Post-Surgery Cough and Steroid Rash: Symptoms After Mediastinal Lymph Node Removal - Pulmonology

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Post-surgery symptoms, such as cough and skin rashes, can be concerning for patients and their families. In the case of your husband, who underwent mediastinal lymph node removal due to the presence of multiple hamartomas, it is important to understand the potential causes and implications of these symptoms.

1. Coughing After Surgery: It is not uncommon for patients to experience a persistent cough following thoracic surgery, including mediastinal lymph node dissection. This can be attributed to several factors:
- Surgical Trauma: The procedure itself can irritate the airways and surrounding tissues, leading to inflammation and a cough reflex.

- Fluid Accumulation: Post-operative fluid accumulation in the chest cavity (pleural effusion) can also cause coughing. If your husband feels like he has phlegm, it may be due to secretions that are not being cleared effectively from the airways.

- Pulmonary Function Changes: After surgery, lung function may be temporarily compromised, leading to symptoms like cough and shortness of breath. The body is adjusting to the changes in lung volume and function, which can take time.

- Infection: Although less common, post-operative infections can also cause coughing. If there are any signs of fever, increased sputum production, or worsening symptoms, it would be prudent to consult a healthcare provider.

Given that your husband has already discussed his symptoms with his doctor, and if the doctor has reassured you that it is a normal post-operative occurrence, it may be reasonable to continue monitoring the situation. However, if the cough persists or worsens, seeking a second opinion or further evaluation may be beneficial.

2. Steroid-Induced Rash: The appearance of a rash after starting corticosteroids is a known side effect. Corticosteroids can cause various skin reactions, including:
- Acneiform Eruptions: These can resemble acne and are often seen on the upper body.

- Allergic Reactions: Some individuals may develop rashes due to an allergic reaction to the medication itself or other factors.

- Skin Thinning: Prolonged use of steroids can lead to thinning of the skin, making it more susceptible to irritation and rashes.

The fact that your husband reduced his steroid dosage but still has the rash suggests that it may not be solely related to the dosage but could be a reaction to the medication itself. It is essential to communicate this ongoing issue to his healthcare provider, who may consider adjusting the treatment plan or prescribing topical treatments to alleviate the rash.

In summary, while coughing and rashes can be common after surgeries like mediastinal lymph node removal, it is crucial to keep an open line of communication with healthcare providers. Regular follow-ups and monitoring of symptoms are vital to ensure that any complications are addressed promptly. If symptoms persist or worsen, further evaluation may be necessary to rule out any underlying issues.