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Unexplained breathing difficulty after trauma
Dear MedHelp Community,
I’m reaching out to ask for any insight and advice on my rare condition that traditional medicine fails to adequately address. My story is as follows…
I am a 31-years-old male without any chronic diseases aside from some history of pediatric asthma, I don’t smoke or drink, and have a healthy lifestyle and exercise habits. In 2007 I was hit as a pedestrian by a drunk driver. The impact happened primarily to the right side of my body. I lost consciousness and was taken to the hospital, examined for bone fractures and internal bleeding and discharged the same night as none of the above was detected. In the following months I experienced some pain, particularly in the neck, right shoulder and the right thoracic area and it hurt to take a deep breath.
Unfortunately the pressure of my career at that point forced me to resume my normal activities almost immediately despite the pain. I thought that since no bones were broken and no serious internal injuries were detected my trauma would heal on its own overtime so in the months following the accident I never followed up with a doctor, a decision that I now deeply regret.
Over time the pain did go away but a crackling sound developed in the upper right thoracic area particularly when moving the right shoulder and scapula. I also started experiencing a gradually increasing sense of tightness, difficulty breathing normally, and the urge to swallow more frequently than usual. Excessive susceptibility to allergies and chronic fatigue became major symptoms as well. It became difficult for me to take a deep breath and I constantly felt "hungry” for air.
Hoping that physical exercise would strengthen my cardiovascular system and counteract the shortness of breath I was experiencing, I pushed myself to continue exercising. But things progressively got worse until in October last year my life started literally falling apart. Following a change in a living situation (which I believe may have contributed to the unraveling of my symptoms as it exposed me to some new air allergens) excessive mucus accompanied by coughing, difficulty breathing felt on the right side, and inability to get refreshing sleep had developed. Once a person who could always count on his memory, I found myself struggling to recall basic events and felt fuzziness in general when it came to memory function. I felt tired almost all the time and felt constant difficulty when trying to take a full breath of air. The more I tried the harder it became to breathe.
Since at that point the injury was about 3 years old I did not immediately connect the symptoms to the hit and run accident and instead suspected in could be something infectious. So my first move was to see a host of pulmonologists all of whom said that I have nothing infectious, that my lungs are fine, and there is no obstruction of any sort and that my respiratory function is great. Then there was an ENT doctor who did bronchoscopy of the upper respiratory tract and found no obstruction there either. In December 2010 my significant other told me that I barely breathe when I sleep and that my heartbeat is very shallow and rapid. I went for a sleep study and was diagnosed with sleep apnea with oxygen levels hovering around the low 80% during the study. I started using a CPAP machine, which helped get better sleep but did not solve other issues or answered any questions. The pulmonologist who did the sleep study said that the apnea was not obstructive. Trying to confirm whether it was central apnea I saw a neurologist who didn’t seem particularly thorough but did an MRI of the brain and some reflex tests and said that there were no problems…
Thinking that the mucus and coughing could perhaps be caused by my childhood asthma returning in some new form, I went to see an allergist who prescribed me Singulair pills and Albuterol inhaler. The meds helped control the mucus but did nothing for the breathing difficulty so it did not fix the problem.
After the pulmonary and obstructive issues were ruled out the next suspicion was that the problem is of muscular nature and that it’s perhaps some of the respiratory muscles that are not properly engaging for whatever reason causing restricted breathing and fatigue. So then there were multiple chiropractors and massage therapists who said that there is scarring of soft tissues all over the right thoracic region which may have lead to a tight rib cage. Massages, particularly of the intercostals and other accessory breathing muscles, provided temporary relief but tightness always returned after a few hours.
Next, I went to see a physical therapist who diagnosed me with the right long thoracic nerve damage evidenced by slight winging of the right scapula and the result of nerve conduction velocity study. The PT doctor also found uneven diaphragmatic excursion with diaphragm descending more on the left than on the right and loose ribs T2, T3, T4 in right sternocostal joints. The therapy focused mainly on strengthening the serratus anterior muscle for the winging scapula problem. For loose ribs the doctor recommended prolo therapy but after reading about the risks associated with the procedure I hesitated to proceed without further inquiry.
Most recently I started seeing a couple of A.R.T. (active release technique) chiropractors who confirmed the extensive scar tissue potentially trapping some of the thoracic nerves and interfering with their proper functioning. One of the A.R.T. doctors also said tight psoas muscle shortening in response to the trauma may be causing a lot of my symptoms as well. The therapy now is focused on releasing the psoas, releasing the long thoracic nerve, and breaking up the scar tissue with Graston technique. So far the therapy has been quite effective, even to the point that I was able to stop using the CPAP machine and get OK sleep. Using Kinesio tape on my chest and back also somehow helps me breathe.
Finally, I saw a rolfer who noticed hardening of the liver caused supposedly by misaligned fascia. Since I just started this treatment very recently it’s hard to judge the effects yet but the first session did bring some noticeable relief.
Overall, in the past couple of months I started seeing considerable improvement and I am hopeful that as the tight muscles are further released and internal scar tissue is further broken up and/or realigned by the A.R.T. and rolfing therapies, my breathing will gradually return back to normal. But after such a long and exhaustive search for cure I feel uneasy putting my full faith into a combination of two relatively new and relatively unproven therapies. One thing I feel particularly uneasy about is that multiple specialists said I have extensive internal scarring and that all sorts of internal organs may be adhering to each other causing all sorts of problems but no one was able to pinpoint where exactly the scars are, how big they are and what the extent of adhesion of internal organs is. I’ve been told that there is no reliable diagnostic screening for internal scars. Is that really the case? Does anyone know of any reliable methods for diagnosing internal adhesions? Another thing that bothers me is that no one was able to identify what causes the breathing difficulty: multiple pulmonologists and an ENT doctor ruled out any problems with lungs and any obstructions but I still feel a pronounced restriction of berating that I don’t know how to explain. So my goal with this post is to get an unbiased perspective on whether the way I am addressing the problem now makes sense and whether there are any other types of specialists or potential causes of my symptoms I should look into.
Thank you so much for taking the time to read my very long post. Any insight and perspective you may provide will be much appreciated.
I’m reaching out to ask for any insight and advice on my rare condition that traditional medicine fails to adequately address. My story is as follows…
I am a 31-years-old male without any chronic diseases aside from some history of pediatric asthma, I don’t smoke or drink, and have a healthy lifestyle and exercise habits. In 2007 I was hit as a pedestrian by a drunk driver. The impact happened primarily to the right side of my body. I lost consciousness and was taken to the hospital, examined for bone fractures and internal bleeding and discharged the same night as none of the above was detected. In the following months I experienced some pain, particularly in the neck, right shoulder and the right thoracic area and it hurt to take a deep breath.
Unfortunately the pressure of my career at that point forced me to resume my normal activities almost immediately despite the pain. I thought that since no bones were broken and no serious internal injuries were detected my trauma would heal on its own overtime so in the months following the accident I never followed up with a doctor, a decision that I now deeply regret.
Over time the pain did go away but a crackling sound developed in the upper right thoracic area particularly when moving the right shoulder and scapula. I also started experiencing a gradually increasing sense of tightness, difficulty breathing normally, and the urge to swallow more frequently than usual. Excessive susceptibility to allergies and chronic fatigue became major symptoms as well. It became difficult for me to take a deep breath and I constantly felt "hungry” for air.
Hoping that physical exercise would strengthen my cardiovascular system and counteract the shortness of breath I was experiencing, I pushed myself to continue exercising. But things progressively got worse until in October last year my life started literally falling apart. Following a change in a living situation (which I believe may have contributed to the unraveling of my symptoms as it exposed me to some new air allergens) excessive mucus accompanied by coughing, difficulty breathing felt on the right side, and inability to get refreshing sleep had developed. Once a person who could always count on his memory, I found myself struggling to recall basic events and felt fuzziness in general when it came to memory function. I felt tired almost all the time and felt constant difficulty when trying to take a full breath of air. The more I tried the harder it became to breathe.
Since at that point the injury was about 3 years old I did not immediately connect the symptoms to the hit and run accident and instead suspected in could be something infectious. So my first move was to see a host of pulmonologists all of whom said that I have nothing infectious, that my lungs are fine, and there is no obstruction of any sort and that my respiratory function is great. Then there was an ENT doctor who did bronchoscopy of the upper respiratory tract and found no obstruction there either. In December 2010 my significant other told me that I barely breathe when I sleep and that my heartbeat is very shallow and rapid. I went for a sleep study and was diagnosed with sleep apnea with oxygen levels hovering around the low 80% during the study. I started using a CPAP machine, which helped get better sleep but did not solve other issues or answered any questions. The pulmonologist who did the sleep study said that the apnea was not obstructive. Trying to confirm whether it was central apnea I saw a neurologist who didn’t seem particularly thorough but did an MRI of the brain and some reflex tests and said that there were no problems…
Thinking that the mucus and coughing could perhaps be caused by my childhood asthma returning in some new form, I went to see an allergist who prescribed me Singulair pills and Albuterol inhaler. The meds helped control the mucus but did nothing for the breathing difficulty so it did not fix the problem.
After the pulmonary and obstructive issues were ruled out the next suspicion was that the problem is of muscular nature and that it’s perhaps some of the respiratory muscles that are not properly engaging for whatever reason causing restricted breathing and fatigue. So then there were multiple chiropractors and massage therapists who said that there is scarring of soft tissues all over the right thoracic region which may have lead to a tight rib cage. Massages, particularly of the intercostals and other accessory breathing muscles, provided temporary relief but tightness always returned after a few hours.
Next, I went to see a physical therapist who diagnosed me with the right long thoracic nerve damage evidenced by slight winging of the right scapula and the result of nerve conduction velocity study. The PT doctor also found uneven diaphragmatic excursion with diaphragm descending more on the left than on the right and loose ribs T2, T3, T4 in right sternocostal joints. The therapy focused mainly on strengthening the serratus anterior muscle for the winging scapula problem. For loose ribs the doctor recommended prolo therapy but after reading about the risks associated with the procedure I hesitated to proceed without further inquiry.
Most recently I started seeing a couple of A.R.T. (active release technique) chiropractors who confirmed the extensive scar tissue potentially trapping some of the thoracic nerves and interfering with their proper functioning. One of the A.R.T. doctors also said tight psoas muscle shortening in response to the trauma may be causing a lot of my symptoms as well. The therapy now is focused on releasing the psoas, releasing the long thoracic nerve, and breaking up the scar tissue with Graston technique. So far the therapy has been quite effective, even to the point that I was able to stop using the CPAP machine and get OK sleep. Using Kinesio tape on my chest and back also somehow helps me breathe.
Finally, I saw a rolfer who noticed hardening of the liver caused supposedly by misaligned fascia. Since I just started this treatment very recently it’s hard to judge the effects yet but the first session did bring some noticeable relief.
Overall, in the past couple of months I started seeing considerable improvement and I am hopeful that as the tight muscles are further released and internal scar tissue is further broken up and/or realigned by the A.R.T. and rolfing therapies, my breathing will gradually return back to normal. But after such a long and exhaustive search for cure I feel uneasy putting my full faith into a combination of two relatively new and relatively unproven therapies. One thing I feel particularly uneasy about is that multiple specialists said I have extensive internal scarring and that all sorts of internal organs may be adhering to each other causing all sorts of problems but no one was able to pinpoint where exactly the scars are, how big they are and what the extent of adhesion of internal organs is. I’ve been told that there is no reliable diagnostic screening for internal scars. Is that really the case? Does anyone know of any reliable methods for diagnosing internal adhesions? Another thing that bothers me is that no one was able to identify what causes the breathing difficulty: multiple pulmonologists and an ENT doctor ruled out any problems with lungs and any obstructions but I still feel a pronounced restriction of berating that I don’t know how to explain. So my goal with this post is to get an unbiased perspective on whether the way I am addressing the problem now makes sense and whether there are any other types of specialists or potential causes of my symptoms I should look into.
Thank you so much for taking the time to read my very long post. Any insight and perspective you may provide will be much appreciated.
Hi there nik472, wondering how you are doing all these years later. If not on here, you are hopefully feeling better. Following major trauma and surgery back in the 90s, my difficulties breathing are similar. Am wondering if you found out anything further about possible adhesions. I have a surgeon who is told me it is time to look inside and see, but I am trying to get clearned right now by heart doc. Heart is starting to take a beating from my weird breathing.
If you lived here, they would tell you that's it's anxiety!
They now run one or two tests...if nothing shows up they start chanting "anxiety, anxiety"...how lucky you are to be tested.
I wish I could tell you more. I've been having the same kinds of problems since I did a nose dive off of a high dive platform when I was 12...hit the cement pretty darn hard. Have had the same problems as you ever since, but I have never had ANY testing done. Sorry...they DID xray my one arm at the time as it was a compound fracture...which means that they could already see that something was wrong with it. They never did a CT scan or any head xrays...which made my mother very angry. I was in a comatose state for 2 days...which means that if I were a hockey player I would have made millions and gotten time off for a nasty concussion. lol
I have been complaining ever since about multiple symptoms...and all they say is " It must be anxiety!" UGH!
You are on the right path as far as I am concerned. Keep at it!
As long as they are willing to test...and hopefully you will one day find your answers.
Good luck and the best to you.
They now run one or two tests...if nothing shows up they start chanting "anxiety, anxiety"...how lucky you are to be tested.
I wish I could tell you more. I've been having the same kinds of problems since I did a nose dive off of a high dive platform when I was 12...hit the cement pretty darn hard. Have had the same problems as you ever since, but I have never had ANY testing done. Sorry...they DID xray my one arm at the time as it was a compound fracture...which means that they could already see that something was wrong with it. They never did a CT scan or any head xrays...which made my mother very angry. I was in a comatose state for 2 days...which means that if I were a hockey player I would have made millions and gotten time off for a nasty concussion. lol
I have been complaining ever since about multiple symptoms...and all they say is " It must be anxiety!" UGH!
You are on the right path as far as I am concerned. Keep at it!
As long as they are willing to test...and hopefully you will one day find your answers.
Good luck and the best to you.
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