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Suggest Treatment For Chronic Chest Pain, Body Pain, Shortness Of Breath And Cough

Posted on Mon, 17 Dec 2018

Question: I have chronic chest pain shortness of breath and cough for one year. I was referred to a pulmonologist by several ER doctors and primary doctors. I went to pulmonologist and had pulmonary function testing done that was basically normal showing only mild restriction. I had a CT scan done. The Ct showed rib fractures, from so much coughing, and nodules that he didn't think were of a concern. He didn't think asthma was at work here. I have history of allergies and lupus with chronic body pains as well. I am now chronic dyspnea. With very few findings or help, is a pulmonologist no longer necessary? What do I do with chronic shortness of breath? Am I just to assume that it's constantly allergies?

Answered by Dr. Drkaushal85 (44 minutes later)

Brief Answer:

Get done PFT (Pulmonary Function Test).

Detailed Answer:

Hello,

No, this is not true. You should consult a pulmonologist on a regular basis. For chronic shortness of breath, you should definitely get a PFT (Pulmonary Function Test) done. PFT will not only diagnose bronchitis but it will also tell you about the severity of the disease and the treatment is based on its severity only.

You will need inhaled bronchodilators (Formoterol or Salmeterol) and inhaled corticosteroid (ICS) (Budesonide or Fluticasone).

Please let me know the following:
1. Are you taking any inhaled treatment?
2. Have you ever undergone PFT?
3. Do you smoke?

Please reply to the above asked questions, so that I can guide you better. I will be happy to help you further.

Wish you good health.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (30 minutes later)

Not now. I've had albuterol and several other inhalers in the past and they didn't help. Albuterol even decreased my lung function some. Are PFT's where you blow into a tube several times? I've had that done several times and they say it shows mild constriction. I don't smoke. I tested for low oxygen levels some years back and took oxygen for several years, as needed, two liters, in which time it did help my shortness of breath some. This doctor however says oxygen will not help shortness of breath. That was not my experience. It isn't helping as much now but I am not sure if that is because I cut back using it or because I have a lot of additional pain now too from the cough and rib brakes which oxygen won't help that. Should I still follow up with pulmonologist though regularly? I'm just not sure what to do at this point with so little information now. Is asthma still a possibility even if it doesn't show up on CT scan and basically normal spirometry?

Answered by Dr. Drkaushal85 (21 hours later)

Brief Answer:

Yes, you should definitely consult a pulmonologist regularly.

Detailed Answer:

Yes, you should definitely consult a pulmonologist regularly. The possibility of bronchitis is more likely in your case and bronchitis or asthma can not be diagnosed by CT scan.

You need to get done PFT again. It is better to start newer long acting inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) than albuterol which is short acting).

Consult pulmonologist and discuss all these.

Hope I have solved your query.

Wish you good health.

Thanks.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

Above answer was peer-reviewed by : Dr. Raju A.T