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What Causes Breathing Difficulty In A Child?
Question: Im an ER RN concerned and stumped about my son.
He is 15 years old. 5'8", 117 lbs., athletic. Never tried alcohol, drugs or cigarettes (I trust this as we live in a tiny town so Id hear about it, no behavioral changes, successful in sports, great grades, etc) He went running approx 1 month ago and ever since has felt like he cant take in a deep breath; as though something is "blocking his airway". He says this feeling is constant; doesnt change with position or resting vs exercise. No use of accessory muscles or distress....but is obviously uncomfortable. He is able to swallow food or liquids without problems but has to take in a deep breath between bites. He gets dizzy with standing and orthostatic VS's show no changes in BP, but HR speeds up 30-50 pts with standing. He has not had cold symptoms, cough, fever etc. No change in appetite.
His vitals were perfect 100/67, 57, 14, 98% and temp 97. Lung sounds clear but slightly less audible on the right.
His HR speeds with inhalation; goes from 50-60's to 120-130"s with inhalation. He told me he woke up one night gasping for air, but felt better when he sat up for a few minutes. He feels like his hands are numb and they are cold to the touch. He doesnt feel the changes in his HR...Ive caught them even at rest on a pulse ox I have at home.
Took him to the doctor and his peak flow was only in the low 200's...did it correctly with good strong blow. This number did not improve after a neb tx. The doctor confirmed that his HR speeds up and that he is slightly diminished on the right, but told us to 'wait and watch and come back if its not better?!" Again, clear lungs.
Chest xray was negative. Went to another doctor and she did labs (CBC, CMP, thyroid panel) only abnormals were glucose of 54 (3 hrs after eating large bowl of cereal) and a bilirubin of 2.1?! They did a Holter monitor for 24 hrs that didnt catch anything.
They re-did labs this morning and havent recieved the results....Im stumped. what are your thoughts?
He is 15 years old. 5'8", 117 lbs., athletic. Never tried alcohol, drugs or cigarettes (I trust this as we live in a tiny town so Id hear about it, no behavioral changes, successful in sports, great grades, etc) He went running approx 1 month ago and ever since has felt like he cant take in a deep breath; as though something is "blocking his airway". He says this feeling is constant; doesnt change with position or resting vs exercise. No use of accessory muscles or distress....but is obviously uncomfortable. He is able to swallow food or liquids without problems but has to take in a deep breath between bites. He gets dizzy with standing and orthostatic VS's show no changes in BP, but HR speeds up 30-50 pts with standing. He has not had cold symptoms, cough, fever etc. No change in appetite.
His vitals were perfect 100/67, 57, 14, 98% and temp 97. Lung sounds clear but slightly less audible on the right.
His HR speeds with inhalation; goes from 50-60's to 120-130"s with inhalation. He told me he woke up one night gasping for air, but felt better when he sat up for a few minutes. He feels like his hands are numb and they are cold to the touch. He doesnt feel the changes in his HR...Ive caught them even at rest on a pulse ox I have at home.
Took him to the doctor and his peak flow was only in the low 200's...did it correctly with good strong blow. This number did not improve after a neb tx. The doctor confirmed that his HR speeds up and that he is slightly diminished on the right, but told us to 'wait and watch and come back if its not better?!" Again, clear lungs.
Chest xray was negative. Went to another doctor and she did labs (CBC, CMP, thyroid panel) only abnormals were glucose of 54 (3 hrs after eating large bowl of cereal) and a bilirubin of 2.1?! They did a Holter monitor for 24 hrs that didnt catch anything.
They re-did labs this morning and havent recieved the results....Im stumped. what are your thoughts?
Brief Answer:
Could be vocal cord dysfunction
Detailed Answer:
Hi...I feel this could be a vocal cord dysfunction. All symptoms fit into it except a low blood sugar. Even the peak flow being low is suggestive of it. I suggest you make him I undergo a pulmonary function testing in which the graphic depiction will be classical. As you say there's no wheeze, no point in trying bronchodilators.
Basically vocal cord dysfunction is not a disease by itself. It is more of nonorganic in origin than organic.
I suggest you consult a pediatric pulmonologist and get things clarified. I am always here to help you. Please get back if there is any other doubt regarding this.
Regards - Dr. Sumanth
Could be vocal cord dysfunction
Detailed Answer:
Hi...I feel this could be a vocal cord dysfunction. All symptoms fit into it except a low blood sugar. Even the peak flow being low is suggestive of it. I suggest you make him I undergo a pulmonary function testing in which the graphic depiction will be classical. As you say there's no wheeze, no point in trying bronchodilators.
Basically vocal cord dysfunction is not a disease by itself. It is more of nonorganic in origin than organic.
I suggest you consult a pediatric pulmonologist and get things clarified. I am always here to help you. Please get back if there is any other doubt regarding this.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much. I will ask for a peds pulmonology consult!
Brief Answer:
If you are happy - kindly rate the answer
Detailed Answer:
Hi...I am happy that my answer has helped you and put you at ease.
I will be glad to help you further. Please keep me posted regarding your son. I wish him a speedy recovery.
Regards - Dr. Sumanth
If you are happy - kindly rate the answer
Detailed Answer:
Hi...I am happy that my answer has helped you and put you at ease.
I will be glad to help you further. Please keep me posted regarding your son. I wish him a speedy recovery.
Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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