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Suggest treatment for breathlessness, wheezing, cough and increased fatigue

DOCTOR OF THE MONTH - Sep 2017
Sep 2017
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Pulmonologist
Practicing since : 2008
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Hi--soon after I moved into an apartment in a very old house(due to divorce), I began having increased SOB, wheezing, coughing, and increased fatigue. I an 60, and on disability, but this has reached a severe state. I also have cats; one cat has died, and 2 weeks ago, another cat when comatose, and the others were having the same symptoms I've been having. The SOB is severe at times, with cyanosis present as well. When I got the comatose cat to the vet, she said his CXR was consistent with an environmental issue. Everytime the cats and I go back into the apt, the one cat slips back into a comatose state & stops breathing, and the rest of us are not much better. When away from the apt, my symptoms are still present, but greatly reduced. We moved into a temp. apt., and they had the apt. tested. It supposedly came back negative for black mold and asbestos. Can you shed any light on the situation PLEASE? Thank you.
Tue, 29 May 2018 in Lung and Chest disorders
 
 
Answered by Dr. Kaushal Bhavsar 3 hours later
Brief Answer:
Please get the allergy testing done.

Detailed Answer:
Thanks for your question on HealthcareMagic.
I can understand your concern.
By your history and description, a possibility of allergy is more likely.

There is something in the apartment which is causing allergy to you and your cats as well.

This could be anything like paint or some particular smell or carpet dust or furniture polish or water tank chemicals etc.

The best treatment of allergy is the identification of allergen and if possible complete avoidance of it.

So please get done detailed allergy testing of yours.
Also get done serum IgE level.
If IgE is raised then go for detailed IgE levels to identify allergens.

Please let me know:

1. Which inhaler are you taking?
2. Have you ever undergone allergy testing?

Please let me know the answers to above-asked questions so that I can guide you better.

I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for breathlessness, wheezing, cough and increased fatigue 1 hour later
Thank you for your response. The inhaler I'm on is Dulera 200mcg/5mcg; 2 puffs BID. No, I have not undergone any allergy testing. The allergy doc said I didn't have allergies. I have to take anywhere from 2-5 24hr-dose allergy pills/day, as well as a decongestant 0-4/day. I developed adult onset asthma, but it doesn't usually give me trouble, unless I'm around something too strong or back in that apartment. My hair was literally falling out by the handfulls, I had no appetite, and my brain was even more "fuzzy" than usual(I have severe fibromyaglia + a host of other hlth issues). But have never had the severe SOB & wheezing like I have been experiencing. They got the air samples report back; it states that it was a "limited" test, but on that level, did not indicate a problem with mold or asbestos. But, there's GOT to be SOMETHING in that apt. My cats were having the exact same symptoms as myself; they had stopped eating totally, & were totally lethargic, coughing, and sneezing too. I use the highest level of allergy filtration air filter that's supposed to last 3 months;mine was full and nearly black in a matter of weeks. But no one will listen to me! Now they say I have to move out of the temporary apt too. Since being here, my cats are eating me out of the house, playful again, & doing fine....but they received treatment. I'm better in the new apt, but not improving as no one will take me seriously, so no real treatment. Now they all think I'm just some nut case. I'm not an MD, but worked in the hlth field x 15 years as an EMT/Corpsman, Resp. Therapist, Telemetry Tech, did just about anything. This is not normal for me. When I go to the "old" apt to get clothes, etc. my nose & throat burn, and the SOB/wheezing gets worse. Sir, where do I go from here if no one will listen. I'm a f/t student too, and all my professors have witnessed everything, as have other students. Spasmodic coughing requires that I leave class some times. If no one will help me or believe me, where do I go from here?? Will this be a long-term or chronic issue now?
 
 
Answered by Dr. Kaushal Bhavsar 30 minutes later
Brief Answer:
You should consult another allergy specialist.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
If untreated, this can be chronic long term disease.
In my opinion, you should definitely consult another allergy doctor and discuss your case.
Get done detailed allergy report and find out causative allergen in your case.
Newer treatments are available for allergy like immunotherapy, omalizumab (monoclonal antibody) etc.
You should definitely try these treatments.
Please let me know
1. Have you ever undergone PFT (Pulmonary Function Test)?
2. Have you ever consulted pulmonologist?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for breathlessness, wheezing, cough and increased fatigue 1 hour later
Yes, I did have a PFT done, and was so SOB I barely made it through it. He said it was "normal." While it has been a long time since having one, due to scoliosis & kyphosis, I don't have full lung capacity anyway, and haven't had a "normal" PFT since age 20. I have seen our local pulmonologist, but, forgive me, it's been an absolute waste of time. He never even took a history on me, and sends me out the door so fast, I don't have time to discuss anything with him. I called his office yesterday, to update him on the situation and to see if he would order any labs. I was curtly told to wait until my appt in January to discuss that with him, and they hung up. Like I said, I can't get anyone to listen or do anything. I do now have the name of another pul. doc in VA, but have to wait till Christmas is over now. Unfortunately, hlth care in our town is far less than desireable. I've been to the ER 14 times since XXXXXXX because I don't have proper care. Very frustrating. Is there any agency that I can go to that will follow up on this with me, or contact an attorney, or what? I missed so much class this past semester that I had to get a month extension to get assignments done. Can't take another semester like these last 2. Is there anything I can do to "detox" or anything else to help myself improve? Can all this be printed out? Can I go to a lab and request those tests myself? Thanks.
 
 
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
This is very disappointing.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
By hearing your story, I am very much worried now. This is very disappointing.
Person is genuinely symptomatic and they are doing nothing.
This is pathetic stuff from medical side.
You are genuine case of allergy and yet to be recieve treatment.
Sorry to say but this conversation is not for medico legal purpose.
You can definitely take out print out of this and show to some doctor and ask for allergy tests.
Which anti allergic drug you are taking?
I can guide you better anti allergic drugs if you are not taking them.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for breathlessness, wheezing, cough and increased fatigue 35 hours later
Thank you for your time and response, but especially for confirming that I'm not loosing my mind, LOL! I take 1 Xyzol at bedtime, and Claritin & Phenyl.decong. during the day, plus the inhaler BID. Just using it BID is better than nothing, but leaves me without a rescue inhaler. I've been given the nickname "Squeaky" because of the audible wheezing. Now that we're closed up with heat running, I keep a vaporizer running nearly 24/7. It has reached the point of completely controlling my life, even more so than any of my other health issues. Amazing how exhausted one can get trying to breathe! I was notified yesterday that the air quality test results are back; "acceptable" levels of asbestos and black mold, but no other comments about any other allergens. I've been given 30 days to get out. My concern isn't just for myself and my cats, but also for whomever may move in after me. If they have a compromised immune system, worse allergy/asthma than I DID have, they could really have trouble. Other than the above info, anything else I can/should be doing to get through this or to "detox?" Thank you!
 
 
Answered by Dr. Kaushal Bhavsar 10 hours later
Brief Answer:
You should take combination of montelukast and levocetrizine.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through the drug list you have mentioned.
You are not taking any anti allergic drug.
So better to start montelukast (anti allergic) and levocetrizine (antihistamine) combination instead of plain levocetrizine (Xyzal).
This might give you more relief.
This combination should be given once a day at night before going to sleep.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for breathlessness, wheezing, cough and increased fatigue 34 hours later
Can those 2 meds be purchased OTC? If so, is there also a ge?neric choice for them? Any other options for the coughing? I've just been taking the inhaler BID & dextrom. OTC, but still having episodes of spasmodic coughing that leave me severly SOB, usually results in vomiting and bladder leakage unfortunately. If I can't get any help locally, will have to do what I can to get a handle on this before classes start again on 1/15, and be moved out by 1/30. Very difficult to do without physical help AND when you can't breathe. Thank you so very much for all your time, input, and understanding.
 
 
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
These drugs are not available OTC in US

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry to say but I don't think you will get these drugs over the counter.
Better to consult another doctor and discuss about these drugs and get prescription for these drugs.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by
 
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