Query:  “I am an 18-year-old boy who has been suffering from aggravated cough and phlegm for a while. It developed into a wheezing condition and I got medication for it. While the wheezing condition subsided, the phlegm condition persisted. After a few weeks of continuous coughing, I decided to seek medical attention again. However, my condition didn’t improve. Since I was concerned, she advised me to get a full blood test and an ESR (Erythrocyte Sedimentation Rate) along with an x-ray of my chest. While my blood test didn’t reveal any defects, my x-ray didn’t highlight any abnormalities as well. My ESR depicted a value of 55. I was told by the doctor, upon check up, that an ESR should generally be below 10 and 55 is unusual for someone my age, since it is usually that high in arthritis conditions. The only change that was done was a change in the antibiotic which didn’t make that much of a difference in my condition. Could this be a normal condition that would brush over with time? What does my ESR mean? Should I be worried?” 

Navin Rathnayake from Maharagama

Reply: “As you haven’t mentioned the duration of your cough, but insists that you have been experiencing it for a while, I will assume that it’s a considerably long time. Considering the case in that aspect, you seem to be suffering from asthma and the wheezing condition that you have mentioned confirms it. From what you seem to say, despite the normal conditions of your blood tests and x-rays, your ESR has shown a high value. But I disagree with the fact that high ESR values could only depict arthritis. High ESR rates could also mean infections and inflammations which is most likely the case. In your condition, I think you are suffering from a chest infection as you seem to have been experiencing a lot of coughing and wheezing. The fact that you haven’t been recovering from the antibiotics could be due to the untimely taking of the antibiotic course. But there is a slight chance of your infection being a fungal one. If you are still taking medication, I suggest you take it on time without delay and check whether your condition improves. If that doesn’t take place, seek medical attention from a consultant physician specialized in the respiratory area. You shouldn’t be worried as I don’t think it’s something serious. It just appears to be a case of aggravated asthma. Take your medication on time and stay away from cold beverages and follow good behavioural patterns that aid the subsiding of the cough condition you are experiencing.”