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Feeling tight chest and cough. Having short of breath. Treatment?

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Practicing since : 2006
Answered : 554 Questions
Hi Dr.

I just need another opinion. I Have asked a couple other Drs. on here with different answers.

So, I had these porcelain tiles installed in my house. They cut the tiles in the house and all this dust in the house. My girlfriend would not leave and we stayed in the bedroom, cleaning it up over several days and not realizing how much dust and how XXXXXXX it was.

I got really sick and left the house. i felt like very tight chest and major inflammation and a hollow feeling in the chest. I felt like I almost died and could barely breath with a very restricted chest also. Also very dry crystal sounding cough, but only voluntarily. This was 3.5 months ago.

Now I feel as if i am kind of healed up except for a some restriction in the lower center of the chest by sternum area and lower lungs in the back.
Still a dryness when I try to cough. I have not had an involuntary cough the entire time pretty much.
Also, I still have this hollow dry feeling and sound in my breath, especially exhale.
And, my breathing feels not the same as before. A little short of breath still.

So what do you think is my diagnosis? Can I heal all the way without any future symptoms?

Do you think there is permanent damage to my respiratory epithelium, causing the dry hollow feeling and sound when i exhale?



Also. Ct scan six weeks after incident showed a small patchy area of infiltrates on right upper lobe. Normal xray and pft three weeks ago (3 months after incident).
Posted Mon, 3 Jun 2013 in Lung and Chest disorders
Answered by Dr. Satyadeo Choubey 1 hour later
Thanks for your query.
I went through your symptoms and strongly feel that it is some sort of acute silicosis like symptom, similar as if some one is exposed to heavy rock blasting.
The treatment usually consists of supporting one with inhaled steroids and bronchodilator which you are already taking.
You must monitor your disease by a repeat pulmonary function testing and see if there is any improvement.
There is some special advice. Avoid contact with tuberculosis patient as you are prone to get it. And avoid smoking for the same reason. The mechanism is silica dust is toxic to lung defence mechanism (macrophages) which counteracts tuberculosis and smoking further attenuates it.
Do continue the inhaled medications. You can try increased doses of inhaled steroid if on mild to moderate doses at present.
Prognosis of the disease is not too bad, so don't worry. It will slowly go away.
Just get on to me with repeat pulmonary function test.

Best wishes

Above answer was peer-reviewed by
Follow-up: Feeling tight chest and cough. Having short of breath. Treatment? 4 hours later
Hi, i do not understand. Do you think it is actual acute silicosis? They say that is fatal disease? And does not go away?
Answered by Dr. Satyadeo Choubey 4 hours later
Again I will say don't worry too much. I said earlier that it is some sort of acute silicosis like symptom, not truly acute silicosis. Acute silicosis usually doesn't occur after a single dose exposure (multiple heavy doses over a shorter period) and also there is a lag period of months before disease becoming apparent . And usually do not get relieved by the period of three months.

Your case can be described as respiratory manifestation of inhaled stone dust. That's all. If your respiratory epithelium has been damaged permanently, your symptoms would not have been improving.
Follow your case with PFT, which will normalise in due course of time....

Best wishes
Above answer was peer-reviewed by
Follow-up: Feeling tight chest and cough. Having short of breath. Treatment? 3 hours later
Hi Dr.

Ok, I hope you are correct. It just seems like a fine line of it being for real acute silicosis or acute silicosis symptoms only.

It was a lot of dust for the first few days and even during the remainder of the week. We spent many hours inside the house. It was so cold outside we could barely open the windows also. I was so foolish for staying in the house. I just could not believe it to be so harmful, and so much of it. It was very fine and I could barely see it as well.

I do feel improvement, but I was so sick in the beginning that I feel as if I could only die or get better from that point. I felt like my body became overwhelmed and injured badly

I guess I am just still afraid of not having a normal life again, or even worse dying a horrible death. I guess I am just looking for whatever reassurance that I can get. but also honestly so I can understand it is a possibility.


Answered by Dr. Satyadeo Choubey 2 hours later
Thanks again,
Hopefully helped you.

Best wishes.
Above answer was peer-reviewed by
Follow-up: Feeling tight chest and cough. Having short of breath. Treatment? 28 minutes later

I just realized the dry hollow whistly sound when I exhale has a name and is called Stridor. Is that something that can heal with time on its own, or should I be concerned? I read that my trachea may collapse because of it? I have exhaled hard to hear it more and it sounds like a pop or crackle almost.

Also, how long of time to you think before I may become asymptomatic with my other sypmtoms?

How long do you think before I should get another xray or CT scan? I would like to make sure nothing shows up in the future.

Answered by Dr. Satyadeo Choubey 2 hours later
Thanks for follow up,
Considering your speedy recovery I think you may be normal in a month or two.
You may get a repeat CT scan after 6 months of exposure. Your x-ray and PFT was already normal, so I don't think new abnormality attributable to the exposure will develop. You can follow up with PFT 3- 6 monthly ( not needed actually).
In repeat CT scan just see whether that lesion has increased in size or not. If it is stable don't worry, many a times acute lesion heal by small fibrosis and it harmlessly persist for life.
And yes avoid smoking and tubercular contacts....

Best wishes
Above answer was peer-reviewed by
Follow-up: Feeling tight chest and cough. Having short of breath. Treatment? 28 minutes later
Ok. I hope you are right, and ill heal up. I did always want to to live in philippinnes again. Can i get a tb vaccine?

If I heal up ALL the way, i meant. Acute silicosis does not sound good. I hope you are certain about it not being real acute silicosis.

I have that whistle and harsh dry sound when I put my chin down and exhale.
I thought that it was maybe my epithelium. Do you think it is Stridor? And can it go away with time? It does seem a little better then originally

One last thing. My lungs seems to hold in cold air and moisture longer now. Like if i take a hot shower and then come out after a few minutes, there is still moisture blowing out of my mouth. Could that be respiratory damage?
Answered by Dr. Satyadeo Choubey 16 minutes later
Thanks for follow up,
I am quiet sure that you are not having acute silicosis.
Whistling sound occurring chiefly during exhalation signify air way constriction and are termed wheeze. They use to be relieved by bronchodilator which you are taking. They may occur in any acute insult to airway mucosa or in obstructive airway diseases like asthma.
Stridor are chiefly inspiratory sound heard due to proximal large airway obstruction like trachea obstructed by foreign body.
I think you have got wheeze. If it is not the asthma, wheeze will certainly go away.
Moisture blowing out of lung signifies temperature difference between exhaled air and environment, nothing to do with respiratory damage.

Best wishes
Above answer was peer-reviewed by
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