breathing difficulty-attn ccf neuro

    
      Re: breathing difficulty-attn ccf neuro
    


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Posted by ccf neuro M.D. on June 01, 1997 at 12:42:05:

In Reply to: Re: breathing difficulty-attn ccf neuro posted by Ellen on May 30, 1997 at 19:11:11:

: I should have added that I've seen the psychiatrist, early
  on to rule that sort of problem out.
  They cannot help me with this trouble.  This started
  in ONE DAY, on Sept. 6, 1996.  No stress, nothing.
  And the surgeon says that my hernia shouldn't be causing
  the type of pain I'm describing, the specific pulling pain.
  I've been pretty impressed by this forum and was hoping
  you could be more helpful, or at least informative about
  my specific question regarding the vagus nerve.  
  Unfortunately, not many doctors seem to know about it.
  Can you shed any light?
========================================================
The vagus nerve is the nerve that carries parasympathetic nervous system fibers to all smooth mucle cells, the heart, and glands for most of the body, and specifically most of the intestines. The only conscious pain fibers that it has supply a very small portion of the eardrum and ear canal, and a portion of the larnyx and throat. Symptoms of vagal nerve injury depend on where the nerve is injured, but may include tachycardia, ileus (paralysis of the intestines), poor gastric emptying, but not pain, diaphragmatic dyfunction (the diaphragm is controlled by the phrenic nerve, which originates from the 3rd, 4th and 5th cervical spinal nerve roots), or esophogeal dysmotility sydromes (which, by the way, can generate excruciatingly intense pain), or weakness of any muscles. There is a syndrome called Tietze's syndrome that affects young women and generates horrific pain in the chest wall as a result of inflammation of the costochondral cartilage junctions. It is highly responsive to treatment with indomethacin (an antiinflammatory drug) and/or corticosteroid treatment. Your pulmonary function test results do not indicate any meaningful comprimise in respiratory function, and the results of such tests are highly dependent on the effort of the person undergoing them. Sometimes pain in the shoulder or elsewhere is the result of so-called "referred" pain, where a problem in the abdomen (like gall bladder inflammation) produces pain in the shoulder, much the same way angina of the heart can result in arm or jaw pain, even though the heart is the source of the problem. Tension resulting from your hernia could conceivably result in some sort of referred pain. I hope these thoughts are useful to you. I cannot think of any neurologic illness that would explain your symptoms, although an evaluation by a neurologist to check for whether or not there may be findings that help explain some of your many symptoms would not be a unreasonable course of action. If you are near Cleveland and are interested in being evaluated at the
Cleveland Clinic, our number is 1-800-223-2273 ext. 45559; the information provided in this response is intended for general information purposes only; specific treatment options and appropriate courses of action should be determined in conjunction with your treating physicians.