Undiagnosed Symptoms for 9 Months

[eilig]

I'm a 39 year old male non-smoker, non-drinker, marathon runner who has never had any surgeries or hospitilizations.  

Always healthy until November 2007.  I moved items in and out of a basement storage area of a very old apartment building, later discovering that the entire area contained airborne asbestos.  An Industrial Hygienist confirmed chrysotile and amosite fibers were airborne at higher than safe levels.  A day or two afterward, I felt like I had come down with the flu or a virus.  The symptoms persist, and include:

Sore throat
Hoarseness
Burning and tightness in chest
Irritated trachea/airway, often feels "dry," and "cold"
Burning sinuses
Sinus headache
Exercise induced asthma
Always feel very tired
Mucous in back of throat, tastes like blood, sometimes contains blood
Tender tonsils

Doc visits to date: 2 different internal medicine doctors, 2 different ENTs, a pulmonologist, an occupational therapist, an allergist, and a gastroenterologist.  And to date, I have no diagnosis, and my symptoms persist.  I have visited the National Jewish once for an initial consult and some initial tests, and have my second appointment scheduled for October.

Tests to date: Many blood tests (all negative, with exception of IGE level being toward the high side of normal), Barium swallow (negative), full battery of allergy tests (most of which came back 4+, I'm very allergic to many things), asthma tests w/wo albuteral (positive for exercise induced asthma), many chest x-rays (positive for hyperinflated lungs), Sinus catscan (positive for some chronic damage).

During the last 7 months, I've tried sinus rinses, Protonix, Prevacid, Symbacort, 2 different antibiotics, Singulair, Allegra, several steroid injections, various different steroidal nasal sprays.  None of these medications have provided ANY relief.

I'm at my wits end.  This is having a profoundly negative impact on every aspect of my life.

What else can I, or should I do?  

[eilig]

Just to close the loop, the only remarkable portion of the CT Sinus Scan reads as follows:  

"Mild swelling of the inferior nasal turbinates and displacement of the nasal septum from right to left are present along with scattered ares of mucosa proliferative change in the ethmoid air cells.  Chronic sinusitis is present in the ethmoid region."

[eilig]

Thank you.  I will contact my patient coordinator at National Jewish tomorrow in an effort to get my second visit scheduled sooner than October.

[National Jewish Health]

The first thing you should do is to check back with the industrial hygienist to see if other irritant or potentially allergic substances were found in the storage area.  Your description suggests that your exposure to asbestos fibers was intense and such an exposure could cause extensive acute or sub-acute inflammation, with findings to suggest airway obstruction as is seen with asthma.  Your symptoms are both upper and lower respiratory and you could have widespread inflammation from, either asbestos or from a large number of other infectious and non-infectious agents, in the storage area.  The main concern is lower respiratory inflammation and the effect it could have long-term on lung function.  There are many causes of hyperinflation.  In some instances with bronchiolitis, especially bronchiolitis obliterans, hyperinflation has, at least initially, been the only x-ray finding.  It is highly likely that you will need a high resolution CT scan of the lungs.

You should also call National Jewish Health and urge the scheduling staff to give you a re-visit appointment much sooner than October in an attempt to establish a diagnosis and initiate appropriate therapy.