Is there anything wrong?

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I am concerned about my husband.  He is a 49 year old electrician, he has never smoked and doesn’t drink.  About 5 years ago he started coughing.  He went to the doctor who arranged an x-ray and diagnosed asthma.  He was given a blue and brown puffer to use.  His cough didn’t improve and so eventually he stopped taking these.  He continued having the cough and in 2014 we paid for a CT scan, just to check things were ok.  We were worried about asbestos as we know he has worked in buildings containing it.  The CT scan showed up some scars, granulomas and a raised left hemi diaphragm.  He mentioned this to his GP, but he didn’t do anything about it.  During his routine tests they found out he had a low heart rate, he was referred to a cardiologist who said his heart was fine.  In November/December 2015 his cough got a lot worse and at times his peak flow was 250.  He was prescribed a course of steroids and it got a lot better only to come back again so another course was prescribed.  His GP then referred him to a respiratory consultant who did a CT scan and a lung function test.  His consultant wrote the following

He had a high resolution CT scan of his chest which was essentially normal.  He also had a lung function test done which showed FEV1 93% of predicted.  Vital capacity was 104% of predicted whereas the ratio between FEV1 and FVC was 69.  After 200mcg of Salbutamol inhaler his FEV1 improved by 270 ml indicating some reversibility so overall my clinical impression if that his cough could be secondary to hypersensitive airways plus/minus mild asthma.

He was prescribed Symbicort Turbuhaler 200/6 one puff twice a day.  This was back in September.  His cough wasn’t improving so a couple of weeks ago he went to see his GP who told him to increase his dose to two puffs twice a day.  Two weeks later he still hasn’t improved.

He is constantly tired and get pains in the centre of his chest.  He doesn’t see his consultant again until March next year and I am concerned that there is something more going on in his chest. 

If the Symicort was working, shouldn’t he be feeling better by now?  Does this sound like asthma or COPD?  Can you offer any advice please.

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