Need some help.

[LGD]

I've been experiencing mild SOB, slight wheeze, intermittent cough, and sort of a dull, deep seated achy back and upper abdomen pain. All of these symptoms have been present for a little over a year, in varying intensity. I've been to my GP, and now to two different Pulmonary. About 5 years ago, I had some relatively short term exposure to silica dust while siding a house. My exposure was probably equivilent to a week or two of work. I have had multiple chest x-rays, methacholine challenge, to which I was wildly positive on the first dose, multiple PFT's-all normal. I was diagnosed with asthma by my first pulmo 5/06, and put on pulmicort, which didn't seem to help. At a 6 month follow up, my pft's showed 11% improvement over the previous normal readings. I went to a new pulmo in 2/07. Since I have had a history of allergies all my life, he attributed my symptoms to a "asthma like condition" and perscribed advair, nexium, and allegra, thinking that I have a mixture of GERD, allergies, and asthma. I got the flu a week ago, and have had more of a cough and sore throat, and raspy/weak voice. I also have, from time to time, odd expiration sounds that include a sort of gurgling at the way end of a deep breath. This started after the puking. Any thoughts? Any different tests I should seek out? Blood tests? TB tests? anything else? I'm petrified that I have silicosis, and the doc that I'm now seeing is some sort of silicosis expert!? What to do? I'm a healthy (besides my lunger issues), albeit stressed and slightly overweight 29 year old male.

[National Jewish]

With a normal x-ray, normal pulmonary function tests (PFTs) and a transient, relatively trivial exposure to silica, it is extremely unlikely that you have or will ever have silicosis.  It is equally likely, with the strongly positive methacholine challenge that you have asthma, and are being appropriately treated for it.  That is not to say that your exposure to silica and any other irritant might have aggravated your underlying asthma, but if so, that is highly irrelevant.  Neither asthma nor silica exposure would explain the achy back pain.  At your age that is most likely muscle pain.

You don't need any further testing at this time, unless your doctor recommends allergy skin-testing.  Be patient and work with your doctor to get the presumed asthma under control.  Exercise regularly, try to lose a few pounds and try not to focus as much on your body and your health.

[LGD]

Thanks. That might be the best damn advice I've ever got from a doctor!