Patient story

Patient stories Patient 1: Patient a male 45 years old. Comes for a regular visit. Patient complains of severe, productive coughing, fatigue. Upon inquiry, admits that has suffered from this kind of coughing before throughout the year. Suffers from fever, 38 degrees. After being asked about the duration of the sickness, he responds that it began as a light influenza some 15 days ago, and then the coughing appeared and would not subside. Patient did not come for a visit within the first 5-6 days, after hearing the patient’s breathing with a stethoscope, the doctor detects several breathing elements that point toward the diagnosis of acute bronchitis. Because the patient also indicated that this phenomenon has happened to him several times throughout the year, the doctor asks if the patient also has had a history of allergies in his youth, if he has ever taken medication for bronchial asthma. Patient admits that up to the age of 10 he has had asthmatic problems, and used to use breathing pumps. Doctor issues medication, prescribing antibiotic from the cephalopsporin second generation group, for 7 days, antihistamines to be taken in the evenings, cysteins to be taken after the 3rd day until subsiding of the disease, antipyretics for whenever fever arises, vitaminotherapy. Recommended residing in warm environments, consuming a diet of mainly warm liquids. Doctor recommends revisitation on the 5th or 6th day of medication. After the patient arrives on the 5th day of medication, the fever subsided after the third day after beginning medication. Patient appears to be feeling better overall, appetite has not been affected. Coughing is most apparent in the mornings, and the quantity of sputum exuded in the mornings has increased. Doctor recommends for a continuation of the medication for the remaining days, and the usage of cysteins until the coughing secretions diminish and disappear. After 10 to 15 days, the patient returns for another visit. He complain of dry coughing that is bothersome throughout the day, and which prevents him from falling asleep at night. After a visit at the allergist and several examinations conducted there (spirometry), patient is prescribed bronchodilators and cortisone pumps. He is suffering from an asthma relapse. This is the case of a relatively young allergic patient. Frequent viral infections and the superposition of acute bronchitis occurring for a considerable time period as well as the negligence to see a doctor and receive the appropriate medical care when the aforementioned occurred, and of course, the patient’s predisposition has led to the relapse of bronchial asthma. Patient is kept under frequent observation while under the asthma medication, from time to time consulting with the allergist. Medication can be intermittently used, depending on the progression of the patient’s condition. Patient 2: Niko, 45 years old, had a light influenza that lasted about two weeks. Afterwards, a severe cough with phlegm appeared and was lasting for several days. He had fever around 38 degrees (Celsius) and was feeling constantly tired. Since the coughing did not subside, he decided to go to the family doctor for a consultation. He told the doctor that he had suffered from a similar cough in several cases throughout the year. After hearing Niko’s breathing with a stethoscope, the doctor additionally asked if he has had history of allergies in his childhood or youth, and if he had ever taken medication to cure bronchial asthma. Niko recalls that he had asthmatic problems up to the age of 10 and used breathing pumps. Based on Niko’s symptoms and the stethoscope hearing, the doctor pointed to acute bronchitis and prescribed him medication (antibiotics for 7 days, antihistamines to be taken in the evening, cysteins to be taken after the 3rd day until subsiding of the disease, antipyretics in case of high fever, and vitamins). The doctor recommended Niko to stay in warm environment and consume a diet with warm liquids and to come for a follow-up visit on the 5th or 6th day of medication. Niko started to take the medication right away as advised. The fever subsided three days after he started the treatment. He was feeling better, less tired and his appetite had not been affected. The cough was mostly present in the morning, when he was also exuding more phlegm than before. He visited the doctor again on the 5th day of treatment and told her about the current situation. The recommendation of the doctor was to continue the medication for the remaining days and use cysteins until the secretions from coughing would diminish and disappear. Unfortunately, the situation did not improve. In the next days, the secretions disappeared, but a very bothersome dry cough started and it was preventing Niko from falling asleep at night. He returned to his doctor, who recommended this time a consultation with an allergist (doctor specialized in allergies). Several examinations were conducted by the allergist, among others a spirometry*. The doctors concluded that Niko was suffering from a relapse of bronchial asthma. Niko was then prescribed asthma medication and kept under frequent observation, consulting with the allergist from time to time. Medication would be intermittently used, depending on the progression of his condition. Doctor’s tip This is the case of a relatively young allergic patient who had frequent viral infections throughout the year, but neglected for a long time to see a doctor and receive the appropriate medical care. Especially after a prolonged acute bronchitis (or symptoms of severe coughing with phlegm, and fever), a visit to the doctor after the 5th or 6th day is highly advised. This series of events and patient’s predisposition led to the relapse of bronchial asthma. *Spirometry is a common office test used to assess how well your lungs work by measuring how much air you inhale, how much you exhale and how quickly you exhale. Spirometry is used to diagnose asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect breathing. Spirometry may also be used periodically to check whether a treatment for a chronic lung condition is helping you breathe better.

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Medical Author: Dr. med. Diana Hysi