Can't breathe and sore chest

[auzziunit]

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 (allergies), 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

[National Jewish]

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 specialist, you should.

[myproblem]

The fact that you mention joint pain in addition to the breathing difficulty and chest pain suggests an autoimmune problem. There are 80 autoimmune diseases, but your symptoms and blood work will help narrow it down. Have you had any blood work done? You should have a complete autoimmune panel run to rule out systemic disease. How about a complete Pulmonary Function Test? Spirometry is not the only indicator of how well you breathe. How about comparing a new chest x-ray with an old one? Or a chest CT? Have you had the function of your immune system checked? There are other diseases besides AIDS that can affect your immune system function. Regarding the CF test, I would not think that it could change, because it is a genetic disease, but it wouldn't hurt to test again, just to put you at ease.

[myproblem]

One more thing. What meds are you taking?

[auzziunit]

im talking tetracycline 2 tablets a day and im taking seritide 4 puffs a day.

i dont think ive had my immune system checked.
been tested for aids it was negative

[myproblem]

I assume that you are on the tetracycline because of the many respiratory infections. I think Sertide is a combination inhaler that has a steroid and a long acting bronchiodialator. It should be doing a good job if you really have asthma, unless your asthma was way out of control when you started it. Have you had a full set of pulmonary function tests recently? Did they give you a nebulizer treatment, and then run some of the tests again? Comparing test results before and after the nebulizer treatment will show whether bronchiodialators work for you. If it does not help, asthma is usually ruled out, and if it does work, it typically confirms asthma. if you are sure of the diagnosis of asthma, and feel that there is no other underlying problem that you may be masking with agressive treatment, then you should take a 2 week course of prednisone in addition to your regular asthma medications. This should dramatically decrease the level of inflamation (inflammation) in your lungs, and permit your other medications to work better. If you do all of this, and the medication does not help, I would suggest trying a different "maintainance" drug, or a combination. Advair works for many people, and is similar to Sertide. Singulair is also a good choice to take in conjunction with inhalers. Do you have an albuterol "rescue" inhaler? Take it 5-10 minutes before you use the Sertide. It will increase your  ability to to inhale the Sertide, and may help make it more effective.

[myproblem]

By the way, I was misdiagnosed with asthma for 11 years. Scroll down the respiratory forum to read my post.
"Q: Restrictive Lung Disease or what? - myproblem: 03/02/2006 "
I'm not trying to say that your diagnosis is wrong - Just make sure, that's all.

[Patti Lodes]

ACCUTANE PEOPLE, HAVE YOU EVER TAKEN ACCUTANE IN YOUR PAST?  It has horrible LATENT side effects, we're talking YEARS after ingestion.  Log onto one of the Accutane sites to find out more.

[ARIES56]

I AM A 56 Y/O FEMLE WITH NO HISTORY OF ALLERGIES OR ASTHMA OR BRONCHITIS.In Jan 2006 I had right side neck cartoid artery cleaned and when i woke up i was gasping for breath,told nurse s she said she was gonna give me a breathing treatment back to slee i went so i guess it worked i am still here.Then a couple weeks ago one morning while drinking my coffe and taking my daily pills i started sneezing and then i started gasping for breath again so bad hubby called 911 and my breathing was 98% but yet i couldn't breath so i went to er had chest x rays all came back normal,Now they said i had bronchitis and that i need an inhaler and gave me steroids for a couple days and antibotics. so today i had another sneezing spell and almost gasping for breath but not as bad as it was a couple weeks back.I have mucus in my throat and no cough so i try to bring the mucus up myself,my chest feels so full.It feels like when you get strangled while drinks soda when it goes up your nose.
can one get bronchitis after 56 years? can this be from my surgery right side of neck is still a little numb..any info appreciated..   ARIES56

[kimmy1958]

A related discussion, problem swallowing food was started.