In a person who has a normal chest x-ray and who doesn
Has he had an allergy workup? With all the medications he's on and the history of the Advair allergy, perhaps he allergic to another medication he's on. It definitely sounds like uncontrolled asthma to me which could be due to an unknown asthma trigger. His doctor may need to tweak his asthma meds. There are a variety out there. Considering the Oral Steroid seemed to help, perhaps he needs a higher dose of inhaled steroids than he's currently on.
Has he been back to the Pulmonologist after all these tests? Also being overweight can contribute to many of his health related problems, even the asthma. Hopefully he is a non-smoker? If not, that would definitely cause the asthma to flair.
I assume since he's seeing a Pulmonologist, they have ruled out other lung problems such as Chronic Pulmonary Obstructive Disease (COPD) and Emphysema?
It definitely seems like further medical evaluation is necessary. If you are not happy with the current Pulmonologists answers, seek a second opinion. Good luck!
P.S. reflux is also an asthma trigger. Maybe those meds need tweaked as well
has he ever had his heart checked out....you sometimes can pass out when the vagus nerve is stimulated or if you have an arrythmia undiagnosed