Breathing issues well investigated?

[basiclife]

I am here for a parent. I have read the forum and the rules, and I will make this question as succinct as I can. Its tricky.

My mother is 65 and has had some chest heaviness and shortness of breath at times on only one side (right) of her chest. She has had a ct scan (chest and neck soft tissue), an x ray, been to see cardio, gastro, ENT with endoscopy and swallow tests and went to visit a neuro. Neuro administered both nerve test and emg to her entire right side (upper torso and lower torso). These investigations netted a clear bill.

She visited a pulmo at UofM because she has soreness and tickle-like dry cough. I went with her. The Dr. suggested asthma, administered the breathing tests - don't remember the name sorry. (blew through a tube as fast and long as possible - measured on a graph three times). Trying an inhaler now to see if it helps.

With regards to bulbar on-set.
1. Are breathing issues ever a first symptom?
2. Does an EMG and Nerve test upper and lower torso cover bulbar onset diagnosis.
3. Are we missing something
4. Am I annoying anyone with these questions? I am sorry if I am. My close friend's mom is struggling with ALS, and perhaps this is very close.

I thank you for your time and inspiration. I am a counselor, and so impressed by the level of support, knowledge, and dedication of the family and friends to one another.

Thank you,
Karinah

 

[lgelb]

Karinah,
1) Yes
2) Yes, esp with the clinical pic you have described
3) You haven't missed much, and there is such a thing as late-onset asthma
4) Not to this point! General forum rule: don't ask rhetorical questions. On this one, even less so.

Sorry to hear about your friend's mom. Please encourage them (friend, her mom, her dad(?) to join the forum.

Your mom's sx don't say ALS, even before the neg tests. As for asthma, the one thing you didn't mention is whether during the PFTs a reversible obstruction was demonstrated (they would have given her an inhaler then repeated the measurements). That would be highly suggestive of asthma (vs. obstructive dz) given the other neg tests.

As with any asthma, I would look at the allergy link and try to eliminate possible triggers in your mom's environment -- mold, dust, smoke, pets who need brushing...and treat any allergies that need it. Many asthma pts find significant or complete relief from adequate allergy treatment. Tweaking the humidity in her home could also help.

Thanks for being a thoughtful daughter.
--Laurie

 

[basiclife]

Laurie,

Thank you for the thorough reply. Allergies and late on-set asthma is precisely what the pulmonologist discussed with us. He offered that it was either a combo of, or either: allergies/asthma, and reflux. He sees a lot of late on-set asthma that is brought on by new allergies - exacerbating and irritating the lungs and chest.

He was incredibly thorough, and when I asked if her chest soreness and breathing issues could be muscular he said only in neurological issues such as ALS.

With your answer on breathing issues are as a first symptom then, with the neuro testing she has had - do we say negative test is a negative test and let it alone? I find with the healthcare system you constantly have to be self advocating to investigate/rule out.

I have talked to my friends family, and directed them to a support group in MI. It took her a while to want to attend, because she was embarrassed at not being able to talk. I love them so much, and its just been awful. I will share out about this great site. She does use her computer often, as a means of staying connected to friends.

Thank you so much for the allergy information. We need to do this and be consistent about it to see if it works.

 

[lgelb]

Yes, it would have been more precise to say that breathing issues are ALS sx at onset comparatively infrequently. But regardless, with her negative tests and the hx you presented, she is very much in the clear. So I would proceed exactly as you are doing -- diet is a good thought too if reflux is in the picture -- e.g. some people lose tolerance to dairy...

Thanks also for sharing info with /helping your friend.

 

[basiclife]

Yes, it would have been more precise to say that breathing issues are ALS sx at onset comparatively infrequently.

Meaning that breathing issues are a symptom of ALS at the very begining /onset very infrequently. In that - its not typically first symptom?

 

[lgelb]

Yes.

But more importantly, your mom's symptoms don't correlate at all overall, plus testing was negative.

I hear you about the health system but in this case it's done its job, pending evaluation of the asthma meds and what you accomplish on the allergy/reflux side.

All the best.

 

[basiclife]

I agree. Local hospital not as great as UofM, but we got to it in the end so that worked.

Thank you for your time - moving forward.