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Ive got a really bad sore throat since yesterday morning. It

Ive got a really bad...
Ive got a really bad sore throat since yesterday morning. It hurts to swallow. Quick strep yesterday was negative
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Answered in 3 minutes by:
4/20/2013
Anthony Bray, MD
Category: Health
Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
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Anthony Bray MD :

Hello again!

Anthony Bray MD :

I'm sorry to hear that you have worsening sore throat....

Anthony Bray MD :

It sounds that you may need another antibiotic as you had to stop the Augmentin early....

Anthony Bray MD :

I would recommend that you have a follow up exam for your throat (as well as your sinuses and lungs...)

Customer: Pressing on the outside of my neck up to my ears causes pain
Anthony Bray MD :

It would be helpful to conintue the gargles severaql times a day... Listerine or salt water or 1:1 hydrogen peroxide/water...

Anthony Bray MD :

That would be probably due to Eustatian tube inflammation....

Anthony Bray MD :

These are the tubes from the middle ear space to the bck of the throat...

Anthony Bray MD :

A throat spray such as Chloroseptic would also be helpful.....

Anthony Bray MD :

Taking some Tylenol may help a little....

Anthony Bray MD :

With your recent sinus infection and some lower respiratory symptoms I suspect that you are likley to need and antibiotic again.....

Anthony Bray MD :

I hope this is helpful for you.. Let me know if you have further questions!!

Anthony Bray MD :

Best regards ***** *****!

Anthony Bray MD :

Anthony Bray MD

Customer: Im still on the prednisone will that help
Anthony Bray MD :

It would help to reduce inflammation BUT would NOT help any infection....

Anthony Bray MD :

Prednisone by itself may tend to weaken immune response to infection and this could actually make it worse....

Customer: Anything symptoms i should watch for?
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Hello again,

I switched to Q and A mode because I could not get the chat mode to reload on my computer for some reason....

Yes >> watch for worsening or signs of more extensive symptoms of respiratory infection >> increased sinus symptoms (pain , pressure, post-nasal drainage) ear pain, cough, fever, increasingly productive cough, shortness of breath...

These would be the things that I would watch for....

Since you were checked yesterday and they evidently your MD thought that your infection may be viral and did not place you anew on an antibiotic I would wait and see how this pans out over rest of weekend....then follow up Monday if it seems to be progressive... hopefully it won't be....

I hope this helps! Let me know if you have further questions. I will be happy to get back with you!

Best Regards,

Anthony Bray MD

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Customer reply replied 4 years ago
The dr didnt check me out. He just ordered a quick strep without seeing me

Hello again,

OK I see... well I disagree with that approach.. I guess with you in your situation I would probably opt to try and wait over the weekend and see how it goes.. be seen sooner if you feel worse... continue to watch for concerning signs/symptoms....

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

Anthony Bray MD

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Customer reply replied 4 years ago
Do you think its just a cold? My chest hurts to cough

Hello agin!

Well statistically viral respiratory infections are more common than bacterial. It is about 80% to 20 %...

Bacterial pattern is more of slow progressive pattern so watch for this type of progression...

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

Anthony Bray MD

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Customer reply replied 4 years ago
At least my pulse is back to normal 52

Hello again,

Well that is good news! That is quite a remarkable difference...

I'm glad to hear that it is back down. That is reassuring to me....

Let me know if you have further questions... Take care!!

Anthony Bray MD

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Customer reply replied 4 years ago
Im suppose to take librax 3 times a day. Will that make me tired and ok to take with restoril

Hello again,

Well Librax is of course for anxiety.... The Restoril is for sleep. They both will tend to make you sleepy of course. I would not advise taking the Restoril and Librax simultaneously ... I think that that would not be necessary.... If you take last Librax at say 800 PM then you still need help getting to sleep at say 1100 PM then OK go ahead and take the Restoril BUT I would just advise caution with the combo of the last Librax vs the added Restoril ... you don't want to overdo this....

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

Anthony Bray MD

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Customer reply replied 4 years ago
Gave me librax for ibs. But i dont want to tske it 3 times a day if its going to make me tired

Hello again,

Well I hope that it is helpful for you in this regard. You may do fine with it on twice a day basis. I would advise that you try that ...I was really more thinking of Librium (=chlordiazepoxide) which is one of two ingredients in the Librax... this has an anticholinergic ingredient in addition to the benzodiazepine... it is a mild dose of the "librium" component....

I hope this helps. Let me know if you have further questions! I will be happy to get back wtih you! Best regards,

Anthony Bray MD

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Customer reply replied 4 years ago
Im not going to quit taking the reflux meds

Hello again,

I agree with you on that!!

Take care,

Anthony Bray MD

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Customer reply replied 4 years ago
I know im probably being a pain. I have ringing in the ears. And have thrown up blood

Hello again,

Two separate problems there of course... First of all with the more serious... was this a small amount of blood as previously?? If this is the case then you would not need emergency treatment BUT if a large amount >> frank blood or coffee ground appearance then you might then need to consider going to ER ... we have discussed this issue at length previously of course... let me know if you have further details or question on this issue...

With regard to the ringing in the ears... this may benefit from a benzodiazepine (a small dose is present within the Librax but probably not enough to really help...) Valium is commonly used for this problem... Valium or other benzodiazepine works to Diminish the symptom but not eliminate it all the way...different causes of this problem are possible... evaluation of this by ENT may be helpful to you... Do you also have sense of vertigo?? Any decrease in hearing?? Cause of Meniere's disease is one of several possible causes (Meniere's produces triad of symptoms >>ringing, vertigo and hearing loss>> caused by too high pressure of inner ear structure>> this cause benefits from treatment with diuretic >> Acetazolamide often used...)

I have noticed recent advertising of OTC product >> Bio-flavanoids ( I believe) as being helpful to problem.. I can't vouch for effectiveness of this but if you should try this route I would be interested in your experience feedback... you may ask pharmacist with regard to this type of product....

I hope this information is helpful. Let me know if you have further questions, discussion and I will be happy to get back with you!! Positive feedback would be much appreciated!

Thank You and Best Regards,

Anthony Bray MD

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Customer reply replied 4 years ago
Im going to head to the er.

Hello again,

OK >> Good luck to you!! Let me know when you get back home....

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
My aunt whos 49 smoker just had a ct showed a mass covering a whole lung. What does it mean

Hello again,

Well it does NOT sound good at all for her I'm afraid...

A mass on the lung (your wording) sounds probably consistent with a tumor or cancer in other words.. of course I can't diagnose her based on just your second hand report. There are other reasons that a lung field may show opacity on a chest CT>> severe pneumonia would be another possible cause of "white out" of a lung...

If she has a complete opacity of one lung then either way it would be VERY SERIOUS and of a life threatening nature. I'm sorry that I can't offer more encouraging report on this... I hope that she gets good care and that it is of less ominous nature (as much so as may be possible) Further diagnostic steps (culture, bronchoscopy, biopsy) would be needed based on your report of her condition....

Best Regards,

Anthony Bray MD

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Customer reply replied 4 years ago
They told her its cancer

Hello again,

I see.. I'm sorry to her that your aunt has this very serious problem.

Best Regards,

Anthony Bray MD

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Customer reply replied 4 years ago
What do you think her prognosis will be

Hello again,

Well her prognosis may depend greatly on the specific type of cancer that she has... some are more responsive to treatment than others... if she currently has essentially a "white out" of one lung then this would sound to be probably very poor prognosis. I hesitate to say much with regard to prognosis with regard to her case as I really do not know the details of her case however.... your description makes her situation sound pretty dire....

I have had a patient with a grapefruit size tumor on initial diagnosis that survived beyond five years... not the typical case however....

I hope this is somewhat helpful...

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
She judt had ductus carcinoma in situ last yeAr

Hello again,

This may be a separate type cancer. I suspect that to be the case...Biopsy results will be needed to establish the diagnosis....

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
Er tested vomit. Tested positive for blood. Said inwas hemodynanically stable and to follow up with gi dr

Hello again,

I see>> well I am sorry that you are having so many problems>>

I'm glad that at least it is not worse!!

It is of course good that you are hemodynamically stable... with your recent episodes of the tachycardia this has been of concern to me...

Is your hemoglobin now better than last measure or about the same??

Let me know. I'll be happy to address further questions that you may have ... Best Regards,

Anthony Bray MD

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Customer reply replied 4 years ago
Its a little lower 10.9

Hello again,

I see... it is a bit low there so you are anemic. Your iron levels should be checked soon as well. You may have benefit to take an iron supplement if iron is low... Ferrous sulfate 325mg/day plus vitamin C (helps absorption) may be of benefit... I would wait and have your iron level checked first though...

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

Anthony Bray MD

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Customer reply replied 4 years ago
I am taking an iron supplement alreadyot

Hi again ,

I see>> well if you do not currently take this along with vitamin C 500mg >> this taking of the iron along with Vitamin C does help the absorption of iron... just a tip if you are not already doing this...

Take care,

Anthony Bray MD

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Customer reply replied 4 years ago
This is what ct report says
1) Large left hilar mass nearly completely occluding the left main bronchus. There is complete occlusion of the left upper lobe bronchus where there is collapse and dense consolidation
2)innumerable left lung nodules, including one cavitary nodule and one nodule measuring up to 18 mm in diameter. These likely represent metastatic disease

Hello again,

It still sounds very bad in terms of her probable prognosis BUT this does not describe a complete "white out" of her left lung either...

It sounds that her lung on the left side is probably about 40% compromised... (unable to exchange air)

It involving the hilar region will probably prove to be inoperable would be my guess.. it would be getting to the center of the chest and likely involving key vascular structures...

The metastatic nature and extent of her disease is of major concern. She will probably also need a head CT or MRI to rule out metastasis to the brain...

Her prognosis would still depend much on the exact diagnosis and the degree of susceptibility of the tumor.... Some lung cancers are very susceptible to radiation treatment for example...

Her care would probably be considered palliative ... (relief of symptoms and reduction of tumor burden without expectation of cure)

I'm sorry this has happened to your aunt.

Let me know if you have further questions.

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
How long would you guess

Hello again,

I would hazard a guess that she has probably about 70% or so probability that her life expectancy would now fall between 2 months to 18 months... with the remaining 30% split to about half of this being less and half greater....

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
Shut up

?????

>>>>

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Customer reply replied 4 years ago
That short of time

Hello again,

I can't be very certain you understand as I do not have the details and these details will impact her prognosis. Her tumor description is very bad I would say on face value from that...

I'm sorry that she has this >> I know that it is hard to deal with....

Take Care >> Anthony Bray MD

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Customer reply replied 4 years ago
Do you think it can be surgically removed? Chemo/radiation

Hello again,

No I doubt that she will have surgery. I think it more likely that a combination of chemo and radiation will be the more likely treatment strategy. Her oncologist will probably discuss this with her soon... I would imagine that a pulmonologist will be consulted to do a bronchoscopy procedure and obtain samples of the tumor...Her treatment options will depend a good deal on the type of tumor that it is...

I hope this helps. Again I'm sorry that your aunt has this....

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
This fricken sucks

Hi again,

Yes I realize that it does. I am very sorry that she is so ill....

Let me know if there is anything that I may do to be of help and support to you... Take care>>

Anthony Bray MD

Anthony Bray, MD
Category: Health
Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
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Customer reply replied 4 years ago
But she seems fine except for a little SOB

Hi again,

Well hopefully she may do better than what I think that she may.... we do not have a crystal ball and as I said I do not have all the details of her case AT ALL !! I hope that she DOES do better than what I fear from your description of her tumor!!

Let me know if you have further questions or discussion>> Take care,

Anthony Bray MD

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Customer reply replied 4 years ago
Since starting the prednisone ive been really thirsty

Hello again,

It may be a good idea to have your blood sugar checked. Prednisone may push up blood sugar and this could be the reason for increased thirst...

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
The other day fasting it was 136. My other question is ive been up all night coughing. What can i do for that

Hello again,

OK that would be a bit high for fasting>> I would suspect in this time frame that it is likely related to the prednisone. It needs follow up though ... I would advise a follow up check on fasting blood sugar and a hemoglobin A1C test...

For cough you may start with OTC such Robitussin or cough drops such as Sucret's or Hall's for example. It is concerning that your respiratory symptoms seem to be increasing since you stopped the antibiotic. I would watch this closely.

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

Anthony Bray MD

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Customer reply replied 4 years ago
It has got to be just a cold. I have congestion (nasal and chest) thick snot and a cough

Hi again,

Well hopefully it is just a cold.... If viral then it should be improving significantly by 7 days out...

I hope this helps. Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
Snot is green. And everytime i swallow it seems like im swallowing a mouthful if mucous

Hi again,

You may benefit to thin the mucus with taking Mucinex (or other product with guafenesin) plus drinking lots of water.. hopefully this will help...

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
I have 3 little sores on the inside of my mouth on my lip

Hello again,

These may be cold sores. You may try Abreva as an option. You may benefit to stop the Prednisone at this point if you do not still need it (I would not think that you would have an ongoing need due to that recent Augmentin allergic reaction) Steroids weaken the body's defense to viral infections and a viral cause of the sores of the lip are most probable...

If it is getting worse then you may want to see a doctor about this as you may have benefit to use an anti-viral Rx medication such as brief course of Valtrex or Famvir...

I hope this helps. let me know if you have further questions! Take care,

Anthony Bray MD

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Customer reply replied 4 years ago
Have you heard of nonerosive reflux disease? Do you think my symptoms fit that?

Hello again,

Yes >> this would just be a matter of having ulcers(erosions) or not...

You may very well have this. Endoscopy would be the most definite test to help distinguish if you had ulcers, esophogitis, gastritis, non-erosive reflux or disease free.. (I doubt the last based on your history...)

I hope this helps. Best Regards,

Anthony Bray MD

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Customer reply replied 4 years ago
Every scope ive had showed gastritis. So are you thinking its gerd

Hello again,

Yes I think that you have some reflux as well... you may also have gastritis the two would frequently co-exist...

I hope this helps!

Take care,

Anthony Bray MD

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Customer reply replied 4 years ago
Maybe i have mono

Hello again,

Well possibly I suppose but it does not sound like mono to me.. the sore throat could fit.. we don't usually see so much upper respiratory congestion with mono. Especially if it were a first episode for you then a bad tonsillitis with fever would be more typical...

I hope this helps. Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
Still think its a cold?

Hi again,

It is suspicious to me since you were diagnosed with a sinus infection but were not able to finish the course of antibiotic. Now you seem to have rebound symptoms... based on this I would bet a bacterial infection is actually more likely in your case... it could be either....vial or bacterial is certainly possible.. your progression of symptoms sounds more suspicious for bacterial infection to me...

I hope this is helpful for you. Best regards,

Anthony Bray MD

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Customer reply replied 4 years ago
Still have thick green mucous, sore tgroat still, cough, and the outside of my neck hurts to touch Sinus headache. How long do i give it to go away

Hello again,

I would give it about five days from its best point >> if it is getting better then give a few more days but if not or worse by this mark then I would definitely advise that you follow up with your doctor.(It is more common these days of course to hold back on too much antibiotic treatment to try to avoid over-treating the ever so common viral infections..) Of course at any point if you develop concerning progression of symptoms such as fever, shortness of breath, severe cough that disrupts your sleep, then be seen sooner vs later...

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

Anthony Bray MD

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Customer reply replied 4 years ago
My cough keeps me up at night esp if i lay flat

Hello again,

Well with the cough keeping you up at night then it would be prudent I think for you to follow up with your doctor tomorrow. (I realize that you must be tired of trips to the doc at this point!! Sorry!!) I think a good listen to your lungs would be advisable though. As I noted I have concern with regard to your history of being diagnosed with the sinus infection but having to stop your antibiotic prematurely. That treatment followed by your progression of symptoms over the past few days to me seems more suspicious for a bacterial infection bouncing back on you vs a new viral infection.

I hope this helps. Good luck >> I hope that you feel better soon!

Anthony Bray MD

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Customer reply replied 4 years ago
I have some old cherstussin cough syrup from like 1.5 years ago. Do you think it would be ok to try

Hello again,

It probably is OK but may be weaker...

Take care,

Anthony Bray MD

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Customer reply replied 4 years ago
Is it ok to take with the restoril?

Hello!

Yes it would be OK to take these in normal low doses together.

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
Can i listen to my own lungs. Id really like to avoid going to the dr once again
Hello again,
No I am afraid that I can't train you to listen to your own lungs!! I know that you must be tired of visiting doctors lately. I leave it to your common sense and sense of how sick you feel as to whether to see your doctor tomorrow or wait and see how things go a few days. This is a common decision scenario that plays out for thousands of people every day. I hope that you feel better soon.
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
Ive been trying to fall asleep but yhe coughing is keeping me up. And my chest hurts
Hi again,
You are just further convincing me that you should follow up with your doctor tomorrow...
I hope that you feel better soon! Best regards,
Anthony Bray MD
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Customer reply replied 4 years ago
Im more than likeky going ti see my dr today. Increase in chest pain, increase cough, increase SOB. And my pulse is back up to 120
Hello again,
Yes --- with the changes that you describe please do go to see your doctor today!!! With those changes on symptoms and signs I would be inclined to recommend evaluation to include a chest X-ray to help rule out pneumonia...
Best regards,
Anthony Bray MD
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Customer reply replied 4 years ago
Said my lungs sound clear. Gave me an rx fir promethazine with codeine
Hello again,
I see--- well I hope that it is just viral.... I hope that you feel better soon. The promethazine/ codeine would help with symptoms of cough and nausea. This should at least help you rest better at night.
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
My chest really hurts
Hello again,
What part of your chest hurts?
Does it hurt to take a deep breath or cough?
Do you feel shortness of breath?
Is your cough productive of sputum? ( if so then a sputum collection into a sterile cup may be helpful to determine if you have a pathogen = disease causing bacteria that may need antibiotic treatment)
Let me know and good luck to you!
Anthony Bray MD
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Customer reply replied 4 years ago
Under my ribs. It hurts a lot to cough. I cant take a deep breath without coughing. Rhe cough produces gunk Sob on exertion. Dr didnt want to put me on an antibiotic seeing that i just had a reaction to one
Hello again,
I see. Well I think that in your situation that you need to watch your symptoms carefully. I hope that your own immune system will beat back this infection. You will need to watch closely for worsening of your condition and get further help if this should be the case....
I hope this helps. Take care!!
Anthony Bray MD
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Customer reply replied 4 years ago
What do i need to watch for
Hello again,
You should watch for increased shortness of breath, wheezing, increased severity of cough. You should watch for fever( temperature above 99.9) You should pay attention to your pulse rate ... I am more reassured when this is down to normal range of 60 to 100. The more elevated that it is that it is above 100 then I would be more concerned. Increased pain/ discomfort would be of concern as well...
I hope that this helps guide you... Let me know if you have anything further!
Take Care,
Anthony Bray MD
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Customer reply replied 4 years ago
When do you think i should be feeling better?
Hello!
If your immune system is handling the infection well the I would expect you to feel better by about three - four days from now since you have been battling it a couple if days not at least and probably longer... So if you do not sense improvement say by the end of this week then I would advise that you follow up ( hopefully you will be feeling better and this won't be necessary)
I hope this helps -- Best regards ,
Anthony Bray MD
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Customer reply replied 4 years ago
The cough syrup isnt helping at all
Hi again,
It should take the EDGE off the cough at least. We don't want to excessively suppress your cough reflex because this helps to protect your airways!! So even though the cough is an aggravation it is necessary ....
Hang in there! Let me know if you have further questions...
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
In all honesty, do you think its viral
Hello again,
Honestly I doubt it... It may be or it may be a bacterial illness that your immune system will successfully negotiate... It is possible that your infection will need the benefit of further antibiotic treatment ... I understand your doctor' s reluctance to treat you further since your lung exam was clear . I'm sure that your doctor will place you back on antibiotics if in his judgement you are in need of them. Doctors will vary somewhat in these judgment calls--- that is quite normal..
I hope this helps. Let me know if you have further questions
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
Coughing up a whole bunch of green stuff
Hello!
Well that does sound concerning. Since you were just checked yesterday I would at this point try and give it more time and see if you improve on your own.... You may still need further antibiotic treatment... Time will help to tell if this is the case....
Take Care,
Anthony Bray MD
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Customer reply replied 4 years ago
Talked to my pcp he basically told me to suck it up. Such a compassionate guy he is. I talked to the other dr ive been seeing he gave me an rx for cipro for 10 days
Hello again ,
I think the Cipro will probably do the trick for you!! That would seem to me to be a good choice. I would agree with that move!
I hope that you feel better soon! Let me know if I may be if further help to you! Best regards,
Anthony Bray MD
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Customer reply replied 4 years ago
What does cipro treat.
Hello!
Cipro is a broad spectrum antibiotic which is used to treat a very wide range of infections. It is used to treat respiratory infections such as what you have. It is used to treat skin infections, urinary tract infections, GI infections( such as diverticulitis for example)
For respiratory infections the most common bacterial sources would include the bacteria ---pneumococcus, H.influenza(this is not the flu) and moraxella.... These have a degree if potential resistance to ANY given antibiotic but this potential is low vs Cipro--- so you would be expected to most likely have a good response...
I hope this helps! Take Care!
Anthony Bray MD
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Customer reply replied 4 years ago
How long will it take to work
Hello!
Typically I would expect you to feel improved by three days of treatment. I would not judge it to be a treatment failure though unless you were no better or worse by day five of treatment...
I hope this helps to guide you in what to expect. You still need patience for several days... It does take some time even with the antibiotics.
Take care!
Anthony Bray MD
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Customer reply replied 4 years ago
I opened a new page but someone else responded
Hello again,
Ok well you tried... Yes this thread is getting long again... What is your question?
I'll be happy to get back with you!
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
http://www.justanswer.com/health/7pz3j-think-start-antibiotic-wait.html
Hello !!
Thank you so much for the link! I found your question and have just now answered you on the new thread! I appreciate you starting the new thread. Let me know on that one if you have further questions!
Take care!
Anthony Bray MD
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Nurse Milli, RN

Nurse (RN)

4,051 satisfied customers

20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.

Dr. Ketch

Dr. Ketch

Doctor

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Medical Degree, Former Assistant Professor at School of Medicine at Yale University

DrRussMD

DrRussMD

Doctor (MD)

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Practice Director

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Dr. Arun Phophalia

Doctor (MD)

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MBBS, MS (General Surgery), Fellowship in Sports Medicine

Dr. Chip

Dr. Chip

Doctor (MD)

14,036 satisfied customers

Over 20 yrs of Family Practice

Dr. Mark

Dr. Mark

Doctor (MD)

6,234 satisfied customers

U.S. Physician/Surgeon in Neurosurgery

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Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

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