“Cushing’s syndrome is a clinical manifestation of the abnormal excess of glucocorticoid hormones over a long period of time and all its consequences. Excess glucocorticoid hormone can be caused based on external (exogenous), which is relatively often found in patients who receive long-term corticosteroid therapy. “
Questioner: Aghniarie (RH)
NarasiPost.Com-I have complaints of shortness of breath & cough, every day taking medicine because every day relapse.
Approximately 7 years of treatment & consultation according to an internal medicine expert to a lung specialist but there is no clarity of what the disease is and I have to undergo treatment how outdated. Already 4 or 5 X-rays resulted in the same bronchitis pneumonia.
Last treatment at a pulmonary expert, my lungs have no disease but my lungs are full of smoke, my lungs have been damaged. I’m 30 years old but the lung conditions are like 65 years old heavy smokers. So it can not be treated, take drugs or not permanently will recur.
I’m only told to go back when the medicine runs out.
Of the various drugs that I have gotten from various doctors (ranging from generic doctors to an expert) there are three drugs whose effects are relatively long to reverse nyesek.
But there are mom’s concerns. In addition to risi affect the kidneys are also worried about getting fatter. I took this medicine for almost two years. My generally 49kg weight is now up to 76kg. Because the term herbal specialist “dexamethasone” this is influential in fattening the body.
Is there another solution mom, if it is difficult to heal. At least there are other drugs that can replace dexamethasone, so that my weight does not increase. Honestly mom, I’m so scared. I take the medicine every day, because every day relapses.
In the past, You and Brother were heavy smokers, if you often exist outside the house (work because of the age gap of 10 years) while you from childhood are quite close (I like to playin asep cigarettes made in circles the Father) first Mother uses mosquito repellent on the dwelling for mosquito repellent. If the cook has been using a stove not firewood.
Before he died, he had chronic lung disease.
The beginning is often crowded since high school second grade when activities are very dense in addition to school, participate in poly exkul &organization, eating is often late. (That time is at least a month or 2 months once relapsed). If it recurs every day. It used to be junior high school, elementary school to toddlers there are no complaints of tightness.
Since the disease of tightness & cough. If there is dust that is over (e.g. being clean at home) exclusive sneezing & relapse (sesek also cough), if the impact of extreme cold sometimes relapse sometimes not. Before there are complaints of tightness, there is no impact of dust or cold, fine aja, no problem.
Assalamualaikum wa rahmatullahi wa barakatuh, Mbak RH who may be blessed by Allah.
Thank you for wanting to develop the story to Rubrik “With doctor Nisa”, hopefully I can give an answer that can answer the anxiety of Ms. RH so far.
I’m permission to conclude first yes.
So Mbak RH who is 30 years old, complained of tightness and coughing since the last 7 years. This complaint is missing, has been treated to various doctors, but there has been no restoration. The results of the examination of chest X-rays are said to be “Pneumonia Bronchitis”. By one doctor a pulmonary expert said that “the lungs are already damaged, filled with poly smoke for example the lungs of heavy smokers aged 65 years”. Complaints increase in weight when experiencing fatigue, or exposed to poly dust.
Family history, father &brother is a smoker. He died of chronic lung pain. Riw
Currently there are 3 drugs such as attached photos, namely Salbutamol 4 mg, CTM 4 mg, &Dexamethason 0.five mg. This drug is routinely taken in the last 2 years, and most provides a better complaint control effect. It’s just that currently patients experience a weight gain of 27 kg in the last 2 years after the consumption of the drug.
The question: Is there a replacement drug Dexamethason for complaint control but that does not make weight gain?
The answer, God willing there is, there are other therapeutic options that are less minimal risk of impact in addition to the increase in weight earlier.
Based on the Guidelines or Guidelines for International Treatment summarized in the “Global Initiative for Chronic Obstructive Lung Disease, 2017” or abbreviated gold 2017, treatment using corticosteroid drugs (e.g. Dexamethason earlier) on a long-term basis is no longer recommended. Because it will cause side effects in the form of Cushing’s Syndrome (Cushing’s Syndrome) which is iatrogenic.
Cushing’s syndrome is a clinical manifestation based on an abnormal excess of glucocorticoid hormones in a long time and all its consequences. Excess glucocorticoid hormone that occurs in RH causes according to external (exogenous), which is relatively often found in patients who receive long-term corticosteroid therapy. Well, this is what nir poly people know that actually in Herbal Sore Linu which is considered to be ‘herbal medicine’ turns out to contain corticosteroid drugs in a high dose. This is also not uncommon as the cause of the emergence of Cushing’s Syndrome exogenously for example in this RH problem. So teak with herbal medicine or herbal medicine that is sold freely & cheaply in the market, because the contents can also contain chemicals with doses that are not in accordance with the dose.
Returning to Cushing’s Syndrome, one of the symptoms based on Cushing’s Syndrome is central obesity or obesity due to fat buildup in the abdominal region, can be known with increased weight and increased waist circumference. It’s great if Ms. RH has attention to the side effects of this drug, I really appreciate it. Because in addition to obesity, Cushing’s syndrome also has other relatively dangerous symptoms, such as high blood pressure, heart disorders, impaired blood sugar metabolism, kidney disease, and have a higher risk of exposure to infection because the body’s resistance decreases (immunocompromised). So it must be done tapering-off or decreased dose of Dexamethason in a smooth until it can be stopped thoroughly (off).
if stopped, how to use complaints of tightness and cough that have been felt before?
If I analyze complaints of tightness and cough that MS. RH naturally refers more to Chronic Obstructive Pulmonary Disease (COPD). Because it is strengthened based on the results of X-rays that are said to be ‘full of smoke like smokers’ lungs’.
Why be able to, get COPD when Mbak RH does not smoke?
Ms. RH is a victim based on the smoking habit of more or less people, or better known as Passive Smoking. The effects of lung damage on passive smokers can indeed be more severe. As an image, if we are in one room for 1 hour using people who smoke, then the poison we breathe is the same as we smoke 35 cigarettes at a time! Moreover, MBAK RH since childhood has been exposed as Passive Smoking, so it is not strange if at the age of 30 years only his lungs have been damaged for example smokers aged 65 years.
My advice, try to consult again using another pulmonary specialist, for Second Opinion or a second opinion from another expert, related to routine treatment that is currently run and diagnosis for sure.
Because to say someone has COPD, in addition to using a lung X-ray actually also needs to be done Spirometry. That is an examination to find out the function of our lungs, based on it can be seen whether due to blockage or temporary constraints. After that will be done bronchodilator test, as a result can be known whether the blockage is reversible (can return to normal) or irreversible (settled).
If it turns out that copd disease is known from these inspections, it will also be determined the degree of the disease. Later MBAK RH will be guided to fill out a CAT survey (COPD Assessment Test). From the classification of the degree of severity this will be determined the next treatment plan, of course using also assessing the frequency of recurrence that occurs & controlling risk factors in each patient.
What are other therapeutic options besides the drug dexamethasone?