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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6526
Experience:  14 years as clinician in the field of Family Practice
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Have a feeling of food getting stuck in my throat

Customer Question

Have a feeling of food getting stuck in my throat
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD : Hello!
Anthony Bray MD : Is this immediately upon trying to swallow?
Anthony Bray MD : do you have problem with liquids?
Anthony Bray MD : symptom sounds potentially concerning for problem such as esophageal stricture.... Has this been occurring for some time or just this AM??
Customer: It is when it goes down the wind pipe is where it feels like it get stuck. And a couple times a day after drinking i get coughing spells
Customer: I had a motility study. It showed that i high lower esophaheal pressure. And i had an upper gi series that showed i have a esophageal diverticulum
Anthony Bray MD : You may be aspirating... You should see a gastroenterologist .... It sounds that you need a modified barium swallow study to evaluate this problem further....
Customer: I have a gi dr
Anthony Bray MD : OK --I see --- it sounds then that you are symptatic from the esophageal diverticul then...
Anthony Bray MD : symptomatic ...sorry typo...
Customer: Will it just fix itself.
Anthony Bray MD : No not exactly.... More a matter if severity... Bad enough may need surgery....
Customer: How do i tell its severity
Anthony Bray MD : I would suggest that you follow up with your gastroenterologist...
Customer: I dont see him until the middle of may
Anthony Bray MD : well if you have severe trouble with your swallowing that is getting worse then contact the GI's office or be seen at ER....
Customer: Also my reflux has been horrible lately. Im burping up vomit. And my chest fels like its on fire constantly
Anthony Bray MD : Are you taking medication now for your reflux?
Customer: I dont know that i would say that i am having severe trouble swallowing
Customer: Im taking pantoprazole abd carafate
Anthony Bray MD : Are you on reflux precautions? --- Elevate head of bed 4 to 6 inches.... Wait 1.5 hours after eating before going to bed ... Avoid hot spicy foods or acidic foods... Tomatoes, citrus fruits, peppers, onions--- avoid coffee and alcohol ...
Anthony Bray MD : you already said you were restricted off of anti- inflammatory MEDS ...
Customer: He didnt tell me any of tgat. But my head is elevated. And i wait aftwr eating. And i avoid them foods. I am ordered to never take nsaids because they gave me multiple ulcers
Anthony Bray MD : OK you are on a good combination to help with reflux....
Anthony Bray MD : It sounds that you are doing all that you can to help but procedures to help prevent reflux( ex Nissan fundiolication) and procedure to fix the diverticula may need to be considered ...
Anthony Bray MD : Fundiplication
Customer: The gi dr i see now said hes done everything he can for me. He wants me to go to the mayo clinic
Anthony Bray MD : I see--- referral to surgeon whom performs the fundiplication
Anthony Bray MD : Procedure would also be an option ... This may be part of what your GI doc has in mind with referral to Mayo clinic...
Customer: I had a 24 hour ph and according to the gi dr i didnt have enough episodes of reflux to consider surgery
Customer: We have surgeons at our clinic who do that procedure
Anthony Bray MD : Ok it sounds that he has been thorough...
Anthony Bray MD : I would think he would refer you to one of your more local surgeons that perform this procedure....
Customer: Ok
Anthony Bray MD : I hope this helps some... Good luck in getting this taken care if!!
Customer: My gi dr wont refer me to a surgeon because im not having enough episodes of reflux in a 24 hour period
Anthony Bray MD : hmmm... What about the condition of your esophagus on most recent EGD??
Customer: It showed inflammation
Customer: Every egd ive had has shown inflammation
Anthony Bray MD : well that sounds expected... No diagnosis of Barrett' s esophagitis ???
Anthony Bray MD : It sounds to me that you would need procedures that we discussed....
Customer: Nope. They have all been basically normal besides inflammation. Besides the one that showed numerous ulcers
Anthony Bray MD : OK well that's good..
Customer: But i think maybe my symptoms could be from ulcers again. When i throw up there is blood. My hgb went from 15 something to 11.2 in less than 2 weeks. It was up to 12 something but now is down to 11.2
Anthony Bray MD : Wow ---you have so many problems going on! Yes you need to have the vomiting blood followed up and the anemia!!!
Customer: I was pretty healthy until this past year. Im sorry that i have so many things going on. My gi dr said he wont scope me again to check for ulcers. My uncle who is a surgeon said i need rescoping and he offered to do it
Anthony Bray MD : Right-- I agree that you need scoping again... Surgeons often do this procedure as well so hopefully you can get this checked soon!
Anthony Bray MD : how much blood have you been throwing up?? Bright red or coffee ground appearing??
Anthony Bray MD : do you have black tarry stools??
Customer: Ive been throwing up both red and coffee ground gunk. No black stools
Anthony Bray MD : if you have signs of severe ongoing blood loss then you may very well need to go to ER for this!!
Anthony Bray MD : The tachycardia of last PM could be a sign of blood loss as well but if this were the case then I would not expect your heart rate to be in the 50s today even with the Atenolol...
Anthony Bray MD : Still your vomiting blood now as you are is very concerning. I think you would be best to go get this checked more immediately at ER . ( based on previous discussions I suspect that you won't do this but seriously consider if you should do this!!!)
Customer: The er has never done anything before anout it
Anthony Bray MD : Well it would be a protective measure if your blood loss were ongoing... You could potentially need to be admitted for acute upper GI bleed and may potentially need transfusion
Customer: Im not throwing up a lot of blood. And my hgb isnt that low. http://s1280.photobucket.com/user/Kate_Miller2007/media/image-2_zpsf5e5f017.jpg.html
Customer: Do you still think er is a good idea
Anthony Bray MD : Hang on.... Only your last question is showing on my screen now... I guess I'll try switch to Q an A format....
Expert:  Anthony Bray, MD replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Customer: replied 1 year ago.
If its not a lot do i still gotta go to er
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again --

Haven't looked up link yet. I'll do that next... If not throwing up much then going to ER may not be necessary but you need to be careful in this decision!! I'm concerned that bleeding is internal and your blood loss may not be immediately apparent...

>>>>
Customer: replied 1 year ago.
Ok
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

I tried to look up pic but unable to find pic--- photobucket asks for a sign in and I'm not on that site....

>>>

Let me know how I may be of further help...
Customer: replied 1 year ago.
It wont let me attach a pic
Expert:  Anthony Bray, MD replied 1 year ago.
Sorry for the trouble....
Customer: replied 1 year ago.
http://m.flickr.com/#/photos/94762849@N06/
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

I made it to the photos this time and that was helpful . I don't think that you would need to go to ER based on this appearance ....

I hope this helps. Let me know if I may be of further help .

Anthony Bray MD
Customer: replied 1 year ago.
Do you think i probably have ulcers again
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Based on your past history and symptoms I agree that it would be a high probability of this. The small amount of blood in the vomit could be due to a Mallory-Weiss tear( recurrent vomiting may make an injury to the junction of the stomach and esophagus but this is not usually serious. ) still you have also mentioned the drop in your hemoglobin from 15 to 11.2(??) so this would remain a concern too and needs follow up soon.

I hope this helps. Take care... Let me know if you have further questions

Anthony Bray MD
Customer: replied 1 year ago.
Im just frustrated with all my medical issues
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

I'm sure that you are....I'm sorry that you have to deal with do much. Hopefully things will get better for you. Some things like your migraine headaches I think may be really improved with good treatment. Some if your problems are more challenging I realize. Hang in there

Best wishes to you. Let me know anytime if I may be of further help !! Thank you for your accept and positive feedback yesterday!! Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Ill ask my dr for a referral to neurology
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again ,

I agree-- I think that will be helpful for you.
Customer: replied 1 year ago.
Of someone gets punched in the knee can it do any damage
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Well --yes if hard enough punch it could injure the knee... In general this large joint is pretty study though and not easily significantly injured by a fist punch... Superficial bruise would be the most likely outcome of this...

I hope this helps>> Take care,

Anthony Bray MD
Customer: replied 1 year ago.
Im having a panic attack and crying
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Hang in there on the panic attack these will calm down in about 30 minutes...

No doubt the crying is part panic/anxiety/depression... Not sure at this point if you should go back up on the Zoloft or if that was causing the paresthesias that you had...

Try to distract yourself with talking with me, someone else, TV as options...

>>>>>>
Customer: replied 1 year ago.
I cant keep doing this
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

If you have panic attacks too then you would benefit from adding an anxiety medicine such as Klonapin, Xanax, Valium or Ativan would help. Many docs are very reluctant to prescribe benzodiazepine class though due to abuse potential...( other choices are also possible options)

At any rate I have no doubt that seeing the psychiatrist should benefit you -- even if not until May it will be here before you know it....
Customer: replied 1 year ago.
Im not going to make it until may
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Yes you will make it. You are suffering a rough time right now but it will get better!! It may be hard to believe at this moment on time but this passage of suffering will be in the past and your life will get better (ups and downs if course as everyone has but there will be sources of happiness for you too....)
Customer: replied 1 year ago.
Im not crazy
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

I never accused you of being crazy! Trying to be helpful !!

>>>>
Customer: replied 1 year ago.
My eating disorder sucks right now too. Nothing is right
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

Eating disorder???
Customer: replied 1 year ago.
I have an eating disorder. Some dr say i have anorexia and others say bulimia. I lost 55# XXXXX less than 2 weeks
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

What has the time course of this been? Have you been losing weight lately ?? Have you been inducing the vomiting??
Customer: replied 1 year ago.
It was suppose
To say 2 months. Lately i havent been vomiting but in the last 2 week ive lost 9 #
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I see . The weight loss due to your lack of appetite or anorexia may be leading to poor nutrition which would be a factor that could lead to or worsen your ulcers ( possible ulcers)

Would advise adding supplement for nutrition such as Ensure or Boost...

What is your height and weight currently??
Customer: replied 1 year ago.
Ive tried ensure and its nasty
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again, Even regular milkshakes help! Cook Out has a great variety if this chain is in your area...
Customer: replied 1 year ago.
That chain isnt around here. I dont want to get fat
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again, The point is not to get you fat but to STABILIZE your weight and SUPPORT your nutrition. Ulcers won't heal if you have very poor nutrition. Losing weight puts you in a catabolic metabolic state which limits your body's capacity to heal!!
Customer: replied 1 year ago.
But when i was scoped the end of feb i had no ulcers
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again ,

Well you have been concerned today with the vomiting and noting some blood. Also you have the concerning drop in hemoglobin. I had the impression that you also FELT similar to past when you had been diagnosed with ulcers. I think keeping your weight STABLE would make sense....not saying that you must gain weight ...

Also for reasons that we have discussed already it would be best for you to have a follow up endoscopy....

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
I know but my gi dr wont do it
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

Right I know ... You told me that earlier ... You said that your uncle is a surgeon and may do it for you... Other surgeon would be an option and your GI doc wants you to go to Mayo clinic...

>>>
Customer: replied 1 year ago.
Mayo clinic is a 4.5 hour drive
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

I see-- that is pretty inconvenient-- it will be up to you as you have a few options for the next step...

Let me know if you have further questions. Best regards XXXXX
Customer: replied 1 year ago.
What would you do if you were me
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,I would probably get an endoscopy done by a local surgeon and seek a surgical referral to consider repair of the diverticula and a Nissan fundiplication. Depending on your insurance requirements you may be able to self refer and make your own appointment or your primary care doctor could refer you to a surgeon. ( it does not have to be referral by the gastroenterologist) You may opt to have the endoscopy done by your uncle but most medical boards frown upon treating family members. I hope this helps. I would ask that you continue to periodically accept and leave positive feedback for my time! This is very much appreciated. Thank you and best regards,Anthony Bray MD
Customer: replied 1 year ago.
What are the criterias for doing a nissan fundiplication
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,I'm not sure of the specifics here since I am neither a gastroenterologist not a surgeon whom performs this procedure. Usually these judgment calls have some difference of opinion. Insurance requirements may come into play. The severity of symptoms, complicating factors such as asthma related to reflux or the diverticula in your case. If you should have recurrent ulcers then I would think that this would support necessity of the procedure. It sounds that your GI doc concluded that you may not be insurance qualified based on the pH probe study but I think that a second opinion and repeat EGD would be called for. Personally I would be at the point to refer you to consult a surgeon but the decision to proceed with surgery would be between you and the surgeon. I hope this helps... Let me know if you have further questions>>>>
Customer: replied 1 year ago.
Is there a certain diet you have to follow aftewards
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I would say the main thing would be to watch out for meats and anything that had potential to cause obstruction. You would be provided with detailed graduated diet if you had this surgery. Initially in recovery this would be liquid diet- then bland/ soft....
Customer: replied 1 year ago.
Is there any other meds i can try for reflux
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

You are pretty much on max therapy with Protonix plus Carafate...

Reglan could be potentially added as this speeds the emptying if the stomach and may help some to support the lower esophageal sphincter tone.

A past med Propulsid was helpful but has been taken off the market( there are special cases but very difficult to obtain this anymore)
Customer: replied 1 year ago.
Would surgery help reduce the pressure in my lower esophagus?
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

It seems that we have a mis- communication here. The surgery would reduce the sense if pressure from reflux. It would tighten the LES( lower esophageal sphincter) if you mean back pressure up in the esophagus from reflux then YES-- the surgery would reduce this. It just seemed to me that we have carried on a bit of mixed signals in the last question or so .... Trying to make sure that we are clear on what the surgery would accomplish...

I have also been offline several hours---will be off and in tonight if you have further questions!

Best regards,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6526
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 2 other Health Specialists are ready to help you
Customer: replied 1 year ago.
TAlked to the gi dr he added ranitidine 300 mg at bedtime to the protonix and carafate
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

OK >> this combination uses two mechanisms to lower the stomach acid. Hopefully this strategy will be helpful for you.

 

Let me know if you have further questions!

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
What can i do for a suspected sinus infection
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well if you have a sinus infection then these are going to be bacterial in nature.. (sometimes a viral upper respiratory infection may lead to stagnant fluid in the sinuses.. once you have stagnant fluid in the sinuses over a period of time this usually becomes overgrown with bacteria)

 

You would benefit to see your doctor and be treated with an antibiotic if you have a typical sinus infection. A ten day course of antibiotic treatment is standard for this. Using this along with a product such as Mucinex D would be helpful to clear out the infected sinus. (Plain mucinex is over the counter and Mucinex D (also has decongestant is behind the counter at pharmacy)

 

I hope this helps! Let me know if you have further questions!

 

Thank you for your positive feedback! Best regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Its like the 3rd one in 2 months. Ive alreadt done 2 courses of augmentin
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well I would advise that a different antibiotic be chosen this time as the recent treatment with Augmentin would increase the likelihood of resistance. Levaquin may be a good choice in your current situation. This will be up to your doctor of course however...

 

I hope this helps some... Let me know if I may be of further help to you!

 

Best Regards,

 

Anthony Bray MD

 

PS as a prevention measure you might ask about obtaining the pneumovax vaccine >> protects against 23 strains of pneumococcus bacteria = most common cause of bacterial respiratory infection....

Customer: replied 1 year ago.
How do they know when to treat a sinus infection
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

In general this is a clinical judgment call based on exam and finding tenderness over the sinuses on exam or signs of purulent discharge, inflammation of the nasal passages that appear consistent with this diagnosis. Sometimes a sinus CT may be performed. This may be the case especially if very chronic case or too many recurrent infections.... This might be considered in your case...

 

I hope this helps! Let me know if you have further questions!

 

Best regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
I have sonus pressure, headache and congestion
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

 

It does sound that you need to be checked for this by your doctor again then...

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Does it sound sinus
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

Yes it sounds consistent with a sinus infection>> how many days has it been going on?? Runny nose > clear or yellow /green? Post nasal drainage?

 

Increased number of days > especially > 7 days would be more consistent with bacterial sinus infection vs possibly just a viral URI...

 

I hope this helps. Let me know if you have further questions!

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
4 days. Green nasal discharge Lots of post nasal drip
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

The nature of the discharge and the sinus congestion and headaches >> all make me think it sounds more consistent with a bacterial sinus infection. You could opt to try a few days of Mucinex D by itself but I suspect that you will probably do better being on an antibiotic sooner vs later... (some docs may disagree with the argument of it being preferable to hold off to avoid possibly over-treating for viral infection) If the symptoms have been getting progressively worse over the last several days then this would also be consistent with a bacterial sinus infection...

 

I hope this helps. Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Ive been doing sudafed and mucinex
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

That's good. This would tend to help. It is sounding to me that you will probably need an antibiotic course again though....

 

Take Care!

 

Anthony Bray MD

Customer: replied 1 year ago.
I will call my dr tomorriw
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

I agree that is the best idea. Good luck! I hope that you feel better soon!

 

Anthony Bray MD

Customer: replied 1 year ago.
Should i ask for a different antibiotic then augmentin
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

You might gently suggest this...YES ....of course doctors LOVE being told what to do!! ;)

 

Good luck!

 

Anthony Bray MD

Customer: replied 1 year ago.
Last question. What does it mean if the lower esophageal pressure is 59
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

I really do not deal with this test directly...always ordered by GI specialists ...SO .. I can't interpret this particular result for you quite honestly...

 

Let me know if there are other questions that I may be able to help you with though...

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
What do you think of restoril for sleep
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

It is a good sleep aid. It is generally effective.

 

Let me know if you have further questions, Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
30 mgs nightly
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

That is the higher dose that may be used. How is that working for you?? How long have you been taking it??

 

>>>>

Customer: replied 1 year ago.
I sleep really well. I am groggy in the morning when i gst up. About 4 in the morning i wake up and get restless before i fall back asleep. Ive been taking it since monday
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

So the early AM awakening >> is this before or since you have been taking the Restoril??

 

I would be sure to go to bed at consistent time.... this will help to set your body clock... will help the medicine to be more effective....

 

If the early AM awakening pattern continues (a pattern common with depression then Trazadone may be another option to consider...)

 

I hope that this helps. Let me know if you have further questions!

 

Take Care!

 

Anthony Bray MD

Customer: replied 1 year ago.
Efore the restoril i would wake up multiple times a night. When taking thevrestoril i wake up early and am restless. And ut feels like i just got to move around and eventually i get back to slerp. I go to bed at the same time.
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

This description makes me wonder if you may have some RLS (= restless leg syndrome) going on....

 

It sounds that the Restoril has improved your sleep then but incompletely....

 

A sleep study might be considered if this continues to bother you...

 

A trial of med to help with RLS may be another route to consider....

 

I would advise that you discuss these angles further with your doctor...

 

I hope this helps. Let me know if you have further questions!

 

Best regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
My dr put me back on augmentin
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well I will tell you that Augmentin IS my favorite choice as well for a sinus infection. The only thing I worry about is that in general if you use and antibiotic for a second course within 2 moth period then this does carry some increased risk of resistant bacteria. Hopefully the infection will still respond to it however..

 

If you have a treatment failure and it does not cl;ear with this then your doctor would change antibiotic...

 

I hope this helps! I hope that you feel better soon!

 

Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
This isu my 3rd round of augmentin. He put me in the 500-125 mg 1 tab three times a day for 14 days. With 1 refill
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Yes I realize that. Hopefully it will still work for you this time though. You might have a treatment failure but it may still work for you...

 

Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
How do they test for rls? Also when i stretch my leg shakes
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again!

 

Technically the best way to test for RLS is to have a sleep study.

 

I have also based decisions to try treatment based on a patient's symptoms and then have a follow up to see how well the medication works. BTW > there are several potential options to treat RLS >> Mirapex and Requip have FDA indication for this condition BUT also used off label and studies and effective have been Klonapin, Sinemet and Neurontin....

 

I hope that this helps.

 

Take Care!

 

Anthony Bray MD

Customer: replied 1 year ago.
But i dont have any reason to get a sleep
Study
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well technically the suspicion for the diagnosis for RLS could justify. For many it is simply more practical and cheaper to try a medication if a patient is symptomatic and use this trial as a test in it's own right. I was just trying to lay out your potential options. You may discuss this issue with your doctor of course... Different practioner's may have slightly different approaches on evaluation and treatment of RLS...

 

I hope this helps. Let me know if you have further questions.

 

Take Care!

 

Anthony Bray MD

Customer: replied 1 year ago.
Last question. I sound wheezy upon exhaling
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Any cough?? This may be associated with your sinus infection. Often an upper respiratory infection may lead into a lower respiratory infection... so that would be one possibility...

 

Are you a smoker or former smoker?

 

Do you have history of asthma?

 

Are you having any cough as well?

 

Do you have any pain in the chest or back with taking a deep breath?

 

Any shortness of breath??

 

Let me know and I'll get back with you!

 

Tack Care>> Anthony Bray MD

Customer: replied 1 year ago.
No cough. Never smoked. No asthma. My chest hurts a little but breathing doesnt make it worse
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well I would presume that it is not that bad at this point but something that you have noticed. If this gets WORSE over time or you develop increasingly alarming symptoms of lower respiratory infection then you might need to follow up with your doctor.

 

I would not be concerned about a bit of a cough that did not awaken you from sleep. I think this is likely to occur and HOPEFULLY your infection will be covered by the Augmentin! If you develop fever // shortness of breath // pain with taking in deep breath then these would be concerning type symptoms that I would suggest that you pursue follow up!

 

I hope this helps! Let me know if you have further questions! Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
I know you are probably sick of hearing from me but how long will it take the ranitiine to work
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

No, I am not sick of hearing from you!

 

The Zantac will start to do what it does within the first 24 hours >> HOWEVER > it may take longer for sensitive areas or injured areas of the esophagus to HEAL >> this may take weeks >> so clinically I would anticipate possible gradual improvement in symptoms over next 1 to 4 weeks...You DO need to keep good nutrition and weight constant to heal well....

 

I hope that this helps. I hope that you feel better soon!

 

Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
Yesterday i ate english muffin with jelly and cream cheese for breakfast. For lunch i had popcorn wnd a banana. For supper i had some applesauce. Thats a typical daily diet. Good enough
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Yes I think so.

 

Keep track of weight and make sure that you are not still losing.... could lack calories to keep weight stable...

 

I hope this helps.

 

Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
But im still losing weight
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

As I said before milkshakes would help this... you don't have to overdo it but it is a good way to boost calories without hurting your stomach or esophagus... Boost / Ensure you have said you don't like... You need to have good nutrition to heal well though >> that is for sure! I've seen scenario many times > patients don't feel like eating or eat very little but ulcers need resources from the body to heal...this means good nutrition >> all the meds in the world will not help if you eat poorly....

 

I hope this helps. Take Care!

 

Anthony Bray MD

Customer: replied 1 year ago.
Does my current diet have enough nutrition in it
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well as you say that you are losing weight > probably not...

 

I presume that you do not eat the exact same thing everyday as you listed above.... if only this it would appear to me to lack adequate protein, You may benefit to consult a registered dietitian for assistance in this regard as well. This could be a useful resource for you....

 

I hope this helps! Best Regards!

 

Anthony Bray MD

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