im a 27 yr old medic working as a orthopedic resident in India.. i have been smoker since last 6yrs with progressive episodes of cold/sinusitis and cough through out the year since my early childhood . i had more than regular episodes of cough and cold last year which usually lasted for a couple of weeks.
2 + 1/2 months back i developed severe cold with productive( initially yellow colored then black brown colored , now no expectoration since 1month) cough. the cold symptoms subsided but then within 10 days i developed bouts of sudden cough usually associated with air hunger/ wheezing and occasionally vomiting after an episode. these symptoms progressively increased with multiple episodes during the day unlike only "morning episode" initially . My chest doc diagnosed me with wheezing bronchitis; said i had post-nasal discharge with severe chest ronchi ; advised me 1. nasal spray DUONASE - azelastine hydrochloride + fluticasone 2puffs twice daily( was discontinued after 1 month 2. SYNASMA - doxofylline 400mg B.D 3. SEROFLOW rotacap inhaler - salmeterol 50mcg + fluticasone250mcgs 2rotacaps B.D 4. antibiotic coverage ( which was been started at the start of symptoms and was revised several times to be discontinued since last 20 days. 5. DUOLIN rotacap inhalation 2 caps t.d.s - levosalbutamol 100mcgs + ipratropium bromide 40mcgs ( this was started 7 days back)
i had sympoms of voice hoarsness with throat irritation and acid refluxes for which i started on pantoprazole 40 mg twice without any absolute relief but significant reduction of symptoms
i had an episode of binge drinking with severe posterior pharyngeal wall/ uvula inflammation the morning after on 1/1/08 !!!! i stopped all inhalers and took NSAIDs for 2 days with pantoprazole drugs
My treatment was revised with advice for addition of DUOLIN and discontinuation of antibiotics and DUONASE .
i had been experiencing occasional muscle cramps in the upper limbs and back since last 20 days but has progressively increased since last 4 days with severe constant pain in upper limbs ,back and neck . pain is so severe to incapacitate me . I had taken 3 tabs of potassium citrate 540mgs since yesterday at regular intervals with vitamin- e supplements .
now i have occasional minimal cough with air hunger twice or as a lone episode with throat irritation / hoarseness / weakness / muscle cramps
what should i do??? help me please doctors