Question: 22 year old male 6' 5" diagnosed with a hole in his lung approx. 12 months ago after going to the ER with severe pain and sweating . Now has chronic fatigue and wakes in the middle of the night unable to breathe. He is muscular with slender build and hyper active by nature. His family physician has been taking blood tests but so far no diagnosis.What should he do next ?

Thank you for you're reply.

The original diagnosis in the ER was 'Sporadic pneumothorax' His doctor is now telling him that his breathing problems are from a pulled muscle in his chest. He does not believe this to be true. How would that account for extreme fatigue in an otherwise healthy young man. His work is quite strenuous , driving tractor , loading materials onto trucks , driving trucks etc.

My concern is that I have heard of sudden death in young men with this diagnosis. Am I right to be concerned ?

Thank you.

Dear Dr. Bhavsar,
I am not sure if you received my latest reply to your questions so I will repeat them.

My grandson (patient in question) Does have a long neck in proportion to his muscular slender build.

He has not been treated with intercostal drainage tube.

The chest pain and breathing difficulty is sporadic night or day. About three weeks ago during the night he was awakened by chest pain and had difficulty breathing for 3 hours . He did not alert anyone at that time . When he went to work that day he was extremely tired and was advised to see a doctor. X-rays were taken of his chest at that time and the doctor said he had a "pulled muscle" and prescribed muscle relaxant. my grandson did not believe that was the right diagnosis. He is still extremely tired and the chest pain and breathing difficulty comes sporadically , when this happens he sits down for 20 minutes or so until he is breathing normal. He often does not eat breakfast as he says it often upsets his stomach in the morning. he normally eats 2 meals a day. He drinks plenty of water and Gatorade during the day , and often 1 large Pepsi (soda).

I Do not want to cause him added stress so have not mentioned that this condition could be fatal. I have tried to stress the urgency of seeing a pulmonologist. Do you have any other suggestions if he has an episode prior to an appointment with a specialist ?

Thank you.