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Suggest Treatment For COPD And Costochondritis
Posted on
Sun, 3 Jan 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 3 Jan 2016
Answered on
Fri, 29 Jan 2016
Last reviewed on
Question : I have COPD and Costocondrosis my sats have been very irregular but a hospital at a hospital visit the Dr at a and e concluded i was OK because my sats were 95 they have been dropping at night below 86 about 6 or 7 times a night and i am waiting for an urgent referral to the sleep clinic for sleep apnea, sorry about spelling, my sats are 98 at the moment but i have a resting pulse of 88 minimum to high 90's, could my ribs be pressing on my lungs or putting any strain on my heart or lungs?
I'm confused about this i have tried anti-inflammatory tablets daily for extreme back injury pain but found they restrict my breathing further i am breathless all the time even with a good oxy level my pulse will rise past 125 on a very short walk up my hall, thank you for your time Susanne ps i also take tramadol 6 daily for fibromyalgia pain
I'm confused about this i have tried anti-inflammatory tablets daily for extreme back injury pain but found they restrict my breathing further i am breathless all the time even with a good oxy level my pulse will rise past 125 on a very short walk up my hall, thank you for your time Susanne ps i also take tramadol 6 daily for fibromyalgia pain
Brief Answer:
You need to rule of infective exacerbation of COPD
Detailed Answer:
Hi! Welcome to health care magic!
First of all, it is sad to know what you had to go through but you are fighting with all these illnesss with courage and determination and that is a very good sign. Based on the history you have shared, it can be due to costochondrosis as fear of chest pain with rubbing of internal organs or structures against painful segment may cause troubled breathing must falling sats and other features you have discussed with winter season in progress, you need to rule out infective exacerbation of COPD if increasing shortness of breath alongwith decreasing sats can be due to that and pneumonia or other respiratory tract infections in aged post 50, may present with typical cough and fever. Cough is also part of copd so until thick greenish sputum isn't been produced, it is difficult to comment whether it is due to copd or infections. You should have chest Xray and blood screens and if anything suggests so, you may need a course of antibiotics. Also that if sats doesn't improve despite these measures, you can discuss with your pulmonogist after having fresh blood gases whether you need long term oxygen therapy or not? With a home based oxygen concentrator if so.
Also discuss using tramadol alongwith liver cirrhosis as it may cause over sedation at times. Status of liver cirrhosis is also important as any underlying water accumulation in the body due to that, may also lead to the symptoms you have shared.
Hoping you a speedy recovery. If you have any more questions, feel free to ask. Regards.
You need to rule of infective exacerbation of COPD
Detailed Answer:
Hi! Welcome to health care magic!
First of all, it is sad to know what you had to go through but you are fighting with all these illnesss with courage and determination and that is a very good sign. Based on the history you have shared, it can be due to costochondrosis as fear of chest pain with rubbing of internal organs or structures against painful segment may cause troubled breathing must falling sats and other features you have discussed with winter season in progress, you need to rule out infective exacerbation of COPD if increasing shortness of breath alongwith decreasing sats can be due to that and pneumonia or other respiratory tract infections in aged post 50, may present with typical cough and fever. Cough is also part of copd so until thick greenish sputum isn't been produced, it is difficult to comment whether it is due to copd or infections. You should have chest Xray and blood screens and if anything suggests so, you may need a course of antibiotics. Also that if sats doesn't improve despite these measures, you can discuss with your pulmonogist after having fresh blood gases whether you need long term oxygen therapy or not? With a home based oxygen concentrator if so.
Also discuss using tramadol alongwith liver cirrhosis as it may cause over sedation at times. Status of liver cirrhosis is also important as any underlying water accumulation in the body due to that, may also lead to the symptoms you have shared.
Hoping you a speedy recovery. If you have any more questions, feel free to ask. Regards.
Above answer was peer-reviewed by :
Dr. Sonia Raina
I'm very sorry Dr. Saddiq Ulabidin i should have mentioned that i have recently finished a course of antibiotics and cortisone tablets, sats are between 94 and 98 in the day but i am constantly breathless tho i do not feel any obstruction in my chest or cough or sputum my pulse seems to be the problem getting very high on very little exertion and some pain in ribs and upper right chest area and spike pains in heart that last just a second when my pulse is high but not unbearable, do you think that my ribs could be rubbing on my lungs also i am due for an ECG on Thursday how good an indication is a resting ECG of heart condition it will be done in my surgery so will be quick one. i cannot understand my pulse problems and breathlessness even when sitting down with good day sats, thank you for your compassionate reply i look forward to hearing from you Susanne
Brief Answer:
You need to have an EKG and Echo cardiogram
Detailed Answer:
Hi! Thanks for such warm and encouraging reply. It is good to know the rest of the details. In current scenario, in my opinion EKG should be done to avoid any arrythmias as the drugs used to relieve chest spasms may also trigger abnormal heart rythms and fast pulse. This can lead to cardiac failure or incomplete filling or rapid emptying of heart and thus leading to wet lungs which can also add into your troubles. An Echo cardiogram is a useful modality to be used here to rule out any dip in the ejection fraction of the heart or any valvular involvement. In such cases addition of a diuretic drug may be need along with a detailed cardiologist opinion. Keep me apprised about the updates regarding further work up and the surgery you have mentioned. Good day and Regards.
You need to have an EKG and Echo cardiogram
Detailed Answer:
Hi! Thanks for such warm and encouraging reply. It is good to know the rest of the details. In current scenario, in my opinion EKG should be done to avoid any arrythmias as the drugs used to relieve chest spasms may also trigger abnormal heart rythms and fast pulse. This can lead to cardiac failure or incomplete filling or rapid emptying of heart and thus leading to wet lungs which can also add into your troubles. An Echo cardiogram is a useful modality to be used here to rule out any dip in the ejection fraction of the heart or any valvular involvement. In such cases addition of a diuretic drug may be need along with a detailed cardiologist opinion. Keep me apprised about the updates regarding further work up and the surgery you have mentioned. Good day and Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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