Many symptoms

[nathan345]

Recently I have had trouble swallowing and a lot of nasal drip.  I have been to many different doctors and they all seem to have a different diagnosis.  My health problems started about a year ago when I moved into a new house.  I began having trouble breathing and was diagnosed with pneumonia twice in two months the first accompanied by sever sinusitis the second time with bronchitis.  When I was diagnosed the second time it was by an ER physician not my regular doctor and he referred me to an allergy and immunology specialist.  Upon a visit with him I was diagnosed with severe asthma and allergies mostly to animal dander. The allergy diagnosis was not a shock, I have been allergic to animal dander my whole life, but it has been manageable by OC drugs when needed.  This doctor's recommendation was to begin treatment with inhalers and begin allergy shots.  After three months of allergy shots, I had a bad anaphylaxis reaction and ended up in an ER.  After that, I switched allergy doctors and was diagnosed with something different.  He diagnosed me with triad asthma and said it could be treated and I should be able to not be dependent on inhalers or other treatment.  He prescribed me an allergy pill and nasal spray to shrink the nasal polyp.  Recently I have noticed that I have trouble swallowing and at times it seems that I really have to struggle to swallow when there is nothing in my mouth. I occasionally chew tobacco and am not sure if this is related.  The trouble swallowing has not occurred while I am eating or drinking.  After reading some things online it appears that all these symptoms could be related? Is this something I need to be concerned with?    

Nathan  

[National Jewish Health]

Triad asthma, described by Dr. Samter is comprised of nasal polyps, aspirin sensitivity and asthma, referred to more commonly these days as, aspirin-sensitive asthma.  The ingestion of aspirin or the non-steroidal anti-inflammatory drugs (NSAIDs), most notably ibuprofen, results in worsening of both nasal polyps and the asthma.

You have provided a nicely detailed description of your problems.  Most notable is the temporal relationship between your moving into a new house and the onset of respiratory problems.  This observation is strongly suggestive of your being exposed to one or more allergens in the new house.  With a lifelong history of allergy to animal dander, it is highly likely that one of the allergens is cat dander.  That you were diagnosed with pneumonia, not once but twice, presumably without a past history of pneumonia, suggests yet another allergen and the diagnosis of hypersensitivity pneumonitis.  You should seriously consider moving to another home; one in which no cats or dogs or other animals have resided.

Effective treatment of nasal polyps with a nasal steroid spray, along with the avoidance of aspirin and NSAIDs, is crucial to the management of aspirin-sensitive asthma.  You may or may not need to use other inhalers to optimally control the asthma, but the answer to that will become readily apparent over time.  An oral medicine, montelukast has also been shown to be efficacious in aspirin-sensitive asthma.

You should be sure that your current allergist obtains detailed information about the circumstances of the anaphylaxis, so that a recurrence can be avoided.

That your problem swallowing does not occur with eating or drinking is a good sign and suggests that there is not a serious neurological or anatomic problem.  What you describe could be due to anxiety or reflect a fungal infection of the throat, caused by the inhaled nasal steroid.  You should have your throat examined by an ENT doctor.

Good luck.