I will present to you a case I found today, quite an interesting case, from many aspects. Let's see...
An 80-year old Chinese grandfather complained of 2 weeks non-stop coughing. He was afebrile, tired and just laid in bed.
Upon probing, he said: "I'm not dead yet!" He continued coughing ... and tried to close his eyes to sleep.
A habit becomes noticeable at lunch time; when he ate, there was no coughing at all. After he completed his plate of rice, he started coughing again. What could his problem be? What are probable causes?
He went straight to bed after lunch, coughed and tried to sleep.
What could his problem be?
Upon further probing, he said: "I want to live another 10 years because all my ancestors died at about age 90!"
Well, well, well! So the patient has a wish ... and that is ... he wants to continue living another 10 years. But what do we do about his coughing? How do we relieve that and give him back his health, so he could live another 10 years?
Good thinking ... someone suggested to do a chest x-ray and see what that says. Well, today's Friday, and a chest x-ray can only be done on Sunday. What can we do?
Further probing gave this information: His children had taken him to an expensive hospital where the doctor examined him and gave him medications worth RM50, but the coughing hasn't subsided.
My questions are: What did the doctor at the expensive hospital give him? Why did this patient expect to be cured when he paid an amount of money to the doctor? Does money paid mean a cure will be successful?
What are the dangers and consequences of leaving chronic cough untreated? What is the urgency in this type of cough that is refractile to prescribed medicines?
What do we do next? How do we proceed?
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