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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18907
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Recently I went to the doctor at Nuffield in Newcastle and

Customer Question

Recently I went to the doctor at Nuffield in Newcastle and had a chest X-ray after finding it difficult to breathe and having a sharp pain each time I coughed or sneezed, which was often and had progressed over 3 months. The X-ray showed a white area in the left lung which the Dr. was concerned could be Hilar Mass so i had a CT scan the following day and a Bronchoscopy, the findings was no cancer but an inflamed airway and swollen vein. I was prescribed Prednisolone, Clarithromycin and Pregabalin (Lyrica). The coughing stopped and the pain was almost gone when the tablets finished and I then re-deployed to Iraq for 5 weeks before returning. A week before returning the pain in the chest returned when coughing or sneezing and is pretty onset. The doctor game me another X-ray showing the same white area and has given me a peak flow monitor to keep a diary of breathing flow morning and night to see if it is asthma as my breathing fluctuates. He said that the steroids worked but things have relapsed and I may need an inhaler of steroid to keep the condition at bay. Could the pain when coughing really be down to Ashtma and what about the white area on the X-ray?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

The pain in the chest can be associated with asthma (or chronic bronchitis of other causes), although not directly due to the asthma, The spasm of the airways that is the essence of asthma will not cause chest pain. However, it is possible to get inflammation around the lung associated with asthma, which can cause pain. It is also possible that chronic asthma can cause musculoskeletal chest pain, because the muscles in the chest have to work harder.

Since the white area on the first chest x-ray was found to be inflamed airways and a swollen vein on the CT scan and bronchoscopy, it is very likely that the white area on this recent chest x-ray is the same. The bronchoscopy is the most sensitive test to detect any abnormal growths in the major airways in the center of the chest, and the CT scan s the best method for identifying growths in the outer aspect of the lungs or growths in the center of the chest that arise outside of the airways, so you have had the best tests for assuring that there is no growth that is causing the finding on the chest x-ray.

At this point, with the recurrence of symptoms and findings on the chest x-ray, it would be appropriate to use steroids. Oral steroid would be appropriate to get rapid control of symptoms, but your doctor is correct that the use of a steroid inhaler would be appropriate for long-term management because it has less side effects.

If I can provide any additional information, please let me know.