One more post today. How do you best deal with post-thoracotomy pain. I admit I see it fairly often as well.
Patient writes in a recent comment
I have acute persistent pain in my right breast and along the six inch incision at the base of my breast. I have tried gabapentin, Lyrica, and Topimate. I am on my third round of corticosteroid injections into the intercostals. I am reluctant to use narcotics, but if the steroids do not work, I am at a loss. I cannot move my right arm without pain. Any suggestions would be greatly appreciated.
Discussion of interesting or befuddling cases related to pulmonary and critical care medicine.
Saturday, April 05, 2008
ABPA without steroids
A reader writes:
I am 48 years old female, and lived with asthma for the last 25 years. I am not under great control. I have had blood work done recently, and found out I have severe allergies. I have an IgE of 1700, my aspergillus allergen is 2.05 ku/l. I recently had a chest ct which showed nonspecific infiltrates with ground glass appearance. A sinus ct showed acute maxillary sinusitis. my physician says she is not sure of a diagnosis of ABPA, and is hesitant to treat me with steroids. In the past year I have been diagnosed with avascular necrosis of both hips, and my right knee as well as severe cataracts in both eyes. I was told probably from the use of steroids to treat my asthma. My concern is I never feel great, and why is this so hard to diagnose, and if I have ABPA what will ahappen if it goes untreated.
What types of steroid-sparing therapies do you use for ABPA (or asthma)?
I am 48 years old female, and lived with asthma for the last 25 years. I am not under great control. I have had blood work done recently, and found out I have severe allergies. I have an IgE of 1700, my aspergillus allergen is 2.05 ku/l. I recently had a chest ct which showed nonspecific infiltrates with ground glass appearance. A sinus ct showed acute maxillary sinusitis. my physician says she is not sure of a diagnosis of ABPA, and is hesitant to treat me with steroids. In the past year I have been diagnosed with avascular necrosis of both hips, and my right knee as well as severe cataracts in both eyes. I was told probably from the use of steroids to treat my asthma. My concern is I never feel great, and why is this so hard to diagnose, and if I have ABPA what will ahappen if it goes untreated.
What types of steroid-sparing therapies do you use for ABPA (or asthma)?