I met with both the pulmonologist and the GI doc.
The GI is positive that I have severe acid reflux and that it is causing all of my asthma symtoms. He later did a scope that showed just about everything from my throat down to the duodenum is inflammed. We've upped my Nexium to morning and evening and have put me on a restricted diet by food type and time of day made a bunch of typical GERD changes like raising the head of the bed type of thing. I have felt some relief from this - still the nagging hacking cough at all times. Still exhausted when waking up. He even blames my uncontrolled GERD for my resent gallbladder removal!
The pulmonologist thought that GERD would explain most of my symtoms as well. I did not tell her the GI said the same thing. She is being thorough and I am going back in late April for the meth. challenge. My understanding is that a negative responce to the enhaled drugs COMPLETELY rules out asthma. Generally my spriometry readings are on the low side of normal - abnormal readings have been rare. I am also getting a full chest CAT scan the same day. Heck - by the time the meth challenge comes around I will have been on double dosages of Nexium and a special diet for long enough it should be pretty easy to tell if my asthma-like symptoms are GERD related or not.
The army doc that sees all of the asthma cases is not convinced that my symptoms are 100% GERD and believes there is asthma contributing. I'll be seeing him again after I am complete with all of the follow-up testing with the civilian pulmonologist. He said at that time we have to start talking about a permanent profile since I am on high dosages of inhaled steroroids. From the sounds of it, the doses I am at now would require a profile that would trigger a board for the Army to decide if I can continue my 11 year career.