Respiratory Therapist/Chronic cough for 4 months
Hello, I am hoping you can advise me as to the possible causes of a chronic cough I have had for over 4 months. First off I should say that I'm a caucasian male in the UK, 37 years of age, 181cm tall, and have never smoked. Back in September I noticed an occasional very light, dry cough that I had every day. After about 6 weeks of this I went to my doctor. He sounded me and said he heard nothing, not to worry and give it a month. About a week after this visit (late October/Early November) my breathing worsened a lot. I was never wheezing but in my right lung there was a real heaviness, even a coldness or wet feeling with every breath. I continued to cough a lot, but the cough has always been completely dry and unproductive of mucus. I also remember back then I kept my window open all day long hoping fresh air would clear the cough, as a result I was always in the cold, which may not have helped.
I visited the doctor again and he said it was ok and to give it another month. Next time in December I visited a different Doctor, she sent me for an x-ray (which she told me came back clear) and then gave me two week-long courses of antibiotics. Now in January the constant strange feeling in my right lung has lessened by about 50-70%. I'm unsure if this was due to the antibiotics or if its more just time combined with not leaving the window open anymore and living in warmer conditions.
I am now being tested for asthma, the asthma nurse said it would be pointless to give me a spirometry test if I had a lung infection, so instead I have to take a peak flow test and record it morning and night for 2 weeks. For my height I should be getting 640 but it has always measured around the 550 mark, and using the inhaler (salbutamol sulphate 100micrograms) doesn't affect this result.
So where I am now: there is a constant, very slight feeling of discomfort in my right lung which feels worse in the cold. Whenever I get up and move around I begin to cough, a loudish dry cough. This will last constantly when I'm moving (e.g over an 8 hour shift at work). There has never been any blood or mucus. My left lung feels perfectly fine and always has. The location of the discomfort in my right lung seems to vary - sometimes more central, sometimes upper right of lung. As for breathlessness, I am very unsure - there are times I feel a little out of breath, for instance when I am wrestling with my nephews or have briskly walked for 20 minutes to the top of a hill. But then I question if I was always a bit puffed out after doing those things and am now just paranoid or depressed. I can still certainly do a full 8 hour shift of stacking shelves, on my feet and carrying things all the time, without breaking a sweat or having to stop for breath.
Do you have any ideas what could cause this?
Thank you so much for entrusting me with your personal health concerns today. So sorry to hear you're not feeling well, but you have given me abundant information to consider, which always helps. Without knowing your complete medical history, your symptoms do certainly sound much like Asthma. Especially the Peak Flow test results. My second thought is early-onset CHF (Congestive Heart Failure), which plenty of my younger patients have. The shortness of breath, lingering cough, etc are common in CHF patients as well as Asthma patients.
I would go to a Pulmonologist or Cardiologist for a second opinion.
I hope this helps!
Best of health,
Larry W, RRT