Conversation: The conversation between human and AI assistant.
[|Human|] I ve had a small-but-nagging cough for aprox. 6-8 months, and a problem with wheezing when I laugh too hard. I have never smoked, or lived with anyone who has. In the last week, the cough has become much heavier/harder and I feel a near-constant pressure on my chest, just over the breastbone. Is it possible this could be walking pneumonia or something similar?
[|AI|]  Hello, I read your message and understood your medical issue. I see that you have a persistent Chat Doctor.  I don't know what you have used to treat it, but this is quite a long period of time for the symptom to be self-limited even if left without any treatment. When laughing, much more pressure develops inside the pulmonary system which makes the obstruction of the airways to become more evident. Chest discomfort and the sense of pressure in the chest followed by a more severe cough especially after a physical efforts are signs that show that the pulmonary function is getting down. It can be due to pneumonia of course or as a side effect of the previous pneumonia episodes. In this case, the pulmonary function is reduced because of atelectasis which is the substitution of the pulmonary tissue with fibrous tissue. Anyway, I do not think that this is your case even though I do not expel it as a differential diagnosis. What I think is a possibility of HERD (gastroesophageal reflux disease) which has not been treated adequately and might have caused aspiration pneumonia. Anyway further tests are needed to rule it out and treat it adequately like chest X-ray, upper endoscopy and a good physical examination. Bronchitis may become chronic and may lead to more severe pulmonary disease like COPD. My suggestion is that you must see your doctor and do the respiratory tests to evaluate the function of your lungs. Chest X-Ray is very important in this case. It can be due to an allergic reaction as well. Maybe you are constantly exposed to the allergic substance that causes obstruction to the airway and produces the symptoms. Mediastinum organs like large vessels, trachea, lymph nodes etc. must be evaluated. Tumors in this region, also the pulmonary tumors are not usual and if found they are successfully treated. My advice is that you must do at least the pulmonary tests, a chest X-ray and all the random laboratory examinations and if you can do the allergic tests. Hope this is helpful for you.