Mother in the hospital

[Mike78]

My mother (71 years old) went into the hospital early Monday morning after aspirating, she was weak, shaky and couldn't catch her breath. It was the 5th time since mid December that she has aspirated and they finally admitted her (She was hospitalized 2 years ago for the same thing - aspiration Pneumonia).

For the last 5 years or so she has lost her voice (she speaks in a whispered tone) due to a paralized left vocal chord. She had a scope done and the doctor was unable to figure out a cause and wanted to schedule another procedure so he could see behind the vocal chords, but she declined. She has also had a violent cough for as long as I can remember (30 years) and she always mentioned that she felt like her throat was breaking. She hasn't had a stroke to the best of our knowledge and none of the doctors have suggested that at any point.

Anyway, she has had a few tests done in the past couple of days and they've come to two possible conclussions, either she has Histoplasmosis (swelling and calcifiying of the lymph nodes) which may be adding pressure to a nerve that controls the vocal chords (or resting against her vocal chords) or she has Myasthenia Gravis which is causing her to aspirate, lose her voice, sense of smell, etc. Now they did say that she has the calcified nodes, but they aren't sure if one of them is causing her current problem.

My question is, if it's Myasthenia Gravis, what can be done to treat that? And if it is related to the calcified nodes, is that something that could be removed to improve her speech, ablity to swallow, etc?

Thank you

[Abhijeet Deshmukh, MD]

Hello.

I am not sure how much my reply will help. The first thing to be done is to do certain tests for diagnosing or ruling out Myasthenia.

In Myasthenia Gravis, there is progressive muscle weakness on repeated use. The Tensilon Test can be done to confirm the diagnosis. If found positive for MG, appropriate medication can be started.

Only once we have ruled out one condition can we concentrate on the other. I am not sure which lymph nodes are involved. There are procedures to monitor Recurrent Laryngeal Nerve stimulation, which can tell if the nodes are the cause.

Regards

[Mike78]

Thank you very much, I'll make a note of this and make sure to ask her doctor about the Tensilon Test. She was visited briefly by a neurologist and there hasn't been very good communication between the different doctors seeing her.

Thanks again
Mike