I'm dying.....

[tRmedic21]

At least, I think I am.

God, what a wuss. A simple case of bronchitis has had me in bed for 3 days now.... only getting out to go to the Dr. and read the boards. :roll:

The cough isn't so bad, but the headache is killing me... everytime I cough, I think my intracranial pressure skyrockets into triple digits! Last night I used a mepergan fortis to help me sleep, dint really feel much effect. Today the doc gives me some codeine to help with the cough and the headaches... man, this stuff SUCKS! 20 mg, and I am NOT a small guy! I have taken 3 already (since 4PM), and I am thinking of another one, or one of the mepergan again.... this sucks so bad... can't heal if you don't sleep, can't sleep if I don't heal!

Hey George, you think an isopropyl alcohol respiratory lavage would help, you know, like the ones they used to give for CHF 50 years ago? Maybe it would help kill some of this bacteria off quicker.... I can't go to class, I can't sleep.... and Finals coming up in 2 weeks. I am sure the amoxycillin will prolly knock it down by then, but if I miss a week of class and studying in the meantime, it ain't gonna be pretty come Finals-time... :(

1:30 AM and I'm up complaining about my minor bronchitis... what is the world coming to? :oops:

[MushieCookie]

hopefully you'll start feeling better soon. it does suck that you got sick a couple of weeks before finals...but it could be worse. you could be sick right before finals!

good luck with finals btw.

[xyzabc]

bud.. take Honey mixed with Warm Milk.
This is one of the best cures that ever existed.

try it , post your condition in the AM>

[teratos]

Isopropyl lavage usually takes care of things. If that doesn't work, then go for the insulin coma. You should probably see a doc, could well be a bacterial bronchitis. Being the healthy young buck that you are you can prolly kick it on your own, but a Z-pack is always a bit faster. G

[AUCMD2006]

you guys ever heard of a treatment for URI's with a 1:1 mix of saline and hydrogen peroxide via jet neb? heard it a while ago, supposedly it kicks it out in a day or so..

[tRmedic21]

you guys ever heard of a treatment for URI's with a 1:1 mix of saline and hydrogen peroxide via jet neb? heard it a while ago, supposedly it kicks it out in a day or so..

Wow, interesting. I mighta tried that if I was still in the States working on the ambulance. Dang.

Isopropyl lavage usually takes care of things. If that doesn't work, then go for the insulin coma. You should probably see a doc, could well be a bacterial bronchitis. Being the healthy young buck that you are you can prolly kick it on your own, but a Z-pack is always a bit faster. G

Yeah, I went to Dr. Van de Waag yesterday (you remember him? lol) and got some amoxycillin, codeine, and acetominophen! lol The codeine only helps me sleep if I take 2 at once, and it gets me about 3-3.5 hours before I have to wake up and dose myself again. In this manner, I managed to get a bit of sleep last night, but the bad news is, I am already down to 3 codeine! I know this isn't going to get me through, so I may see if I can go back and get some more. I don't want them to think I'm a dopehead or anything, this is actually the first time I've ever taken more than one narcotic pill. When I broke my ankle, I took ONE Darvocet, then switched to Tylenol/Advil. When I had a sternoclavicular dislocation, I took ONE Lortab, then switched to Tylenol/Advil. That's about all I can remember ever taking until this week. Now I've gone through like 10 codeine in less than 24 hours!

But the thing is, while it helps my cough (ONLY if I take TWO of them!), it doesn't make me drowsy. I think it helps the headaches a little, too, but maybe that's just cause the cough is supressed. Either way, because the cough is gone, I can get some rest, but it isn't the codeine that makes me drowsy. :(

I think I'll go back to Van der Waag today and see if he'll gimme some more. Even if I have to pay another $25 office visit, it's worth it to get some SLEEP! lol :roll:

BTW, do they really still do alcohol lavages??? That was one of those horror stories I heard about from the 50s! :shock:

[FLK]

I think you need ping pong balls placed in your chest cage

I got a pneumonia my first semester.
All that in and out of air conditioned cadaver lab, combined with too many Red Stripes on Friday. I was sick for 3 weeks.
No chest X Ray. No doctors. No antibiotics on Montserrat. You either got beter or you died.
Wonder if it was mycoplasma?

anyway, I survived, only to get RSV my first day of Peds in England.
Wish I'd died on the rock!

Interesting that you were given Amoxicillin for bronchitis.
Now I'm no adult doc, like George, but I would think something to cover atypical organisms would be a better choice.
It's probably viral anyway

Maybe I'm just biased from treating too many hospital acquired infections. I can't remember the last time I saw a sensitivity sheet without this on it

Ampicillin <-> R
:lol:

[tRmedic21]

I think you need ping pong balls placed in your chest cage
Ok, I musta missed that one...
Interesting that you were given Amoxicillin for bronchitis.

Might be my own fault, I asked him to give me something really cheap, cause it's coming down to the end of the sem, and we are kinda tight right now when it comes to funds. Also odd that he only gave me 5 days worth.... 500mg tid x 5. Every time I've ever had antibiotics, it has been for 10 days. Now, I know that some of the newer ones are like qid x5 or something, but I didn't think amaxicillin was like that. I dunno, I always took cephalexin for my bronchitis, and I told him that, but he gave me amoxicillin, so... that's life.

[teratos]

In terms of ABX you would be better with something that covers atypicals, as FLK says. Most likely something viral, next on the list would be atypicals like mycoplasma. I'd have given you erythromycin, or doxycycline. Doxy is shown to be AS GOOD AS levaquin (Expensive, popular floroquinolone) in treating community acquired pneumonia. PCN is a pretty bad choice. G

[anencephalic]

...Zithromax! :D Great stuff...either that or some Isoniazid for that bloody sputum you've been hacking up...perhaps a CXR is in order? :?

Aloha,

[teratos]

Most common cause of hemoptysis is bronchitis. Zithromax IS great stuff, I use it on almost everyone that has bronchitis, becasue it covers so much (and I can save the quinolones for the sick people) The American Thoracic Society and The Infectious Disease Society (or whatever their organization is) recommends Azithromycin by name for sick people such as *****. I can't say what the American College of Psychiatry would recommend for him, but I'm quite sure it would be potent and in very high doses. G

[anencephalic]

I second Dr. Durst's seconding my opinion....hmmm, this post is pretty useless....Micro would be proud. *sniff, sniff* :cry:

Aloha,

[microphage]

I second Dr. Durst's seconding my opinion....hmmm, this post is pretty useless....Micro would be proud. *sniff, sniff* :cry:

Aloha,

This conversation is way out of my league. Z what? D what? I wouldn't even know how to point this in the wrong direction.

[PaulN]

Hey man I've been to your place so I have the cure. I left a tea with Jules called Mate, see if she has any left mix equal parts of that with your Dominican coffee (super strong) and let that go through your coffee pot. Drink all, salt water gargle evry hour for that throat for I expect post nasal drip for a day get out in the sun preferably Maho beach take in the view Take the codeine at night. Oh yeah quit smoking!!!

****

[anencephalic]

Oh yeah quit smoking!!!

Ladies & Gentlemen, I believe we have a winnah! :P

Aloha,

[anencephalic]

Oh yeah quit smoking!!!

Ladies & Gentlemen, I believe we have a winnah! :P

Aloha,

[FLK]

actually I have some pretty good advice for *****....courtesy of a fellow student at AUC, named Jose.
Jose came to class every day with a drink in his hand.
Jose lasted 2 1/2 semesters, at which point he told all of us that he was accepted to medical school in El Salvador ( lucky them. I think he passed one class at AUC )

anyway, Jose gave us one Pearl of Wisdom, which I can personally vouch for.

When we asked Jose how he looked so healthy , but stayed drunk all day he replied

Tequila is a macrophage

Words of wisdom.
Learn it
Know it
Live it.

Screw macrolides!

[microphage]

Oh yeah quit smoking!!!

Ladies & Gentlemen, I believe we have a winnah! :P

Aloha,

Sound effect: DING DING DING.

YOU TOO WON A MILLION DOLLARS!!!

[tRmedic21]

Haven't had a smoke in 5 days now! Course, that's prolly more because I couldn't than 'cause I am quitting! lol

Although, this illness has now got me wondering a bit about a few things. I have never really taken many painkillers, other than standard NSAIDs, which seem to work ok for me. But the 2 times I've ever taken narcs, they didn't really do anything to me that NSAIDs didn't do. Well, since I've been sick this time, I've taken mepergan fortis (demerol/phenergan, I think), which almost kills my wife, but only helped me sleep slightly better. Seriously, nothing else. Then I got the codeine, and a single 20mg codeine did absolutely nothing to me. I found that taking 2 at once eased my cough and helped me sleep for about 3 hours at a time. Well, last night, I only had 3 left, so I took a mepergan and a codeine, which helped me sleep, then when I woke 4 hours later coughing again, took my last 2 codeine and made it through the night. Today I got some more, took 2, got slightly drowsy, took a 2-hour nap, and woke up feeling great.

Now, help me out here, docs, but shouldn't these amounts of narcs seriously put a person out for a good amount of time? I mean 2-3 hours on 40mg of codeine? That's it? Wow. Also, I've never had a problem with nicotine or alcohol. I know that addiction tends to run in families, and mine has had more than its fair share of addicts, but these things not only don't seem to get a grasp on me, they seem to have less effect on me, too. My alcohol tolerance has always been pretty high, though not out of this world. I know one guy who can sit and do shots of hard liquor all night long, and never get a buzz. :shock: Seriously, alcohol has NO EFFECT on him whatsoever. It's almost freakish! lol Anyway....

What does this mean? Am I just one of those people who metabolize things quicker or something? :? Did my family's generations-long alcohol problem cause an evolutionary lobe to be added to my liver? :shock: That would be a nice research topic, eh? lol Some would think this could be a good thing, as in, I can party harder and all that, but I look at it more the other way around....

What if someday (God-forbid) I end up in an accident or a major surgery and need to be placed on painkillers for a time? If my body metabolizes these things quicker than the average Joe, I would need mega doses to keep my pain under control. Obviously, I know how things in the medical field work, and when people keep telling the docs that the mega-drug's they're getting aren't working it, eventually comes to a point where to docs says, "Any more and you'd either be addicted or dead." I don't want to be in that spot. Or to be the one they think is a druggie because I have a high natural tolerance and they assume it is from prior drug abuse!

I've never really used narcs before this week, except a couple of singular use occasions, and since they didn't affect me at all, I assumed it was just.... I dunno, I didn't think about it much. But now it has me wondering.

How often do you guys run into patients who have abnormally understated reactions to narcotic anagesics? What can you do for them? Do you try different meds till you find one that works better than the others, or do you just up the dosage until they're a walking, liquid-state pharmacy? How does this affect toxicity guidelines? Are there tests to run to check levels of certain meds, say to determine the rate these drugs are metabolized and cleared? I am beginning to sympathize with some of these people who complained to me that their painkillers weren't strong enough. Now, I know that the object is not 'painfree' but 'manageable'. That's fine, and I am certainly not incapacitated now, but if something happens in the future, I would like to be able to address the issue, and have my healthcare providers believe me! lol

Any thoughts?

[TXRN]

Have you ever used

Phenergan/codeine
and biaxin ??????????????????

Phenergan with Codeine is used to relieve coughs and other symptoms of allergies and the common cold. Promethazine, an antihistamine, helps reduce itching and swelling and dries up secretions from the nose, eyes, and throat. It also has sedative effects and helps control nausea and vomiting. Codeine, a narcotic analgesic, helps relieve pain and stops coughing.

Biaxin is also known by its generic name clarithromycin. Biaxin is used to treat a variety of bacterial infections such as pneumonia, bronchitis, Legionnaires' disease, ear infections, strep throat, sinusitis, and tonsillitis. Biaxin is also used to treat MAC (mycobacterium avium complex) infections in advanced AIDS patients. It will not, however, treat the common cold or other viral infections. Side effects of biaxin use include mild diarrhea, headache, nausea, abdominal pain, and indigestion. Biaxin can worsen preexisting kidney problems.

[TXRN]

I once gave 60 mg of codeine to a thin female patient (130 lbs).
It didn't do a thing for her. lol.

[teratos]

I forgot ***** was a smoker

It's probably cancer.

It's been real.


Biaxin. Good drug, covers about the same stuff as azithromycin. Azithro and Carithromycin are actually both first line treatments for MAC prophylaxis in AIDS patients. I like azithromycin because it is once a day for only 5 days. The easier and shorter you make the treatment, the more compliant your patient will be. You don't want to confuse people with twice daily treatments. That gets to be too much for them :shock:

G

[FLK]

*****, take the whole bottle of narcs at once.
Chase it with a 5th of tequilla. You'll sleep like a baby

Seriously, perhaps you got bogus meds. I mean it is the Caribbean. Maybe those drugs are expired, or placebo, or watered down to save money for the pharmacist. It happens in America so I am sure it could happen elsewhere.

My advice to quit smoking is to train for a half marathon.
Run 5-7 miles a day. Then have sex. If you want a cigarette after sex, run a few more miles.Do some wind sprints.

The 2 thousand bucks a year you save will add up not to mention your groin arteries will stay patent, and you won't need viagra ( if that's "impotant" to you )

[Silenthunder]

Hey all,

sorry to hear you're sick trmedic21. Even sorrier to hear that you
can't smoke :D I quit smoking a few months ago. SO basically what that means is I've spent just about everyday since then wanting a cigarette. This gets pretty bad when I go out with friends to bars (most of my friends smoke; especially at bars) My primary motivation for quitting smoking was economic. I can't find a job after graduating, and cigarettes are $8 a pack in Canada (yes that's right: $8!!)

No lecture from me. Everyone should have the freedom to do whatever
they want to do. While democracy harps on freedom, I feel that we are prisoners without knowing it....... (sorry, I said no lecture..... :D

I actually wanted to comment on FLK's great advice:

My advice to quit smoking is to train for a half marathon.
Run 5-7 miles a day. Then have sex. If you want a cigarette after sex, run a few more miles.Do some wind sprints.

did you actually do this FLK?! :D WOW!!! I get mental image of someone just "finishing up" with their wife and then immediately getting out of bed, putting their sneakers on and bolting out the door!! :lol:

Cheers all,

Silenthunder

hmmm..... useless post.......

[FLK]

\
[quote]My advice to quit smoking is to train for a half marathon.
Run 5-7 miles a day. Then have sex. If you want a cigarette after sex, run a few more miles.Do some wind sprints

did you actually do this FLK?! :D WOW!!! I get mental image of someone just "finishing up" with their wife and then immediately getting out of bed, putting their sneakers on and bolting out the door!! :lol: .



you see, I am a nonsmoker, so after sex I do not crave a cigarette, so therefore no need to do windsprints.
8)

[###]

.................

[tRmedic21]

It's probably cancer.

It's been real.

Great. Thanx, G. lol

2 thousand bucks a year

The beauty of Sint Maarten.... 1 carton every 2 weeks at $8.75 per.... that comes out to less than $250 a year. :P

I really don't miss the smoking tho, truthfully. I have really never been addicted (no one ever seems to believe that, especially addicted smokers! lol), but it has now been almost a week with no cigarette and I haven't had a craving yet. I've even been around friends smoking and didn't want one. Actually, I am much more of a social smoker than anything. Hanging out with friends is when I want them the most. I don't smoke at home, unless friends come over, and we usually go outside and smoke. My wife hates me to smoke in the house, but she doesn't mind if my friends do... par for the course of being married, huh? lol

I am actually prolly gonna quit once I get back from break. Well quit smoking cigarettes, anyways, but I'll still have the occasional Cuban cigar. :)

[PaulN]

This is the longest thread in a while congrats to ***** for invoking such sympathy. My hat is off to you!
****

[anencephalic]

It's probably cancer.


D'oh...hopefully something resectable like a periperal pleural-based adenocarcinoma....then again, with his symptoms, could be something like bronchioloalveolar CA or even worse....small cell! :shock: Have fun in Pathology, dude! :lol: Wrong age demographic, though...how many cases a day do you smoke again?!

Aloha,

[FLK]

It's probably cancer.

It's been real.

Great. Thanx, G. lol

2 thousand bucks a year
1 carton every 2 weeks at $8.75 per.... that comes out to less than $250 a year. :P



1/2 carton per week equals 14.3 cigarettes per day.
that's some social life you have, since you are only a "social smoker" 8)

[microphage]

It's probably cancer.


D'oh...hopefully something resectable like a periperal pleural-based adenocarcinoma....then again, with his symptoms, could be something like bronchioloalveolar CA or even worse....small cell! :shock: Have fun in Pathology, dude! :lol:

Ah yes, look for the mitotic cells... fun fun. (oh look, there's one in metaphase!!!)
:lol: