Understanding Causes of Bradypnea: Seeking Guidance
I have a complex medical background, including conditions like Chiari malformation, syringomyelia, hypermobile Ehlers-Danlos syndrome (hEDS), bilateral thoracic outlet syndrome (TOS), tethered spinal cord, intracranial hypertension treated with a VP shunt, a spinal venous fistula, mast cell activation syndrome (MCAS), dysautonomia, and cranial-cervical instability characterized by a fusion from the skull to the C4 vertebra.
In the past, I had central sleep apnea linked to brain compression from excessive Chiari decompression surgery, which had not been an issue before. Fortunately, that was addressed with my spinal fusion. However, I still experience remarkably slow breathing rates, averaging between 8 to 11 breaths per minute. My oxygen levels appear stable, although post-surgery, they tend to drop further, necessitating supplementary oxygen. This pattern of bradypnea has lingered for several years, despite numerous adjustments to my medication regimen, including variations in opioid dosages.
Additionally, I suffer from significant venous compression bilaterally across various positions due to thoracic outlet syndrome. I can't help but wonder whether this compression is impacting the phrenic nerve, contributing to my slow breathing rates. Despite the persistence of this issue, it has often been overlooked because my oxygen saturation levels are generally acceptable.
I possess the results from peripheral venous blood gas assessments, although I'm uncertain of their implications:
- pH: 7.36 (normal range: 7.32 - 7.43)
- pO2: 18 mm Hg (normal range: 35 - 49)
- pCO2: 49 mm Hg (normal range: 41 - 50)
- HCO3: 28 mmol/L (normal range: 23 - 27)
- Base Excess: 2.0 mmol/L (normal range: -3.0 - 3.0)
- O2 Saturation: 25% (normal range: 60 - 80)
- Lactate: 1.8 mmol/L (normal range: 0.6 - 2.0)
I am 39 years old and my measurements are 171 cm in height and 88 kg in weight. I do not smoke or use drugs. My current medications include hydromorphone, ropivacaine, and clonidine administered intrathecally, alongside metformin, ozempic, Nebivolol, ketotifen, Targin, Dantrium, Zyrtec, and famotidine.
Shortness of BreathBronchitisPulmonology