Discussions By Condition: I cannot get a diagnosis.

Shortness of Breath

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: Anonymous
  • December 12, 2007
  • 09:20 AM

I am 18 years old, 6'2'', and 123 pounds. I was diagnosed with a Spontaneous Pneumothorax on July 18th 2006. I went into the Emergency Room ONLY with shoulder pain, no shortness of breath, but I've had this exact shoulder pain for 10 months. It was sort of an ache more than a stabbing pain. They took an xray and the technician said "Have you had any shortness of breath?" and I replied no not at all. My Sp02 level was 96-97% going into the emergency room that day. So apparently I didnt notice the lung collapse whatsoever. They inserted a small catheter into the left lung (40% upper collapse) and I was in the hospital for 3 days. I have not had a reoccurance yet, but my problem is now I can't breathe. I've been to two prior pulmonologists, and primary care doctors and they told me its in my head and I need to consult my psychiatrist. I've seen my psychiatrist and said there is nothing she can do because she feels its not psychological, but having anxiety would definately be scary seeing as something is medically wrong and undiagnosed. I have shortness of breath 24/7. The shortness of breath feels like I need to just work harder to inhale, but it never fully feels right. If I had to describe it, its as if I take 3/4th of a breath and it just stops, I can feel it actually stop right underneath my rib cage, almost like a knot. I also get sometimes a 2 second stabbing pain different locations on my chest every 4 or 5 days maybe, and chest aches right in the center of my chest every other day usually. I am a constant mouth-breather, and sometimes when I breathe through my nose it helps a bit, but not very much. I seem to yawn constantly, most of the time because my body tells me to, but sometimes it helps me feel like I get a decent breath in. 2 days after the "reinflation" once I was home, the shortness of breath started and never stopped. I can't for sure say if its progressively getting worse, its been so long I can't seem to tell, I just know its constant 24/7. CT scans (no contrast) are clear, Chest X-Rays are clear, Lung sounds are great, and Pulmonary Function Tests are unremarkable and checked out above average according to other doctors i've seen. I was also told there is no reason for a biopsy because there is nothing suspicious on the lung itself to biospy, and no need for a bronchoscopy, also because there is no suspicion of it being airway related. I've returned to the hospital at least 10-12 times since the collapse for pain and shortness of breath, and they do a 2 view chest x-ray and it always comes back perfectly fine, but the doctor never seems to mention what I should do for it. I felt 100% better while my lung was collapsed (aside from the off and on shoulder pain) but my life was ruined once it was "inflated". I could run a couple miles with only very very mild shortness of breath before the catheter. I have no family history of any lung issues. I was given an inhaler (Xopenex) but only works a little bit but never enough to take a full breath. It gets a lot worse in thunderstorms and in the shower. Warmer or colder air doesn't seem to make much of a difference but if i had to choose, breathing is a bit easier in summertime, but only very very slightly. The shortness of breath seems worse in the morning, and as the day goes on it seems a bit better but not much at all. Different air enviroments dont make a difference either such as pumping gas and the gasoline smell, and being around a lot of scented candles, but cigarette smoke and fire smoke makes it much worse. I get really out of breath (more than the 24/7 usual shortness of breath) just saying a long sentence. I actually seem to be more out of breath resting than walking. Also i'll mention that once the lung was "reinflated" no shoulder pain since, so it was directly related to the lung, but doctors say NO way I could have not noticed it collapse and it especially couldnt be collaped for 10 months and i'd have no symptoms. I've been to two different pulmonologists, one here in my city, one in Phoenix AZ. The Phoenix pulmonologist and my primary care physician diagnosed me with Tachycardia and gave me a prescription for Metoprolol ER 25mg once a day, which helped me feel much better dizzyness and feeling faint wise, but no effect on the shortness of breath. At my last appointment with him, he said he's going to have to make it PRN seeing as nothing is showing up, and he just wants me to "live my life and its going to be fine". I was referred to Arizona Heart Institute in Prescott with an abnormal EKG, and the doctor completed an Echocardiogram, and it came back perfectly fine, and he said the EKG was nothing to concern myself with, but gave me no explaination of the Tachycardia, or the dizzyness and faint feeling. Doctors seem to make it out to be no big deal just because my Sp02 level currently is 97-99% range. I can walk in to the office on my own two feet, but I surely feel it every day, all day. Its been 24/7 for over a year and a half now.

Personal Hypothesis: I feel because I had that shoulder pain 10 months prior to going to the ER (I didnt go earlier because I assumed it was just a really bad pulled muscle or pinched nerve) my lung was collapsed so long, my body adapted to it being down, so when it was reinflated, it shocked my body into thinking its a foreign object and/or the lung was down so long it lost its ability to transport oxygen.

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  • Since your problem is not "seen" by the docs, maybe it's a form of anemia. RBC's transport hemoglobin which contains the oxygen used by our cells. (roughly) Hypochromic anemia is a form of iron deficient anemia. Have you had a CBC lately? Hypochromic anemia is a form of anemia characterized by a disproportionate reduction of red cell hemoglobin in proportion to the volume of the erythrocyte and an increased area of central pallor in the red cells.Hypochromic anemia may be caused by iron deficiency from a low iron intake, diminished iron absorption, or excessive iron loss. It can also be caused by infections or other diseases, therapeutic drugs, and lead poisoning. One acquired form of anemia is also known as Faber's syndrome. It may also occur from severe stomach or intestinal bleeding caused by ulcers or medications such as aspirin. Or, possibly the phrenic nerve which controls the diaphragm was damaged during the re-inflation of your lung. Look up diaphragmatic paralysis.
    rad-skw 1605 Replies
    • December 12, 2007
    • 11:38 AM
    • 0
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  • Since your problem is not "seen" by the docs, maybe it's a form of anemia. RBC's transport hemoglobin which contains the oxygen used by our cells. (roughly) Hypochromic anemia is a form of iron deficient anemia. Have you had a CBC lately? Hypochromic anemia is a form of anemia characterized by a disproportionate reduction of red cell hemoglobin in proportion to the volume of the erythrocyte and an increased area of central pallor in the red cells.Hypochromic anemia may be caused by iron deficiency from a low iron intake, diminished iron absorption, or excessive iron loss. It can also be caused by infections or other diseases, therapeutic drugs, and lead poisoning. One acquired form of anemia is also known as Faber's syndrome. It may also occur from severe stomach or intestinal bleeding caused by ulcers or medications such as aspirin. Or, possibly the phrenic nerve which controls the diaphragm was damaged during the re-inflation of your lung. Look up diaphragmatic paralysis.Its not diaphragmatic paralysis because when I looked it up it said my Pulmo Funct tests woulda failed and they are passing with flying colors, but ill get my blood work tested asap.
    Anonymous 42789 Replies
    • December 14, 2007
    • 05:40 AM
    • 0
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