Pulmonary Patient History: Fill & Download for Free

Copd and asthma are very similar in their symptoms. Generally, we use a tool called a pulmonary function test, which includes a spirometry test, to differentiate them.Asthma shows an obstructive process that completely reverses to normal with use of a bronchodilator. Copd doesn't completely reverse.As for pneumonia and pneumonitis, chest x-rays and CT's readily identify them. They are frequently accompanied by fevers, chills, elevated white blood cell counts as well.Acute bronchitis is sometimes difficult to tell from exacerbations of chronic bronchitis. Mainly, we use the patient's history to tell us.

One of the best part about living is FOOD.!Don't you agree? If not read further.I am a 24 old guy with very average life style. I completed my bachelors two years back and got a job as management technician in a mobile manufacturing company.September 2018, I had a lump on the right side of the neck. I went to a local clinic and after doing some tests (FNAC, CT Neck, chest x ray and some blood tests) they told I have TB (extra pulmonary tuberculosis) and take TB drug for six months.After three months of medicine, the lump size never reduced and doctor had doubts regarding the treatment. He asked me to do the CT neck again just to confirm that the size got increased. He referred me to a neck surgeon and told that lump must be removed by operating and it could cost me more than three lakhs for surgery alone.I don't want to spend so much money so went to Government Hospital. I explained my medical history to them and they had some tests to be done on me. After test results they told the same thing as previous doctor that it is TB and also explained that it takes nine to twelve month to get away from the lump. They even showed me some previous patients history because I was very doubtful. Doubtful because I never had TB symptoms.Fast forward six months, no improvement. It's almost nine months that I am taking the TB drug and have nothing changed.May 2019, I was there for counselling and to my surprise doctors told me to undergo surgery (to remove the lump). I have decided to go for surgery because it's almost an year. After all the basic tests, I got the fitness certificate for getting operated and it took almost a month since Government Hospital. I couldn't go regularly due to work and for every single test it took almost a day due to crowd.4th June 2019, the operation day. I was told that the lump can not be removed completely because it is strongly matted with the neck and so they will do excision biopsy and check what it is. Operation was done and I was discharged after two days.After three weeks result came as Cancer. They confirmed that is not TB after these many days. Primary source of cancer was unknown so I was referred to various doctors for opinion. My parents doesn't want to waste time so went straight to an oncologist. He directed me for PET scan and found the primary source of cancer. Nasopharynx cancer it is. A tumor behind the nose part.I never struggled in this entire journey of growing a lump and finding it is as Cancer.It is the treatment that made my life hell. I was told to have radiation therapy combined with chemotherapy. Radiation therapy was given for 36 days with Saturday and Sunday off. Between these three cycle of Chemotherapy was completed.Radiation therapy drove me crazy. Third day into the treatment I lost my sense of taste. Two weeks into the treatment I am unable to chew the food, so it is liquid diet after that. The last ten days I even had difficulty in swallowing.Somehow everything ended within August and my taste sense never returned. I am still having liquid diet due to dental problems.Now I realize, what an amazing gift I had once 'the sense of taste'Imagine a life, where you can eat anything but everything tastes same which is tasteless.It will take some months to get my taste sense back and until thenI will be waiting to taste the food I love the most.Lesson learnt: ENJOY YOUR MEALEdit:My taste buds works fine and I am recovering. Thank you all for your kind words and prayers. It means a lot.

Here are some of mine.Patients telling me what they want to do based on what they have read on the internet - before they even ask me for my opinion. I've decided on this reply: "I can download a comprehensive manual for a Boeing 747 from the internet - but, as a passenger - would you really want me to be the one flying the plane?"Insurance denials based on "Coverage Policies" which exclude certain treatments based, not on what is best for the patient, but purely on cost. I've grown accustomed to having the "Peer to Peer" phone call, followed later by the written appeal, ultimately leading to a discussion with the independent reviewer (a radiation oncologist who apparently can't get a job actually working as a radiation oncologist - and who has zero experience treating patients with proton therapy). I ask them: "If you had the exact same brain tumor that my patient has, would you want treatment with conventional radiation therapy or would you want proton therapy?" These calls are always recorded. My question is invariably followed by a ten to twenty second pause and then the response: "I can't answer that" - meaning "They won't ask me to review cases for them any more if I tell you the truth."Non-compliance - It's amazing, but carrying the prescription around in your pocket isn't nearly as effective as actually filling it and taking the medicine.Trying to read computer generated consult notes/follow-up notes. Medicare (and other payers) require a certain quantity of information in each section of each type of note in order to bill a particular level of service. Nowadays, most of the "information" in the note is just fluff - inserted to fulfill the billing requirements - which wouldn't be so bad, except that you have to dig through all of the fluff in order to find what's really pertinent to the patient's history. Some of my consultants put the text they've actually inserted in bold - which helps a lot - but it's striking how little bold text there really is in a five page note.The electronic medical record - There are studies of physician productivity which show that on the average - a doctor can see only about half as many patients we used to - because half of our time is spent inputting everything into the electronic record. The amount of time we get to spend with each patient is reduced, since we have to type on our laptop while we're trying to interact with them.That new cancer treatment modalities are discouraged due to the financial interests of those using older modalities of treatment. The best example of this being Proton Beam Radiation Therapy.Proton Therapy (in properly selected patients) - as opposed to x-ray therapy (usually given today with a technique called Intensity Modulated Radiation Therapy or IMRT) is not a "new" modality of treatment for cancer (it's been used for over 50 years - starting with the Harvard Cyclotron), but it's availability has increased over recent years. There are now 15 Proton Treatment facilities in the US. It is FDA approved and is covered by Medicare for the majority of cancer diagnoses. It is not a panacea, but offers huge benefits in terms of limiting treatment related side effects and long term complications.Today (this is written 3/4/2016 - but the same is true every day) five breast cancer survivors will die from radiation induced heart damage, twenty cancer survivors will die from radiation induced secondary malignancies, thousands of lung cancer survivors are pulmonary cripples due to radiation induced lung fibrosis and hundreds of brain tumor survivors are living with radiation induced brain damage, hundreds of people have had to have some or all of their teeth removed due to radiation damage to the salivary glands, hundreds are deaf in one or both ears, hundreds are blind in one or both eyes, hundreds have limitation of joint mobility due to radiation induced scaring around joints or direct damage to the joint itself. Most of these problems can be eliminated by using proton therapy as opposed to conventional x-ray radiation therapy. I believe I have a moral obligation to disseminate this information in order to improve the quality of life for the 1.1 million cancer survivors added to the US population each year (especially in light of the anti-proton therapy propaganda disseminated by the special interest groups that profit from the use of conventional x-ray radiation therapy).Now the Stark Law was passed by Congress for the purpose of preventing physicians from referring patients to entities that they own for the purpose of profiting from the technical charges paid to those entities. For example, you shouldn't be able to buy a medical laboratory and then send all your patients there for their lab work, since, obviously, one might be tempted to order lab that the patient didn't really need if you were making money every time you did it. Unfortunately, there is a loophole in the Stark law called an "In-Office Exemption" which allows you to provide services in your office and collect the technical charges for those. So here's the ploy - A group of doctors build an IMRT center and each of those doctors go there one afternoon per week and see a patient or two - that then becomes one of their "offices", so they can claim the in-office exemption - then - every time they refer one of their patients to the radiation oncologist who manages the IMRT treatment of their patients, they get a kick-back of say $30,000. So if you are a surgeon who operates on breast cancers, you send ten patients to your IMRT center every month for their post-op radiation therapy and collect $300,000 in kick-backs - every month!!! I hope you're getting outraged by this point.The urologists were the first group of specialists to adopt this practice and there's a good link to a story in the NY times outlining the practice. Here's it is -http://www.nytimes.com/2006/12/0...So the greatest impediment to the use of Proton Therapy for cancer treatment is the IMRT gravy train.If you are interested in “No Nonsense” answers to serious medical questions, please follow me. (>200 answers on cancer, medicine and human behavior.)