Asthmatic since birth but developing new symptoms, can't find relief

[joeuser95a]

In January of 2005 I got sick with a virus...  several weeks later my asthma kicked off and found myself on albuterol neb treatments several times a day.  My symptoms however were different from what I usually associate with asthama.  Yes I had some wheezing, but I generally exprienced pressure and discomfort when breathing - very labored breaths.  I get short of breath laughing or talking alot.  Strangely enough however, exercise would often help.

My Dr's put me on advair 500/50 twice a day, albuterol and atrovent.  Albuterol and Atrovent would solve my issues but only briefly (45-60 minutes).  This continued throughout the year and my Dr's took chest xrays, ct scans, blood work, complete pulmonology workups, EKGs for heart problems, etc..  Everything was always 100% ok.  My oxygen is excellent at 96-98 all the time and my peak flows are typically fine.

I did have an esophogram confirm reflux.  I've been on prilosec 40mg twice a day for 3 months (and to date it has not helped with my symptoms).

2 weeks ago I started coughing up dark brown mucas and a chest x-ray showed borderline "walking pneumonia", I was put on zithromax for 5 days which resolved my mucas production, but I've had a worsening chest "pressure" and sometimes severe pain.  Basically my symptoms of the past year increased 10 fold.

I'm at my wit's end.  My Dr's are stumped.  I continue to suffer from extreme chest pressure/discomfort, to the point that the pain is so great I'm positive I'm just not breathing - but all test come ok.  What other lung conditions could account for this?

[National Jewish]

Lung problems seldom cause pain, especially of the degree you describe.  The exception to that is pleurisy.  This is a problem that affects the membrane that surrounds the lungs called the pleura.  Pain can also be due to pericarditis.  This is a problem that affects the membrane that surrounds the heart called the pericardium.  Pericarditis is usually an acute, self-limited problem.  However a small number of people with this problem can develop recurrent bouts of pain.  This pain can be chronic and debilitating.  While a virus causes the majority of cases of pericarditis, other types of diseases, including autoimmune disease, can cause chronic pericarditis.

Problems of the lungs or nearby structures may not be the cause of your pain or your shortness of breath.  The pain you describe could also be coming from your abdomen.  It could even be neurogenic.  An example of which could be chronic nerve or nerve root inflammation.  This is seen with herpes zoster infection such as "shingles".  The point is that your problem may not be a lung problem, with the exception of the recent brown sputum.  It may be necessary to repeat some of the tests that were initially negative or normal, with a mind open to unusual possibilities, including problems of the abdomen or chronic infection of the chest.

[joeuser95a]

I recently saw my Dr. again and had my Thyroid tested (100% normal), I also had a chest CT with contrast (100% normal).

The pain that I've been experiencing over the past month pretty much magically went away over night several days ago (so maybe some temporary pleuracy..), however I continue to experience a shortness of breath - easily brought on by talking or laughing.

My Asthma medications do indeed help, but only very briefly (30 minutes or so of relief).  My recent spirometry was ok (not great but not horrible, 71%, but Dr. said all lung functions were normal)

It is as though I have a "persistent trigger", my asthma medication helps (but only briefly) and then bam, the symptoms are back.  I think I've elliminated all environmental factors, but who knows for sure...

[joeuser95a]

Thank you - I have an appointment on Monday and will discuss Thyroid with my Dr.

[mshypo]

It might be worth it to check thyroid antibodies/thyroid function.  I had an asthma diagnosis before finding out I had Hashimoto's/hypothyroidism...and also had extreme chest pain/air hunger.  Hypo makes the chest muscles weak...and all sorts of things that can mimic respiratory disease.  With thyroid hormone medication, I was able to quit taking the asthma medication that I'd taken for 10 years.