1 Chronic cough
2 Current smoker - 15-20 pack-year history
3 Gastro-oesophageal reflux disease/hiatus hernia
4 Diverticular disease
5 Osteoporosis
Thank you for referring Jillian Whiffen, a 72-year-old lady who has previously owned a news agency and worked for a family business. Jillian currently smokes six cigarettes per day and keeps no pets. Regular medications are Nexium, Ostelin, Cardia, Crestor, Prolia infections and she was using Pulmicort a couple of months ago.
Around three months ago, Jillian developed a moist-sounding cough in the absence of any clear infective symptoms. She was on a cruise, returning back New Zealand at the time.
Over the last month, the cough has improved but does persist. Jillian is not aware of any notable …show more content…
Two heart sounds were audible with nil else.
Assessment;
The lung function test are interesting and do indicate a borderline reversibility suggesting some ongoing bronchitis. Jillian’s smoking is likely contributing to this and an infection has initiated her symptoms.
The profoundly reduced gas transfer is discordant with her clinico-radiological presentation and I suspect that her ongoing smoking is impacting on this reading.
At this point, I have suggested we trial Alvesco to see whether this helps deal with some of the bronchitic symptoms. In the event the reflux is also contributing, I have suggested she increase Nexium to 40mg note day. I have also arranged to Jillian to undergo a bronchoscopy through the Austin to ensure that there are no endobronchial abnormalities, particularly given the more prominent atelectasis.
We have again had a discussion about smoking cessation and I am hoping she will take this onboard.
I will see her again in a few weeks and will repeat her lung function thats at this stage. If there remains a persistently low gas transfer,
2 Current smoker - 15-20 pack-year history
3 Gastro-oesophageal reflux disease/hiatus hernia
4 Diverticular disease
5 Osteoporosis
Thank you for referring Jillian Whiffen, a 72-year-old lady who has previously owned a news agency and worked for a family business. Jillian currently smokes six cigarettes per day and keeps no pets. Regular medications are Nexium, Ostelin, Cardia, Crestor, Prolia infections and she was using Pulmicort a couple of months ago.
Around three months ago, Jillian developed a moist-sounding cough in the absence of any clear infective symptoms. She was on a cruise, returning back New Zealand at the time.
Over the last month, the cough has improved but does persist. Jillian is not aware of any notable …show more content…
Two heart sounds were audible with nil else.
Assessment;
The lung function test are interesting and do indicate a borderline reversibility suggesting some ongoing bronchitis. Jillian’s smoking is likely contributing to this and an infection has initiated her symptoms.
The profoundly reduced gas transfer is discordant with her clinico-radiological presentation and I suspect that her ongoing smoking is impacting on this reading.
At this point, I have suggested we trial Alvesco to see whether this helps deal with some of the bronchitic symptoms. In the event the reflux is also contributing, I have suggested she increase Nexium to 40mg note day. I have also arranged to Jillian to undergo a bronchoscopy through the Austin to ensure that there are no endobronchial abnormalities, particularly given the more prominent atelectasis.
We have again had a discussion about smoking cessation and I am hoping she will take this onboard.
I will see her again in a few weeks and will repeat her lung function thats at this stage. If there remains a persistently low gas transfer,