Thank you for posting query at DoctorSpring.com
I request you to cool down, not to lose patience or faith in doctors and keep a presence of mind.
I do agree that i gather nothing from what information i have got.
So did your aunt have a productive cough? was sputum being produced? Was she ABSOLUTELY normal prior, being able to walk 500 metres on a level ground if needed, at a decent pace?
If the answer is yes, then we are dealing with something in blood-clots/ infections.
I didn't see any antibiotics in the short list that you provided.
I need to have a complete blood count, electrolyte, RBS kidney function and liver function test also- which i am sure must have been already done.
I do believe an ECHO to evaluate heart function is also done by now.can i have that report too?
I disagree with the decision of pirfenidone, as there is nothing in CT scan to suggest IPF - a disease for which it is used.
However, other medications are rationale.
However the investigations provided are incomplete.
I suggest you to request a treatment summary from the doctor and attach it as a mail, so that we may be able to give some valuable inputs.
Local application of volini will not cause any of the effects mentioned. it was a mere coincidence.
Looking forward for your reply,
I do guess your aunt is having rheumatoid arthritis. Rheumatoid arthritis affecting the lungs is a difficult to treat condition and can present in various forms.
The present form is Cryptogenic organising pneumonia and treatment is steroids ( Medrol). i think they are also continuing azoran as the response is poor.
I don't think i have much to suggest.still i would like to get an echo done so as to assess the heart- especially right heart function.
The disease will take 2- 3 weeks to resolve ,and requires high dose of steroids. it is probably too early to suggest ventilator / nebuliser at home.
The seizures which occurred has nothing to do with the present condition and is probably due to the meningioma in brain.
I would advise heparin so as to prevent clotting of blood in periphery, passive limb exercises, and pulse steroid therapy for 3 days.
I think the follow-up you have sent was the same you sent yesterday night.
I do suggest an Echocardiography (ECHO) of the heart to assess any cardiac problems as a cause of breathlessness.
I think the working diagnosis will be COP (Cryptogenic Organising Pneumonia)- which is difficult to treat, however the management is in the same line as what is going on.
Unless we have another cause for breathlessness from the ECHO, we shall continue likewise.
Dr. Jacob George P.