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Respiratory Disorders  (Expert Forum)
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Can't breathe and sore chest
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This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis

Can't breathe and sore chest

by auzziunit, Mar 11, 2006 12:00AM
Hi my names clinton and im a 21 year old from australia but am living in missouri to go to college. i have been a national level sprinter for years so i practice alot. since 1999 i have had numerous chest infections which leads to pneumonia. i have been hospitalized since then for over a week at least 14 times. i have been diagnosed with asthma, Bronchiectasis  and acute bronchiopulmonary  aspergillosis. In my most recent visit to the speciallist i was positive for many alergies, i have a sinus infection, and my spirometry wass 47%.  i fall right into the cystic fybrosis  category as i constantly have a cough, have constant phlegm, have salty tasting skin and i eat so so much food yet i am 142 pounds.

i have been tested 6 years ago via sweat test for cf and i believe the result was negative, can that change

over the last month i can not even run 100m without taking 15 minutes to recover because my chest kills me and i cant get any air in, i get tired, sore joints and it is really worrying me. in my recent spirometry tests last week i was sitting at 50% whichc is terrible. does anyone have any idea to what it can be as i am very very worried about my condition

thanks

by National Jewish, Mar 21, 2006 12:00AM
Cystic fibrosis (CF) is a genetic disease of the exocrine glands affecting the lungs and the digestive system.  Sweat tests can be falsely negative for CF if done with an insufficient volume of sweat.  If there is real concern on your part or on the part of your doctors you should have genetic testing for CF, especially if you have intestinal problems along with your inability to gain weight.  Do not rely on a negative sweat test alone.  Salty tasting skin is found in 10% of all adolescents who do not have CF or any other disease.  It is suggestive but definitely not diagnostic of CF.



With asthma the basic problem is chronic inflammation along with tightening of the smooth muscles that surround the airways of the lungs.  This tightening is called bronchospasm.  Usually asthma is treated with 2 types of medicine for long-term control and quick relief.  This is how they work:  

· an inhaled steroid decreases and prevents the inflammation when it is used daily; and

· an inhaled bronchodilator relaxes the smooth muscle tightness.  A long-acting inhaled bronchodilator prevents bronchospasm when it is used daily.  If it is known that something like exercise causes asthma symptoms, a fast-acting inhaled bronchodilator is used as a pre-treatment before exercise to prevent bronchospasm.  When asthma symptoms happen, a fast-acting inhaled bronchodilator is used as a rescue medicine to quickly relieve bronchospasm and stop the asthma symptoms.

Needing to use a fast-acting inhaled bronchodilator as a rescue medicine more than twice in a week means that the inflammation and asthma are not well controlled.  The doctor will help you get the medicines that will work the best to control your asthma.  Getting your asthma under good control should result in marked improvement in our ability to run.  Please read our asthma information at http://www.nationaljewish.org/disease-info/diseases/asthma/index.aspx to learn more.



Allergic bronchopulmonary aspergillosis (ABPA) is an allergic reaction caused by inhaling a fungus called Aspergillus.  People with asthma are most likely to have this problem.  When inhaled steroids are not helping, then oral steroids are used.  Anti-fungal medicines, most notably Sporanox® (itraconazole), may allow for treatment with lower doses of steroids.  Your sinus infection may be bacterial in nature but could also be allergic fungal sinusitis due to the Aspergillus.



Bronchiectasis can develop at any age.  Inflammation causes damage to the airways of the lungs.  When the airways become dilated this is called bronchiolectasis.  When the airways become distorted with areas where mucus can collect this is called bronchiectasis.  This can certainly be due to a lung infection during childhood, but it can follow lung infections as an adult especially severe pneumonia or repeated/ongoing lung infections such as ABPA.  Usually these changes can be seen with a CT scan of the lungs.  It can be difficult to clear this mucus because of damage to the normal methods that the lungs use to clear mucus.  This can lead to episodes of infection.  Typically an ongoing infection can lead to inflammation.  So it is important that lung infections are treated.  Pulmonary hygiene is very important in preventing and controlling lung infections.  Using an inhaled bronchodilator may help to loosen the mucus.  Many people find the routine use of a mucus clearance device to be very helpful in clearing the mucus from their lungs.  This is a small device that you exhale into causing a vibration in your lungs that loosens mucus so that you can cough it up easier.  The names of 2 types of devices are Acapella and Flutter Valve.  Bronchiectasis can result from airway blockage along with infection, so it may affect only one area of your lung.  If your recurrent lung infections are always in the same area of the lung, surgery to remove that portion of your lung may provide a cure.  Please read our bronchiectasis information at http://www.nationaljewish.org/disease-info/diseases/bronchiectasis/index.aspx to learn more.



Your concern is warranted.  If inadequately treated, the ABPA can result in permanent lung damage.  If you have not yet seen a pulmonary