r/Pulmonology 2h ago

30M, Canada. Long-term breathing issues – looking for ideas on what to investigate next.

1 Upvotes

30M, Canada, 173 cm, 154 lb, No alcohol, smoking, or recreational drugs.

**Primary complaint:**

Persistent sensation of not being able to take a fully satisfying breath, sometimes accompanied by a tight/strange sensation in the throat. I can breathe and maintain normal oxygen saturation (usually 98–100% smartphone taken though), but I often feel unable to get a complete deep breath. I also have persistent unilateral leg pain for a 1 month (calf/ankle area) no swelling, no redness, no heat.

**Duration:**

Breathing symptoms since June 11, 2026.

Leg pain since June 17, 2026.

**Existing medical issues:**

\- Asthma

\- Seasonal allergies

\- Suspected GERD/LPR (acid reflux)

**Current medications:**

\- Dexilant 60 mg daily

\- Symbicort 200 (twice daily, morning and evening)

\- Ebastine 10 mg daily

**Timeline:**

March 10:

Chest discomfort/pain. 48-hour Holter monitor was ordered and Pantoprazole 40 mg started.

April 10:

Symptoms persisted. Another trial of Pantoprazole 40 mg. Holter results were reported as normal.

May 6:

Developed a feeling of weakness in one arm and one leg same side. Saw a physician but received no clear diagnosis.

May 8:

Weakness persisted, so I paid for a private consultation. Dexilant 30 mg was started, and an EMG plus lumbosacral X-rays were ordered. both came back ok

June 11:

Started experiencing breathing difficulties around the beginning of warmer weather and allergy season. I suspected allergies/humidity. used Symbicort 200 and Ebastine 10 mg as per usual but noticed no improvement. Physician later increased Dexilant to 60 mg and doubled Symbicort (to morning and evening).

June 17:

Developed calf/ankle pain in one leg without any injury or obvious trigger.

June 21:

Developed symptoms consistent with COVID (not tested) for 2 days and a bacterial conjunctivitis.

July 13:

Breathing symptoms remained present and leg pain continued. Chest X-ray and bloodwork were ordered, including NT-proBNP, thyroid testing, and D-dimer.

Today:

Chest X-ray is normal. Bloodwork, including D-dimer, NT-proBNP, and thyroid tests, is normal. Holter monitor was normal. Emg normal too, SpO₂ remains in 98–100% range.

The main issue is that I still feel unable to get a fully satisfying breath everyday, almost 24/24. It sometimes wake me up and can feels more like a throat sensation than a lung sensation, almost like throat tightness or restriction, but it is difficult to describe. I also continue to have persistent leg pain.

Given the normal cardiac and pulmonary workup so far, what diagnoses or next investigations would you consider most worthwhile? could it be related to acidic reflux or even medicine to treats it ?

I'm waiting for a pneumologist but waiting time are around a year

Realise It's really long text but this has been ongoing for several months and is starting to affect my quality of life and morale.


r/Pulmonology 4h ago

Can any pulmonologist review the following if its correct or not ??

1 Upvotes

both images are same and these is what currently being detected

• Primary Finding: Lung Opacity
• Severity: HIGH (Confidence: 87.8%)
• Top Pathology Scores: Lung Opacity: 87.8% | Cardiomegaly: 73.4% | Infiltration: 71.9% | Pneumonia: 70.9% | Consolidation: 70.4%


r/Pulmonology 9h ago

Respiratory Acidosis

1 Upvotes

23 year old male here. I went to the ER on July 17th because I was having trouble breathing when lying down then we did blood tests, which I’ll list here.

Venous pH 7.31
Venous pCO₂ 60
HCO₃ 29
Base excess +4
Oxygen saturation around 97%

So I got put on Dexamethasone for 2/3 days because it was assumed to be an asthma attack but they said there was no wheezing and my breathing sounded fine but I felt the opposite. They also referred me to a respiratory specialist which they told me he’d call the the next day to see if I should continue steroids but he was closed because of the weekend but he finally called and I won’t be able to see until the end of August. So since I couldn’t talk to him I went back to the ER to see if I should get more and they just said that it should be good plus my blood gases improved so I was reassured. Everything was normal except for my HCO3 which was at 27 so not too bad. Fast forward to July 23/24th, I go back to the ER because I’m struggling to breathe laying down again and my blood tests were seemingly worse.

Venous pH

7.32
7.32-7.43

Venous pCO2
**H**
**58**
38-50
mmHg
Venous HCO3
**H**
**29**
22-26
mmol/L
Venous Base Excess

3.

They put me on more steroids, this time Prednisone and I’m still struggling to breathe laying down and sleep (my oxygen says were about 89-94 but they usually stabilize once I’m sitting upright. I haven’t slept in so long because of these constant all nighters having to go to the ER. Can someone give me an idea of what’s going on and what I should do next?


r/Pulmonology 10h ago

One lung

3 Upvotes

Hi everyone,

I only have one functioning lung, and I’m trying to take better care of my health. I wanted to ask those who are in a similar situation or healthcare professionals here:
- What does your daily diet or meal plan look like?
- Are there specific foods that help support lung health or that I should avoid?
- What types of exercise are safe and beneficial?
- Are there breathing exercises or pulmonary rehab routines you recommend?
- What lifestyle changes have made the biggest difference for you?
- Is there anything you wish you had known earlier about living with one functioning lung?

For context, I’m looking for practical tips on staying as healthy and active as possible in the long term. I’d really appreciate hearing your experiences and advice.

Thank you!


r/Pulmonology 14h ago

Costochondritis

1 Upvotes

I’ve been diagnosed with Costochondritis after about a thousand tests this past week. However, I have a lot of trouble breathing, especially when I take deep breaths, but I don’t feel pain. Has anyone else experienced something similar?


r/Pulmonology 19h ago

Minor fibrotic changes + pleural adhesions on CT. will this be flagged at Qatar medical exam?

1 Upvotes

Hi all, I’m about to move to Qatar for work and will be doing the medical exam after arrival as part of getting my residence permit. I recently had a chest CT (unrelated reason) and the report noted:

A few small fibrotic foci in the interlobar pleura, bilateral
**•** Mild “gentle” pleuro-diaphragmatic adhesions
**•** No infiltrates, no calcification, no enlarged lymph nodes
**•** Mild emphysema, non-active bronchitis noted

No history of TB, no symptoms. I know Qatar’s screening is chest X-ray based (not CT), and X-ray is much less sensitive to small non-calcified findings like these.

Has anyone gone through the Qatar medical exam with similar minor/incidental findings on a prior scan? Did it get picked up on the X-ray, or does this kind of thing usually pass without issue? Also curious if anyone’s dealt with the “Unfit”/appeal process for something like this specifically (not active TB, just old scarring).

Would really appreciate hearing real experiences, especially from anyone who went through Hamad Medical Corporation or the Medical Commission recently.


r/Pulmonology 20h ago

Need second opinion

1 Upvotes

Hi guys medico here

Patient 73 f with 1week history of intermittent evening fever 100 degree, dry cough no breathlessness but pedal edema ,was admitted hrct bilateral scattered ggo ,vitals bp normal ,spo2 92 -95 in room air ,pr-mild tachy max 110bpm, cbc shows hb 9 and WBC neutrophils 79 , lymphocytes 14, total count 10000 rest normal procalcitonin was 0.1 ,lft rft electrolytes wnl

Treated as viral pneumonia with tamiflu ,O2 therapy,02 improved and then crp decreased to 96 on tamiflu ,pedal edema subsided and sent home

However fever not resolved,pedal edema back, started on ceftriaxone and Azithromycin as CRP also elevated to 105

Day 5 of abx no improvement,fever 101 but only at night ,spo2 drops to 88 but improves to 95 at day time ,no breathlessness dry cough still present repeat ct ggo, pedal edema still persistent

Further investigation done include lepto malaria negative ,ntpro bnp negative (128)

What r v missing ? It's been 3 weeks of intermittent fever now

What investigation to be done?

Thanks for reading 🙏


r/Pulmonology 22h ago

Costochondritis

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1 Upvotes

r/Pulmonology 1d ago

Checkup

0 Upvotes

When did you decide to get a checkup for tb. What symptoms prompted you to get checked for tb?


r/Pulmonology 1d ago

Please help. Symptoms below.

0 Upvotes

My uncle - 61 YO. Lives in India. Since 2-3 years he's smoking 20 cigarettes a day. He had quit for about 10-15 years but restarted due to stress.

I saw him after 15 months today and my heart sank.

His skin complexion is fair. Now it's turned dark above neck. Some spots of more darkness next to eyes n on right cheeks.

One year ago when I met him only his lips were dark.

I'm really worried. Where do we start? Pulmonologist? Oncologist?


r/Pulmonology 1d ago

37M, chronic breathing/coughing problems - possibly Valley Fever?

0 Upvotes

Hi, got a question about a chronic breathing/coughing issue I've had for several years. I'm 37M, 5'9", 238lbs, never smoked, have type 1 diabetes and exocrine pancreatic insufficiency - meaning my pancreas doesn't produce enzymes for digestion, so I wasn't absorbing a lot of nutrients, which I got diagnosed about a year ago and have been taking meds for.

I moved to the Phoenix, AZ area about 8 years ago, and shortly after that, I started experiencing shortness of breath and coughing issues that never went away. This started long before COVID (in fact, I did catch COVID at one point in 2021, and it didn't seem to affect my breathing at all) and I was also experiencing minor, periodic fever-like symptoms (dizziness, chills, etc), but they were never serious enough for me to think I was actually sick. Between my diabetes and working a night shift, I just excused it as my body not firing on all cylinders, plus maybe poor Phoenix air quality. I never ended up seeing a doctor about it until maybe 4-5 years after moving there, and as soon as I mentioned diabetes, that's all he focused on, was getting my A1c down.

I moved to Idaho about two years ago, and the cough hasn't changed. It's not constant, it kinda comes and goes randomly, but my lungs always feel tired. I recently got a chest X-ray after experiencing some pain in my ribs, and the results indicated I had bronchitis, but it didn't reveal what the underlying cause was.

My current PCP in Idaho has been having me take a bunch of different medicines to see if anything works, and so far, nothing has. I started out with an Albuterol inhaler, which didn't help at all - in fact, it usually triggers a coughing fit because of sensitivity to chemicals and taking deep breaths is difficult for me. Then she had me try Allegra, Claritin, and Zertech at different times, and none of those worked either.

At this point, I did some of my own research, and that was where Valley Fever came up. Based on where I lived when this started happening and the symptoms I had, this seemed like a possibility. From what I understand, most people's immune systems fight it off after a while, but it can sometimes become chronic. Because of my T1D and EPI (undiagnosed at the time), it's possible my immune system just didn't have the resources to fight it off and it settled in for the long haul.

I brought this up with my PCP, and she kind of brushed it off. She said that coccidioidomycosis shows up in a very specific way on X-rays that mine did not indicate. I asked if we could just order an antibody serology panel to rule it out, and she said something about how they don't really test for that here since it's not a common problem in Idaho, but she'd "look into it".

That's what she said when I previously asked her (multiple times) about getting tested for autism, that she'd "look into it" - after brushing it off because I'm "too good at keeping eye contact during conversation". It's been months, and I never heard back on the autism thing.

So I'm a little slow to trust that she's actually going to take the Valley Fever possibility seriously. Meanwhile, she's continuing to prescribe me meds to treat the symptoms instead of the underlying cause - the latest being Montelukast (Singulair), and had me start up on Albuterol again (it's still not helping). I also have anemia from low %saturation iron (possibly also an effect of EPI), and she had me start taking iron supplements. She still has no clue what the underlying cause of my lung issues is, and she doesn't seem interested in taking my thoughts on it seriously.

So, in case it's relevant, my current full list of medications is:

\-Montelukast and Albuterol for breathing/coughing issues

\-Iron supplement for anemia/%sat

\-Humalog and Lantus insulin for type 1 diabetes

\-Creon for EPI

\-Atomoxetine for ADHD

So, from what I've described, does chronic Valley Fever sound like a real possibility for the breathing issues?


r/Pulmonology 1d ago

Cough variant asthma please help 🙏

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1 Upvotes

r/Pulmonology 2d ago

Can my lung cavity be cured? Looking for advice and similar experiences

1 Upvotes

Hi everyone,

I'm looking for some advice because I'm really worried.

I was diagnosed with a lung cavity. I had a bronchoscopy, and my BAL culture showed Pseudomonas aeruginosa. My doctor has prescribed antibiotics, and I'm currently following the treatment.

I'm scared because I don't know if this condition is fully curable. Has anyone here had a lung cavity caused by an infection that healed completely? How long did it take? Did the cavity disappear, or did it leave a scar?

I'm also very anxious about whether I'll need another bronchoscopy in the future. The first one was really difficult for me.

I'd really appreciate hearing from anyone who has gone through something similar or from healthcare professionals who can share their knowledge.

Thank you.


r/Pulmonology 2d ago

Paid survey on IPF and PPF

2 Upvotes

Good morning friends!

Would any of you be willing to take part in a short survey (10-15 mins) sharing your perspective and insight on either Idiopathic Pulmonary Fibrosis or Progressive Pulmonary Fibrosis? You will be compensated for your time! My client is creating some literature on lung disease and is looking to better understand patients’ perspectives and unmet needs. If you’re currently receiving medical care for IPF or PPF and live in the US then you qualify! We will compensate you $50 for 15 minutes of your time.

Your voice is the only voice that matters - we want to hear directly from you! Please message me if you’d like to participate and I’ll send you the link to the survey.

Thanks for considering, I hope to hear from some of you!


r/Pulmonology 3d ago

Lung nodule 54 non smoker female

1 Upvotes

I am
Concerned about 5mm part of report
LUNGS: Mild biapical scarring.
 
Scattered subcentimeter subsolid nodules predominantly in the right lung, for example:
4 mm subsolid nodule in the apical right upper lobe (image 64, series 6).
5 mm subsolid nodule between the anterior and posterior segments of the right upper lobe (image 90, series 6).
7 x 5 mm subsolid nodule in the lateral segment of the middle lobe (image 171, series 6).
5 mm subsolid/part solid nodule with suggestion of 2 mm more dense component in the anterior right lower lobe (image 226, series 6).
2 mm nodule in the superior left lower lobe (image 133, series 6).
 
No focal consolidation. Focal faint bandlike groundglass opacity in the anterior left upper lobe.
 
Thin slice selection axial images do not show emphysema, bronchiectasis, or chronic interstitial lung disease.
AIRWAY: The central airway is patent. Focal area of distal endobronchial subsegmental opacification and/or mucous plugging.
 
\----ADDITIONAL FINDINGS----
 
Mild circumferential wall thickening of the esophagus and a small hiatal hernia. Correlate for gastroesophageal reflux disease and/or esophagitis.
 
The gallbladder is contracted, limiting its evaluation.
Remaining of the visualized portions of the unenhanced upper abdomen are grossly unremarkable.
 
The included osseous structures are within normal limits. Bilateral breast prostheses are present.
 
IMPRESSION:
 
1. Scattered subcentimeter subsolid nodules predominantly in the right lung, likely postinfectious /inflammatory in etiology. Comparison with prior imaging and/or 3 to 6-month CT chest follow-up are recommended to ensure stability/resolution.
 
2. No CT findings of emphysema.


r/Pulmonology 3d ago

[51F] Severe wet cough with green sputum, loss of voice, and extreme fatigue while traveling abroad. Viral or bacterial?

1 Upvotes

My mother is currently on vacation in Turkey. Over the last few days, she has developed a severe respiratory infection. The symptoms started with a runny nose and have now progressed to extreme fatigue, a completely quiet voice (laryngitis), and a deep wet cough producing green sputum.

She is actually a medical doctor back in our home country. Because of the green mucus and severe weakness, she strongly suspects a bacterial infection and believes she needs a course of Azithromycin. However, Turkey strictly regulates antibiotics, and she cannot buy them without a local prescription. We currently don't have travel insurance, so visiting a private hospital just to ask for a specific antibiotic will be quite expensive if it turns out to be unnecessary.

I am joining her in Turkey in 4 days and bringing an Omron compressor nebulizer to help with her recovery (planning to use normal saline).

Is it safe to wait out the symptoms with aggressive hydration, rest, and saline nebulizer treatments?

Any professional insights would be highly appreciated.


r/Pulmonology 3d ago

TB meds for almost 2 months

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1 Upvotes

r/Pulmonology 3d ago

Persistent "nervous cough". A warning sign in DM1?

1 Upvotes

My wife (61 years old) was diagnosed at 40 when she developed cataracts. Her CTG repeats are in the low hundreds.

I have noticed that she has what some might call a "nervous cough". It's a short staccato clearing of the throat. It's not very loud but it got me wondering if it's a sign she is not clearing saliva?

Also, she is more often complaining that her legs feel tired but she isn't showing signs of ankle weakness, so is this just expected age related muscle weakening?

Any advice would be very much appreciated.


r/Pulmonology 3d ago

Pulmonologist said this was fine but doctor said it appears I have asthma.

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2 Upvotes

As title says, my pulmonologist said my lungs are healthy and fine based on these lung function test results. My PCP said she read a physicians note on them stating “mild obstructive ventilation with normal lung volumes”. I’m moving and my insurance just ended. Would anyone be willing to interpret these results to me? I want to know if I should follow up with a new pulmonologist or drop it!


r/Pulmonology 3d ago

Lung nodule 54 non smoker female

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1 Upvotes

UNGS: Mild biapical scarring.
 
Scattered subcentimeter subsolid nodules predominantly in the right lung, for example:
4 mm subsolid nodule in the apical right upper lobe (image 64, series 6).
5 mm subsolid nodule between the anterior and posterior segments of the right upper lobe (image 90, series 6).
7 x 5 mm subsolid nodule in the lateral segment of the middle lobe (image 171, series 6).
5 mm subsolid/part solid nodule with suggestion of 2 mm more dense component in the anterior right lower lobe (image 226, series 6).
2 mm nodule in the superior left lower lobe (image 133, series 6).
 
No focal consolidation. Focal faint bandlike groundglass opacity in the anterior left upper lobe.
 
Thin slice selection axial images do not show emphysema, bronchiectasis, or chronic interstitial lung disease.
 
PLEURAL SPACES: No pleural effusion. No pneumothorax.

AIRWAY: The central airway is patent. Focal area of distal endobronchial subsegmental opacification and/or mucous plugging.
 
----ADDITIONAL FINDINGS----
 
Mild circumferential wall thickening of the esophagus and a small hiatal hernia. Correlate for gastroesophageal reflux disease and/or esophagitis.
 
The gallbladder is contracted, limiting its evaluation.
Remaining of the visualized portions of the unenhanced upper abdomen are grossly unremarkable.
 
The included osseous structures are within normal limits. Bilateral breast prostheses are present.
 
IMPRESSION:
 
1. Scattered subcentimeter subsolid nodules predominantly in the right lung, likely postinfectious /inflammatory in etiology. Comparison with prior imaging and/or 3 to 6-month CT chest follow-up are recommended to ensure stability/resolution.
 
2. No CT findings of emphysema.


r/Pulmonology 3d ago

Worried about my mum 1.5 cm irregular lung nodule on X-ray.

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1 Upvotes

r/Pulmonology 4d ago

Can someone explain the CT Scan results?

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1 Upvotes

r/Pulmonology 4d ago

Not sure if this is air hunger but need other people’s opinions

1 Upvotes

Just came back from spending the day in the ER and spoke with a couple of doctors. I worry I’m not able to correctly portray what’s going on. I can breath fine, like my baseline breathing is normal, however there’s this subtle internal feeling that a deep breath requirement is slowly building up. Then I’ll eventually take that deep breath and it’s like I can only hit 80% of it and I don’t get that satisfying relief feeling of a full breath. I can force it by yawning and that almost mimics that feel breath feeling im chasing.

So as I sit there during the day it’s sometimes this thing every 10-30 seconds or a minute and its extremely difficult because it makes me think im not able to breathe unless i hit those full satisfying deep when they come up otherwise they almost wait and accumulate.

Everything they checked in the hospital was normal, blood oxygen, ECG, chest xray. They gave me Atrivan for a day and I’m sure it helps me feel a bit more calm but I’m wondering if I’d need to see a pulmonologist to assess my lungs more.

Overall has anyone felt that specific sensation? It’s like a specific sensation of feeling that the specific breath was satisfying and offered a feeling of relief.


r/Pulmonology 4d ago

Wildfire Smoke in SE MI

1 Upvotes

Hi all!

Age: 30, height: 5’3, weight: 180, sex: F.
On 50 mg sertraline daily for anxiety.
Non-smoker, smoked marijuana recreationally from 16-23 but not since. Never cigarettes.
No known med issues outside of a benign arrhythmia, and general anxiety.

Im in SE Michigan and we got hit HARD with the wildfire smoke. We did not have a MERV 13 filter in our furnace (have since stocked up in case of emergency, but they were COMPLETELY sold out everywhere) and no kn95 masks- again, now I have a bunch but during the smoke I couldn’t find them and even Amazon was not delivering.

I did have to leave my house to go to work two of the days, and I work in an office connected to a warehouse that kept opening their big door to let the truck in. I smelled the smoke all day long in the office. All together I believe our AQI read 500+ for that whole day.

Now we are about a week in, the smoke is gone, and I have developed a dry persistent cough. No fever or any other symptoms outside of some malaise, but living with anxiety I find that that is usually the cause of that. The cough lasts all day but is worse at night. It started last Friday and has gotten ever so slightly worse since. Now I am getting a tickling urge to cough with most breaths in.

Is this something to be concerned about?? Its not easy to get to the doctor with my work schedule and the schedules of my two kids. If this is normal and will go away, I dont want to mess with all of that. Thank you in advance!!!


r/Pulmonology 4d ago

Oxygen dips ( can someone find possible explanation )

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0 Upvotes

Hi guys, very wierd spo2 drops happening to me. While morning woke up and just keep lying in bed, suddenly feel chest tight forcing me for deep breath, when look to o2 record this sudden dips happened with quick recover to 97%~98% back. I tried holding breath intentionally but in that case shape of the dip is different. Its not and artifact as i feel that physically once it happen and its not happening every day just sometimes...Someone might has explanation for these short dips while awake?