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    Suggest treatment for shortness of breath and muscle weakness

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Posted on Fri, 23 Jun 2017 in Brain and Spine
Question: Is it possible I have myasthenia gravis? riginally felt something wasn’t moving properly when I breathed in and out, ordered chest xray which came back clear. Prolem kept ketting worse. One year later, with shortening breath still I went for lung function test which showed 85% with some scarring, but doc said this was OK. Since then my breathing ability gas worsened with shorter and shorter breaths possible week by week. I have keep returning to doc as feel the cavity in which I can breathe is less and less, and just dismissed as anxiety. No wheezing or any symptom like that, just that i couldn’t breathe deeply any more. Problems have persisted, getting worse with worsening panting shortness of breath at all times and worsening feeling of suffocation especially when lying down. I’m breathing about 40 breaths every 30 secs now, constantly like this and am exhausted with it and scared at the increasing shallowness and choking feeling. Very bad feeling of choking all the time and gurgling noises in throat now, very shallow breaths n and out. Can still swallow but feels very odd and uncomfortable. Have also had a diaphragm test this was also clear. Have now such a shallow breath in and out and permanent choking feeling, wretching sometimes which is so difficult even as so little air. I! Now having to sit with my mouth open to breathe but if I open it wide start choking. I've paid for ent appointment and my throat is OK, no vocal fold paralysis or anything like that. My voice has changed too over past few months and struggling to talk without choking.
I've had extreme weakness in my legs and arms for months now too. Also barely able to smile or move face, twitches up side of my head. have barely been able to smile for nearly two years as feel muscles in face not working, they feel kind of numb. Please don't say anxiety as doc has said this, have tried relaxation, meficatipn, everythíngg and still worsened. Can barely breathe in or out now and very frightened. The doc says if I go to urgent care they will read chest xrays are clear and say I'm anxious. He seems unable to understand I'm anxious as this has worsened so much since the onset. I feel like something is semi paralysysed in chest stomach and throat, and just not moving properly. I feel it need urgent treatment and don't know how to proceed. I am 44 eight stone 6 points , one metre 68 and not taking any medication. Also to add..my symptoms started after four months of bed rest following following a leg accident. I have always felt that because I was immobile such a long time this weakened my muscles but my doc dismisses this. I can barely touch my throat now and feel I'm choking when I eat, when I breathe its so fast and shallow and restricted, the lessening amount I caninhale or exhale is so frightening, along with choking feeling. I've had 2 spirometry tests also at docs which gave inconclusive reading as unable to inhaleor exhale as I used to.. The doc said again anxiety. I only wish it were.. I know mybody and know something is going badly wrong with my breathing mechanism. Scared I'm going to suffocate soon as running out of breath daily. My face is now tingling also and my lips feel numb, they're not blue but feel numb. My oxygen sat is normal. Do you have any idea what could have caused this and is there anything I can do before I really do run out breath, as this is what is happening with each passing day? Yours very frightened. Thanks.

Also o was told when i had chest xray that this wouldn't have picked up muscle weakness, which is why I originally went, as felt muscles couldn't work properly. Would the diaphragm ultrasound have picked up if there was any paralysis? Haven't had any muscle tests on chest wall either which I complained about at start. There is no pain just reak weakness in breath chest, stomach everything I usedvto use ,normally, to breathe.
doctor
Answered by Dr. Neeraj Kumar 17 minutes later
Brief Answer:
Get investigated as advised

Detailed Answer:
Hello,
I have gone through your question and understand your concern.
Feeling of extreme fatigue and muscle weakness with speech change may be due to myasthenia gravis.
You can get CPK levels, nerve conduction study and antibodies profile for myasthenia.
Possibility of anxiety should be kept if all investigations are normal.
Visit to a neurologist for examination.
Hope you found the answer helpful.
Do get back to me for further information.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Neeraj Kumar 26 minutes later
Hi thank you. I'm struggling so me CH to breathe now and don't knowvwhat to do as know if I go to a and e they ll just dismiss as I have no diagnosis. Each night lately has taken me hours to go to sleep as breathing is so constricted and worsening. I feel I've not got much air to play with and tightening feeling across my chest and throat, what do you think I should do please, I'm really feeling this is an emergency and don't know what to do. I font feel I gave time to wait for a referral but fear being did!issued again by general practitioner. I'm in the uk by the way.
doctor
Answered by Dr. Neeraj Kumar 2 hours later
Brief Answer:
Stress upon muscular weakness and increase with exertion

Detailed Answer:
Hello again,

Please upload/attach your blood reports here to reports section so that I can look into it further.

Do stress upon the muscular weakness and speech changes with exertion.
Anxiolytics like Clonazepam or Etizolam can be taken with a prescription.

Regards
Dr. N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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