Question: Congestion/Coughing/Production of Tone
After a lupus flare in 2006, I spent over 2 months in ICU, sedated and intubated. The diagnosis centered around pericardial and pleural effusion When I was released from ICU, I couldn't walk or talk and had to do rehab (occupational, physical, and speech) for several months. Since my lupus diagnosis in 2006, I've used Astelin Azelastine Hcl (Nasal) SPR 0.1% 137mg 2 sprays twice daily and Laratadine (Claritin) 10mg once daily. Now I still have a productive cough. There is thick mucus, sometimes with very small black stuff. Before it only happened in the morning; lately it’s more mucus and happening all day with sneezing and tears. I always feel like there is “stuff” in my throat. Ears, especially left, still feel clogged. I tried using the netti pot and rinsing with warm salt water a few times, and that seemed to help in clearing the ear canal by coughing up more and thicker mucus; but never totally clear. Plus once I coughed up a larger piece (a little smaller than the size of half a pencil eraser) of black mucus.
What might be causing the congestion, and what might be done to clear it up?
My speech has plateaued. I can talk, but I'm still hoarse and cannot sing. Will I get my singing voice back? Can you explain all this for me?

I've had two PFTs since the 20016 lupus diagnosis. I was diagnosed with bronchitis a couple of years ago, treated with antibiotics, I think, and got better, but the coughing was always there. Maybe I need another PFT, or something else is happening that prevents the production of tones for singing. Any other ideas?