Can someone please read my doctors handwriting. I need more info.

Chest and lungs
1

Hi,

I was diagnosed with Pneumonia. On a follow up 10 days later the Doc only told me that I am coughing and gave me an inhaler to open up my airways. And a nasal spray. And sent me home.

My worry, after seeing a copy of the note, do I have something else. I can read post pneumonia bronchitis...but can't make sense of the context, etc. Especially what is "CoupL".

This is not my usual family doc so I can't really see this person any time I want. And I am currently abroad and have very crappy insurance and I can't just go in to see a doc to read this.

If someone has experience reading doctors handwriting. Could you please tell me what is written here. There are some terms like Rx, etc. which I also don't know.

And since I saw "branchitis" I put this discussion here.

Thank you!

2

Hello.

From reading the notes you have post pneumonia symptoms coupled with bronchitis. He outlined the meds prescribed

3

Thanks, Doc,

Is this normal? To get Bronchitis(viral?) after bacterial Pneumonia?

My HR is still 110+ for about 18 days (maybe even longer since my initial Doc visit was on 20th and I've been coughing for days before). Is this something to worry about?

How long will these usually take to get over with? As in the post Pneumonia symptoms and the Bronchitis. Or will they both resolve the same time?

Lastly, I'm still coughing but more often than not it's dry. I've been coughing white clear product since the 24th (after 4 days of antibiotics)

I understand the cough can last long but according to a government health line, I shouldn't go back to work until I stop a productive cough.  

Thanks much!

4

Pneumonia is a difficult one as the residual effects can be extremely different depending on the severity. In your case the antibiotics sound like they have done the job. With antibiotics you tend to see the immune system go into overdrive causing more pain, pus/mucus and swelling. The swelling is the damaging factor here. The lungs are very sensitive to grazing. The dry cough may last for weeks. It really does depend on how fast the damage in the lungs is resolved by the body. You may even develop temporary asthma. The best thing to do would be to rest, stay hydrated and maybe look into a humidifier. Moisture in the air will soothe and take some of the dryness out the cough. Obviously if you smoke or use e-cigs cut them down in any way. I personally think you'll be absolutely fine once the residual effects fade. You can use ibuprofen, 1 or 2 every 4 hours to help reduce swelling and if the weather is cold cover your nose and mouth with a scarf to avoid breathing cold dry air.

In the case on returning to work, pneumonia is an infection, not a virus. It is not contagious. As long as you practice good hygiene and cover your mouth when coughing or sneezing a return to work should be fine when YOU feel fit to do so. Just make sure to have plenty of water to keep your throat lubricated, as you breathe this will also ensure moisture is brought into the lungs.

Now moving into my area with your heart rate.

Your immune system is still producing a lot of antibodies reducing the number of red blood cells. The red cells carry oxygen to your organs. So your heart needs to work harder to get more red cells to the vital areas. The heart rate should decrease as time goes on, however stress and anxiety can also increase the pulse so relax, drink less coffee and focus on getting better.

I would say you should notice a significant improvement within a week and complete recovery within a month. It may take longer but without actually seeing you all I can do is give a rough estimate but I am fairly confident.

Mark

5

Thank you, Doc!

At the moment what worries me is that sometimes productive cough.

All these years when I cough, it's either complete dry or always produces something during a single illness(flu). And I suppose they can follow the other, first dry then productive. Never have I mostly coughed dry and can also often cough productively, randomly. As for as I can remember, I haven't had the flu for couple seasons. But I also never had Pneumonia before, and now Bronchitis...

You gave such a detailed explanation, thank you. I would just feel more reassured if this is also within normal recovery process to what I have currently. 

Do you think I need a follow up, when do you think I should go? As mentioned my insurance is not that good and will only let me have finite follow ups for the same illness but I will definitely go if it's recommended.

The timeline:

Feb 14-16 coughed, Flu symptoms

Feb 17-19 Coughed colored mucus tinged with blood.

Feb 20 ER visit, coughed clear mucus with blood, nothing found on XRay,blood, EKG. 10 days antibiotics because symptoms were good enough for Pneumonia. (This is also part of my concern, the day I went to ER I didn't cough colored mucus anymore, but clear mucus with little blood),

I should also mention that when I woke up this day, I coughed frothy pink, once during that day and never afterwards...googling I thought I had Pulmonary Edeme...

Feb 23-24 Coughed clear mucus, no blood anymore.

2nd March follow up (it's the doc notes in the post). Given inhaler and spray.

Today still coughing, mostly dry but can cough productively white clear mucus.

Thanks so much, Doc.

6

Hello.

The pink frothy mucus was agitated bloody mucus. Imagine adding red food dye to cream then whipping it. It's usually caused from residual blood in the lungs. The lungs are always wet so the blood cannot clot and form scabs which is why the healing process can take a while. I would recommend a follow up to have your chest listened to. The fact you're coughing up mucus every now and then is a good sign. It's clear which is a good indication that you have beaten the worst of the infection. You may still have a minor URI (upper respiratory infection) but I really wouldn't imagine it be any great cause for concern. I would recommend a follow up with your doctor in the next 5-7 days. Get your chest listened to just to make sure your airways are good and check on that heart rate. Normal resting rate is between 60 and 100 bpm so 110 really isn't that bad given your recent infection. You said you googled and came to the conclusion you may have a pulmonary edema... don't do things like that, pulmonary edema is usually caused by heart related illness, causing blood and mucus to fill the lungs (both)

Your EKG was clear so you're all good.

Google is great for searching but it's terrible at diagnosing, I mean just terrible. You can say you feel tired and the symptom checkers will say your about to lose an ear or something.

I may have gone slightly off topic...

You'll only stress yourself over the results because 1 illness will share symptoms with 50 others.

7

Thank you, Doc!

The EKG is okay according to the nurse that gave it. The Doc didn't say anything about it so I assumed it was ok. 

I am attaching a copy of the ER report, if you have time, could you please review it, to see if anything jumps out, like the actual EKG result?

I also can't read this handwriting, or makes sense of it.  

I do remember on the 20th Feb, the only flag my blood test showed was low Lymphocyte of 0.8 (normal is 1.0 - 4.8 10^9 L). Is this expected when you are ill? Should I do another blood test soon?

Thanks again, Doc. I feel a lot more reassured now. I do Google a lot about health this winter because I had a string of unfortunate infections after decades of no needing antibiotics. And as mentioned my insurance is very limited, I believe I can only see a doc for something "unexpected" and can't really visit one if I feel I have something. November 2017, skin infection, Dec-Jan Sinus infection(only got antibiotic ointment here), and then this one. RIght now I am especially paranoid about germs as well as how contagious I am to others and take special precautions I wouldn't even consider last year...

8

Having read that it seems like you are all set for recovery. He mentioned what you presented with and the symptoms you have experienced. In the "final diagnosis" section he said you have hemoptysis (coughing up blood) and pneumonia. There's no mention of the EKG probably because it was normal. He did say you are tachycardic but that was in the points of interest and was ultimately not mentioned in the final diagnosis. As I said the reasons for your high heart rate (tachycardia) are the result of an immune response.

Mark

9

Thanks Doc. I will go to the doc in a couple of days. It's unfortunate that the ER didn't give me a copy of the EKG graph (I saw it). 

As I mentioned, if I do go to Doc, it would be better if they give me tests that they think I need, in as few visits as possible. My insurance would be less...difficult if I have less visits but I can have as many tests as necessary.

What kind of tests do you think I should...nudge the Doc for?

Do you think I need a new blood work after, on the 20th ER visit, my lymphocytes were 0.8 (normal is 1.0 - 4.8 10^9 L).

Given my string of infections, especially the sinus one where I only got a AB ointment and there was no follow up (I read there should have been one), what if my lymphocytes were always low because I was still fighting the Sinus infection(after more than a month) when i got the Flu,that complicated into this Pneumonia.

The ER visit was the only time I had blood work done in a couple of years. I am afraid my immune system is problematic. 

Haha, I'm sorry if I'm sounding so paranoid even against your advice. This winter has made a bit wary.

I think I will be ok before the Docs visit but if you could please answer those few more questions that would be great.

Thanks, Doc!.