Shortness of breath

I have had muscular/skeletal pain, fatigue and apparent neurological problems (numbness, weak legs/arms) for many years with no clear diagnosis.  The neurological problems have worsened over the past year and a half.

Since Spring I have developed frequent shortness of breath which occurs with exertion. For example, doing the dishes, walking across my house, bending over to retrieve an object.  If I do not lie down when the shortness of breath occurs it worsens and may progress to hyperventilation. My doctors think I am having anxiety attacks. I don't think that I am.  I have tried Klonopin which makes the breathing problems worse, they progress  to hyperventilation more frequently.

I have normal Chest X-ray, and blood gas test.  CT scan showed no pulmonary embolism. Nuclear stress test was normal.

I had a Pulmonary Function Test in which results got worse post-bronchodilator on the spirometry portion.   The test showed the FCV with  6% improvement, but all other values dropping -29 to -71%. Pre bronchodilator tests were normal.  I saw a pulmonary specialist who told me my lungs were sensitive but there was nothing wrong over all.  He said that the drop in post-bronchodilator values could indicate a problem, but did not tell me what the problem might be or schedule any follow up.   Could that drop in values be something significant, given the rest of my condition?  Is there any follow up I should initiate, or other investigations?    

Thank you    

[National Jewish]

The first question that must be answered is what is the nature of your 'neurological problems'?  Are they purely neurologic or neuro-muscular and, if the latter, might you be experiencing the rapid onset of muscle, including respiratory muscle fatigue, to account for the apparent worsening of your lung function, post-bronchodilator?  More likely is that your effort was not as good during the second set of breathing tests.

You should ask your pulmonologist to interpret the pulmonary function tests.  The normal FVC, pre and post, argues against restrictive lung disease.  You could have had a 'paradoxical' response to bronchodilator.  It would be helpful for your doctor to do a simple spirometry and listen to your lungs after exertion of a degree to cause shortness of breath and 'hyperventilation'.  You should also have a graded exercise test.  Also ask the pulmonologist what he meant when he said your 'lungs were sensitive'.

The shortness of breath you've experienced with minimal exertion is severe to a degree that would almost certainly be associated with obvious lung or heart disease.  Failing that and with embolism ruled out, your doctors may be right

[mossesb43]

A related discussion, need help for SOB and back pain was started.