
What Causes Difficulty Breathing Despite Having Normal Chest X-ray And CT Scan?

Mention your test reports.
Detailed Answer:
Hi,
Thanks for your question.
After going through your question, I really feel sorry for you.
As you have mentioned you have breathing difficulties but your chest xray and CT scan is normal. The Oxygen saturation measured by pulse oxymeter is also normal.
In such case there may be following possibilities for your symptoms -
1) Heart problems.
2) Neurological problem that limiting the capacity of breathing.
3) Cause in upper respiratory tract.
But for better opinion I want to know results of test done (as you have mentioned "my tests have not been good".)
Also want to know -
1) Have you visited Respiratory physician?
2) Have you underwent PFT (Pulmonary Function Test), if done what is the result.
Also you have mentioned there is yellowish discoloration of palate and eyes, it may indicate jaundice so it is advisable to do Liver function test, urine Examination, ultrasonography of abdomen and pelvis if not already done.
Regarding presence of large ketone it is usually due to insulin deficiency.
I want to know -
1) since how many years are you diabetic?
2) What is the type of diabetes are you having, if mentioned by your doctor?
3) What are the current medicine for diabetes?
4) Present Diabetes control? HbA1c level, Fast want Postprandial blood sugar levels.
I am waiting for your reply.
Regards ,
Dr Abhay Mali.
Diabetologist.


Visite ER.
Detailed Answer:
Hi,
Thanks for your reply.
Whatever Arterial blood gas parameters you have mentioned is technically impossible. (Raised Ph, raised CO2, raised HCO3).
As you have lost significant weight over short period and there is ketone present with breathing difficulties you should visit ER immediately.
There is need for detailed clinical Examination and need for evaluation for Diabetic Keto acidosis.
There is a need for -
Blood sugar test.
Repeat Arterial Blood Gas analysis.
Complete Blood Count.
Liver and Kidney Function tests.
Urine Examination.
Hope this helps you.
Regards.
Dr Abhay Mali.
Diabetologist.


You should consult your family doctor.
Detailed Answer:
Hi,
Thanks for your follow up question.
It is really difficult to correlate your symptoms with your test reports.
Both Lactic acid and Ketones usually associated with low Ph and low HCO3 and in this case, it is really difficult to get ABG result with increased Ph and HCO3 without taking external bicarbonates (HCO3).
- Raised Lactic acid is usually due to
1) Infection.
2) Dehydration.
3) Drug induced (as with metformin antidiabetic medicine)
- Raised Ketone is usually due to
1) Diabetic ketosis or ketoacidosis.
2) Starvation and dehydration.
It requires detailed clinical examination and various tests for -
1) Assessment of diabetes control.
2) Assessment of kidney function..
3) Assessment of hydration.
4) Assessment of liver function.
5) Assessment of your medicines.
In your case there is high possibility of severe dehydration which may be due to diabetic ketoacidosis.
In that case you need intravenous re-hydration for which you need to be hospitalized.
All these things cannot be done at home without help of a doctor.
If you thing it is not possible to visit ER then at least consult your family doctor.
Hope this may help you.
Regards,
Dr. Abhay Mali,
Diabetologist.

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