Conversation: The conversation between human and AI assistant.
[|Human|] Hello Dr,I am 35 years male. Healthy but i have been suffering from chronic throat infection (8 to 10 months), took several medicines but no or temporary results. Now a days i am feeling a bit better in terms in throat infection. But now a days (from last 5 to 6 days) i am feeling very tired, breadthless and feverish (no fever but) and very lousy. I get very shallow breadths. My recent CBC shows high ESR (15) and high heamoglobin 17.5. But i always had high heamoglobin (since last 4-5 years around 18). Few days before i had some pain in my temporal region and had a very strange feeling there. I remain very depressed because of this chronic problem of throat infection and now this. My doc here did PFT test and said some problem is there (i am not convinced, sorry to say that) and has put me on some oral and nasal spray which is not helping (taking from last 2 days). I sometimes feel pain in my right side of chest and get very (very very) thick phlem. I dont get coughs and when i try to take this thick phlem out from my throat, i cant and i just have to engulf it with no option. I got my all tests (yearly health check up tests) done and nothing wrong came in that some three months before. i m not losing weight. Please advice
[|AI|]  Hi there. Your symptoms seem to point to your lungs - I worry if there is bronchiectasis (permanent enlargement of airways in the lung due to chronic infection). In fact, the high hemoglobin you have had for the past 4 - 5 years could explain this fact i.e. your blood has had to compensate for the reduced oxygenation by your lung by increasing its oxygen-carrying capacity. The high ESR indicates an ongoing inflammatory or infectious process. A few questions to help pinpoint your problem:1. Are you a smoker? If so, how many pack years?2. Did you suffer a bad chest infection a few years ago?3. Any exposure to fungus (working in moldy environment, stored grain or compost)? I would like to rule out aspergilli. I strongly recommend you see a doctor to get a proper infectious disease panel done (both blood and sputum) along with a proper chest x-ray. Consider doing a high resolution CT as well of the lungs to help pinpoint your problem. Thank you