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Developed skin rashes, asthma, cough, wheezing and have trouble in swallowing. What is going on?

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30/F... I have recently within the past 3-4 months developed really bed asthma, coughing, wheezing, trouble swallowing. I have also developed skin rashes within the same time frame. Symptoms much like those of Dyshidrotic Dermatitis keep reappearing on my one finger, and a completely different rash (red hot circle) just appeared on the inside of my elbow. I have gained significant weight within the last year, but that might not be related, as I quit smoking last year and had bad side effects from a birth control shot. Also, sometimes I get very itchy on the skin where my ears XXXXXXX my jawbone and occasionally on my neck under my chin. Most recently my cough wakes me up in the middle of the night or early in the morning, so it is definitely worse at night, and I occasionally cough so hard that I slightly lose control of my bladder. I literally gasp for air sometimes when I inhale and then I cough so hard after that it has become painful-- but not like a sore throat, I'm positive that its much more serious that that. I have since developed a metalic-blood sort of taste when I cough really hard, which may or may not be related to my asthma inhaler, as I'm just not sure whats what anymore. Last month my doctor sort of brushed of my symptoms as asthma and stress/anxiety related. I explained to him that I woke up one night coughing really hard and that my inhaler didn't help, it instead made my heart race. He suggested that it was a panic attack brought on from being scared from my "slight" asthma attack. My mother has severe asthma, COPD, sleep apnea, and her mother passed away at a very young age of 32 due to breathing related issues, so I understand the severity of it all. I also understand that some of these issues are not necessarily hereditary, but that the ability to develop them could be. I am so confused. Any ideas what could be going on with me? I don't even know where to start with my medical treatment, especially since getting the snub from the last doctor. Please help!
Posted Wed, 28 Nov 2012 in Lung and Chest disorders
Answered by Dr. Gyanshankar Mishra 5 hours later
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:

1. You seem to be suffering from bronchial asthma with atopic dermatitis.

2. Considering you symptoms and related family history, you need to get yourself evaluated in detail.

3. Your asthma management needs to be evaluated in detail by a Pulmonologist. Apart from clinical evaluation , investigations that may be required are Chest xray, Pulmonary function test,Serum IgE levels, ECG, Blood sugar, 2 d echo. If you have the history of sleep apnea in family and if you are obese, it is suggested that you too undergo a sleep study.

4. The asthma symptoms need to be managed based on your clinical profile and pulmonary function test results. Also for associated skin symptoms you need to be started on oral anti histaminic drugs (eg. levocetrizine) and an opinion of dermatologist be sought.

5. You need to do home peak flow monitoring with a peak flow meter so that any increase in symptoms can be picked up early and managed accordingly at home by escalating the home treatment (normally the doses of inhaled medicines are increased).

6. You should also consider allergy testing to rule out specific triggers.

7. Annual flu shots and 5 yearly pneumococcal vaccines are recommended for you.

8. If serum IgE levels are too much elevated then anti IgE medication options like omalizumab may be discussed with your treating physician / pulmonologist.

9. Stress if any needs to be treated in consultation with a psychiatrist as stress is a very important trigger.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
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