OpenHealth Q&A

Rib Pain Intensifies with Persistent Coughing

Hello everyone, I'm a 30-year-old male managing asthma. I’ll make this brief, as I’m addressing a recent development. Since October 2024, I've been encountering breathing difficulties. The slightest exertion leaves me feeling dizzy, and I've been troubled by a persistent cough. Prior to these issues, I was quite active, regularly jogging and engaging in martial arts like Brazilian jiu-jitsu and kickboxing. My occupation as an electrician involves mostly residential work, but I’ve been unable to work due to these complications. My asthma was previously stable, but the cause of my current symptoms remains unclear. I've undergone numerous tests after my symptoms began. I was referred to a pulmonologist, whom I've been seeing since late December. A range of tests, including MRIs, CT scans, x-rays, bronchoscopy with wash cultivation, and a gastroscopy with biopsy, were conducted, along with courses of multiple antibiotics and pantoprazole. All results appeared normal except for a tiny lung nodule, less than 1mm, which my doctors indicated poses no concern and would not require further scans. The bronchoscopy indicated my lungs were producing cells to combat infections, even though no infections were detected. The doctor adjusted my asthma medications and prescribed antibiotics to address potential lingering bacteria that could be causing my symptoms. Now, to explain why I’m posting this: Recently, around March 12-13, I fell ill with what felt like a cold. I didn’t have much of a fever and generally didn’t feel fatigued. However, I experienced significant congestion and an increase in the severity and frequency of my coughing. Each morning, I’d produce bloody phlegm, with traces of blood reappearing later in the day. Eventually, towards the end of this episode, I was coughing up thin, pinkish or red-tinged phlegm consistently for about 4-5 days, primarily in the mornings. While I wasn’t wheezing, I noticed a crackling or bubbly sound in my breathing. The rib discomfort began toward the end of this period, making it difficult to manage my cough without pain. On March 20, I had a CT scan planned to monitor my overall condition, not specifically for the cold. Following that, I had a telehealth consultation with my pulmonologist on March 27, during which she explained that my condition hadn’t changed significantly, although signs of pneumonia and fluid in my lungs were identified. I detailed the progression of my symptoms since my last update on March 4. She inquired about my pain, particularly if it was located on the right side, where the pneumonia and fluid were noted. However, my pain is situated on the opposite side, near where my ribs meet the lower part of my breastbone. She plans to bring me in around April 21 for a check-up to assess whether my condition has improved, advising that I should seek emergency care if I experience severe breathing difficulties. Currently, my cough is gradually improving, with far less frequency than before my recent illness. However, the discomfort in my ribs is worsening daily. Pressing on my breastbone is painful, and any twisting or movement can also trigger pain. My coughing feels excruciating, akin to being stabbed. I can breathe relatively well, and my blood oxygen levels are at 99. Though my ongoing health issues complicate matters, my last visit to the emergency room resulted in being sent home, as my vitals were stable, and I was directed to continue consulting my specialists. I fear a repeat outcome will occur if I seek help again. Is it safe for me to wait almost a month for further evaluation? The pain appeared around March 16, and I hoped the CT scan would provide insights regarding it, but no substantial findings were reported.

Answers (1)

3/28/2025, 3:01:15 PM

OpenHealth AI

It sounds like you're experiencing significant discomfort and distress due to your rib pain and ongoing respiratory symptoms, particularly following your recent bout of illness. Given your asthma history and the investigations you've already undergone, it's crucial to manage your symptoms carefully while awaiting further evaluation from your pulmonologist.

Key Points

1. Worsening Rib Pain: Your rib pain is intensifying, particularly with coughing and movement.
2. Cough Improvement: While your cough frequency is decreasing, the association with rib pain is concerning.
3. Respiratory Symptoms: You have a history of breathing difficulties and elevated lung fluid, which should be monitored closely.

Explanation

Your rib pain could be due to a few factors, including muscle strain from persistent coughing, which can result in soreness and discomfort in the chest area. The bloody phlegm and crackling noises in your breathing are noteworthy but may relate to your underlying respiratory issues rather than a new infection.

Next Steps

1. Pain Management:

   • Over-the-Counter Pain Relievers: Consider taking NSAIDs like ibuprofen or acetaminophen to help manage the rib pain. Always follow the recommended dosage.
   • Gentle Stretching: Engage in gentle stretching exercises that might help alleviate some discomfort in your rib cage area. Avoid movements that cause pain.

2. Symptom Monitoring:

   • Keep a symptom diary detailing your pain severity, cough frequency, and any changes in your breathing. Note if there are triggers for your rib pain or cough.
   • Be vigilant for changes such as increased shortness of breath, high fever, worsening pain, or new symptoms like chest tightness.

3. Hydration and Lung Health:

   • Stay well-hydrated to help a productive cough and thin secretions, making it easier to expel any mucus.
   • Use a humidifier in your living space to ease respiratory irritation, particularly during coughing episodes.

4. Evaluate Need for Immediate Care:

   • If your rib pain significantly worsens, or you experience severe breathing difficulties, do not hesitate to seek emergency care, regardless of past experiences with healthcare consultations. Your health is the priority.

5. Prepare for Upcoming Appointment:

   • Before your April 21 check-up, jot down any concerning symptoms and questions you would like to address regarding your ongoing pain and cough. This will ensure you make the most of your time with the pulmonologist.

While awaiting your upcoming evaluation, it's essential to prioritize understanding your pain and its causes. You can manage the discomfort through pain relief strategies while closely monitoring your respiratory status. If symptoms escalate or you're unable to find relief, consider seeking medical advice sooner.