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When Thomas couldn't shake off a persistent cough, his colleague suggested he should visit the respiratory clinic. Thomas was surprised. He was 43, there was no family history of chest problems, he was fit and enjoyed regular rounds of golf, running and cycling. When he went to see the local respiratory team, the nurse asked about his symptoms. Thomas reported that he coughed a lot, mainly at night, and that he felt tightness in his chest. He was tired for much of the time but thought his cold-like symptoms were just hay fever.

The respiratory team decided to investigate using FeNO testing and spirometry. They tested Thomas' FeNO level. His score was 149 ppb. A normal FeNO level is up to 25 ppb so Thomas' score was very high. The spirometry test did not find anything wrong. With his high FeNO score, however, the team knew it was likely that Thomas had inflamed airways and that his symptoms could probably be treated with inhaled corticosteroids, a type of medication that is taken using an inhaler.

After a few weeks of using his medication, Thomas came back for a follow-up appointment. His FeNO level had already dropped to 80 ppb. At his next appointment, Thomas' FeNO result was 40 ppb. This was great news. At his third check-up, Thomas discovered his FeNO had reduced to 13 ppb - a normal level - and now he only needs to visit the clinic once a year to keep on track. Thomas reports that he is managing well with his medication, he is no longer tired and he can focus better at work.

All stories are real patient stories. Names, ages and genders may have been changed to preserve anonymity.

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