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RH, Board Certified Neurologist
Category: Neurology
Satisfied Customers: 1949
Experience:  Expert in various areas of Neurology
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I'm not sure if this is a question for a neurologist - but I

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I'm not sure if this is a question for a neurologist - but I have a question about the Vagus nerve. I have trouble with shortness of breath. I had tuberculosis as a teenager and had an artificial pneumothorax for several years. Never had any recurrence. I am now 73 years old. I never had shortness of breath until about 6 years ago and it came on very suddenly and has never left. Some days it is worse than others. Lung function tests show very slight difference in the inhaled and exhaled volume of air. Otherwise my lungs are apparently normal although I do have some calcification on the side of the lung that was collapsed. I have a hiatal hernia and now I wonder if the vagus nerve is somehow pinched or irritated and is affecting my breathing. The shortness of breath is very noticable on mild exertion but gets worse in the evenings after dinner and affects me more lying down. Sometimes at night I find myself staying awake just to make sure I keep breathing. It's as if I have to make a conscious effort for every breath. I can walk a mile in about 24 minutes on a treadmill three times a week but if I push myself too hard, like dancing, I experience hypoxia and have a really hard time catching my breath.

By the way, I had a complete workup including stress test and echocardiogram last February and my heart is fine.

Submitted: 5 years ago.
Category: Neurology
Expert:  RH replied 5 years ago.

Your breathing issue does not appear to be related to a neurological problem or anything to do with the vagus nerve from what you described - but am concerned given your symptoms about your cardiac function - your symptoms are consistent with decrease in the ejection fraction (amount of blood pushed out of the heart to circulate to the organs) - if you have not already had done - would recommend getting echocardiogram and stress test and to see a cardiologist.
Customer: replied 5 years ago.
I just added the information that I have already had my heart checked out and everything is normal. If the vagus nerve is not involved, I really don't understand what is wrong with me. As I said, the problem came on very suddenly and has never left. It has not gotten significantly worse over the last 6 years but I do have an occasional day or two when it feels worse. I don't know what to try next.
Expert:  RH replied 5 years ago.
ok. sorry i guess i missed the last line you wrote while reading. ok since pulmonary and cardiological causes have been ruled out, the next thing in line to rule out would be neuromuscular junctional disorder - not necessarily in relation to the vagus nerve. Do you have any weakness of your proximal muscles (thighs, shoulders) more or so at the end of the day , any drooping of the eye - at the end of the day? any fatigue throughout the day or at the end of the day?
Customer: replied 5 years ago.
Well, I was diagnosed at LSU Medical Center as having fibromyalgia (about 15 years ago). It's getting worse as I get older and of course I have muscle pain and weakness and fatigue problems. I've learned to live with it. Never noticed eye drooping but both my eyelids are puffy and swollen in the mornings. It resolves somewhat during the day but never goes away completely any more.
Expert:  RH replied 5 years ago.
Well fibromyalgia would not lead to any breathing issues. I was trying to assess if you had any symptoms of Myasthenia Gravis in which breathing problems can persist along with weakness and fatigue. The tests that your doctor can order are: Acetylcholine receptor antibody test and EMG/Nerve conduction study to diagnose or exclude this condition.
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