OpenHealth Q&A

Navigating Unresolved Health Issues

A 29-year-old male with a past medical history of a pulmonary embolism presents with concerning symptoms. Over the course of two weeks, he began experiencing symptoms akin to allergies, which swiftly escalated to chest discomfort, tightness, and flu-like indicators. Additionally, he has been afflicted with intermittent chills, excessive sweating, and a peculiar cough surfacing a few times each day. His oral temperature has consistently remained around 98 degrees Fahrenheit – even during times of significant illness, his readings rarely exceed this mark. After several days, he reached out to his primary care physician (PCP). Considering his symptomatology and previous episodes of unprovoked bilateral pulmonary embolism last year, the medical staff recommended he visit the emergency room. However, tests including D-dimer and troponin evaluations led the ER physician to forgo a CT scan, and an X-ray ruled out pneumonia. Notably, his white blood cell count was elevated at 19,000, potentially influenced by a prednisone regimen initiated over a week prior. He was prescribed Tessalon perles to alleviate his cough and subsequently discharged. As five days went by with minimal improvements, he experienced fever-like symptoms without an actual spike in temperature, alongside a worsening cough and heightened chest pain. The discomfort progressed to include severe pain at the base of his neck. Upon re-contacting his doctor's office, he was advised to visit the clinic since his PCP was unavailable. After additional blood tests, the opinion remained that his condition might be viral, and he was given a prescription for antibiotics should his health not improve over the next few days. Again, Tessalon perles were provided for his escalating cough. The latest lab results indicated a white blood cell count of 14,000, with no steroids having been taken in the past five days. A subsequent X-ray reaffirmed the absence of pneumonia. Currently, he finds himself on the couch, attempting to avoid disturbing his girlfriend due to a persistent cough that disrupts her sleep – he even wakes her from the adjacent room. The medications prescribed have yielded little benefit, as he notices a substantial decline in his ability to breathe deeply, triggering coughing fits that can last between two to five minutes. Furthermore, he is plagued by increasing hot flashes and chills along with unbearable pain in both his neck and upper chest. This overwhelming discomfort has left him in a state of distress, prompting worries about the necessity of another ER visit but uncertain of what alternative treatments might be available. In addition to these challenges, he also suffers from a pinched nerve in his neck, compounding his anguish. He is desperate for answers regarding the nature of his ailment.

Answers (1)

8/27/2025, 2:52:24 AM

OpenHealth AI

Main Points: This patient has significant respiratory symptoms following a history of pulmonary embolism. While initial tests ruled out pneumonia and suggested a viral process, the persistent cough, chest pain, and increasing discomfort warrant careful monitoring. The patient should prioritize symptom control and consider further evaluation if symptoms worsen.

Explanation: The combination of symptoms—persistent cough, chest discomfort, atypical fever without high temperature, and elevated white blood cell count—suggests a potential respiratory issue, possibly viral in nature, given the initial assessments. However, given the patient’s history of pulmonary embolism, the return of significantly worsening symptoms needs careful attention.

Persistent cough, along with chills and chest pain, can be distressing and affect daily life. It is understandable to feel worried, especially since the discomfort is impacting both the individual and those around him.

Next Steps:

1. Symptom Management:

   • Continue taking the Tessalon perles as prescribed for cough relief.
   • Consider using a humidifier in the room to help soothe the airways and reduce coughing.
   • Stay adequately hydrated to help thin mucus and ease coughing.

2. Monitoring Symptoms:

   • Keep a symptom diary noting when coughs occur, their severity, and any accompanying symptoms (like chills, chest pain, etc.). This will help identify patterns and triggers.
   • Pay attention to any new symptoms like increased shortness of breath or changes in pain.

3. Follow-Up and Emergency Plans:

   • If the worsening cough leads to difficulty breathing, significant chest pain, or confusion, seek emergency care immediately.
   • Contact the PCP again to discuss the worsening symptoms. Emphasize the increasing pain and breathing difficulties so they can reconsider the necessity of further imaging or evaluations.

4. Seek Support for Emotional Well-being:

   • Feeling anxious or distressed about symptoms is normal. Consider discussing feelings with trusted friends or considering stress-reducing techniques such as mindfulness, gentle stretching, or light meditation to help manage anxiety during this uncertain time.

5. Review Home Treatment Options:

   • Since the upper body pain is compounding discomfort, gentle neck stretches or warm compresses might provide some relief for the pinched nerve. However, these should be approached cautiously.

This situation can be distressing, but taking proactive steps to manage symptoms and communicate with healthcare providers is vital. Reassure your partner, and seek spaces where silence is maintained during your symptomatic periods. Let me know if you need further guidance or adjustment to these steps.