Open Question: For a western medicine dr please?
Patient admitted 8 weeks ago for wheezing and sob,
Myocardial unit x 3 days ruled out congestion from chf and pneumonia and called it allergy related congestion
dc’d with xopenx 1.25 mgs q 4-6 atc / guafeninsin bid wheezing resolved with regular treatments
Nursing home dr lowered xopenex to .63 prn
Wheezing returned for a few weeks but within last week of few weeks, became labored breathing with little effects from xopenex Instead of starting prednisone as the xopenex website reccommends, she lowered tube feedings to 65 ml per hour to reduce fluids in the body and gave 1 day of lasix 40mg(even though patient was ruled out of chf congestion at hospital) A week later 10 days of prednisone started which relieved labored breathing and wheezing and need for regular xopenex treatments. TOday 16 days after reduced calories(1600 a day to 1300 a day) and 3 days post predisone patient is wheezing heavily 4 hrs post xopenex and has developed her reoccuring cellulitis which was resolved with the 80 ml per hr diet. Argggh Please help family with advice.