OpenHealth Q&A

Ongoing Asthma Challenges for Four Months

Greetings! Allow me to introduce myself: I'm a 33-year-old female, weighing 250 lbs, and standing 5'6" tall. Here’s a summary of my current medical condition and prescribed treatments: - I have been diagnosed with ADHD, for which I take 30mg of Adderall. - I also experience depression and anxiety that have led to agoraphobia – likely linked to my ADHD, as I noticed these issues improved once I started treatment. This mental health struggle contributed to a weight gain of around 75 lbs. My medications for these conditions include 300mg of Wellbutrin and 60mg of Cymbalta. - For asthma and respiratory concerns, I am on Trelegy, Singulair, Albuterol inhalers, and I am currently tapering off prednisone. As a vegetarian, I maintain a healthy diet, primarily consuming tea, water, and bubbly water. I don’t smoke or drink heavily, opting for an occasional glass of wine. I am also free from recreational drug use. Beginning around the age of 30, I experienced worsening allergies, leading to a slight cough and nasal congestion when I spent too much time outdoors. Four months ago, I unexpectedly developed a persistent dry cough along with breathing difficulties, allergy-related congestion, and wheezing. My doctor diagnosed me with asthma, attributing its onset to my allergies. After being prescribed prednisone, I noticed significant improvement; however, my symptoms resurfaced just a few days after stopping the medication. I am now on my fourth course of prednisone. My doctor expressed concern over the persistence of my asthma symptoms—my blood oxygen levels have been dropping, and I find myself breathless even from minimal exertion, such as walking across the room. Consequently, I have been referred to a pulmonologist but am currently on a waiting list for an appointment in mid-October. To further evaluate my condition, my doctor ordered blood tests; both my complete blood count (CBC) and metabolic panels returned normal results. Additionally, a chest x-ray showed clear findings. However, my recent d-dimer test came back positive at 0.810. Due to my ongoing shortness of breath, I was sent for a urgent CT scan, which revealed no blood clots, but it did show multiple enlarged lymph nodes. My heart appeared normal. Here are the details from the CT scan results: - Right hilar lymph nodes measuring 1.2 cm, with another 1.2 cm more inferior. - Bilateral axillary lymph nodes: right side up to 1.8 cm and left side measuring 1.6 cm. - Mild atelectasis or scarring in the inferior lingula and right middle lobe, with no focal infiltrate, and a 5 mm non-calcified solid nodule in the lingula. - Enlarged lymph nodes in the upper abdomen, including a superior peripancreatic lymph node measuring 1.5 cm and a portacaval lymph node measuring 1.4 cm. My doctor plans to consult with another colleague in the practice before deciding on next steps, likely leading to a biopsy. I am attempting to manage my anxiety amidst this situation, but the uncertainty is quite stressful. Generally, I’m a level-headed person; however, I have never faced significant health issues before.

Answers (1)

8/7/2025, 12:41:03 PM

OpenHealth AI

It sounds like you're dealing with a complex and concerning health situation, especially with persistent asthma symptoms and the additional findings from your imaging tests. The fact that you are experiencing ongoing shortness of breath and coughing, coupled with the large lymph nodes identified, understandably creates anxiety and uncertainty. Let's address your immediate concerns and provide clarity on what steps you can take while awaiting further evaluation.

Key Points:

1. Your asthma symptoms have been persistent and are affecting your quality of life.
2. Imaging results show enlarged lymph nodes and mild lung changes, leading to a request for further evaluation, likely a biopsy.
3. Managing anxiety and monitoring your symptoms are crucial at this time.

Explanation:

Asthma can be exacerbated by various factors, including allergies and infections. While it's good that you've had improvement on prednisone, the recurrence of symptoms indicates a need for better management strategies and possibly further investigation due to the findings of enlarged lymph nodes.

The lymph nodes may suggest an underlying inflammatory or infectious process, but they are also not uncommon in certain conditions. Your medical team is likely considering potential causes and appropriate next steps, which could involve a biopsy to rule out more serious conditions.

Next Steps:

1. Symptom Monitoring: Keep a diary of your symptoms, noting any changes, triggers (like pollen or cold air), and your response to medications. This information will be valuable for your pulmonologist.

2. Medication Adherence: Continue taking your prescribed asthma medications (Trelegy, Singulair, and Albuterol) as directed. Ensure your technique with inhalers is correct to maximize their effectiveness. If you notice increased wheezing or severity of asthma symptoms, use your rescue inhaler (Albuterol) as needed.

3. Anxiety Management: Engage in relaxation techniques such as deep breathing exercises, meditation, or gentle yoga to help manage anxiety. Consider discussing therapy options or support groups with your doctor if anxiety becomes overwhelming. These can provide emotional support during this uncertain time.

4. Diet and Lifestyle: Maintain your vegetarian diet, focusing on balanced nutrition to support your overall health. Staying hydrated is also important, as it helps with respiratory health. Continue avoiding tobacco, excessive alcohol, and other irritants.

5. Follow-Up Care: Be sure to keep track of your upcoming appointment with the pulmonologist. If your symptoms worsen significantly (increased shortness of breath, chest pain), seek immediate medical attention.

6. Staying Informed: Educate yourself about asthma management and what your imaging results may indicate. Understand that many conditions can cause enlarged lymph nodes and not all are serious; remaining informed can help reduce anxiety.

Your health is a priority, and seeking proactive, thoughtful approaches to your situation will empower you in managing both your physical and mental well-being. Please keep me updated on your situation or reach out if you have any further questions.