“Chronic bronchitis, asthma, vocal cord dysfunction?”
23F, 5’4,123lb, Caucasian - abnormal PFT with confusing results. cannabis smoker 10 years daily since my teen years (13). chronic daily throat clearing going on for 3 years.
low dose ct showed no abnormalities, normal esonohil, c reactive protein, neutrophil levels since smoking cessation 2 months ago. Phlegm has gotten a bit better but still throat clearing daily (is this considered a cough?) confused on what my “ratio“ is based off the way the results are listed (66 or 77?) no improvement post bronchilator (actually worse?) I have already been taking a steroid inhaler 1 month prior to my pft (Flovent) during this test I had chest pains which have been on and off since the test.
no available pulmonology appointments for another 2 months. Really confused and concerned by my results.
low dose ct showed no abnormalities, normal esonohil, c reactive protein, neutrophil levels since smoking cessation 2 months ago. Phlegm has gotten a bit better but still throat clearing daily (is this considered a cough?) confused on what my “ratio“ is based off the way the results are listed (66 or 77?) no improvement post bronchilator (actually worse?) I have already been taking a steroid inhaler 1 month prior to my pft (Flovent) during this test I had chest pains which have been on and off since the test.
no available pulmonology appointments for another 2 months. Really confused and concerned by my results.
Female | 23 years old
Complaint duration: 3 years
Medications: Flovent, ipatropium bromide
2 Answers
The images are too fuzzy for me to read clearly. What I can see looks like a normal configuration for air flow. It looks like the FEV1/FVC ratio is 77 percent as best I can read. This again is normal. I don't see anything to be concerned about on your tests.
There are many reasons to clear one's throat. It is good you have stopped smoking tobacco. However, mariuana smoke is also loaded with toxins including oxidizing tar. Other things can cause irritation in the throat. Sinus drainage with post nasal drip, Reflux of stomach contents into the esophagus can also irrigate the throat. Reflux can also cause chest pain.
I am not sure whether to call your throat to clear a cough or not. It does sound like there is some irritation. Looking into post-nasal drip or reflux might be helpful for that irritation. Eliminating potential irritants, like marijuana could also help. Vaping is also potentially very irritating to the lungs and airways and should be strictly avoided.
There are many reasons to clear one's throat. It is good you have stopped smoking tobacco. However, mariuana smoke is also loaded with toxins including oxidizing tar. Other things can cause irritation in the throat. Sinus drainage with post nasal drip, Reflux of stomach contents into the esophagus can also irrigate the throat. Reflux can also cause chest pain.
I am not sure whether to call your throat to clear a cough or not. It does sound like there is some irritation. Looking into post-nasal drip or reflux might be helpful for that irritation. Eliminating potential irritants, like marijuana could also help. Vaping is also potentially very irritating to the lungs and airways and should be strictly avoided.
I am unable to see values clearly on scanned reports . Flattening of inspiratory FV loops point towards possibility of extrathoracic airway obstruction such as VCD. If patient has had any major operations requiring prolonged intubation, subglottic stenosis could be considered given ?BOX like feature of FV loops. Patient should get direct laryngoscopy for evaluation of VCD.
Cannabis smoking can contribute to chronic bronchitis and she should consider stopping smoking.
D-dimer had high negative predictive value and as such borderline elevation might not be that informative. Clinical correlation/examination would be required.
Consider silent gastroesophageal reflux as a cause of constant throat clearing. Avoiding eating or drinking within 3 hours of bedtime and elevating head of bed at night could be helpful in minimizing silent GER.
Cannabis smoking can contribute to chronic bronchitis and she should consider stopping smoking.
D-dimer had high negative predictive value and as such borderline elevation might not be that informative. Clinical correlation/examination would be required.
Consider silent gastroesophageal reflux as a cause of constant throat clearing. Avoiding eating or drinking within 3 hours of bedtime and elevating head of bed at night could be helpful in minimizing silent GER.
