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Doctor is guessing at this point, need help from you guys

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Sorry this is so long, I want to be throrough, I think someone on here can help me.

Here are my symptoms, I am re-posting here because while it seemed pretty much like an exercise induced asthma case, albuterol did not help at all. The direction my doc is going does not seem accurate to me, I would love to find someone with similar symptoms and haven't really found anyone describing something similar.

I am a 30 year old non smoker. Only weigh 140 pounds so not even slightly overweight. I am somewhat active, throughout all seasons I play at least one recreational sport one day per week. I sit at a desk all week though, and as the years have gone by have done less and less cardio. Never been a runner, running has always been a struggle for me and I more or less hate it, but I'm not just a bump on a log, I'm a huge sports guy and play as much as I can.

I play in a mens adult rec basketball league in the winters. Starting two seasons ago, in increasing frequency, I started having an issue where after exerting myself hard on the floor, when I got taken out of the game and would be at a pure rest stage on the bench, something would happen where it felt like there was a golf ball of phlegm that just appeared in my throat and almost felt like it was attached to my uvula. It would cause an overwhelming desire to cough, but no matter how hard I coughed or hacked nothing at all would come up. This sensation when at its worst would make it absolutely impossible to continue playing. The deeper I breathe the more I feel this obstruction. To best describe the sensation, it's not like I fear that I am not getting air, its just like something is suspended there in my throat that air can get around trying to make it more difficult. The desire to attempt to hack it up is intense.

One of the key's to this is that it happens AFTER I exert myself, not during. Sure, I am out of shape and full court basketball against grown men is very aerobically challenging. It is definitely the most physically challenging of all the sports that I play, and I am usually sucking wind and visibly tired after 7 to 8 straight game minutes playing, so I will call for a sub. Again, although I am sucking wind, I feel none of the above symptoms until a couple minutes AFTER I am sitting on the bench watching the game. Over time it seemingly got worse and worse, leading to less elapsed playing times before I would feel symptoms.

When I get home after these episodes, the symptoms linger for a long time. I usually feel tired and defeated and just downright uncomfortable, and even when I make up the next morning I still feel remnants in my throat, like that golf ball has shrunk down to a dime. I get a headache I assume from the hacking and wake up not feeling rested.

Some things to consider. I have NEVER felt symptoms doing any other aerobic activity. The buildings we play in, old middle school gyms and churches, are a bit notorious for not having the best air flow.

I went to my Doctor who said this sounded like Exercise Induced Asthma or Bronchial Spasms. He prescribed me an albuterol puffer. Last Wednesday was my big test. I used the puffer before, and feeling very confident that this would solve the issue, I played longer and harder than I have in a long time. This time I played the last ten minutes or so of the game all the way to the buzzer. Immediately after, I felt very winded but had no symptoms. Told my teammates that it looked like it worked. Wrong. As I was in my car about four or five minutes after leaving, the symptoms showed up out of nowhere and were worse than ever. I looked so rough by the time I pulled up at my house, that my wife wanted me to go the emergency room. This thing in my throat would not go away. It is now 5 days later, my throat is still irritated from this bout with the symptoms, it hurts to cough and it feels like bronchitis or something but there is no doubt its a 'hangover' from these symptoms.

I emailed my Doctor who said now he is thinking it is an allergy, and he wants me to try taking Benadryl before I play. This seems bizarre to me, first of all how I am supposed to play on something that makes you so tired, and secondly, how can I coincedentally be allergic to something that is in three different buildings? How can I play other sports in these buildings and not have the symptoms? It seems to me it is directly tied to the fact that this is strenuous aerobics, NOT something in the buildings.

I really do not want to have another week of these issues if these Benadryl do not work, which I really do not see them doing. Its getting to the point where I have to consider quitting, and that is the last thing I want to do. That means even less exercise.

Has anyone felt symptoms similar to this? If so, what helped? Has anyone found that albuterol didnt work the first time but worked after more uses? Does this sound like your EIA or EIB? Can you compare and contrast your symptoms? Should I just bypass my GP and go to a specialist? I'm not a doctor, but I know my body. I really do not think this is an allergy. I think it is a combination of me being out of shape and not getting correct air when I am exerting myself to the maximum. Any help would be greatly appreciated, I am not looking for someone to reply with "go to the doctor" comments, I have been doing that and I am looking for some comparable symptoms that will help me discuss options with my GP or a specialist.

Thanks in advance, god bless all of you and happy breathing.
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replied April 4th, 2011
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replied April 21st, 2011
Hi. Your doctor is right about your symptoms being related to activity and the environment. Some things to consider though:

-Asthma/reactive airways have 2 components: inflammation & constriction of the airways. Albuterol only works on the constriction part. If you're having mucus issues with fatigue, it's coming from the affects of the inflammation, so albuterol won't put an end to your symptoms, although it will be helpful.

-You may be allergic to something in the old building you are playing in that is causing your airways to become inflamed. Chronic inflammation causes fatigue and mucus production. Benadryl may help a little, but there are better meds available.

My suggestion: See an allergy/asthma specialist. Primary care doctors can only help you so much before you need the attention of a specialist.

I would also recommend not exposing yourself to that environment until after you've spoken to a specialist.
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