OpenHealth Q&A

Week 7 of Pleurisy Suffering

A 36-year-old woman weighing 200 pounds with a history of transient ischemic attacks is experiencing intense chest discomfort rated 7 out of 10, persisting for seven weeks.  Since the beginning of the year, I've been trapped in a cycle of severe pain that I thought would ease after a course of antibiotics. Initially, the pain was unrelenting, but after a brief treatment with a Z-pack, it transformed into painful flare-ups occurring every few days. I believed I was on the mend, but today the agony returned so fiercely that I found myself in tears before my family. I've visited the hospital twice recently, only to feel dismissed by the rural emergency room doctors. Now, I am attempting to endure this without seeking immediate help again, although it's proving to be incredibly challenging. My symptoms began on January 1st, starting with a sore throat that quickly escalated to chest pain. Taking deep breaths became painful, and I began to experience overwhelming feelings of doom at night, accompanied by an inability to fully inhale. At that time, I did not have a cough or a runny nose; I suspect I contracted an infection after my daughter had RSV just a week earlier. On January 10th, I went to urgent care, where I underwent an X-ray and an EKG. The doctors did not provide a diagnosis and advised me to reach out to my primary care provider (PCP) for an appointment later in the month. However, by January 19th, the pain intensified to the point where I feared something serious was wrong, prompting me to visit the emergency room. I have a history of stroke from when I was eight, which was accompanied by migraines—managed with medication that I stopped taking in my teenage years due to my parents not keeping up with it. When I arrived at the hospital, I informed the staff about my previous blood clot issues and requested tests for a possible pulmonary embolism. They conducted another series of X-rays, a CT scan, an EKG, and a stress test, all of which returned normal results. The doctors noted unusual findings with my thyroid and observed two small, round glass-like nodules at the base of each lung, recommending future testing. Unfortunately, my visit concluded without any specific diagnosis—just the label of unspecified pain—and I was sent home. Desperate for relief, I tried another nearby hospital. I explained my situation, but after another round of tests, including an ultrasound of my chest, it was determined I had a small pulmonary effusion. The doctor reassured me that it was minor and would resolve on its own, advising me to follow up with my PCP. Upon visiting my PCP, she confirmed the effusion and prescribed steroids to alleviate inflammation. Unfortunately, this did not bring relief, and the pain persisted, leading me back to the ER. The physician's assistant was unsympathetic, questioning me about intravenous drug use and presumptively dismissing my condition before I was even formally registered. He contradicted the earlier findings, claiming I had pleurisy instead, with an expectation for it to resolve naturally. Returning to my PCP for further help, she finally prescribed a Z-pack and assured me that if my pain continued, she would refer me to a lung specialist. I completed the antibiotic course last week, hopeful for improvement, but I am still grappling with pain. I reached out to her office today—only to learn that due to the overwhelming backlog, I won’t be able to see her for a referral until April. Now, here I am in my seventh week of distress, questioning whether this is how my life will be from now on, and struggling with the idea of being a parent while just wishing I could curl up and escape it all. Below are some of my abnormal blood test results. I apologize if there are any repetitive items, as I’m flipping through my medical records. Any advice or insights from others who have dealt with pleurisy would be immensely appreciated. **Abnormal Lab Findings:** - **WBC**: 18.1 - **MVC**: 76.9 - **MHC**: 22.8 - **MCHC**: 29.6 - **RDW**: 15.3 - **AST**: 10 - **Alkaline Phosphatase**: 186 - **Reactive Lymphocytes**: 11% - **Neutrophils (Absolute)**: 9.24 - **Immature Granulocytes (Absolute)**: 0.35 - **Morphology**: Abnormal - **D-dimer**: 724 - **Platelet Count**: 452

Answers (1)

2/17/2026, 2:40:51 AM

OpenHealth AI

I'm truly sorry to hear about the intense pain and distress you've been experiencing. Navigating such prolonged discomfort, especially when previous medical interactions have left you feeling unheard, can be incredibly challenging. Let’s look at what might help you find some relief and manage your situation better.

Main Points

• Your symptoms suggest pleurisy with associated inflammation, and the pain can persist despite treatment.
• It’s critical to focus on managing your symptoms and advocating for more effective care.
• Ongoing communication and monitoring with your healthcare team are essential for addressing your concerns.

Explanation

Pleurisy is the inflammation of the lining of the lungs (pleura) and can cause sharp chest pain, especially with breathing or coughing. It’s often linked to infections or other underlying conditions. Although your medical evaluations (X-rays, CT scans) have returned largely normal, the persistence of your symptoms and the abnormal lab results indicate that further investigation is necessary.

Your history of transient ischemic attacks and recent findings, including a small pulmonary effusion and abnormal thyroid results, suggest that a comprehensive approach is needed. The elevated D-dimer may also indicate some level of clotting concern that may require further evaluation, especially given your history.

Immediate Steps to Take

1. Pain Management:

   • Utilize over-the-counter pain relief, such as ibuprofen or acetaminophen, if you haven't already, to help reduce pain and inflammation. Follow dosing instructions carefully.

2. Symptom Diary:

   • Keep a detailed diary of your symptoms, noting when the pain intensifies, any other symptoms you're experiencing (like cough, breathlessness), and any triggers you've identified. This can help both you and your doctors understand your situation better.

3. Breathing Exercises:

   • Try gentle breathing exercises or techniques like diaphragmatic breathing to help manage pain. Focusing on slow, controlled breaths can sometimes alleviate discomfort.

4. Advocate for Continued Care:

   • Given your difficulty seeing specialists, consider reaching out again to your primary care office to explain your urgency. Explain your ongoing severe symptoms and request updates on any cancellation appointments or alternative options.

5. Follow up on Abnormal Labs:

   • Since your blood test results indicate some abnormalities (especially your WBC and D-dimer), ask your PCP for further action steps or referrals to specialists who can address these findings. This is important to understand the inflammatory process happening in your body.

6. Mental Health Support:

   • Feeling overwhelmed emotionally is entirely reasonable. Consider seeking support from a mental health professional or a support group for chronic pain or pleurisy. They can offer coping strategies during this challenging time.

Additional Suggestions

• Aim for a balanced diet and stay hydrated to support your overall health. Nutrient-rich foods may help your body combat inflammation.
• If your pain intensifies or you develop new symptoms (like shortness of breath or fever), seek medical attention immediately.

Navigating these health challenges can be isolating, especially as a parent. Remember, you deserve compassionate care, and your concerns are valid. I encourage you to keep advocating for your health and reach out for support when needed. I’m here to provide any further assistance you may need.