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Start choking when head is slightly bent, slutter speech, tongue spasm ad need to clear thyroid. Cause?

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Practicing since : 1996
Answered : 11 Questions
When my head is slightly bent forward, reading or using my laptop, I begin to choke, not able to get enough air in or out of my lungs. If I roll onto my back when sleeping, I awake in a panic, choking horribly to get the air back into my lungs.
Other symptoms include: often my mouth seems unable to form the word I want to say and I begin to almost stutter, as if my tongue spasms; feels like my throat needs clearing constantly, making me cough but nothing is there; upper back muscles on both sides burn if I spend more than 10 minutes with arms forward, such as at the sink; extreme fatigue after doing two minor chores and must spend an hour sitting to resume any activities.
Posted Tue, 8 Oct 2013 in Lupus
Answered by Dr. Parshant Aggarwal 26 minutes later
Brief Answer:
get serum CPK, LDH, SGOT, SGPT, ENT consult

Detailed Answer:
Thanks for your query.

At this point of time based on the limited data provided, I am unable to think of an organic medical reason to explain the symptoms apart from anxiety itself. However if you can visit your doctor and get a few test, we can be able to exclude organic causes.

If I were to be your treating doctor, I would consider CPK, LDH, SGOT and SGPT tests to evaluate for any muscular inflammation. In addition, I will refer you to consult an ENT surgeon to look for any local lesion in your pharynx or throat. I will also write for chest X-ray (PA view) to look of organic lesions in your lungs.

Sometimes in patients with anxiety hypeventilation could lead to alkalosis leading to muscle or tongue spasms. Adequate calcium and vitamin D supplementation is helpful. It would be worthwhile to also check for Vitamin D and alkaline phosphatase levels.

Hope this helps. Write back for clarifications.

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