Asthma or worse?

[LGD]

I'll try to make a long story short. Around 1/06 I started having a very slight wheeze (audible only when in a small quiet area, like bathroom or car). I also developed a cough that was sometimes mildly productive with small pieces of white/yellowish sputum. I had some mild shortness of breath, but not made worse with exercise or relieved by rest, pretty constant all the time- very mild. I also have some crackles on inspiration and/or expiration when lying down sometimes. I went to my GP in early January to have a chest x-ray, which he and the tech read as clear. I was and remain worried about possible silicosis because I sided my house a few years ago with some material that I only now know contained quartz. I probably worked with the material for a total of 60 hours over the course of a year. That was in 2002. Hadn't had any exposure previous or since. After the x-ray, the symptoms persisted, so I had a full PFT test done in March, which also came back fine. In April I still had these nagging symptoms, so I went to a Pulmonary Physician. He reviewed my x-ray and PFT's and thought they were fine. Another month passed and I just had a methacholine challenge last week. After only the first dose of methacholine I had a 48% decrease in lung function. They diagnosed me with asthma and put me on Pulmicort (two puffs once a day). I haven't had any change in my symptoms for 5 days. Curious if anyone can tell me if my problem sounds like asthma, or if it could indeed be silicosis. I'm scared to death of it being the latter. Looking for opinions. Thanks

[National Jewish]

Asthma can present in exactly this way.  Having a methacholine challenge does not mean 100% that you have asthma, but it is a good bet.  Since you have taken Pulmicort Turbuhaler

[starion]

Inhaled steroids like Pulmicort can take some time (weeks) to be fully effective.  If there isn't improvement in a few more weeks, you might ask your doctor about possibly adjusting your treatment plan so you have a long-acting bronchodilator too, like Foradil or Serevent.  There is a combo med which is widely marketed called Advair.  It contains an inhaled steroid (similar to Pulmicort) as well as Serevent) & is taken one puff 2x/day.  It has helped many folks who have asthma.

There are also different inhaled steroids.  For me, we have found that Qvar with a spacer is much more effective than Pulmicort.  Some docs don't recognize that patients may respond differently to different inhaled steroids, but there can be a significant improvement with the right med.

I'd make an appointment now for a recheck with the pulmo in a few weeks, just in case your condition doesn't start improving by then (it's often easier to cancel if you don't need than try to be fit in if you DO need a visit).

Good luck!
Starion

[poolnoni]

Give it a little more time. If after month, you still are coughing up sputum maybe you should suggest to your pulmonary doctor a bronchoscopy.  See what his thoughts are on that. Don't let it go any longer than a month. Did they do blood work? I coughed up sputum for 8 months and keep going back to the doctors. I was told it was sinus infection and then bronchitis. Was given antibiotics. Found out after seeing another doctor and he did a bronchoscopy found out that I had MAC infection in my lungs. Hang in there.