Asthma-like lung issues?

[mshistory]

Hi all,

I've posted before about my lung issues (chronic cough, chest pain and pressure, shortness of breath and lightheadedness). Recently, my rheumy diagnosed me with pleurisy, and my cough turned into a wheezing cough so I finally went to urgent care this morning. Another chest x-ray showed no pneumonia (thank goodness!) and they gave me a breathing treatment which did help quite a bit with the wheezing cough (but not the pleurisy pain - have Tylenol-3 for that now on top of mega doses of naproxen and Biaxin). I was given a rescue inhaler (Albuterol I think).

For those with similar issues, does this progress to asthma or an asthma like condition? Have inhalers or breathing treatments become part of your normal daily medicines?

I still have a CT scan and pulmonary function tests in a couple of weeks, so will hopefully learn more. It's so frustrating to know something is wrong but no one seems to know what!

Thanks so much for all the wonderful advice you all give!

[Pisces24]

I had a upper respiratory infection which made my chest feel sqeezed but no pain or shortness of breath. I was given abuterol and an antibiotic. I'm over it now.

I have spots on my lungs that come-n-go and increase n decrease. I've had the bronchoscopy which was negative. Tests showed I have reduced lung capacity but I am not noticing any shortness of breath, etc. So, for now my pulmonologist is just watching everything. He thinks it is due to the Sjogrens. 

I get a CT scan in March and another breathing test then too. Dr said if I do develop breathing issues, he would recommend a lung biopsy (Ugh!).    He doesn't really know for sure what is causing the spots other than doing somethin invasive which he doesn't want to do unless absolutely necessary.

I guess for now, just wait and see unless it gets bad enough where you feel you need help. Tyr to keep your air moist with a humidifier as that helps. Sorry can't offer any better advice. You're talking with a gal who had walking pneumonia a couple yrs back and didn't know it. 

Good Luck!

[genko_b]

Keeping the air moist is important, especially with being indoors so much and the heat being on this season.

If you find you are having a dry cough a lot of the time, you can try guaifenesin, which helps to loosen the thick, dry mucus we get. Just take it with lots of liquid. Getting the mucus out is a good idea since that is one way our bodies get rid of infections.

I have lung issues too and end up using the rescue inhaler from time to time. They have not called it asthma.

Take care,

Genko

[irish]

It is not unusual for people with sjogrens to have irritable airways which is the asthma like coughing and wheezing that develops. I was diagnosed with asthma 30+ years ago but I do not wheeze, I just tighten up and can't breath and it helps to use the albuterol inhaler. I also use albuterol nebulizers twice a day plus the QVAR which is the steroid or anti-inflammatory.

When a person has pleurisy it is hard to breath because it is painful and one gets irritable airways because they tend to have mucus that builds up. The mucus builds up because the airways are unable to clear the mucus normally due to the resultant "guarding" that comes from the pain.

Also, people with sjogrens tend to have issues with their lungs. The mucus our lungs produce gets thicker and less. This causes increased pulmonary infections because the mucus pools(harder to expectorate thick mucus) and makes it a better haven for bacteria. Also, the mucus we produce is not isn't made of the normal products and doesn't fight off bacteria like it did before.

Then there is the other aspect. When we have sjogrens this causes the mucus glands or secreting glands to fill with those darn white cells that are trying to kill us off. This causes resultant redness and swelling of the tissues. It is really almost an allergic like response, but not quite. The steroids are used to reduce the swelling in the mucus membranes in our lung tissue. This, in itself, is very useful as far as increasing the amount of air exchange in our airways.

It is good that you are seeing pulmonary and getting theses things checked out. People with sjogrens also get pulmonary fibrosis which is a sort of hardening of the tissues. I would think that the steroid inhalers would be helpful in this case also. Sometimes people with fibrosis are treated with oral steroids also. Many times the drugs like cellcept or imuran are also used to prevent the destruction of the lung tissues.

It has become apparent on this site that many people are having problems with their lungs as more people are posting about this issue these days. For some people it can be their most troublesome symptomo and I would hope that aggressive treatment would be done for them. Good luck. Irish

[LizPetillo]

I was wheezing off and on for a few years BEFORE I got diagnosed with Sjogrens.
After the plaquinel, I don't wheeze nearly as much. 

I still get a really tight chest sometimes. 

Oh ... you mentioned naproxen.  If you have any heart issues be very careful with it.  I have an irregular heart beat and got stuck on a high dose of naproxen for two weeks once (misdiagnosed again!!) and it set my irregular heart beat off even more and even more strongly for months.   Just FYI.

[DragonflyC]

Breathing issues, especially air hunger, were my first AI symptoms. I had two bouts of pleurisy, walking pneumonia. . . it was a terrible year and a half.

Since then (2004-2005), I've gotten my thyroid and my allergies under control and started taking plaquenil for Sjogren's, and it hasn't been a problem for me (knock wood). Make sure, though, that your doctor takes your treatment seriously and looks at all possible treatments (not just those directly related to your lungs, but like me, allergies, thyroid, and the many other "add ons" that can come with Sjogren's). The better your body is functioning overall, the better it can cope with your illnesses.

[sunkissed64]

I haven't been to a pulminologist. Right now money is tight since I am laid off but I do get wheezing worse when I lay down at night. My rib cage feels sometimes like someone is hugging me really hard. My general practitioner doctor thinks it's inflammation of the cartilage between my ribs. Ugh Sjogrens can really kick my butt.

[mshistory]

Thank you everyone for your responses!!

Pisces, I was thinking about getting a humidifier - I worry about the mold issues with them though. Does anyone have a recommendation for a really good humidifier that is easy maintenance?

Genko, thanks for the suggestion - I do have some generic Mucinex that I've tried in the past, but I keep forgetting about it with all the other meds I take every day! (In fact, I forgot to take my Biaxin this morning but my poor 4 year old has a terrible stomach bug so we were back at the doctor this morning  )

irish, thank you so much for that excellent information - you always have such good medical info! That sounds exactly like what's going on with me. So far, I've only had the chest x-ray, but the pulmonologist did say the bronchial tubes were thickened and asked if I had a history of pneumonia (I've never had pneumonia but get bronchitis a lot. I've had it twice now just in the past few months!)

Liz, thank you for the warning about naproxen - I did have an abnormal EKG and have had heart palpitations in the past. That had actually gotten better since starting Plaquenil and all my anxiety meds (I attributed it to anxiety so the anti-anxiety meds were probably helping w/that) but last night, those palpitations came back. I will ask my doctor about the naproxen and if it's safe to continue it.

Dragonfly and sunkissed, thank you for your feedback as well - and yes, SjS can definitely kick our butts!!

My cough has been MUCH better today - I think the combination of the pulmicort/xopenex they gave me at the doctor's office and the antibiotic have helped quite a bit. I'm a bit worried about taking the naproxen indefinitely though because my stomach has been hurting pretty badly. My daughter does have a bad stomach bug (not sure what it is yet - waiting on those test results) but I have had no vomiting or diarrhea, just a really painful sensation in my stomach. I think I'm going to stop the naproxen for now until I can follow up with a doctor about it.

Thanks again for all the great advice!

[anita]

Mshistory,

You should follow-up with a pulmonologist for breathing tests to check for asthma.  If positive, a daily inhaler might help to keep you from having problems.  I developed adult onset asthma a couple years ago and he says this is common with Sjogren's.  As part of the tests I had one called a methacholine challenge test...which was very positive.   http://en.wikipedia.org/wiki/Bronchial_challenge_test

Glad to hear you cough is much better today.

[Iris]

I have chronic cough, chest pain and pressure and shortness of breath.. Before I was diagnosed with sjogren's the pulmonologist I saw said it was asthma.. Breathing treatments and inhalers don't do a lot to help me though.. But now my rheumy thinks it's inflamation and dry lungs from sjogren's..  What really seems to help is a humidifier.. I didn't think it helped much at first but the problem was it wasn't big enough for my living room.. Once I put it in my bedroom I actually have a lot of days my breathing is fine..

[LizPetillo]

those palpitations came back. I will ask my doctor about the naproxen and if it's safe to continue it.

When I asked my idiot PCP she said it was fine to take because .. and I quote ... 'you are young .. take what I prescribe'.   Set my heart off for two or three months ... felt like jello jiggling in there. 

  I've seriously gotta' find a new PCP.  This one is worthless. 

[mshistory]

Anita, I have three different pulmonary tests scheduled in addition to a CT scan - they are doing that breathing test, a blood test, and an exercise test. Hopefully, if this is turning into something like asthma, one of those tests will pick it up!

Liz, I think I'd find a new PCP too  I decided to stop the naproxen anyway because of this pain in my stomach - I read that stomach pain can be a sign of overdose with naproxen. I was taking it exactly as I was told to, but just in case, I'm not risking causing any more problems!