DEAR READER: Yes. Initially, you should request a referral to a rheumatologist. Lupus, a serious inflammatory autoimmune disorder, can affect the joints, kidneys, lungs and several other parts of the body. Many of the symptoms, such as fatigue, joint pain, anxiety, depression and variations in weight, cross over to those of fibromyalgia. Therefore, you should confirm that you do suffer from both conditions.

You should also be under the care of a pulmonologist for control of your chronic cough, asthma and bronchiectasis. The cough could be medication-induced or a result of your asthma. In order to determine what triggers your attacks, it may be necessary for you to undergo testing and to see several other specialists. This may appear daunting but once your textbook complaints of fibromyalgia are better controlled, you will then be able to lift your veil of depression and get on with your life. There is help. The fact that you have written to me is a genuine indication you are ready to get to the bottom of things.

DEAR READER: When responding to readers’ questions, I may be guilty of generalizing, hitting on the most common yet overlooked possibilities. Many coughs are tied to irritants or pollutants, postnasal drip, reflux, COPD, medication reactions and a host of other reasons. Because the reader mentioned only the nagging cough, I failed to cover pulmonary fibrosis caused by an inflammatory response to an unknown substance or substances.

Idiopathic pulmonary fibrosis affects about 200,000 people, with almost 50,000 new cases reported each year. It is a condition in which the deep tissue in the lungs becomes scarred, stiff and thick. The scarring process causes the lungs to lose their ability to circulate oxygen through the bloodstream. Progression of the disease varies between individuals, with people developing either gradually, rapidly or remaining relatively stable. Heredity plays a role, as does asbestos exposure.

Symptoms include cough, dyspnea, exercise intolerance, occasional chest pain, abnormal crackling breath sounds and clubbing (fingernails that curl over the tips of the fingers).

Treatment options are somewhat limited; however, corticosteroids have been found to decrease symptoms. Diagnosis might be made through bronchoscopy, CT scan or biopsy. Patients should be under the care of a pulmonologist. Research, as with most diseases, remains ongoing. Scientists are investigating the use of several prescription medications to slow the progression of the disease.

To provide related information, I am sending you a copy of my Health Report “Pulmonary Disease.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.