Discussions By Condition: I cannot get a diagnosis.

13 month dry "heroic" cough

Posted In: I cannot get a diagnosis. 35 Replies
  • Posted By: Anonymous
  • January 10, 2009
  • 04:27 AM

My symptoms are a 13 month long dry hacking gawd awefull full body contorting stop what I'm doing and almost pass out cough. I cough until I puke frequently if I don't take the prescription cough medicine. As of the last 4 or so months I've become short of breath with mild exertion. On occasion I feel light headed out of the blue and I am always exhausted. To say I'm tired is a massive understatement. Until Dec 07 I was a pseudo body builder and avid backpacker and in good health save an ACL and a broken ankle.

Over the counter Delsum and Day/NyQuill cut it for a good long time but after about four months they gave out on me.

I got sick in Dec. 07 with bronchitis and after 2 months of steroids and antibiotics I finally got a chest x-ray. Doc said Wegner's Granulomatosis and referred me to a Pulm. Pulm said your doctor is irresponsible, you don't have that, you have bronchitis. I asked if it could be asthma or something else, he said it's definitely not asthma, it's bronchitis and when I get it I get it real bad. Ten months, 90 missed days of work and gallons of Tussonex later I still have bronchitis.

I got a second opinion.

New Pulm. says it's definitely not bronchitis, he thinks it's asthma. Three months later, all known asthma meds, plus nebulizer and asthma challenge test later and it's not asthma.

More Tussonex.

Bronchoscopy and biopsy come back clean but my lungs are abnormally inflamed or irritated, forget which but they are also real red. I have calcified granulomas but they are apparently not the cause of my symptoms. I live in the midwest and I am told that this is normal around here.

I've had a combination of over 60 shots and *****s for allergens and it's only Elm trees for me. Had CT's of the chest and sinus as well as a MRI of the head after a bout of smelling smoke everywhere earlier in the process but that went away on it's own. Lab results from 4 ER visits now are within normal ranges with the liver enzymes slightly elevated. All others are within normal, albeit just, ranges- my wife is a nurse an peeked. I had an incident of confusion and disorientation two weeks ago and work sent me to the ER, had another officer drive me there. The coughing was phenomenal during this, even for me, and that's saying a lot. I can't account for half the shift and only have foggy memory of arriving at the ER at all. Blood tests again, IV's, some pills and shots and I was discharged 6 hours later when I had my senses about me again as I didn't have any "emergency" anymore and only slightly out of normal liver levels and only slightly elevated white blood cell count that they attributed to my numerous steroid and antibiotic treatments from the beginning of 2007.

Now I'm on a lidocaine nebulizer and it's helping the cough a lot but it's still there. Like the Tussonex, it just hides it a while. Chest hurts from coughing, cracked a rib early in 07 from it. My entire airway is raw. My Pulm. has me scheduled to see his research partner next week.

Any suggestions? I never smoked, had the occasional cigar on backpacking trips but that equates to maybe 4 cigars a year. Quit drinking 5 years ago. I quit using chewing tobacco 6 years ago after roughly 15 years of use. Heavy usage the last 2 years and I developed a patch on my gums that was slow healing. Turned out to be okay but I did not have a happy dentist.

Until this illness happened in Dec '07 I'd work out 2 hours a day, 5 days a week. I had a good diet and as I said, was an avid weight lifter and backpacker. Now I can't walk the stairs but a flight or two and I have to stop for breath sometimes, not always. I pace my walking for the same reason. And the cough is horrific, my first Pulm. labled it "heroic" and nobody, I mean nobody want's to be around me it is so bad.

Could use a little advice here, thanks in advance.

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35 Replies:

  • How old are you? Where do you live, where have you lived, where have you visited? What exactly do you mean by "slighly out of normal liver levels"? Do you have any other symptoms, nosebleeds, headaches anything?
    qwertyuiop123 453 Replies
    • January 10, 2009
    • 11:41 PM
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  • http://www.wrongdiagnosis.com/s/sarcoidosis/intro.htm Sarcoidosis can cause difficulty breathing, persistent cough, and granulomas, along with many other things. I'm not sure if you fit all of its symptoms, but it seems like it fits all of yours. Do you know if you have been tested for it?
    qwertyuiop123 453 Replies
    • January 10, 2009
    • 11:48 PM
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  • Okay, several points to be made here. First of all, based upon the fact that you live in the midwest, I would submit that the calcifications observed on your lungs are most likely past exposure to histoplasmosis, an extremely common finding on chest films and I would consider it unremarkable. Anytime we see an individual with a persistent cough of the duration being described, we want to avoid jumping to common conclusions such as bronchitis and asthma purely based upon symptoms and cursory lab results. I'd be interested to know whether a capsascin challenge test was performed and the results, as well as methacholine and histamine challenge tests. Realize that certain varieties of receptors are responsible for inducing cough and by examining them under artificial stimulation, we better understand the underlying cause. If these tests have not been performed, then I suggest that you discuss them with your primary care physician or specialist. Since the Raster test was generally unremarkable, I would not think the cough to be allergen related. My concern at this point is whether you may possibly have an Alpha-1 Antitrypsin deficiency. The fact that your liver enzymes are mildly elevated and you have a history of uncertain diagnoses related to bronchitis or asthma places you at particular risk. Understand that this deficiency is due to a gene mutation that occurs most often in persons 45 years of age or younger, although exceptions are observed, and the patient history is quite similar to your own. Depending upon precisely where you live, testing of this type might prove somewhat inaccessible unless a university hospital system is nearby and can send the sample to the appropriate laboratory to determine the outcome. There are certainly other underlying causes for persistent cough but with the presence of elevated liver enzymes, which is not that common in the absence of a directly related and known cause, the Alpha-1 deficiency needs to be ruled out. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • January 11, 2009
    • 02:37 AM
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  • Thanks for the replies gentlemen, I do appreciate it. 1) I'm in my early 30's and live in Omaha, Nebraska and am being treated by a Pulm. doctor I am confident in at UNMC. I'm fortunate that I have a lot of healthcare options here and UNMC is one of them. I have only lived here but I have traveled the country from the Carolinas to Alaska for work and play for most of my early adult life. I work at the largest jail in the state so that is always in the back of my mind with the possibility of catching something from work. I can't be more specific on the slightly elevated enzimes and white blood cell count, that's how it was explained to me. If there is a specific numerical value, I don't know it. The attending physician(s) in the ER visits were not concerned over it though. I get headaches but I attribute it to the constant coughing. It only happens when I'm on a real bender to the point of passing out from coughing. If any of you have ever been choked out, it's like that. It's not every day that I take the Tussonex but it's like 5 or 6 days a week. It keeps it to a dull roar and if I don't get too active or have to fight, it works acceptably for me. It's a godsend. I was getting nosebleeds earlier in 2007 but that stopped around August or so of 2007. That was also about the time the weird smoke smell went away. I was on a round of antibiotics and steroids again at that time and I think that killed whatever that was. From time to time I get a light headed sensation and from time to time I loose my balance but these are few and far between since I quit taking the assorted asthma inhalers. It was a several times a day thing and now it's about twice a week. 2) Not sure if I've been tested for Sarcoidosis or not. I can't say as the Pulm. has mentioned tissue thickening, nodules or enlarged lymph nodes. I know my wife has commented on how this acts like an auto immune disease and wants me to get my something (sed?) rates checked. I don't know if that has been done or not yet. I've given enough blood to make most crime scenes look like amateur hour though. My lung sounds are good, my bronchoscopy looked okay aside from the irritation and red lungs and the biopsy samples taken all came back good to go. Doc told my wife he doesn't know why I'm having this cough or the shortness of breath because the findings above aren't worrysome and my lung capacity is good. 3) I have not had a capsascin challenge test. Methacholine challenge test was conducted a few days ago and I passed it. I don't know the meaning of the numbers but I do know the numbers... I started at 90 and finished at 82. I had not taken the cough syrup for two days prior nor any other medication for that matter. No tylenol, etc. I don't know what the histamine challenge test is so I'll guess I've not had it. Alpha-1 Antitrypsin deficiency- Interesting you hit on that. My wife mentioned this too (nurse) and at our Dec. visit with the Pulm. asked if it could be this or some form of emphysema. The Pulm. said he wasn't going to guess at anything and wanted the CT's first. I don't think I was ever tested for that. I also have a buddy that is a paramedic and he said I act like an emphysema patient but that it didn't make sense. I have a pulse ox thing around here somewhere and I was using it for a few months but my O2 readings are normally 96-99% with a few low readings at rest of 92-94% when I'm just reading a book or watching a movie in the trusty recliner. Which by the way seems to help on the real bad nights if I sleep in it. I'm honestly not sure what to make of all of it. My current Pulm. is aware of all of the above and his stance was, until last week when I passed the challenge test, "It's just asthma and I see nothing here that concerns me." I see his research partner on the 22nd and I'll make sure we look into the Alpha-1 Antitrypsin deficiency thing. Other random bits of info:Relative had heart failure last year but he smokes and drinks Coke like it's do or die and has a high stress job. Until this, there was no family history of heart problems. Mom and cousin have allergy induced asthma. But I'm not allergic to much of anything. I don't even react to contact with poison ivy, but I don't push that one...Family tradition of Alzheimers. Thanks again for your time everyone. If anything else comes to mind, I'll be around.
    Sir Coughsalot 31 Replies
    • January 11, 2009
    • 04:12 AM
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  • Few other things. My first Pulm. had me off work for 60 consecutive days with orders to "Sit and do absolutely nothing. Take 2tsp of Tussonex every 12 hours and do nothing else. Don't do anything that makes you breathe harder because even breathing is injuring your airway. If I could I'd put you in a bubble and keep you still."That obviously didn't work well. I did feel better for about a week and then started to decline again. I have missed roughly 90 working days in 2008 and missed 4 this year so far. Lungs hurt a lot right now but I gues it's from the bronchoscopy and biopsy, usually they don't hurt this much. Mostly it's just a real bad irritation or for lack of a better description "cold" feeling inside them. I cough through the night and it wakes me up some nights but my wife says I cough all night long if I don't take the syrup prior to bedtime. I get what feels like a low grade fever and sweat often but the kids or dog usually destroy the digital thermometer as fast as we replace it. If it is a fever it's certainly a tiny one. I'm friggin' exhausted. I drag myslef through work and come home and sleep till dinner and then I'm okay for a few hours. I'm in bed by 10 most nights. Looks like my post before this one hasn't shown up yet... This may be out of order. My current Pulm. has also scheduled me an appointment with a Psych. Doc. because I asked him if it could all possibly be in my head since we wern't finding anything. I've been looking online for possible answers and you read a lot about people having anxiety disorders and such. Nobody I know thinks I'm having that kind of problem though. I've got what is considered to be a tough job but I think it's fun. He said it's not for him to say, just to look for physical possibilities but that I'm a good patient. I don't think it's in my head though. I lived to work out and I missed out on two backpacking trips in 2008 and one camping trip with my children and that was devistating. If it matters I'm 6'2" and 245lbs. About 10lbs fatter for the loss of exercise than I was at the end of 2007. Thanks again for all the advice from the responders.
    Sir Coughsalot 31 Replies
    • January 11, 2009
    • 04:37 AM
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  • I've read the addendum to your posting and again, recommend that you approach your doctors to have testing performed that would determine whether you have an Alpha-1 Antitrypsin deficiency. We're not speaking of some type of simple vitamin or supplement deficiency here, but rather a change in body chemistry as a result of a gene mutation. I'm also suggesting that you have the capcaicin, methacholine and histamine challenge tests performed unless already conducted, which would tend to help confirm or rule out the more traditional diseases being suggested as the underlying cause. Since you're also demonstrating a low-grade fever, I simply want to reconfirm that the cough is non-productive. Latent TB is a possibility under certain circumstances, as well as a micoplasm infection. I'm assuming that a PPD or TB skin test has already been performed. Incidentally, your symptoms are entirely inconsistent with a psychogenic cough of the type commonly encountered in children and even more rarely in adults. There is too much supporting clinical evidence to suggest otherwise, together with the fact that psychogenic cough is not demonstrated during sleep. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • January 11, 2009
    • 00:57 PM
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  • In my experience with Alpha-1 Antitrypsin defiency,the patient had COPD and a very productive cough,all this by age 45.
    richard wayne2b 1232 Replies
    • January 11, 2009
    • 02:17 PM
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  • Sorry, looks like a rather lengthy post in response to the various questions got lost. The cough is non productive, just a dry deep hacking. I live in Omaha and am being treated by a Pulm. I trust at U.N.M.C. so testing is not a problem. My Methocholine numbers I know, but don't know what they stand for. Beginning test was 90, end of test an hour later was 82. I'll go back and reanswer the other questions if my missing post doesn't show up by tonight. Thanks.
    Sir Coughsalot 31 Replies
    • January 11, 2009
    • 02:25 PM
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  • What is your ancestry?People with Northern European,Iberian,and Saudi Arabian ancestry are more likely to get A1At deficiency.
    richard wayne2b 1232 Replies
    • January 11, 2009
    • 02:25 PM
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  • I too are going to say that your cough dont at all sound psychological, just cause the doctors cant figure it out it dont mean it's psychological. My father used to get a psychological cough and it's nothing like you are experiencing there. Also if it was purely psychological, you wouldnt have some of the other symptoms eg low grade fever, elevated white blood cell count and the raised liver liver enzymes. That sounds something like viral to me. have you been tested for Mycoplasma pneumonia (can last about a month but if one had a compromised immune system in some way i guess things like that could hang about. Im saying that as it's something my specialist tested me for cause of my ongoing long term bad health)............ "I am always exhausted. To say I'm tired is a massive understatement." "Had CT's of the chest and sinus as well as a MRI of the head after a bout of smelling smoke everywhere earlier in the process but that went away on it's own" i know of one illness to which all your symptoms (including those blood findings are often found as well) do fit including the abnormal smell thing and some with it do have a cough (my own cousin and me have this illness and one of her major symptoms she gets with it is a bad cough many dont realise that some get a cough with this condition). i myself have had abnormal smell sense (smelling, also tasting things which arent there.. so i had MRIs and EEGs too). I suggest you have an EEG and see if unspecific abnormality shows up in that as with the illness im about to suggest.. most of us show up a certain unspecific abnormality on the EEG and doctors usually dismiss this cause they dont realise what it means (or put the abnormality down to drug use) If nothing else pans out.. dont go jumping to think it's psychological but rather you may in fact have "chronic fatigue immunity dysfuction". The CDC says that 80% of us remain undiagnosed (doctors aint good at diagnosis this issue as most dont know enough about it and hence are confused on it all). If you do have this.. many doctors also think it's a "females" illness but in fact 25% who get it are male. http://wwcoco.com/cfids/bernesx.html (you will see cough mentioned in the other general symptoms area on there) http://www.cdc.gov/cfs/cfssymptomsHCP.htm (chronic cough and shortness of breath is mentioned there too) (note that they keep changing the defination of this illness as they dont know all that much about it and are still trying to work it out and just cause you dont have a symptom like muscle pains or headaches.. it doesnt necessary mean that you dont have this illness. based on current research thou there may be a proper diagnostic blood test for this illness out within a year).......... i also suggest for you to check out the canadian CFIDS diagnostic criteria as it's different to the American one (actually a stricter criteria) to see if you meet that criteria.
    taniaaust1 2267 Replies
    • January 11, 2009
    • 02:26 PM
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  • DIAGNOSTIC PROTOCOLAlthough it is unlikely that a single disease model will account forevery case of ME/CFS, there are common clusters of symptoms that al-Clinical Working Case Definition of ME/CFSA patient with ME/CFS will meet the criteria for fatigue, post-exertionalmalaise and/or fatigue, sleep dysfunction, and pain; have two or moreneurological/cognitive manifestations and one or more symptomsfrom two of the categories of autonomic, neuroendocrine and immunemanifestations; and adhere to item 7.1. Fatigue: The patient must have a significant degree of new onset,unexplained, persistent, or recurrent physical and mental fatiguethat substantially reduces activity level.2. Post-Exertional Malaise and/or Fatigue: There is an inappropriateloss of physical and mental stamina, rapid muscular and cognitivefatigability, post exertional malaise and/or fatigue and/or pain anda tendency for other associated symptoms within the patient's clus-ter of symptoms to worsen. There is a pathologically slow recoveryperiod–usually 24 hours or longer.3. Sleep Dysfunction:* There is unrefreshed sleep or sleep quantity orrhythmdisturbancessuchasreversedorchaoticdiurnalsleeprhythms.4. Pain:* There is a significant degree of myalgia. Pain can be experi-enced in the muscles and/or joints, and is often widespread and mi-gratory in nature. Often there are significant headaches of newtype, pattern or severity.5. Neurological/Cognitive Manifestations: Two or more of the fol-lowing difficulties should be present: confusion, impairment ofconcentration and short-term memory consolidation, disorienta-tion, difficulty with information processing, categorizing and wordretrieval, and perceptual and sensory disturbances–e.g., spatial in-stability and disorientation and inability to focus vision. Ataxia,muscle weakness and fasciculations are common. There may beoverload1phenomena: cognitive, sensory–e.g., photophobia andhypersensitivity to noise–and/or emotional overload, which maylead to “crash”2periods and/or anxiety.Carruthers et al.11Page 66. At Least One Symptom from Two of the Following Categories:a. Autonomic Manifestations: orthostatic intolerance–neurally me-diated hypotenstion (NMH), postural orthostatic tachycardiasyndrome (POTS), delayed postural hypotension; light-headed-ness; extreme pallor; nausea and irritable bowel syndrome; uri-nary frequency and bladder dysfunction; palpitations with orwithout cardiac arrhythmias; exertional dyspnea.b. Neuroendocrine Manifestations: loss of thermostatic stability–subnormal body temperature and marked diurnal fluctuation,sweating episodes, recurrent feelings of feverishness and coldextremities; intolerance of extremes of heat and cold; markedweight change–anorexia or abnormal appetite; loss of adaptabil-ity and worsening of symptoms with stress.c. Immune Manifestations: tender lymph nodes, recurrent sorethroat, recurrent flu-like symptoms, general malaise, new sensi-tivities to food, medications and/or chemicals.7. The illness persists for at least six months. It usually has a distinctonset,** although it may be gradual. Preliminary diagnosis may bepossible earlier. Three months is appropriate for children.To be included, the symptoms must have begun or have been signifi-cantly altered after the onset of this illness. It is unlikely that a patientwill suffer from all symptoms in criteria 5 and 6. The disturbances tendto form symptom clusters that may fluctuate and change over time.Children often have numerous prominent symptoms but their order ofseverity tends to vary from day to day. *There is a small number of pa-tients who have no pain or sleep dysfunction, but no other diagnosis fitsexcept ME/CFS. A diagnosis of ME/CFS can be entertained when thisgroup has an infectious illness type onset. lows a clinical diagnosis............Your symptom with the smelling something which isnt there.. is a neurological manifestation of this illness (thou not listed in that list). You have had the confusion so would met that catagory. Sounds like you would meet both catagory 1 and 2 with your energy levels and having to take time work etc. Being an infectious illness type onset eg cough, fever you dont need to meet the sleep dysfunction and pain criteria for a CFIDS diagnoses.You dont need to meet a, b and c in criteria six.. you meet 6b with the sweating, and 6 c with the immune manifestations..l. cough, fever i hope this explaination explains why im suggesting this illness as a possiblity in your case to you and others here. so keep this illness in mind if no other cause can be found.
    taniaaust1 2267 Replies
    • January 11, 2009
    • 02:44 PM
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  • This may sound too simple of a fix, but I've had a serious, consistent cough for nearly two years. I've been to numerous ENT docs and have been prescribed the usual nosesprays, cough syrups, testing, etc. etc. for no fix. My recent ENT prescribed the famous purple pill (Nexium) and I am only coughing once a day (small cough) instead of 24 hours a day! Simple but is working!
    painful tum 4 Replies
    • January 11, 2009
    • 09:31 PM
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  • What is your ancestry?People with Northern European,Iberian,and Saudi Arabian ancestry are more likely to get A1At deficiency.I'm a German Irish mutt.
    Sir Coughsalot 31 Replies
    • January 11, 2009
    • 09:47 PM
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  • This may sound too simple of a fix, but I've had a serious, consistent cough for nearly two years. I've been to numerous ENT docs and have been prescribed the usual nosesprays, cough syrups, testing, etc. etc. for no fix. My recent ENT prescribed the famous purple pill (Nexium) and I am only coughing once a day (small cough) instead of 24 hours a day! Simple but is working!Yep, I've been on that but it didn't seem to do anything for my case. Thanks though, I appreciate the information from everyone. It'll at least give me some options to discuss with at the next appointment. This forum is a stroke of good luck.
    Sir Coughsalot 31 Replies
    • January 11, 2009
    • 09:58 PM
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  • With this Alpha-1 Antitrypsin deficiency, wouldn't it show up on my lungs when they did the bronchoscopy or the biopsy?I see my wayward post finally showed up too, that's going to save some typing, heh.
    Sir Coughsalot 31 Replies
    • January 11, 2009
    • 10:04 PM
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  • Okay, several points to be made here. First of all, based upon the fact that you live in the midwest, I would submit that the calcifications observed on your lungs are most likely past exposure to histoplasmosis, an extremely common finding on chest films and I would consider it unremarkable. Anytime we see an individual with a persistent cough of the duration being described, we want to avoid jumping to common conclusions such as bronchitis and asthma purely based upon symptoms and cursory lab results. I'd be interested to know whether a capsascin challenge test was performed and the results, as well as methacholine and histamine challenge tests. Realize that certain varieties of receptors are responsible for inducing cough and by examining them under artificial stimulation, we better understand the underlying cause. If these tests have not been performed, then I suggest that you discuss them with your primary care physician or specialist. Since the Raster test was generally unremarkable, I would not think the cough to be allergen related. My concern at this point is whether you may possibly have an Alpha-1 Antitrypsin deficiency. The fact that your liver enzymes are mildly elevated and you have a history of uncertain diagnoses related to bronchitis or asthma places you at particular risk. Understand that this deficiency is due to a gene mutation that occurs most often in persons 45 years of age or younger, although exceptions are observed, and the patient history is quite similar to your own. Depending upon precisely where you live, testing of this type might prove somewhat inaccessible unless a university hospital system is nearby and can send the sample to the appropriate laboratory to determine the outcome. There are certainly other underlying causes for persistent cough but with the presence of elevated liver enzymes, which is not that common in the absence of a directly related and known cause, the Alpha-1 deficiency needs to be ruled out. Best regards, J Cottle, MDWould you mind if I printed this off and took it to my next appointment?
    Sir Coughsalot 31 Replies
    • January 11, 2009
    • 10:06 PM
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  • Thanks for the replies gentlemen, I do appreciate it. 1) I'm in my early 30's and live in Omaha, Nebraska and am being treated by a Pulm. doctor I am confident in at UNMC. I'm fortunate that I have a lot of healthcare options here and UNMC is one of them. I have only lived here but I have traveled the country from the Carolinas to Alaska for work and play for most of my early adult life. I work at the largest jail in the state so that is always in the back of my mind with the possibility of catching something from work. I can't be more specific on the slightly elevated enzimes and white blood cell count, that's how it was explained to me. If there is a specific numerical value, I don't know it. The attending physician(s) in the ER visits were not concerned over it though. I get headaches but I attribute it to the constant coughing. It only happens when I'm on a real bender to the point of passing out from coughing. If any of you have ever been choked out, it's like that. It's not every day that I take the Tussonex but it's like 5 or 6 days a week. It keeps it to a dull roar and if I don't get too active or have to fight, it works acceptably for me. It's a godsend. I was getting nosebleeds earlier in 2007 but that stopped around August or so of 2007. That was also about the time the weird smoke smell went away. I was on a round of antibiotics and steroids again at that time and I think that killed whatever that was. From time to time I get a light headed sensation and from time to time I loose my balance but these are few and far between since I quit taking the assorted asthma inhalers. It was a several times a day thing and now it's about twice a week. 2) Not sure if I've been tested for Sarcoidosis or not. I can't say as the Pulm. has mentioned tissue thickening, nodules or enlarged lymph nodes. I know my wife has commented on how this acts like an auto immune disease and wants me to get my something (sed?) rates checked. I don't know if that has been done or not yet. I've given enough blood to make most crime scenes look like amateur hour though. My lung sounds are good, my bronchoscopy looked okay aside from the irritation and red lungs and the biopsy samples taken all came back good to go. Doc told my wife he doesn't know why I'm having this cough or the shortness of breath because the findings above aren't worrysome and my lung capacity is good. 3) I have not had a capsascin challenge test. Methacholine challenge test was conducted a few days ago and I passed it. I don't know the meaning of the numbers but I do know the numbers... I started at 90 and finished at 82. I had not taken the cough syrup for two days prior nor any other medication for that matter. No tylenol, etc. I don't know what the histamine challenge test is so I'll guess I've not had it. Alpha-1 Antitrypsin deficiency- Interesting you hit on that. My wife mentioned this too (nurse) and at our Dec. visit with the Pulm. asked if it could be this or some form of emphysema. The Pulm. said he wasn't going to guess at anything and wanted the CT's first. I don't think I was ever tested for that. I also have a buddy that is a paramedic and he said I act like an emphysema patient but that it didn't make sense. I have a pulse ox thing around here somewhere and I was using it for a few months but my O2 readings are normally 96-99% with a few low readings at rest of 92-94% when I'm just reading a book or watching a movie in the trusty recliner. Which by the way seems to help on the real bad nights if I sleep in it. I'm honestly not sure what to make of all of it. My current Pulm. is aware of all of the above and his stance was, until last week when I passed the challenge test, "It's just asthma and I see nothing here that concerns me." I see his research partner on the 22nd and I'll make sure we look into the Alpha-1 Antitrypsin deficiency thing. Other random bits of info:Relative had heart failure last year but he smokes and drinks Coke like it's do or die and has a high stress job. Until this, there was no family history of heart problems. Mom and cousin have allergy induced asthma. But I'm not allergic to much of anything. I don't even react to contact with poison ivy, but I don't push that one...Family tradition of Alzheimers. Thanks again for your time everyone. If anything else comes to mind, I'll be around.What do the numbers mean in section 3) above? And would the Alpha1 show up on a bronchoscopy of the lungs? Sorry if I'm pestering. Thanks for your time everyone.
    Sir Coughsalot 31 Replies
    • January 12, 2009
    • 11:27 PM
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  • I wouldn't suggest printing it off, as some doctors hate to be sort of underminded by the internet. I might instead say your wife is a nurse and introduce the information that way, as the doctor will be less likely to write off your wife then he will be to write off advice from the internet. That has been my experience, but its kind of like a pro-con thing, it could really go either way.
    qwertyuiop123 453 Replies
    • January 15, 2009
    • 00:00 AM
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  • I wouldn't suggest printing it off, as some doctors hate to be sort of underminded by the internet. I might instead say your wife is a nurse and introduce the information that way, as the doctor will be less likely to write off your wife then he will be to write off advice from the internet. That has been my experience, but its kind of like a pro-con thing, it could really go either way. Ive found that that all depends on what exactly you bring in to them to read. If its from a source they recognise.. eg the CDC site or another proper medical site eg medweb. Many doctors wont mind. something coming from another doctor who is speaking in doctors terms..many doctors may not mind that either. So who knows.. this persons doctor may not mind JCottles post. (i guess that would depend on the individual doctors ego and if he feels like another is undermining him). But if one bombarbs their doctors with things which are not obviously relevent to the doctor in anyway or from sites the doctors dont recognise. Yes in those cases most doctors will then start ignoring anything brought in.
    taniaaust1 2267 Replies
    • January 15, 2009
    • 06:41 AM
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  • Understood, good call on the wife angle. Thanks fellas.
    Sir Coughsalot 31 Replies
    • January 16, 2009
    • 03:43 AM
    • 0
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