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Vakul Aren
Vakul Aren, Doctor
Category: Health
Satisfied Customers: 3386
Experience:  MBBS,DTM&H( Univ of Liverpool),34yrs experience in practice
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My wife and I went to Sicily on tour for 13 days and then to

Customer Question

My wife and I went to Sicily on tour for 13 days and then to Rome for 5 days in May this year. For the first 4 nights in Sicily hotel room I slept next to A/C unit developed a lot of coughing. Upon return to California, I went to Kaiser DR and he said Bronchitis and Asthma, gave me Qvar inhaler and 5 day series of Prednisone. Three weeks later little improvement, so Pulmonologist gave me 7 day series of Prednisone, and now still not much improvement so he gave me 21 day series Prednisone and said next step could be Brachoscopy.It has always been only coughing and rattleiing/noisy breathing. I have never had trouble breathing. Never had to use the Albuterol inhaler he gave me at the first appointment. Have not ever coughed up dark mucous. Not ever a smoker. I am 78 years old and have been in very good health. No history of Bronchitis or asthma in family.Breathing test showed only slight asthma. what next??????? to try?
Submitted: 3 years ago.
Category: Health
Expert:  Vakul Aren replied 3 years ago.
Dear customer,
greetings.The cause of sudden development of cough and subsequent asthma may occur due to a variety of reasons.Exposure to bacteria/fungal infections may lead to a hypersensitivity Pneumonitis which may cause similar problems.Air conditioners may carry fungii and bacteria in the system if not maintained properly leading to such problems. Interstitial Pneumonitis,Cryptogenic Organising Pneumonia,Interstitial lung disease due to various causes and idiopathic interstitial pulmonary fibrosis(IIPF) are other conditions which may cause this.Drug induced reactions and lung disease secondary to autoimmune diseases are other possibilities.X-Rays,sputum examinations and cultures,Pulmonary function tests,High resolution CT Scans apart from routine haemogram ,Immunoglobulin tests will help reach a diagnosis.Bronchoscopy with a trans bronchial lung biopsy may help reveal a diagnosis which can guide further treatment.Lung Physiotherapy,rehabilitation and exercise, supplemental Oxygen therapy are the next steps.Vaccination and avoiding infections are essential.
Customer: replied 3 years ago.
I don't think you read/understood the detail given in my question. Your answer is extremely acedemic, but not much help. I am in good health except for my bronchitis going on 4 months. I walk twenty miles a week and hike in the hills 5 miles every week. I had cancerous kidney removed 5 years ago, but no chemo or radiation needed. Chest xray,blood tests, and appt with oncologist every 6 months. Asthma test was negative. If this 21 day series of prednisone does not clear up, I will have bronchoscopy. Is there anything else I should ask for?
Expert:  Vakul Aren replied 3 years ago.
I understood the question but apparently every thing needed to be done is being done by your Pulmonologist.The AS/C filter may have passed along some fungal/bacterial infections which may cause hypersensitivity lung diseases.The prednisolone would help with most hypersensitivity and interstitial pneumonia conditions.Your exercising regularly is excellent.If the condition persists despite the drugs and precautions,bronchoscopy and lung biopsy may help identify the problem.Preventive vaccinations to prevent viral and bacterial lung diseases are required and lastly supplemental oxygen and physiotherapy would be the only other therapy if breathlessness persists despite ruling out other diseases.
Vakul Aren, Doctor
Category: Health
Satisfied Customers: 3386
Experience: MBBS,DTM&H( Univ of Liverpool),34yrs experience in practice
Vakul Aren and 3 other Health Specialists are ready to help you
Customer: replied 3 years ago.
I don't understand your last sentence. I stated that I have NOT had trouble breathing these last 4 months after returning from Italy.
Customer: replied 3 years ago.
none. COMMENT... I don't understand why you give answers that indicate you have not read/understood the details I give with my question and replies. Thank you for your help.
Expert:  Vakul Aren replied 3 years ago.
The chronic coughing and rattling has to have a pathological cause.This has not been helped by the medication so far.Apparently there is some condition which may be allergic,obstructive or infective which is causing this problem.As you suggest no bronchospasm/breathlessness is these,the cough still has to have a basis which may lie in the bronchioles/bronchus apart from the throat.A ENT check may help before a bronchoscopy is done.A little asthma would suggest some brochoconstriction though not enough to cause breathlessness.

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