Hi all, posted on here 3 months ago with my pfts, both of them from last year, one in June 2025, one from November 2025. My new pft (April 2026) is looking much better, though i still remain symptomatic. I am being treated by an allergist, taking montelukast, spiriva, advair, and an allergy pill. I was a heavy weed smoker, 16 years. My Fev1/fvc ratio improved and so did my small airways fairly significantly. I did an asthma phenotyping in November where my IGE was 571 and my absolute eosinophils were .46. For this PFT I was only on high dose advair.
I am still athletic, i can push myself fairly hard, but my bar for athleticism is pretty high. I enjoy pushing myself athleticly, high intensity heartrate exercises like rapidly doing calisthenics sets back to back without stopping. I was doing that type of regime at the beginning of last year, as well as completing sprints and running without stopping. I can still run for a while putting in miles, but i have this lingering tightness still thats still going on as of today. I cant tell if i feel any better today, though my spirometry indicates my airway inflammation is trending positively, even if it feels like my symptoms don't match my spirometry, i also have yellow tan phlegm in the morning still, not ever "coughed" from my lungs, just sitting in my throat. I never feel the phlegm in my chest or "ronchi" sounds and i never have any cough, its also clear white/sticky all day sitting in my throat, which leads to me clearing my throat often. Is this a part of long term airway clearance/remodeling Ive been reading about in cannabis related reversible airway inflammation and long term clearance of cannabis tar? I had allergies to everything on the allergy panel test, so ive heard this could also be post nasal drip. I am also taking flonase, but nothing in this medicine lineup is touching the phlegm production.
Would a biologic liken dupixent help eliminate this remaining lingering tightness and be a good target for those blood biomarkers (IGE 571, .46 abs eosinophils)? My allergist said i likely avoided anything structurally bad happening to my lungs based off my latest pft. He wanted me to try spiriva as an addon to my asthma management for two weeks to see if it makes a difference. So far it made some difference, but not a night and day one. I have one more week and I was going to push for a biologic. I told him in a message on my chart if this doesn't push the bar on my symptoms id be looking at biologics like dupixent.
I know many on here have it worse with varying levels of severity. I come on here because of the people and their experiences and many different variations of lung disease, and if they have seen anything like this develop over time, especially with symptom reduction/resolution? Is time going to be my friend here alongside pushing for a biologic?
Thanks all, everyone on here has been helpful and kind.
Ps I eat incredibly healthy and exercise fairly consistently, despite these symptoms.