Reactive Airway Disease?

[SeanCly10]

I am a 29 year old male with no family history or personal history of asthma. About a week ago now, I had just finished a day of working in the yard and was about to go to bed when I noticed a peculiar tightening in my chest and trouble drawing a full breath. At the time, it didn't concern me overmuch, since I am/was a smoker and it sometimes happened that my chest got tight like that at night when I'd smoked too much. It would always be gone when I got up in the morning.

This time, though, it didn't, and here I am a week later still having to work for breath. I saw a doctor twice over the past week about it. On the first visit I had a bronchodilator treatment, which improved things temporarily, along with chest x-rays and a peak flow test. The x-rays were clear aside from my smoker's lung, according to the doctor, and the bronchodilation improved the peak flow by about 150. He diagnosed reactive airway disease, put me on a once-a-day of Asmanex and sent me home. My symptoms would improve slightly after a treatment, but didn't really get any better, just no worse. By the middle of the week, though, I had so much trouble getting breath on the way home from work that I had to go straight to see the doctor before even going home. This time, another doctor put me on Advair 250/50 twice daily, with a Proventil inhaler to use when I needed it. He also was careful to say that I didn't have asthma, my RAD was only temporary, and that the Advair and Proventil would keep me breathing okay until it cleared up. That was 4 days ago.

In general, my breathing is fine right when I wake up in the morning, before and after my morning dose of Advair and on the way into work. Not long after I get there, my chest tightens up and I have to work to get enough air most of the day, aside from when I distract myself with something for awhile. The drive home is similar, and after I'm home for a little while it eases to a minor annoyance. During the work day, I use the Proventil with mixed results. Sometimes, it provides relief for a decent time; others, it opens me up a little for a minute or two then I'm back to the hard breathing. During the past weekend, when I was at home most of the time, I either got distracted enough or my breathing was easy enough that I forgot about it entirely for most of the daytime. At night, just before bed, it got bad enough to match to as it is at work, despite the Advair.

I don't know what to do here. From my reading, the Advair is a standard medication for people that really do have asthma, but it seems to be doing me little good, and the Proventil just seems to put a bad taste in my mouth for the most part. I can't find any pattern in my environmental exposure to attempt to locate a trigger, and I've even dropped smoking entirely, all to no avail.

I realize that I'm likely wanting results quicker than I should be expecting them, and I also realize that my upset over the whole situation is likely making it worse overall. Most of all, I just find this whole thing so inexplicable. I've never had any kind of breathing issues before, aside from a bout of bronchitis just after I started smoking, which the Advair treated to great effect. Can someone give me their opinion?

[js2630]

Your lucky day! I just joined this group, and have had the same exact thing happen to me 9 years ago. Thanks to your thorough narrative of your daily activities, here is my diagnosis (I am NOT a doctor). The "trigger" you said you were looking for is YOUR WORK. You are probably reacting to mold growing at your place of employment, though it could be a reaction to a chemical or powder/dust in your work environment. Here is the diagnostic test to take. Everywhere you sit, or stand, at your work, tilt your head backwards, and stare at the ceiling. Do you see water stains? For everyone else at your work, they are just water stains. For YOU, they are MOLD that your lungs are reacting to, with the Reactive Airways Disease, that you doctor mentioned. Why you and me, and none of the other people at your work? Who knows? There are many theories. My favorite is genetic predisposition to react to the mold, which your co-workers do NOT have.

The proventil (albuterol) will have only limited effect, as what you are experiencing is NOT medically an allergic reaction, but an irritation and inflamation (inflammation) of your lungs. The Asmanex and Advair will make your lungs less reactive, if taken over a period of time, but you will always react if you are around your trigger. They will NOT stop an episode of bad breathing, once it has begun. Proventil or Combivent (albuterol plus atrovent) will stop a reaction, to a limited extent for a limited duration.

My "prescription" is that you take a 2 week vacation (not even going back to work for 5 minutes to pick up your paycheck.) If you feel better, its the work thats KILLING YOU! If you don't feel better, I'll refund your fee(joke). While you are on your vacation DO NOT work in your yard, as the soil and especially leaves contain mold, doing the job that nature intended them to do, which is to decompose dead matter. When you interrupt them doing their job, they fly into the air, where your lungs breathe them in, and you know the rest of the story. ***@****

Check out this FREE online health group, where hundreds of people are discussing the same problems that you have:

http://health.groups.yahoo.com/group/sickbuildings/

[SeanCly10]

I don't see any marks like that in my particular office...what else can I look for?

[Brian0473]

How is your breathing doing?  I have had the same issue but I know what my trigger was.  It's been about 1 year for me.  Anyway - if you have an update I would like to hear it.

Thanks,
Brian

[SeanCly10]

Well, since the original diagnosis, the problems faded away, and life went on as normal for the most part. I continued using the Advair inhaler, and it did the work it was supposed to do. I started staying away from anything that might trigger another reaction, and wearing a dust mask when I had to do something like that.

Here recently, though, it's started to come back, although I believe that I know why. My trigger this time seems to be allergens in one of our old pillows, which will be replaced today for that matter, and possibly in our aged mattress, which we plan to replace with this year's tax refund.

My rationalization with this whole mess, at least as far as I'm concerned, is that my smoking has sensitized my airways more than they usually are, and made me more prone to the RAD. This actually makes me a touch hopeful, for when I quit I can get back to normal.

Here's hopin'. :)