Best December of my life
December 11, 2014 11:02 PM Subscribe
I had bronchitis and was getting better. Now I have the flu. Due to weakness I'm having a really hard time coughing enough to clear the secretions in my chest. Could I get pneamonia, too, and if so, how screwed am I getting it with the flu?
Had a nasty cough where I was hacking up copious green shit, lungs clear. Diagnosis bronchitis, got a zpack. Finished zpack, better but still coughing wet clear sputum. Went back to Dr, they did a nasal swab, now I have the flu. After four days of fever, nausea, aches, praying for death, I'm starting to see the light but I still feel congested in my lungs. However, I just haven't had the strength to cough hard enough to relieve the congestion. When my sister is home I've been asking her to whack on my back to break it up.
Is this a real danger? I'm an otherwise very healthy 28 year old woman. And I'm taking mucinex to thin secretions.
Had a nasty cough where I was hacking up copious green shit, lungs clear. Diagnosis bronchitis, got a zpack. Finished zpack, better but still coughing wet clear sputum. Went back to Dr, they did a nasal swab, now I have the flu. After four days of fever, nausea, aches, praying for death, I'm starting to see the light but I still feel congested in my lungs. However, I just haven't had the strength to cough hard enough to relieve the congestion. When my sister is home I've been asking her to whack on my back to break it up.
Is this a real danger? I'm an otherwise very healthy 28 year old woman. And I'm taking mucinex to thin secretions.
The flu makes you weak and tired, which makes you want to lay down all day. You need to sit up as much as possible to help clear your lungs. Laying down lets the gunk accumulate in a way that can lead to pneumonia. You should probably ask for a second z-pack or something stronger. Sit up as much as you can, get some sunlight on your skin, drink hot tea with no sugar, and continue with the musinex. Try and see your doctor Friday, before the weekend. I wouldn't wait it out until Monday. Ask what you should look for that would determine if you should be going to the hospital.
posted by myselfasme at 12:09 AM on December 12, 2014
posted by myselfasme at 12:09 AM on December 12, 2014
Mucinex might help loosen the gunk you are trying to cough up, but I agree with myselfasme - you need medical care. You are getting weaker, not better. Go to ER or Immediate Care if you do not have a doctor appointment.
posted by Cranberry at 12:29 AM on December 12, 2014 [2 favorites]
posted by Cranberry at 12:29 AM on December 12, 2014 [2 favorites]
Call a cab if there is no one to drive you to care.
posted by Cranberry at 12:30 AM on December 12, 2014
posted by Cranberry at 12:30 AM on December 12, 2014
Yes, healthy twenty eight year old women can get pneumonia from the flu. In my case I didn't even start out with bronchitis (but I do have a history of mild asthma). Yes, go get medical care. You have a doctor, from your recent diagnosis, so call them and get the ball rolling.
posted by nat at 12:43 AM on December 12, 2014
posted by nat at 12:43 AM on December 12, 2014
I ended up hospitalized from pneumonia as a a healthy 20 year old male when I was in college - so yes, you can get worse. Could you have something viral on top of everything else? I went to the doctor last month when the cough from a cold seemed to be lingering well beyond reasonable time frame. They told me they are seeing the cough and congestion continue 3-4 weeks after all other symptoms clear up with this year's mutations of the cold virus.
posted by COD at 4:51 AM on December 12, 2014
posted by COD at 4:51 AM on December 12, 2014
I would say to also look out for what isn't there. Pneumonia almost always means hearing sounds from your chest--I had popping sounds and my father said his was almost musical. Also, a lot of pain just to breathe is a symptom of pneumonia. Are you just coughing a lot or is it super painful to breathe? Still a good idea to check things out, but that might help give you an idea of what's up or not.
posted by mermaidcafe at 4:58 AM on December 12, 2014
posted by mermaidcafe at 4:58 AM on December 12, 2014
Also, fwiw, most bronchitis is viral, so the z-pack may not do a lot of good. I know bronchitis caused by whooping cough germs can improve with an antibiotic, but most other bronchitis won't respond much to antibiotics.
posted by mermaidcafe at 4:59 AM on December 12, 2014 [2 favorites]
posted by mermaidcafe at 4:59 AM on December 12, 2014 [2 favorites]
Best answer: As a long-time bronchitis suffer as a result of Valley Fever nthing that antibiotics do NOTHING! I've always had steroids and inhalers when it gets bad to prevent pneumonia. The cough medicine you get for this is NASTY but it works great.
Go to the ER, I'm suspicious of your doctor if he's handing out Zpac for bronchitis.
posted by Ruthless Bunny at 5:48 AM on December 12, 2014 [2 favorites]
Go to the ER, I'm suspicious of your doctor if he's handing out Zpac for bronchitis.
posted by Ruthless Bunny at 5:48 AM on December 12, 2014 [2 favorites]
OP, if you are having difficulty breathing, go to the ER.
If you can breathe fine, just call your doctor. Take plenty of non-dairy fluids. Sit up. There is no reason to stop taking mucinex before you see your doctor. Lung congestion can take a while to clear.
posted by zennie at 6:05 AM on December 12, 2014
If you can breathe fine, just call your doctor. Take plenty of non-dairy fluids. Sit up. There is no reason to stop taking mucinex before you see your doctor. Lung congestion can take a while to clear.
posted by zennie at 6:05 AM on December 12, 2014
Mucinex is not a decongestant, so long as it's the plain version; with enough water/fluids it should help thin out the mucus.
Seconding myselfasme's advice. (Hugging a pillow to your chest to cough may help if it hurts to cough.)
posted by cobaltnine at 7:27 AM on December 12, 2014
Seconding myselfasme's advice. (Hugging a pillow to your chest to cough may help if it hurts to cough.)
posted by cobaltnine at 7:27 AM on December 12, 2014
Did the doctor give you anti-viral meds for the flu? Something like Tamiflu? If not, call and ask them to. It can make the flu less severe if taken early.
posted by quince at 8:04 AM on December 12, 2014
posted by quince at 8:04 AM on December 12, 2014
Best answer: I'm an RN working in the ICU, and this makes me a little nervous. At the very least I would call your doctor's office and tell them what's going on. Ask if you can come back in so they can at least listen to your lungs, check your vital signs (you don't mention if you're having fevers or anything like that), and maybe get a chest x-ray just to determine how much fluid is in your lungs. Not being able to cough up your own secretions is not so good.
Unfortunately, I've seen a few cases where people (at least one who was your age) went to a doctor's office or emergency department and had antibiotics prescribed who then ended up in our ICU on a ventilator a few days later. The flu can sometimes get pretty serious even for young, healthy people.
If you're feeling short of breath, anxious, or lightheaded/confused, I would suggest heading to an emergency department. You know your body, and you know best if something is serious or just not right. I know it's expensive and just generally horrible to go to the ER, but you'll be seeing doctors and nurses who are familiar with this year's flu, and you'll get a second opinion. If you feel like you need a higher level of care than you've gotten so far, you should go.
If you feel like it's not as bad as all that, the suggestions above of sitting up, holding onto a pillow to help you cough, consuming adequate fluids, and taking mucinex should help. You might also benefit from a humidifier or at least a warm shower (just be mindful that standing in a warm shower could make you temporarily lightheaded as well and be careful that you don't fall.)
Good luck. Take care of yourself, and I hope you feel better soon.
posted by alittlecloser at 8:07 AM on December 12, 2014
Unfortunately, I've seen a few cases where people (at least one who was your age) went to a doctor's office or emergency department and had antibiotics prescribed who then ended up in our ICU on a ventilator a few days later. The flu can sometimes get pretty serious even for young, healthy people.
If you're feeling short of breath, anxious, or lightheaded/confused, I would suggest heading to an emergency department. You know your body, and you know best if something is serious or just not right. I know it's expensive and just generally horrible to go to the ER, but you'll be seeing doctors and nurses who are familiar with this year's flu, and you'll get a second opinion. If you feel like you need a higher level of care than you've gotten so far, you should go.
If you feel like it's not as bad as all that, the suggestions above of sitting up, holding onto a pillow to help you cough, consuming adequate fluids, and taking mucinex should help. You might also benefit from a humidifier or at least a warm shower (just be mindful that standing in a warm shower could make you temporarily lightheaded as well and be careful that you don't fall.)
Good luck. Take care of yourself, and I hope you feel better soon.
posted by alittlecloser at 8:07 AM on December 12, 2014
Best answer: You should probably ask for a second z-pack or something stronger.
IANYD, this is not medical advice but I'd like to highlight that this is not great advice (to get a 2nd Z pack), in fact, you probably shouldn't have gotten the first Z pack! Antibiotics are not recommended for bronchitis which is generally caused by a virus. The rampant overuse of azithromycin is part of the reason for increasing rates of resistance and that some infectious disease specialists are starting to tell physicians not to just decrease the use of azithromycin, to STOP using it altogether.
FYI a Z pack is a very broad spectrum antibiotic and it's really scary to me when people start saying 'you gotta go get something stronger', especially for influenza which is also a viral illness that is not improved with antibiotics.
That being said, you absolutely can develop a post-influenza pneumonia - your immune system takes a hit with the flu and makes it more susceptible. I recommend seeing your doctor again ASAP if you had started to feel better, and now feel worse.
oh my gosh, on preview, another medical piece of misinformation I need to correct. No Tamiflu!
Tamiflu is not effective at all for flu after the first 48 hours or so of symptoms, and it is questionably helpful even if used with those parameters. (Link is to a Cochrane systematic review from earlier this year that really drove home the point that Tamiflu's usefulness is extremely limited/either minor or negligible).
posted by treehorn+bunny at 8:10 AM on December 12, 2014 [2 favorites]
IANYD, this is not medical advice but I'd like to highlight that this is not great advice (to get a 2nd Z pack), in fact, you probably shouldn't have gotten the first Z pack! Antibiotics are not recommended for bronchitis which is generally caused by a virus. The rampant overuse of azithromycin is part of the reason for increasing rates of resistance and that some infectious disease specialists are starting to tell physicians not to just decrease the use of azithromycin, to STOP using it altogether.
FYI a Z pack is a very broad spectrum antibiotic and it's really scary to me when people start saying 'you gotta go get something stronger', especially for influenza which is also a viral illness that is not improved with antibiotics.
That being said, you absolutely can develop a post-influenza pneumonia - your immune system takes a hit with the flu and makes it more susceptible. I recommend seeing your doctor again ASAP if you had started to feel better, and now feel worse.
oh my gosh, on preview, another medical piece of misinformation I need to correct. No Tamiflu!
Tamiflu is not effective at all for flu after the first 48 hours or so of symptoms, and it is questionably helpful even if used with those parameters. (Link is to a Cochrane systematic review from earlier this year that really drove home the point that Tamiflu's usefulness is extremely limited/either minor or negligible).
posted by treehorn+bunny at 8:10 AM on December 12, 2014 [2 favorites]
A select quote from the Cochrane collaborative from the site above, on Tamiflu use:
"Compared with a placebo, taking Tamiflu led to a quicker alleviation of influenza-like symptoms of just half a day (from 7 days to 6.3 days) in adults, but the effect in children was more uncertain. There was no evidence of a reduction in hospitalisations or serious influenza complications; confirmed pneumonia, bronchitis, sinusitis or ear infection in either adults or children. Tamiflu also increased the risk of nausea and vomiting in adults by around 4 percent and in children by 5 percent. There was a reported increased risk of psychiatric events of around 1 percent when Tamiflu was used to prevent influenza. Evidence also suggests that Tamiflu prevented some people from producing sufficient numbers of their own antibodies to fight infection.
The worldwide use of Tamiflu has increased dramatically since the outbreak of H1N1 virus (Swine Flu) in April 2009. It was initially believed that it would reduce hospital admissions and complications of influenza, such as pneumonia, during influenza pandemics. However, the original evidence presented to government agencies around the world was incomplete. The Cochrane Review has benefited from access to more complete reports of the original research, now made available by the manufacturers, Roche and GlaxoSmithKline. Although the review has confirmed small benefits on symptom relief, there is little to justify any belief that it reduces hospital admission or the risk of developing confirmed pneumonia. Along with the evidence of harms from the medication, it raises the question of whether global stockpiling of the drugs is still justifiable given the lack of reliable evidence to support the original claims of its benefits. "
posted by treehorn+bunny at 8:13 AM on December 12, 2014 [2 favorites]
"Compared with a placebo, taking Tamiflu led to a quicker alleviation of influenza-like symptoms of just half a day (from 7 days to 6.3 days) in adults, but the effect in children was more uncertain. There was no evidence of a reduction in hospitalisations or serious influenza complications; confirmed pneumonia, bronchitis, sinusitis or ear infection in either adults or children. Tamiflu also increased the risk of nausea and vomiting in adults by around 4 percent and in children by 5 percent. There was a reported increased risk of psychiatric events of around 1 percent when Tamiflu was used to prevent influenza. Evidence also suggests that Tamiflu prevented some people from producing sufficient numbers of their own antibodies to fight infection.
The worldwide use of Tamiflu has increased dramatically since the outbreak of H1N1 virus (Swine Flu) in April 2009. It was initially believed that it would reduce hospital admissions and complications of influenza, such as pneumonia, during influenza pandemics. However, the original evidence presented to government agencies around the world was incomplete. The Cochrane Review has benefited from access to more complete reports of the original research, now made available by the manufacturers, Roche and GlaxoSmithKline. Although the review has confirmed small benefits on symptom relief, there is little to justify any belief that it reduces hospital admission or the risk of developing confirmed pneumonia. Along with the evidence of harms from the medication, it raises the question of whether global stockpiling of the drugs is still justifiable given the lack of reliable evidence to support the original claims of its benefits. "
posted by treehorn+bunny at 8:13 AM on December 12, 2014 [2 favorites]
Agreed with the advice above about drinking plenty of fluids, getting yourself upright instead of lying down, and seeing a doctor again since you're getting worse rather than better.
One other thing I wanted to add is to do deep breathing exercises every hour or so while you're awake during the day. Take 10 slow, deep breaths (not gasps or gulps but big, smooth in-breaths) and then breathe out normally after each one. Try to fill your lungs as full as possible by expanding your belly, your ribs, and your shoulders. This can help get some of the crud moving so you can cough it out, and also helps prevent the tiny air sacs (alveoli) in your lungs from collapsing. It's one of the most important things we do in the hospital to help avoid pneumonia in people who are at risk. If you were in the hospital we'd even give you a little device called an incentive spirometer that shows you how well you're doing at breathing deeply and slowly, but you can absolutely do the breaths without it. 10 good breaths in a row at the top of the hour, and try to go a little slower, a little deeper with each breath. Good luck!
posted by vytae at 12:05 PM on December 12, 2014
One other thing I wanted to add is to do deep breathing exercises every hour or so while you're awake during the day. Take 10 slow, deep breaths (not gasps or gulps but big, smooth in-breaths) and then breathe out normally after each one. Try to fill your lungs as full as possible by expanding your belly, your ribs, and your shoulders. This can help get some of the crud moving so you can cough it out, and also helps prevent the tiny air sacs (alveoli) in your lungs from collapsing. It's one of the most important things we do in the hospital to help avoid pneumonia in people who are at risk. If you were in the hospital we'd even give you a little device called an incentive spirometer that shows you how well you're doing at breathing deeply and slowly, but you can absolutely do the breaths without it. 10 good breaths in a row at the top of the hour, and try to go a little slower, a little deeper with each breath. Good luck!
posted by vytae at 12:05 PM on December 12, 2014
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posted by Lyn Never at 11:51 PM on December 11, 2014 [1 favorite]