Frustrated

[Oxygen7]

I am 23 years old, otherwise healthy, and have had a cough, Shortness of breath, and chronic nasal congestion/inflammation with post nasal drip despite treatment for about 4 years now.  I go to an allergy/asthma specialist and he says it's asthma and allergies.  I also do have diagnosed vocal cord dysfunction but it hasn't flared up for the last six months.  I have GERD too but have been and still am on Protonix for it.  i know that can cause a cough. I am on Nasonex (steroid), astylen (antihistamine), zyrtec, singular, albuterol MDI, occasionally xopenex nebs, and pulmicort respules (i can't take advair b/c dry powder irritates my vocal cords). I have been put on xop nebs and pulmicort QID for a month now. I have been taking all of these medications with little relief.  I am stil extrememly congested and still have the red patch in the back of my throat from the post nasal drip, and I still get SOB and tachypnic. I don't wheeze and my chest hardly ever, if at all, feels tight.  I just feel like I can't expand my lungs well and my FVC and FEV1 fluccuate. with my FVC between 75%-100% of predicted and FEV1 80%-100%. I also have slight digital clubbing but I don't get reccurent pneumonias or sinus infections. I cough up clear/white secretions with little chuncks of yellow in it all day (not a large amount but some) Nothing is helping me...is there anything else I should get tested?? Some nurses and one DR I work with said I should get a sweat chloride test done, I know you can be diagnosed with CF in adulthood. Someone else told me to get an ANA test done. what should I do?

[National Jewish]

You need to have your lungs evaluated further.  You also need further evaluation of your sinuses.  Cystic fibrosis (CF) is a possibility.  Testing should include a sweat test and genetic testing.  The blood work that is done to test for cystic fibrosis (CF) is a genetic test.  This test looks for any genetic changes that would cause CF.  The "gold standard" or best test to look for CF is not a blood test.  It is called a sweat test.  A chemical is placed on the skin, stimulated with an electrode to trigger sweating, the sweat is collected, and the amount of chloride in the sweat is measured.  A high amount of chloride in the sweat means CF.

[Oxygen7]

I have had a cardiac workup and a chest x-ray. I have very mild mitral valve regurgitation but other than that i'm good.  My chest xray didn't show anything. I have not had a CT scan of my lungs though.

[ozark]

with the clubbing, i would also ask for a cardiac workup as well....have you had a chest xray or ct scan?  a cf workup is also a good idea but i'd first go with the xray and cardiac workup        good luck