First a bit of background. I am a late 40’s male who has been overweight his entire life. In my 30’s I developed sleep apnea and have been on a CPAP ever since. I also have had acid reflux for a long time (had ulcers in my teens). I didn’t do well with PPIs so have had to just deal with it. About 6 years ago I developed a chronic cough and constantly have to clear my throat, but the doctor said it was GERD. I have also been one to have bronchitis at least once a year and sometimes pneumonia as well. Also, covid hit me hard last year.
Whenever I had bronchitis, pneumonia, or when I had covid, I could hear these crackles coming from my mouth. Fast forward to August. I felt bad enough that I did a covid test at home that came back negative. Also, I had the crackles. They were so loud that I could hear them just breathing with my mouth open. So I I make an appointment with my new GP. Due to the delay, I go ahead and get a chest xray ahead of time. I finally see the doc and he says xray was clear. He still prescribes me some steroids and antibiotics. He listened to my lungs but through my shirt and said it sounded clear. I take the meds and stuff but the crackles don’t go away. They might be less there or even gone one day, but they are still there.
I make another appointment and he still hears nothing (still through clothing for auscultation). However, I came with recordings of the sounds of my breathing and pictures of my SPO2 sensor. He sets me up with a pulmonologist and writes a scrip for singulair. The singulair makes me feel a little better (or placebo effect), but doesn’t affect crackles.
Next I see a pulmonologist who once more does auscultation through clothes and hears nothing. To be fair to them, I also had clearer breathing that day than any time in the past month. Strange how that always happens. I do fine on a PFT and when I did the walk, my SPO2 went up rather than down. We schedule the test where they check for asthma and you have to inhale this powder. I also played the sounds I had recorded with my phone.
I come back for the second test but in the mean time I have gotten a stethoscope of my own (cheap one from Amazon) and have been checking myself. At this point I know when and where I can place it to hear the crackles, which sound like velcro. Being big makes it complicated. The next visit I take my shirt off when I go back so there is no choice. I also bring my stethoscope, find the location, and have them place their stethoscope there. They finally hear them and orders an HRCT. Also, asthma test was negative.
So a week or two go by and I call and set up an appointment to get my results from the HRCT. HRCT is negative for everything except possible air trapping and potential spleen issues. So they say all good and clear and that maybe the noises are just caused by something in my upper airways.
Currently I am going for a second opinion and taking my HRCT pictures with me.
The thing is, I don’t want this to be what I have. It honestly scares me to death. However, the only thing worse for me is not knowing due to how much early treatment affects outcome. I think they all think I am crazy. But I can literally hear the crackles from my mouth if I lay down or lean back. I can also hear them in my lower lobes if I put the stethoscope on while slightly leaning back. It sounds like pulling velcro apart. However, HRCT was clear and doctors almost never hear the crackles, though they almost completely go away if I sit up or lean forward.
Oh, one other bit of background, they did find that I had bradycardia after I had been telling people for years about my pulse dropping to the 30’s in my sleep and often 40’s when awake.
I wonder though, can your HRCT actually be negative for everything and you still have issues, or is it more likely a case of human error?
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