What next...

[jimbards]

In November, I started having issues with shortness of breath, dizzy spells, pain/soreness when breathing, rapid heart-rate and pressure on my chest, as if someone had punched me in the chest, or someone was sitting on my chest.  I went to the Vanderbilt walk in clinic in my town, they reviewed it as bronchitis, possible pneumonia, perscribed a Z-Pack (Azithromycin) and an Albuterol Inhaler. The inhaler helped with the soreness at first, and the antibiotic didnt really seem to affect it at all.  I waited thru mid Feb., to see if it would go away on it's own, which it didn't, so I went BACK to the clinic to see what they thought at that point.  They told me they thought I should have a Pulmonary Function Test done, but it would have to be referred by a PCP, so I went to my PCP.  She felt I still had an infection in my chest, and perscribed a stronger antibiotic, along with another inhaler.  I also had an EKG, Chest Xray and bloodwork.  The findings are listed below.  The antibiotics seemed to suppress it some, but after the round wore off, the pressure pain, soreness and shortness of breath came back, WORSE than it was before.  

Having gone thru two rounds of antibiotics, and still not shaking the "infection", I started thinking about it.  No one had perscribed any Guaifenesin WITH the antibiotics, and in MY mind, if you arent getting rid of anything IN the lungs that could be causing infection, to me, it is reasonable to think that as the antibiotics may suppress the infection, the foreign matter causing the infection could/would cause it to come right back with it still being present.  With that in mind, I started taking Mucinex on my own, along with Aleve, to help with the soreness and pressure.  Almost immediately, I started coughing up CLUMPS of mucus, not liquidy or slimy, but more gelatenous (sorry if it is too much info), and the Aleve DID help with the soreness and pressure...  for a while. Eventually, it is almost like whatever it was was altering itself to resist what I was taking.  A few days later, where the Aleve initially was completely relieving the pressure and soreness, soon, it was only relieving the pressure, and the soreness persisted.  I was back to having my spurts with the shortness of breath, finding that just having conversations with people, I would have to stop to catch my breath/take a deep breath.  

I went back to my PCP, and she said at this point (now being 3 1/2 months in with these symptoms) she was going to treat it as either Pleurisy or Costochondritis, and start looking at my heart and lungs to rule out any possibly more serious issues that it could be.  A second EKG was taken, and was normal.  I was referred for my Pulmonary Function Test and also a 3D Heart Ultrasound.  I was perscribed Nabumetone and a Medrol Dose Pack.  This was to be accompanied with a daily child's asprin (cherry flavor, of course... :-)  ).  I have JUST run the course of the Medrol pack, still taking the Nabumetone, twice daily, and still having the soreness in my chest and occassional shortness of breath.  I can feel the soreness mildly all the time, but more-so when i take deep breaths or bending over.  The pressure is gone, but if I do notice it, it is fairly mild.  The PFT came back clear, no issues shown on the test, lungs are functioning normally.  The Heart Ultrasound came back and was determined normal, no issues, heart is functioning normally (accompanied with two good/positive EKG readings).

I called today to see what the Dr. would like to do, or what I should do next to try to help relieve the ongoing symptoms.  The Dr. states would like me to go in for a CT Scan of my chest to check for possible Pulmonary Embolism.  I am kind of iffy about going for it, wondering if it is something else just being thrown at me to go do.  
Understanding Pulmonary Embolisms, if it WERE one, then why, when they test my blood oxygen reading, I am always at 98%?  Wouldnt my oxygen level be decreased?  And why would it not show on my Chest X-Ray, if I DID have one?  I understand lack of Westermark sign and Hampton's Hump, but also, people with Pulmonary Embolisms show signs with decreased percussion note in the heart or strain on the right ventricle.  Would this have not been noticeable on the Heart Doppler that was done?  

So here we are, needing to make the decision to CT Scan or NOT to CT Scan...  Any words of wisdom out there?  OR could it be something as simple as stress causing all this, as we are having financial difficulty, issues in the homefront, legal issues, and an always changing sleep schedule, as my new job of 6 months, rotates shifts every 4 weeks?  

Something else to throw into the picture...  I get this EVERY winter, when the climate gets cold, and it lasts into the spring, but it usually starts LATE in winter (where THIS winter has been more severe) and only lasts a month to two, rather than the almost 4 months this has been going on this year...  Or do you, the reader, feel it is unrelated to my normal annual issue?

What next...???




Tests Performed/Results:

2 EKG's: normal Results, no issues found
Chest X-Rays: showed normal or no issues
Bloodwork: Showed SEVERE lack of vitamin D, low levels of vitamin B12, slightly high cholesterols and high     triglycerides
Pulmonary Function Test: Passed, 100%, no issues
Heart Ultrasound:  3d imaging, shows no issues with the heart or valve functions, heart performing as it should.

Scripts perscribed  from onset to present:

Azithromycin Pack
Albuterol Inhaler
Troleandomycin/Telithromycin (not sure which it was, but stronger than Azithromycin)
Methylprednisolone (Medrol Pack)
Nabumetone- 1/twice daily (Still taking)
Vitamin D 50000 lu caps- 1/wk (Still taking)
Vitamin B12- 1/daily  (Still taking)
Fish Oil- 1/daily (Still taking)
Baby Asprin- 1/daily  (Still taking)

[jimbards]

Thanks for your response and the other response I received. I wanted to leave an update and see if there was any other input.
CT scan was performed and was normal, no issues found.  STILL having constant chest soreness and now the doc wants me to go see a cardiologist. I don't see a point in that considering my bloodwork, ekg's,  heart Doppler and now CT scan all were normal. I don't see what he would find that didn't show on any of those with the exception of possibly a weak heart, which would call for more exercise...  Beginning to wonder if it is a stress induced issue or if my panic disorder is coming back??? Thoughts?

[Resilient_Mimi]

I would do the CT scan, you know medicine is alot of trial and error.  I know the a PE mimics a heart attack. And is life threatening so it would be a good idea just to rule this out.  Normally a PE comes from a leg injury, it is a blood clot that moves up from your lower extremities, if you can think back and remember a leg injury, this could point in the direction of a PE.  Also a CT will give a better picture of what is going on.  Wish you the best, May GOD bless.