results. Gas transfer was 95-100% not indicating lung disease.Got a ct scan of chest with dye to rule out lung disease or to see if anything else is on my lungs but it came back clear other than enlarged thymus gland.They thought it might be respritory muscle weakness although the neurologist said unlikely as when I am lying down the respiratory test shows similar results as to standing.Cardiac possibilities cleared by cardiologist.The cardiologist, pulmologist and neurologist are at a loss and have determined to just hope it doesnt get worse. Please help. ###Output :Restrictive pattern on PFTs essentially fall into three categories, unfortunately you've had them all investigated. It can be the lungs themselves (i.e. fibrosis, or stiff lungs), chest wall noncompliance (think of terrible scoliosis, severe obesity, etc), or neuromuscular disease. The first two are typically pretty easy to diagnose, neuromuscular disease can be very difficult. There is no gold standard for how to determine if restriction is related to neuromuscular disease, but the sitting/supine spirometry is often done as one piece of data (as it appears you have done).Have you done a MIP/MEP (maximal inspiratory pressure and maximal expiratory pressure)? A low MIP tends to indicate diaphragmatic problems, and a low MEP indicates problems with chest wall strength. Like the sitting/supine spirometry, these must be interpreted with caution, as they are not truly gold standard for anything.If all else fails, there is always the Cardiopulmonary Exercise Test (CPET). It's basically a test that measures your heart and lung function through maximal exercise to determine where exercise intolerance may be coming from. It's not always available in all places and can be very difficult to interpret.All in all, with your story I would put my money on a neuromuscular issue. I think the neurologist ruling it out based on the positional spirometry alone is premature. Bring up the MIP/MEP and CPET to your pulmonologist and see what he/she thinks.Mind if I ask where you are being evaluated? You would likely benefit from going to a tertiary care center, such as affiliated with an academic or university medical center. Depending on where you are located I could suggest some places to find docs who'd be interested in you.


###Input :Can visual processing issues stem from 1) respiratory infection or 2) stress and anxiety?I am 30F, relatively active lifestyle, diagnosed with ADHD and treating it using Vyvanse and regular therapy.I am on the tail end of a two-week cold. Still have a bit of congestion and fatigue but no sore throat or cough etc.Something I've noticed over the past couple weeks/in the past is that I feel like I have difficulty processing visual information. E.g. if I'm walking in a forest, the amount of visual information seems overwhelming. I can't really "see" what's in front of my unless I really stop and focus on one thing at a time.My last eye tests showed I had 20/20 vision and I have no issues reading on screens or seeing things far away, it's just that when I'm presented with a lot of visual information, I have issues processing it all.I've also notice this happen in the past when I've had depressive episodes. Does this sound like an actual issue with my eyes, or could it be linked to my mental state? ###Output :Simple answer is yes. Fatigue and illness affect sensory processing and cognition, usually transiently. That's a good thing, since it forces you to rest, slow down, let your body recover. The more complicated question is whether there's something different about your experiences as compared to people without neurodivergent states.Your description suggests that you might have visual snow, though maybe you are just overwhelmed with information during higher stress?


###Input :Muscle, Respiratory, Heart, and Mobility problems: Is this just obesity or something more?I am 29 y/o , 6ft even, and probably 400lbs easy, probably more, i can't afford a scale so idk.For about a year up until March when my job shut down for 7 weeks, i was very capable of doing the physically demanding work at the Auto Plant i worked at.. I was not fit, but it was doable for me. During shutdown from Covid, I started to notice that moving became harder and harder. My lower back would struggle to stay up and that caused breathing to get harder, which caused the heart rate to skyrocket. It eventually progressed to the point of complete muscle failure after about 50 feet of walking.When I got back to my job, I collapsed in front of my supervisor and his boss. Everybody freaked out and I was forced to go home and get tested for Covid 19. It was negative. Even when coming back after a few days out, however, I still could not walk more than 50 feet without sitting and gasping for air with the muscles in my back completely giving out causing collapse.Now I cannot even mow my lawn completely without resting 3 times. It is a tiny lawn that my roommate mows in about 10 minutes. It takes me 30-40 minutes with resting.I cannot walk 50 feet without gasping for air, I have regular heart palpitations, there are huge numb patches in my legs (oval shaped, upper thigh above the knee on the front of the leg), I cannot sleep more than 40 minutes to an hour at a time, and when walking I feel like I ran a marathon when it is only trivial distances. (heart rate, breathing troubles, back and leg muscle failure)Lastly, this morning at 4:30 am up until about 8:00am, I had these horrible feelings of doom, despair, anxiety, and panic, all wrapped up into one horrific attack for those many hours. Along with this, my heart rate was so high I literally almost called 911 many times.In the opinion of the people in this thread, are my issues likely 100% obesity related, or could there be something neurological going on in my back and legs as well? I dont know when the numb patches in each leg started.I'm scared of death, so I'm making what life changes I can (eating better, cutting caffeine down to reasonable levels of moderation, etc) but this is preventing me from functioning as a human being. I do not have insurance so I dont know what to do. I probably need to see a cardiologist, neurologist, or some sort of skilled orthopedic person. Please help, reddit. I dont want to die. I have dreams of owning my own I.T. business for security consulting.If more information would help, please please please ask and I will be 100% open about everything. I'm trying to change my life and contribute to society. I'm hoping to not have to go on disability or anything like that. My father was upper executive branch of a major telecommunications company so I hope to do something that would make him proud as he watches me from the heavens. ###Output :Do you smoke?Obesity can cause a great deal of damage. Think how much more your heart has to pump. Think of your belly compressing your lungs decreasing how much they expand making it difficult to breath. Think of the extra weight your back has to carry. These are just a few things. I know this sounds tough and maybe harsh but Im saying it because Im confident you can make changes. Youre young and if you put in the work, you can definitely make changes. There are many free resources online.From the sounds of it, you might be having some heart failure symptoms. Do you have any swelling in your legs? I say find a PCP. Get worked up and get the studies you need. Maybe start off with an EKG and some labs and go from there. You might need an ultrasound of your heart if your PCP recommends it.Biggest recommendation I can make is lose weight by changing your diet. Preferably something you can live with whether its intermittent fasting or the Mediterranean diet or whatever.You got this


###Input :I do not smoke, and actually had an EKG at the Emergency Room today which came back normal. Could a normal EKG mean heart failure is off the table? Your positive words mean the world to me, friend. ###Output :Well, heart failure is a clinical diagnosis. An EKG may help but doesnt give you the answer. For example the EKG can tell you there might have been a heart attack or signs of decreased oxygen or clue you in that one side of the heart is enlarged but thats about it.We usually use a combination of symptoms and labs to say someone has heart failure. Again, your PCP will be able to help. Again there are a few diet threads on here were guys your size have dropped a bit of weight.


###Input :Here is an image of what they actually did test wise https://i.imgur.com/7fMucgv.png. I have covered all identifying information as well as the weight because I am embarrassed. They checked my blood for Diabetes i guess and said that while my pancreas is compensating and I'm not even pre-diabetic, I do need to stick to the positive life changes I've implemented. If you have time to look at that image, would any of those tests have revealed the existence of Heart Failure? ###Output :No. A proBNP would be helpful and if youve had recent leg swelling that would also be helpful. Otherwise seems like everything looks good from this numbers


###Input :51F (pulmonary) under what circumstances should I take mom to the ER? She has chronic respiratory failure - hypoxia of unknown origin being worked up - but over past 3 days she's gotten worse51F, 59, very thin, getting thinner fast, white, USA. non-smoker, non-drinker; no prescriptions. On supplemental oxygen for chronic respiratory failure - hypoxia. Undergoing workup to figure out whats wrong but its taking taking forever. (This is for my mom.) (x-post)Very long story short: formerly vibrantly healthy moms been deteriorating since January. Shes lost over 25lbs since then, has been having daily oxygen desaturations down to as low as 80 whenever she started walking for months and is now on supplemental oxygen. Exhaustive pulmonary testing (including RHC and shunt studies) and cardiac testing (echo with bubble study) all inexplicably normal. The doctors are puzzled, as you can imagine. She looks awful. She does have a few "good" hours in the morning, but it slowly diminished til afternoons she crashed. As of now, "good" morning hours aren't lasting as long and she's crashing earlier in the day when she hits a wall, becomes totally sapped of energy, becomes very weak.At first her oxygen only went down when she was up and about and moving, down as low as 80, thats when she got the order for supplemental oxygen. But past 3 days, it's going down much more often, even at rest. (But it IS intermittent, not constant.)Heres why Im here today seeking advice: What would be a scenario that would mean we should take her to the ER? As of the past 3 days shes feeling worse, now has oxygen desats at rest, and it also is dipping down more and more often than ever before, and something very new - her heart rate keeps dipping a few times a day down into the 50s and occasional 40s (not necessarily when her oxygen is low - sometimes yes thats the case, sometimes when shes on oxygen it happens too. In the past few evenings shes been having severe shortness of breath even when her oxygen is at 100. Although shes been ill for months w/no answers yet, these worsening signs and symptoms have only been happening for about 3 days.Blessed to live in a city with a nationally known excellent medical center. The head of one of the lung hospital lung centers shes been seeing wants her to come back in to see him again for further investigation since the last study (shunt) was normal and they still dont know whats wrong (what the hell else can they test for???), but that conversation with him was last Thursday, before things suddenly got even worse on Friday til now - and who knows when that appt will happen. He's in high demand of course.In the meantime were in a holding pattern, so please can someone give advice on if there are certain signs or symptoms that would trigger us to take her to the ER? ###Output :The desaturations at rest are concerning, it would be reasonable to take her into the emergency room now. Given your post it seems that she would have very poor reserves, so if things worsen even a little bit she may have profound effects.Another option is to get ahold of her pulmonologist or the person whom is on call for the clinic. He/she would be able to give a more informed opinion based on her unique situation.


###Input :Thank you so much. I begged her to let me take her to the ER last night, it was pretty bad - but she refused - she said she'd "feel stupid" since her oxygen/heart rate go back up to normal in between the bad episodes and she "doesn't want to waste their time." With your advice I think she will listen (she appreciates my asking things here).With her permission I reached out to her regular long-time pulmonologist via her patient portal to ask if she should come in to see him soon. I did mention the low heart rate in that message. Hopefully will hear back soon. If her heart rate goes down that low again I'll remind her of an actual physician's advice (thank you thank you!) and she will listen. ###Output :Assure your mother that she's not wasting anyone's time! Also, it's not her job to know if something is an emergency, s it's okay to go the ER and find out everything is fine.


###Input :I have an upper respiratory infection. Been to the doctor for it. When will it end? It's been 8 days now.25f, 120lb, white, asthmaticI was tested twice for COVID and both came back negative. When it got worse the doctor gave me 4 days of steroids to take, cough medicine, and mucinex.Day 1-3: bad congestion, fatigue, sore throat, voice loss Day 4-7: began coughing. Had to increase use of my rescue inhaler Day 8: began to cough up disgusting green phlegm.Does the green phlegm mean I'm near the end? Or that I should go back in? ###Output :Probably just a viral cold that needs to run its course which is usually 10 days - 2 weeks. I would add some Sudafed/flonase for your congestion. Hopefully you start feeling better soon.


###Input :38 yr old femaleHistory of bronchitis/pneumoniaI was recently babysitting my nephews who were unknowingly sick with an upper respiratory infection both have been tested for coronavirus several times coming back negative. However, in the meantime I got the upper respiratory infection also. Unfortunately, I have a very long, bad history of bronchitis/pneumonia with a hospital stay of two weeks in 2019 with double pneumonia and only an inch of air flow. So my question is how long does congestion last before I should be concerned? I've had this cold since last weekend. I'm on amoxicillin, my inhaler, Albuterol, nose spray etc. But still congested and wheezing but no fever or chest tightness. The congestion however has not improved should I be concerned? ###Output :Assume you've got tested?Most URTIs are viral so I'm not surprised if its not improving quickly with antibiotics, likely they will do nothing.


###Input :I haven't been tested because my nephews came back negative and they were the only people I've seen. Also, if I'm not improving on antibiotics what do you suggest? Er visit PCP visit? Just wait it out? My chest congestion and wheeze is bad but I'm not running a fever, no chest tightness, I'm not getting worse but at the same time I'm not improving. ###Output :You need to isolate and test regardless.No, congestion is normal with a viral URTI and doesn't usually need a doctors visit, you can self manage at home. If it is not improving over time or worsening yes definitely.