CHRONIC COUGH, SHORTNESS OF BREATH. Is it ASTHMA?

Resolved question:
Is this Asthma or something else?

I have had a chronic cough for over 6 months now. I also have had a weird shortness of breath for several months as well, that as of lately, has been much more common ie several times of day. The thing is I have no idea what triggers this.

ICS and albuterol seem to have little to no effect on me. When a flare starts, usually my nose gets inflamed first making it hard to breathe through nose then I feel like my throat gets inflamed and I am not getting enough breath. I bought a peak flow meter to test myself, and I consistently blow a 650 morning, night, and in the middle of what I perceive to be an attack. Ive tried a dose pack of Prednisone which also seemed to do literally nothing. I tried SYmbicort for 3 months which seemed to do nothing. Ive been on Protonix for 3 months which seemed to do little. Ive been taking OTC antihistamines (Claritin and Allegra) for 3 months and they have done little. Ive been taking Qnasl which doesnt seem to help.

I recently started taking Atrovent Nasal spray which DID open up my nose a bit which has helped, but the shortness of breath still comes and goes and it really freaks me out. Sometimes I think the shortness of breath is all in my head so I'll take a Xanax but it doesn't seem to help much. It will calm me down but the shortness of breath doesnt completely go away.

My pulm is not sure what this is either. He ordered Chest Xray, Blood tests, CT sinuses, and complete PFTs with Methacholine challenge. The only test I have taken so far are xray and blood test and xray was normal and blood test showed I had high levels of IgE. Said my level was 152 and doc said it should be 30 or less.

I dont know what to do anymore this is ruining my life. Just today I went out for the first time in weeks for a beer. Everything was ok for first couple hours then symptoms started, it felt like I couldnt breathe completely. Took two puffs of albuterol with no effect whatsoever, symptoms eventually got better once I left the building and got some fresh cool air.

The only med I havent tried yet is Singulair, which I have a script for but I have to wait until after my Methacholine challenge to try.

My doc is not convinced its asthma and neither am I. I am running out of options.

Could allergies cause this? Could this be asthma even know my peak flow is ALWAYS 650, even during what I think is an attack? What other medicines can I try to fix this?

Me: 26, Male, 150 lbs, no history of asthma or allergies. No family history of Asthma. Some family members have seasonal allergies. No audible wheezing when Im having an attack and doctors have never heard a wheeze when listening to lungs. Chronic dry cough that usually gets worse during exercise.

Submitted: 4 Days
Category: Pulmonologist

Expert:  Dr. Jacob George Pulinilkunnathil replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com

The hallmark of bronchial asthma is a reversible airway obstruction, precipitated by triggers. Such a history is lacking from you..
Additionally as all examinations results are negative so I don't think it's asthma. Kindly take a ct of chest to obtain more clarity of the same. Once you have the CT report, you can upload it along with the CXR report. This will give us more clarity.
Also, a disease without wheeze or without response to salbutamol is unlikely to respond to singulair, and unlikely to be asthma. The hall mark of asthma is a pefr variability, diurnal and seasonal, which is also lacking with you. Please feel free to ask any doubt,

Regards

Dr. Jacob George P
MD IDCCM FCCP

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