Diagnosed as allergic rhinitis, worries if it’s more than that (diagnostic dilemma?)

[JKSC]

Family history: My sister & dad have rhinitis. My mom has chronic cough and her PCP said it’s allergic (don't have detail check-up). I had strong allergic reaction to Erythromycin (whole body & face swollen & covered by hives/rash) when I was a kid

Since 2010, I started feeling congested at night (bedtime & early morning) and okay in daytime. Occasionally took Claritin because of tickle in throat but nothing serious. Normal daily life & sleeping is fine.

Things starts changing in 2013-2014.

Oct 2013 when I was 30 (female), me & my husband moved from Culver City CA (Los Angeles) to Carson CA (South Bay).

Jan 2014, I had flu for 2 weeks (101F fever + cold symptoms). In Feb, my PCP started prescribing Flonase (50 mcg 2 sprays per day) as I had really bad congestion, tickle & cough did not go away. In Apr, started feeling chest tight & had disturbed sleep on and off for 2 weeks. PCP prescribed Albuterol and gave me relief. I did chest x-ray, lung function test (carbon monoxide diffusing capacity + spirometry before & after bronchodilator), blood test and nothing is abnormal. Coughing is on and off. In Jun, visited urgent care as had really coughing fit at night & couldn’t sleep (used 6-8 puffs per week). Urgent care doc gave me a trial of Singulair (10 mcg for 3-month) and started feel less cough, chest tight (now use 2-4 puffs per month) and tickle, but still feel a bit congested. In Aug, my PCP referred me to ENT and suggested to add Astelin for treating me persistent rhinitis. I did an allergy blood test for 13 kinds of environmental allergen but it’s negative.

I did ask my PCP if I am having asthma. She said it’s only an allergy.

However, she said I need to keep taking/refilling Flonase & Singulair for long-term, and keep my Albuterol handy. My PCP said I can use the inhaler if I cough a lot at night, feeling short of breathe or wheezing.

How should I follow up with my PCP &/or ENT? I feel a bit better when the weather is warm/hot, but easy to start coughing when it’s cold, temp change, dusty room or laughing hard.

Any suggestion will be greatly appreciated!
Thanks

[margypops]

Have you thought it may be environmental allergies,  are you outside a lot have you looked up and like we do here in CA seen all the aerial spraying they are doing? You could ask for a heavy metal toxicity test to see if there is anything toxic you are breathing in ..

[jenzbugrulz1978]

I would follow up with my PCP unless they feel it necessary for you to keep going to the ENT. That's just me though, cost is a huge issue for my family. Hope this helps! :)