Hello...thank you for giving me an important information about profession.By what you say I feel that the possibilities are -
- Mild intermittent asthma as per GINA guidelines and international recommendations and classification. It is classical to present intermittently like this.
- Seasonal bronchitis.
- Viral Bronchitis.
- Extremely rare - but if you have been exposed to mold then we may need to consider allergic bronchopulmonary aspergillosis.
My suggestions for you -
1. Oral Prednisolone at 20mg thrice a day dose for 2 - 3 days.
2. Inhalers are the newest management strategies for this.
I suggest the use of Formoterol+Budesonide metered dose inhaler (100mcg) 4 puffs twice a day through a spacer and this is for regular use for 2 weeks and then you can taper down to 3 puffs twice a day for another 2 weeks and then stabilize at 2 puffs twice a day to continue. Another metered dose inhaler is Levosalbutamol / Albuterol and this can used as rescue therapy whenever you are having severe cough in spite of regular usage of Budesonide- Formoterol. The technique is very important and very crucial for the drug to be delivered correctly to the lungs. Regularity of medicine usage also matters a lot. So do not discontinue abruptly after you notice some improvement. The technique of administering an inhaler using a spacer has to be taught to you by your doctor and these are prescription medicines. So I suggest you consult your physician for this.
3. Tablet Monteleukast 10mg once a day in the evening at 6pm daily for 3 months.
4. Triggers can be environmental changes/ dust/ talcum powder/ seasonal changes/ un-cleaned a/c vents/ cold weather etc....we cannot specifically say this is the cause - unless we observe closely - best person is yourself.5. You will require a spirometry.
6. If these doesn't work then we need to think about a restrictive lung disease as an occupational exposure related issue.
The other possibility is an evolving interstitial lung disease (but extremely unlikely as breathlessness would be the predominant symptom than cough).
I sincerely ***** ***** I have helped you today!
Is there anything else where I can be of assistance to you in this regard please. We can continue here until you are satisfied, simply use the reply box and let me know.Kind regards ***** ***** Sumanth Amperayani