Dear patient,
Regards from doctor spring.
I have gone through your case and understand your concern.
You have no signs of infection, no fever, cough or sputum, an extra dose of antibiotic has left you with gastritis.
Smoking a cigar / day is dangerous and it does not make a difference if you have cut down on the numbers. Hence kindly try to quit smoking.
The CT showed some air trapping, which means a disease of the small airways. This should benefit from salmetrol/fluticasone that you are already on, and also from smoking cessation.
I do not find any symptoms of idiopathic pulmonary fibrosis in what you have mentioned, and hence for the time being you can keep those thoughts away from mind.
With a normal ecg, holter and x ray, mild abnormal CT, there is no imminent danger of any sorts.
I would recommend continuation of clonazepam to manage the panic episodes, however I also recommend to be under a follow up with your family GP for the same.
Similarly for heart burn, avoid unnecessary antibiotics and take the OTC tab Prilosec once a day, half an hour before a meal for 5 days.
Wishing you good health
Dr.Jacob George P
MD, FCCP