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Dr. Sohaib
Dr. Sohaib, Doctor
Category: Medical
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Experience:  MBBS, FCPS Experienced in all Medical Specialities
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have srogrens auto immune disease (secondary to EDS hypermobile)

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have srogrens auto immune disease (secondary to EDS hypermobile) AND Hashimoto's thryroiditis. LUNGS-ARE-CLEAR every doctor who listens...
BAD THROAT SOUNDS, OCCASIONAL WHEEZE IN WINDPIPE AREA AND most mornings AND EPISODIC daytime....S.O.B. so bad go to tachy and struggle taking atrovent and salbutomol to open airway quicker.....last few months major airway mucous not much coughing but feel airway is closing up.......help?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Sohaib replied 1 year ago.

Hello and thank you for the question.

Answers given are for informational purposes only and are not meant to replace an exam by an in-person.

I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.

You need to answer a few questions first which will help me assist you in a better way.

Did you have pulmonary function tests done?

HRCT of the lungs?

Bronchoscopy?

Were you given a trial of steroids as well?

Customer: replied 1 year ago.

1 test only BUT did have partial lung collapse last fall and WEAR MEDIC ALERT ...says sjrogren and check air for mucous blockage...they did NOT check dog tag!


dont know what HRCT IS but pulmonary function was normal UNTIL lung partial collapse....no steroids and I HAVE endocrinologist and rheumy BUT here in Canada...they know nothing of srogrens MY HASHIS IS NO on prettty much hyper. @ .08 and the still have me on 1.0 MG SYNTHROID too much!! FREE T3 IS RIGHT ON 3.5....OF COURSE! t4 with synthroid 'JUST FINE' t.........feel t3'S must!! BE ADDRESSED...all i can tell you for now...3 days in hosp. oxy only and the tried 3 MIS-DX'S.. :(


 

Customer: replied 1 year ago.

more info have P.O.T.S. and took a 180 fall hard *(5'5-1/2" tall) hit hardwood feet in air (mini blackout) parietal (top of head skull bone) and THANKFULL NO! subdural hematoma by CT SCAN but waited for tht a month BUT did compression fracture T9 by 2 cms....


 


what else, srogens has taken at least 1/2 or my teeth or more so can't get enuff protein any additives or RESOURCE 2.O. takes me into UNBEARABLE beyond!! any dry mouth feel so sick and any sleeps?? wake up with the breathing struggle , feel not saliva to keep windpipe from shrinking yet endoc. says he knows of NO respiratory with srogrens???

Expert:  Dr. Sohaib replied 1 year ago.

Thank you very much for the useful information Patty.

The first step is to make it sure absolutely that there is nothing wrong with the lungs;

With sjogren's syndrome, and other related autoimmune diseases there are chances of PULMONARY FIBROSIS, which is not picked up on routine imaging studies of the lungs such as X-rays. For this, a high resolution CT scan (also called HRCT) is required.

If the problem is there in the throat area like sub-glottic stenosis, it can be picked by the help of bronchoscopy and treated at the same time as well by placing a stent in the narrowed part of the air way, or by planning other forms of surgery such as laryngotracheal reconstruction surgery (LTR) or partial cricotracheal resection (CTR).

Please note that these inhalers like atrovent or salbutamol can not help the subglottic stenosis; these can help only if there is reversible obstructive airway disease in the bronchioles (not in the glottis) --- so if you feel improvement by using these agents, the problem is most probably in the lungs.

The TSH values you have mentioned clearly suggests that you have been over treated, and this poses you at a greatly increased risk for atrial fibrillation (which can give you palpitations; and more serious problems like a stroke) as well as osteoporosis (which can weak your bones). Atrial fibrillation can also make you feel short of breath whenever it happens.

So reduction of synthroid dose is logical here.

To conclude, you need optimization of synthroid dose, and more tests to diagnose the exact underlying problem with certainty, which will direct a more specific and targeted management plan that suits best to your needs.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Customer: replied 1 year ago.

wrote whole xtra stuff just disappeared sorry! they did do DYE CT iv test thinking lung blood clot said copd due to collapsed alevoli....CAN THAT MIMIC YOUR 'FIBROSIS' as they did not even know of my sjrogens at all? i think the POTS yes AND THE HIGH TACHYS (think of an airway every sleep getting NO WATER SIPS AND LIQUID.... i read somewhere it will shrink down due to sjrogren and i have this occasional very thing stringy (vocal chords get al watery sound i have dry cough THAT WILL produce occasional out coming of this mucous ALWAYS CLEAR....not much but after? i can breath better.........THE POTS ALONE CAN CAUSE THE BREATHING ISSUE omg what is it in your best guess...I DO WANT THEM TO SCOPE BUT CAN A G.P. JUST ORDER AN OUTPATIENT HOSPTITAL TEST OF SAME? i also now know (JUST REMEMBERED ) THE EDS m.v.p. BUT NOW ALSO?? LAFB ....scary could i alredy have had minor heart attack? they do NOTHING NOT EVEN SEND me after 2 ekgs show the bundle block, TO MY HEART SPECIALIST!! I WAIT AND APPRECIATE YOUR PATIENCE & EXPERTISE....

Customer: replied 1 year ago.

FOR AIRWAY also i have heard they can widen with balloon method?? also of fair importance is that 3 yrs ago i was on only 0.25 but no-one tsh for 10 months in that period SKYROCKED to 58.6 so they in hosptial (PUT IN A DAMN PSYCH WARD Cry AS BIPOLAR!!() THEN IS WHEN THEY STOMPED ON TSH WITH 1.O. and took forever to come down...then when back in range couple time to hypo 8 or so...but the after that it's been then 3.0 the 1.?? then 1,? again suddenly now. .08 i insisted have monthly tests now ...I WAS SO VERY ILL AT THE SKYROCKET i wonder if that was TOOK TO TO HASHI'S indeed!!...they are NOT treating t3's and i feel this is important PLUS I RESEARCHED AND FOUND I NEEDED THE D3 but i will NOT OVER DO so 1-2000 per day.....I JUST FEEL .......SO SICK! feel most of is thyroid and POTS doing and aldersterone alone or pots COULD BE CAUSING S.O.B too much WRONG!

 

PLUS FEEL KIDNEY BLADDER COULD BE GOING ANYTHING I DRINK IMMEDIATELY VOIDED WITH FEW MINS TO 1/2 HR... could be in bad DEHYRDRATION ALSO....things are worsening clearly but this IS the course sometimes of any AUTO IMMUNE...no cures...JUST FEEL SO HORRID THAT SOME DAYS I FEEL I 'COULD' DIE I...it does say tow major cause of death srogrens RESPIRATORY OR CARDICA ACUTE FAILURE..... :(

Expert:  Dr. Sohaib replied 1 year ago.

Thank you.

The CT you had was done to look for a clot in the lungs (called ct-pulmonary angiogram). It can not read out the fibrosis; HRCT is required for this, which is a seperate test.

Sub-glottic stenosis is a very rare complication of sjogren's syndrome, and this need to be ruled out.

POTS can cause breathing issue but we need to look for the more likely causes first (lungs and glottis).

And off-course an echocardiography of the heart for mvp --- just in case it has worsened.

Thyroid problem is tricky and requires continuous monitoring and dose adjustment --- right now your dose need to be reduced; this has to be discussed with your doctor.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Customer: replied 1 year ago.

SO can YOU say if no lung sounds with stethoscope any 3 doctors now I DO NOT have copd...and i'm not have all day air breathing issues so how could it me 'severe' as i was told....just your quick thought pls plus after collapse then down went spirometer etc..to low normal

 

Also, the left anterior fascicular block could this have cause any heart damage on disease onset and finally yes i insisted we move up echos to 1.5 yrs not 3....it said las the valve was slightly thickenend???

 

I DO! get longer chest pains now not much if any palpitations except when breathing if very bad you can see chest banging and feel it....but not the beginning palpitations and LITTLE jet shooting back in pains much anymore......

 

i WILL ASK FOR the test you said. VERY MAD about the ct scan and AGAIN YOUR CONCLSION RE: THEIR COLLAPSED ALEVOLI DX....pls!! any of these issues could have CAUSED this partical collpase i was! unconcscious by medic arrival in 4 mins...do not remember any emerg xray or anything...then 2nd day i could not SPEAK or enunciatiate at all for min 1 day i was crying over it.....could i have had a stroke in hospital

 

THIS WILL BE LAST QUESTIONS ASKED OF YOU THEN I WILL rate you as most excellent ...oh Lord Above i pray for answers and help here in alberta canada there just IS NONE or as i guessed....MIS DX x many!! (ADDENDED: am now craving sweets where i used to be a quasi saltaholic......worrying about ldl hld now...btw am now only 108 lbs at height given ...'UNEXPLAINED WEIGHT LOSS' ...sighhhhhhhh

Expert:  Dr. Sohaib replied 1 year ago.

Thanks again.

I wish you are diagnosed and treated appropriately.

Even if there are no abnormal sounds heard on stethoscope, one can still have COPD, but if this is giving you a lot of symptoms, then obviously one can definitely hear the abnormal sounds on the stethoscope (but not always).

The block does not damage the heart, but itself is a result of fibrosis is the circuits of heart due to an underlying pathology. Many people do well even in the presence of block just with medications (And even with out them if the hemodynamics remain stable).

You should also get an ECHO of the heart repeated to look at the MVP (to know how is it behaving now; worsened or stable).

A person can have a lung collapse due to blockage of the air ways simply by a mucus plug; which when removed leads to re-inflation of lung back to normal.

Right now you clearly need more investigations which i mentioned earlier.

Goodluck.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Customer: replied 1 year ago.

I absolutely KNEW THIS WAS A MUCOUS plug on the partial collapse AND THAT OXY COULD only 'EVENTUALLY' re-inflate THIS WAS MY FEELING ALL THE WAY AFTER IT HAPPENED AND SO SUDDENLY HAD NO SYMPTOMS OFTHER EXTREME!!! S.O.G. WORSENing..YOU ARE MOST AWESOME and wish you WERE my doc!!....no oxygen for 3 DAYS COULD EVER GET THE B.O. up!!! kept failing down to 70's if oxy removed......til finally low acceptable on 3rd day


so .......it was re-inflation O-M-G! (SO NOW ON MEDIC ALERT IS PRINTED:........sjrogens no saliva risk of airway blockage by mucous brady/tachy sob eds all this on wrist and neck plus ddd and eds dysautonomia////////// so if another emerg happened do you think i am protected enuff now? WILL ASK FOR EVERY TEST YOUR HAVE SAID SIR! (THIS IS MY LAST POST ...PROMISE!) I FEEL BLESSED & RELIEVED (((Embarassed)))

Expert:  Dr. Sohaib replied 1 year ago.

I hope no further emergency situation arise now, and to prvent that i suggest the test and re-evaluation discussing all the details with your doctor i have mentioned.

Goodluck and stay relaxed :)

Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Dr. Sohaib, Doctor
Category: Medical
Satisfied Customers: 4708
Experience: MBBS, FCPS Experienced in all Medical Specialities
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Expert:  Dr. Sohaib replied 1 year ago.

Please post your follow up questions here; not as a new question unless the new question is different.

If the puffers help, then this can be in your lungs like Asthma.

No this did not look like stroke; which usually gives more symptoms than just inability to speak like weakness in legs/arms.

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