Longstanding Breathing Concerns in My Adult Years
I am a 26-year-old male, standing at 5'9" and weighing 175 pounds, with a body fat percentage between 20-22%. I generally maintain a healthy lifestyle, yet I've faced a troubling breathing issue for nearly eight years. My journey has taken me through numerous consultations with various medical professionals, including general practitioners, specialists, and physical therapists. I have sought advice from experts in gastroenterology, pulmonology, three physical therapists, two chiropractors, and both spinal and cardiovascular specialists. Comprehensive imaging of my spine and neck has been conducted. Any insights or suggestions would be immensely appreciated, as my aim is simply to achieve a sense of well-being. A summary of my condition compiled for specialist review includes the following: **Main Issue:** - Persistent difficulty in taking a complete and satisfactory breath - Duration of approximately eight years, first arising during gym sessions - Symptoms have progressively intensified over time **Key Symptoms:** - Incomplete breaths, particularly noticeable during attempts at diaphragmatic breathing - Occasionally finds relief when leaning forward or lying on my side - Experienced a brief period of full relief (lasting 5-10 minutes) only once, after performing stretches combined with chin tucks - Shaky feeling while engaging in core workouts, indicating possible issues with core stability - Persistent acid reflux, challenges in burping, and issues with gas retention - Gas seems to pass more easily in a side-lying position - A sensation of tightness in the pelvic floor area - Delay in ejaculation - Frequent bouts of hiccups triggered by throat clearing or minor grunting - Hiccups can persist multiple times throughout the day, typically for about 15 minutes each time **Imaging and Tests Conducted:** - An endoscopy revealed no significant abnormalities, effectively ruling out issues such as hiatal hernia or other visible gastrointestinal blockages - X-ray and MRI results display the following: - Presence of a syrinx located in the mid-to-upper section of the thoracic spine (estimated T4-T7) - Mild separation observed between vertebrae L1 and S5 **Probable Underlying Cause:** - There may be a neural disruption linked to the thoracic syrinx that affects: - Control of the diaphragm - Regulation of the autonomic nervous system (with respect to reflux, hiccups, and ejaculation) - Engagement of the core muscles and postural stability - Position-related symptoms imply a possible neuromechanical or compressive factor contributing to my condition - Temporary relief experienced through spinal decompression-style positions points toward the transient alleviation of neural or fascial tension **Recommendations for Further Assessment:** - Comprehensive neurological evaluation to examine the effects of the thoracic syrinx on autonomic and motor/sensory functions - Consultation with a functional physical therapist or osteopathic physician, focusing on: - Diaphragmatic functionality and mobility of the ribcage - Tension within the phrenic and vagus nerves - Rehabilitation efforts concerning the pelvic floor and core stability - Explore dynamic spinal imaging, autonomic function testing, or ultrasound of the diaphragm In addition, I underwent an MRI of my thoracic spine with the following findings: **MRI Examination Results:** - History includes chest pain during deep breaths, pain located in the lower and mid thoracic regions that has been worsening. - The MRI procedure involved sagittal views with and without fat suppression, paired with axial images; no intravenous contrast was used. - Comparison made with X-rays from August 30, 2022, showed no scoliosis. There is a hemangioma located at T9. - A syrinx was identified in the thoracic spinal cord extending from about T4-5 to the T9-10 disc space, measuring up to 1.3 mm in anterior-posterior dimension. - Degenerative changes were observed at T1-2. - The surrounding paraspinal tissues appeared unremarkable. - No hardware detected. - Additional findings included a disc herniation at T1-2 indenting the thecal sac without central or peripheral stenosis. Other segments from T2-3 to T11-12 showed no significant herniation or stenosis, although there was some bulging at T12-L1. - Summary: Documented disc desiccation with central herniation at T1-2 but no stenosis present. The syrinx at T4-5 and T9-10 requires monitoring, with a follow-up suggested in six months to ensure no changes occur.
Answers (1)
4/20/2025, 6:50:40 PM
OpenHealth AI
It's understandable that you've been grappling with such persistent and complex breathing issues, especially given your detailed history and investigations. The combination of your symptoms, particularly the connection between your thoracic syrinx and respiratory challenges, highlights a nuanced situation. Let's break this down.
Summary of Key Points:
- Main Issue: Persistent difficulty in taking a full breath for about eight years.
- Symptoms: Incomplete breaths, relief in certain positions, persistent hiccups, and a sensation of tightness in the pelvic area, among others.
- Potential Causes: A thoracic syrinx affecting diaphragm control and nervous system regulation.
Explanation:
Your breathing difficulties might be linked to the syrinx in your thoracic spine, which could be interfering with the nerves that control the diaphragm, essential for breathing. Additionally, your gastrointestinal symptoms could worsen your breathing discomfort, as they may affect how you feel pressures in your chest and abdomen. Your symptom relief in specific positions suggests mechanical issues, possibly due to posture or nerve tension.
Next Steps:
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Neurological Evaluation: Prioritize a consultation with a neurologist who has experience with syringomyelia or spinal cord issues. They can assess the impact of the syrinx on your diaphragm and autonomic functions.
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Functional Therapy: Seek out a functional physical therapist or an osteopathic physician. Focus on:
- Diaphragmatic Breathing Exercises: This can help improve your breath capacity and control.
- Postural and Core Stability Training: This may alleviate some discomfort while promoting better breathing patterns.
- Engagement of the Pelvic Floor: Consider specific exercises to address tightness and related symptoms.
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Breathing Techniques: Implement gentle diaphragmatic breathing exercises regularly. Practice breathing deeply into your abdomen rather than shallow chest breathing. You might find it helpful to lie flat on your back or propped up to ease any tightness.
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Acid Reflux Management: Address your reflux with dietary changes (avoiding trigger foods, smaller meals) and over-the-counter medications. This could alleviate some of the discomfort linked to your breathing.
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Symptom Diary: Maintain a diary documenting your symptoms, triggers, and relief strategies. This information will be valuable for your healthcare team and can help narrow down effective management strategies.
Reassurance:
Your proactive approach to this longstanding issue, along with the extensive medical evaluations you've undergone, indicates a strong commitment to your health. Keep focusing on small, manageable steps, and don't hesitate to reach out for support and more tailored guidance as you navigate this path. Your journey toward understanding and improvement is important, and there are avenues for gaining relief and enhancing your well-being.
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