Asthma or Autonomic Nervous System Disorder: Your Symptoms - Pulmonology

Is it asthma or autonomic nervous system dysfunction?

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Hello, doctor.
I have asthma due to family history (my grandfather had asthma), but under the misconception that I no longer had asthma symptoms after middle school, my parents didn't let me use a dry powder inhaler, fearing the effects of medication.
For over ten years, I had no significant issues, and I do not have any bad habits like smoking or drinking.
However, in late November last year, I developed a throat infection that led to otitis media, and this condition persisted until the Lunar New Year.
After returning to work, the doctor at my regular clinic said it was due to my fatigue.
I then started experiencing nighttime coughs, which were not severe at first, so I didn't pay much attention, thinking it was related to my ongoing illness.
Gradually, the nighttime cough worsened, affecting my sleep, and I felt short of breath.
The next day, I went to a large hospital, and the doctor diagnosed me with an asthma attack, correcting my understanding of asthma.
He also mentioned that my profession (indoor designer and college instructor) could be a triggering factor.
He prescribed a week’s worth of medication (a short-acting bronchodilator, oral corticosteroids, oral bronchodilators, and antihistamines).
However, the effects were minimal, and my symptoms did not improve.
After a follow-up visit, the doctor arranged for blood tests and X-rays, which came back normal.
He prescribed another week of medication, adding antibiotics and cardiovascular medication due to my rapid heartbeat.
After returning home, my condition improved significantly; I was no longer wheezing or experiencing shortness of breath, but the nighttime cough persisted, even waking me up in the early morning.
During my follow-up, the doctor said my blood test results were normal but was unsure of the issue.
He later prescribed a dry powder inhaler, antihistamines, and corticosteroids, stating he was hesitant to prescribe oral bronchodilators due to my high heart rate (around 130 bpm).
I then visited a cardiologist, who conducted tests and found everything normal, attributing my symptoms to autonomic nervous system dysfunction.
In the following days, I was unsure if my physical condition was deteriorating or if it was asthma.
After moving slightly heavy items to another room, I became extremely breathless and needed to rest for a while to recover.
Living on the fourth floor, I usually took the stairs without issue, but gradually I began to feel short of breath and fatigued when reaching the fourth floor.
After a few days, I found myself needing to rest after climbing to the third floor.
This pattern continued for several days.
During my follow-up, I informed the doctor, who ordered another X-ray, which showed no problems.
He prescribed oral and inhaled corticosteroids, antihistamines, and a few days' worth of oral bronchodilators.
The doctor admitted he was unsure how to prescribe medication due to my rapid heartbeat but still prescribed oral bronchodilators for me to adjust.
I continued to have fluctuating symptoms during follow-ups, and my appetite decreased.
Initially, after the otitis media, my appetite was slightly poor, and my weight dropped from 55.8 kg to 54 kg (I am 155 cm tall).
However, since February, after being diagnosed with an asthma attack at the large hospital, my weight gradually decreased, especially rapidly in the later months.
The nighttime cough symptoms have lessened, and I no longer cough severely enough to disrupt my sleep.
My wheezing symptoms have been inconsistent; sometimes, walking a short distance to another room would leave me breathless and needing to rest, while at other times, I would wheeze but not to the point of needing to rest.
On June 12, during a follow-up, my weight had dropped to 45.5 kg.
The doctor was puzzled, noting that patients usually gain weight due to corticosteroids.
He ordered more blood tests related to weight loss, including cancer markers, and asked if I consented to an HIV test.
Although I thought it was unlikely, I agreed to find the cause and also scheduled a pulmonary function test.
On June 19, I returned for the pulmonary function test.
I had to refrain from all medications the day before, which made me feel uncomfortable but manageable.
The testing process was challenging; I struggled with shortness of breath and experienced chest pain or difficulty breathing during forced inhalation and exhalation.
In the second phase, I used a short-acting bronchodilator, which helped somewhat, but the inhalation and exhalation process remained difficult.
The technician ended the test when they saw I was trying my best.
Afterward, I felt extremely fatigued.
During my follow-up, the doctor said all blood tests were normal and suggested that my symptoms might be due to stress or autonomic nervous system dysfunction.
He advised me to eat more and sent me home.
After the pulmonary function test, I was too exhausted to think about asking the doctor about the results.
Reflecting on the past four to five months, I realized I had not improved, which affected my work.
Some suggested I switch to another large hospital, while others recommended seeing a specialist for autonomic nervous system dysfunction.
Now, I am unsure of what to do, so I am seeking your professional advice.
Should I switch doctors or see a specialist for autonomic nervous system dysfunction?

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Miss Song, 20~29 year old female. Ask Date: 2020/06/20