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British Lung Foundation
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Persistent cough, clear phlegm but chest and back pain

Hi I’m a 53 year old male ex smoker of 3 years , I developed a cough along with a very slight cold around 8 weeks ago and it just lingered then started to cough clear phlegm it’s worse when I’m moving around, laying down hardly any symptoms but the chest and upper back pain seems to of got worse but doesn’t hurt to breathe, had X-ray normal, had full blood tests normal, saw Harley street lung specialist a week ago and put me on course of anti biotics and breathing excercises, early days with that but doesn’t seem to make any difference I’m so anxious it’s something more sinister I’m considering having a ct scan as to say I’m worried is an understatement, I did look at a blog on this site from a moody420 with exactly the same symptoms but he didn’t let everyone know his results which is slightly worrying in itself, really need some reassurance

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If you have health insurance or can self pay then yes I would ask for a ct scan, as I found there's anything sinister it will show up on there, X-rays aren't really much help. See the specialist ask them to do a nasal swab, throat swab and sputum sample.

It may just be a really nasty Bronchitis infection, as they can sometimes linger on for many weeks. I am getting over one, it was a good 7 weeks. I get reflux too and that makes it worse for me.

Bronhcitis thats hanging around really requires 2 weeks of a good antibiotic or even two together Clarithromycin is one of th best for respiratory infections and Augmentin is good too, you can take them both together.

I go privately to London Bridge and had all those tests and a CT the other week to rule out any other issues.

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Clear phlegm doesn't indicate infection. Persistent coughing does result in strained muscles around the abdomen front and back.

Pity you are going private, NHS wouldn't have prescribed anti biotics when there is not infection indicative of clear mucus and clear lungs re xray, bloods good etc. A persistent cough surely needs further investigation to find out the cause.

Usually when something sinister is going on, it will show in xray and blood tests, but why not phone the BLF helpline for any suggestions they may have regarding your current situation.

blf.org.uk/

Let us know how you get on with everything

Best wishes

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Sounds like bronchitis, possibly Cronic. This can take 2-3 months to clear, and you will get it every year.

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Viral coughs can take 8 to 12 weeks to clear, in some cases even more. That’s partly why people quite often end up going to the gp thinking they need antibiotics if they’re still coughing after a fortnight. Unless you have underlying copd/bronchiectasis or similar where chest infections tend not to show in blood work (because of the disease mechanism), and unless you’re currently experiencing fevers, then having clear sputum and completely normal bloods would generally suggest that there’s nothing infectious going on. Did the private doc do a sputum culture? Did they report that your lungs sounded clear, or could they hear crepes and crackles? Are you short of breath?

A chest infection would likely show on x-ray, but generally speaking x-rays aren’t always the most helpful with respiratory issues - as per a couple of others, a ct scan is the gold standard diagnostic test for most long-term respiratory conditions. I’m not a doctor or in any way remotely medically qualified, but from what you’re describing and that you were otherwise completely fine prior to the onset of the cold, I think there’s a *reasonable* chance you’ve had a nasty virus (or maybe even two or three) that’s just taking its sweet time to bugger off. Chronic respiratory diseases like copd don’t tend to come on overnight, so if there was something underlying I’d expect you to have had some symptoms prior to falling ill eight weeks ago, even if they were only mild. I’d be inclined to give it a little longer if it were me, and see what happens. Obviously, if anything gets worse or changes, like you start bringing up really manky sputum (green, dark yellow, brown, pink), start getting really breathless or wheezing, or if there’s no improvement at all over the next couple of weeks, then ask for more tests, but I haven’t got any alarm bells ringing from what you’ve said.

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Thanks for your comments, i have had sinus problems as well sore eyes, nose running down back of throat albeit that’s mainly cleared up, I do clear my chest when I get up and it’s yellow / white mucus but then through the day it’s more clear, I have also noticed that I have developed a small bruised like pain in the last few days at the left hand side bottom of the neck where top of rib cage meets neck feels like the bone area, so I have decided that I’m having a ct scan and I’ve booked in for tomorrow, thanks for everyone’s comments

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Hi M0nty

I feel your worry. I have been the same and I think when you have been a smoker, you do worry about any lung damage especially when we read all the time that lung disease or cancer have to be caught early. I pleaded with my doctor for a ct scan and eventually got one after going overboard about anxiety!

The lung specialist did find damage from smoking, emphysema, and has suggested that I have ct scan every 2-3 years to pick up any changes. I’m sure you will be fine but for your peace of mind go back to your GP and share your anxiety. It will be worth it

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Morning so I’ve had all the tests, bloods, sputum, x Ray, ct scan, spiro test, antibiotics, Devonshire st lung specialist, all clear other than minimal peripheral tree in bud nodularity with bronchial wall thickening in keeping with minor inflammatory/ infective changes, the cough has all but gone, still cough up clear pale yellow phlegm but not as much as before and I’m told I should go back in 3 months for another ct scan, I’m guessing these things take time, still get middle to upper back pain and I’m still anxious through all the worry I had so difficult to know whether it’s anxiety now or this minor infection that’s causing these issues, anyway just wanted to update.

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Well 14 days from last post and cough seems to be back mainly in morning and last thing at night with a little sputum clear to pale yellow and when i do cough it now sounds bronchial, still have sinus issues and still middle to upper back pain, I'm so confused i spoke to lung specialists secretary and she says doctor says maybe come back in a week or so if it doesn't get better for more antibiotics, i cant help but worry that they have missed something as this thing is just not shifting, I hear the HRCT i had 2 weeks ago would pretty much pick up anything suspicious , I don't know what my next step is as its now 10 weeks and the doctor has given me a video of breathing exercises and made me an appt for 11th Feb and a follow up HRCT in late Jan because of this peripheral tree in bud nodularity and bronchial wall thickening they found on scan, has anyone had the same symptons

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