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Have Neck Pain Due To Spondylitis, Breathlessness, Swallowing Difficulty, High Blood Pressure. Solution?

Posted on Sat, 8 Sep 2012

Question: My mother who is 75, has severe neck pain (spondylitis ) . Last week she had to be admitted for shortness of breath, she also has swallowing difficulty. She had a v high blood pressure thouh she is generally a low BP patient. Whats the solution?

Answered by Dr. Rakesh Madhyastha (6 hours later)

Hello

Thanks for the query

I would like to know a few more things in order to help you

1. Could you attach the reports of the cervical scan?
2. When she was admitted with high blood pressure and breathlessness what was the working diagnosis of the admitting doctor?
3. Was there any chest pain? Was the breathlessness sudden in onset?
4. Any history of asthma?
5. Have you done an ECHO recently? could you please attach the report?
6. Along with breathlessness did she have cough and fever?
7. Is she on any routine medications? please mention all of them to me

Please get back to me, I am awaiting your reply

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (13 hours later)

Thanks doctor.
Replies below:
1. Cervical scan not with me here.
2. All reports were normal. So doctors could not reach exact conclusion yet.
3. No chest pain was there. Yes, breathlessness was sudden.
4. Major problem in eating as she cannot swallow easily. endoscopy was normal 2 years ago.
5. No Asthema.
6. Echo report not available with me as i am in pune and she is in jaipur.
7. No cough and fever with breathlessness.
8. Homoglobin 9.5
9. routine medication is pain killers for spondylitis .
10 has great weakness and cannot stand also..

Regards,

Answered by Dr. Rakesh Madhyastha (9 hours later)

Hello

Thanks for the detailed reply

As I see it there are two separate issues, She has cervical spondylosis for which she has been receiving treatment and the other issue is acute onset breathlessness which could be due to a acute bronchitis. Acute bronchitis typically presents with acute onset breathlessness with or without a previous history of fever.
The raised blood pressure if she was not previously a hypertensive is because of the shortness of breath which she had, once the breathlessness is settled the blood pressure will fall.

If she is having trouble swallowing in spite of the normal endoscopy it means that there is a central cause for it so a MRI brain has to be done to rule out an infarct in the lower cranial nerves (nerves that supply muscles of the throat). Please approach a neurologist for the same.

haemoglobin is low, ideally it should be 13, this is the main reason for her easy faitugueability and generalized weakness. Please approach a physician to receive iron supplements to correct the hemoglobin. It has to be taken daily for atleast 3 months. Let her eat food XXXXXXX in iron like XXXXXXX leafy vegetables, liver, fruits, etc

I hope I was of help, if you have any further questions please get back to me.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (5 hours later)

Excellent.
Thanks doctor.
Her Son in LAw is a XXXXXXX Doctor there and is taking care of her. I wanted to ask you cause sometimes a new fresh approach throws light on something simple which may have been missed.
need for mri etc investigation to The swaollowing problem is very helpful. MRI was tried but i think she could not get into the machine due to fear of suffocation..

So are you suggesting that there is no connection between spodylitis and breathlessness? and it may be Acute bronchitis attack ?

Thanks for your help and time, appreciate it.

Cheers !

Answered by Dr. Rakesh Madhyastha (8 hours later)

Hello

Thanks for the query

If you ask me 'Can spondylosis lead to breathlessness" my answer would be yes, but it will not be acute, it would be gradually progressing where a patient suggests that she is gradually not able to do her routine work due to breathlessness over several months

I am happy she taken care of by a XXXXXXX doctor.

MRI can be re tried after giving a mild sedative. Many individuals are fearful of the closed space.

I am happy I was of help

I am sorry for the short delay in my reply, I just got back from the hospital.

Cheers!

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar