Mother having severe coughing and xray shows some issues. How concerned should we be?

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Hello all... Really need to figure out if we should be really worried right now. 75yr old female 4'11" 128lbs White. Been having productive cough (sometimes green) for at least 5 or 6 weeks. Breast cancer in left breast triple, negative Partial mastectomy 5 1/2 years after cancer treatment started, so far no re-occurrence. Medications: Methotrexate, duelera 200mg/5mg inhaler, prednisone (took for 5 or 6 days), Simbastatin 10mg, lisinoproil 20mg, Buspirone HCL 7.5mg 3x day, Flonase, vitamin D, ALSO: Cefdinir 300mg Chest xray showed "left lung increased right vascular OPACITIES with a small right pleural effusion." So her doctor, who we don't have much confidence in, says that she has pneumonia. But he also says that she could have cancer again. Chances are 50/50 he said. He did not admit her to the hospital. How concerned about cancer should we be? And how concerned about pneumonia? I know that the Methotrexate causes immuno-suppression, so that's the likely cause of pneumonia. Thank you so much in advance for your advice.

Answers 1 to 8 of 8
Top Answer
A productive green cough is usually suggestive of pneumonia. If this woman has had it for several weeks, I'd suggest you go to the ER tomorrow.

You ask a lot of questions that really should be answered by a treating physician. If you don't have confidence in the existing one, find one in whom you do have confidence.

Is she seeing a pulmonary doctor for her respiratory issues, and an oncologist for the potential reoccurrence of cancer?

"How concerned" should you be? Very concerned, I would say. Even though she's still young, these are not issues to be taken lightly.

There's a lot going on with this woman, especially with the productive green cough and the possible reoccurrence of cancer, and she's also taking a lot of meds.

I wouldn't be asking questions of an online forum but rather finding doctors you do like to address treatment.

I don't mean to be rude, but I'm a bit troubled by the approach of wondering if you should be worried. Why take the chance? If there is something more serious going on, you don't want to chastise yourself later if treatment could be obtained now, or if the condition becomes worse.
Being really worried doesn't seem to be particularity productive, to me. But being proactive to get some answers and get some treatment started if applicable seems very appropriate at this time.

May I ask why you continue with a doctor you have little confidence in? Does Mother have confidence? Does she insist on continuing with him? If not, this might be a good time to switch.
Unfortunately, I cannot convince her to change doctors. I've tried. Her doctor said that she should come back in 10 days to see how she's doing.
Ten days???

I trust, I would expect, that the doctor also said that if you're worried in the interim, or your mother seems to be worse, you should bring her back straight away for a further examination.

Let's assume/pretend he said that, and that his office isn't answering the phone for some reason - probably gets really busy in the 'flu season - and so just to be on the safe side we'll pop down to the nearest ER (preferably with the latest x-ray and any bloods) and get someone to check mother over.

"Afore ye go..." have a good think about what you would like the outcome of this to be. Admission? Treatment? Further investigations? Always best to have a clear idea of what you're aiming for.

How long has she been on the antibiotic?

It took 6 weeks of coughing to GET her to the doctor?

Has she had regular followups with her oncologist for the past 5 years? And regular chest films each year? And this one is significantly different? Or has she not really had any followup?

How is she feeling? Malaise? Or is she perking up since the antibiotics and prednisone started?

If she is still feeling unwell after three days of the antibiotic, I'd say it's the wrong one and get her back to the doctor. (I'm not a doctor; my mother had pneumonia several times, and I learned to recognize when the treatment wasn't working).

Clear up the pneumonia first, then get a second film and back to her oncologist
Helping, sometimes you have to get aggressive and just find another doctor, regardless of what your mother wants.

I assume your mother hasn't appointed anyone as either a financial/legal or medical proxy, and that you have no legal authority to make decisions for her? If not, then use your authority as her caregiver and daughter, and make it clear that you can't be in a position to provide care if treatment isn't an option when needed.

Or just tell a therapeutic fib and say that a new doctor was recommended because of some complication issue.

If you take her to the ER with suspected pneumonia, a lung x-ray will be done and that'll indicate if she does have it. Did the current doctor have x-rays taken?
Read "On Being Mortal" by Atul Gawande.

And have an honest conversation with Mom about whether she wants aggressive treatment, and of what.

You might point out to her that if she doesn't think about these hard issues when she's still relatively healthy, she runs the risk of having an incapacitating event and having medical personnel doing all sorts of things to keep her alive, when perhaps at that point she'd just like to slip away.

Clear up the pneumonia first. And understand that worrying is among the really useless things you can do when caring for an elder.

I wish someone had told me that long ago.
Maybe she'll agree to a 2nd opinion? then keep going to that doctor

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