Unexplicable shortness of breath
 

Hi, I'm a 21 years old italian guy who has been in a frontal car crash at relatively low speed in May, not hitting the hed but suffering a whiplash trauma.
At first i brushed it off (I had no idea that you can injury yourself that way), but two days after I started having miriad of neurological and cognitive symptoms, which got progressively worse over the next few days, such as trouble reading, speaking, thinking, decreased IQ, hypersensitiviy to certain sounds and touches nd occasional numbeness in my hands and feet
The doctors told me that it was not possible to have such problems without hitting the head and that it was stress/anxiety/psicosomatic (the italian medic level is atrocious), which I believed at first, returning to do physical activities (I do martial arts) further aggravating the problem.
After two months of suffering and being unable to function at even an extremely very basic level (after having stupidly trained in martial arts), roughly two months ago my symptoms disapperead in the span of a few weeks and I started to be fine.

But since yesterday I have been experiencing a shortness of breath and a sensation of pressure in my chest.
Could it be a consequence of the concussion, despite the absence of other noticeable symptoms?
I'm worried that it can be a clot near the hearts or lungs due to inactivity, since I have never left my home in the past month and half due to fear of having a relapse, it is possible? What should I do according to you?

Sorry If I made some mistakes, english is not my first language.

Danielson,

Welcome to NeuroTalk.

"I'm worried that it can be a clot near the hearts or lungs due to inactivity, since I have never left my home in the past month and half due to fear of having a relapse, it is possible? "

I would not worry about a clot. If you had such a condition, you would be in severe distress.

I think you could be experiencing one of two issues.
Anxiety can cause the symptoms you mention. or
A whiplash injury could be causing this.
Both can disrupt your breathing, even causing you to not breath until you feel short of breath. This can be nervous system caused and be a form of Central Apnea or it can be anxiety.

When I notice this, my doc ordered a complete exam including a treadmill cardiac stress test and an echo cardiogram. Both were normal.

I suggest you start getting active with walks or maybe some exercise machine workouts at low stress, low impact levels. I use a rowing machine twice a week. I row 4000 meters in 20 minutes.

The subtle neck injury from whiplash can cause inflammation that reduces blood flow to the brain. Restoring that can cause the sudden improvements as the neck settles into proper alignment. Keeping it that way while it stabilizes requires discipline to not aggravate it.

When you are not physically active, it is worthwhile to stimulate your brain in a low stress way. Manual activity doing things with your hands is good.

If this chest issue gets to be more than just shortness of breath and pressure, it would be good to have a doctor check it out, especially while you are symptomatic. Symptoms that come and go can be hard to define.

So get moving and distract your mind with other things, not your head and neck. You will likely see improvements. There is a Vitamin regimen in the Sticky threads at the top. It can help the brain tolerate stress.

My best to you.

First of all, thanks for the welcome, the disponibility and the advices.

I forgot to add that I have had a bad tooth since a lot of months now, that I have not cured because I'm worried that visiting the dentist may causa e relapse (I have a genetic anomaly that make mechanically impossible for me to open my mouth a lot, and on top of that I'm very inclined to throw up as a reflex if something comes near my mouth, so it's necessary to use a conscious sedation with nitrous oxide that I fear could be bad for my neurological state).

It is possible that this breathing problems are related to some infection caused by the bad tooth?
And it's reasonable to fear a relapse by going to the dentist, or it's only a paranoia and I should go without worries?

I think it is anxiety or paranoia. Nitrous oxide should not be a problem. If they want to use Versed intravenously, decline it. It is rough on the brain.

The gag reflex can be suppressed by spraying a topical anesthetic like cetacaine in your mouth and on your tongue.

Thanks a lot for the answers.
However, today while I was cutting my hair I accidentally slightly touched the back of my neck (the soft point where the head and the neck connect) with the point of the scissors (which are not very pointed I specifc, they are squared)
It was a very brief and soft touch without any pain or noticeable injury, but due to the sensitivity of the spot and it's role in neurological disfunctions I'm worried that it can caise some relapses of my symptoms.
It's a legitimate concern, or it only a paranoia?

Anxiety. There is a lot of protective tissue in the layers of skin and muscle that covers anything that is neurologically sensitive.

Thanks, I already supposed that but it is always a great help to have it confirmed by someone who undertstand this kind of things.

I'd say anxiety also. For something blunt to cause damage would have to be either an intentional act or some sort of accident.

Bud

Since when I stopped having neurological and cognitive symptoms almost 3 months ago I started having sleep disorders, to be specific I started to have fractured sleep.
I sleep 2-5 hours every 6-8 hours instead of having a regular sleep pattern.
What can the cause be? Could it be sleep apnea?

Also, it's risky for me to use a clipper to cut my beard, moustache or hair?

There is no risk of using clippers. The previous event was likely a stimulation issue, not a physical vibration/movement issue. The sound can be just the wrong frequency that resonated into your ear. The reaction is a anxiety / fight or flight or freeze response.

Stop sleeping during the day and your night time normal sleep will improve. Some need some food in the system shortly before going to bed to energize the brain so it can sleep. REM sleep uses a lot of energy. It is when neuronal healing/repair occurs.

If you feel tired during the day, it is usually because you are not getting quality sleep during the night. If somebody can observe your sleep during the night, they may notice breathing issues. You can buy a recording pulse-oximeter that reports to a smart phone to track oxygen levels and pulse. It can be helpful at understanding sleep issues. A FitBit will track movement and pulse.

Can a sound cause a setback of symptoms?
How is it possible?

I also started having neck pain (and an electric sensation going up to my spine) along with the trouble thinking when I used the clipper for the beard the previous time, is it possible for a sound to cause that too?

Thanks for the advices, I will try to improve my sleep pattern by following what your suggestion.

Danielson, I was also in a car accident and sustained neck whip lash without head trauma. I can tell you from my personal experience the shortness of breath and a pressure on your chest can be caused by anxiety. I've had almost every test done you can think of and the results always came back negative for any problems. It's been 2 years since my accident and thankfully my condition hasn't gotten any worse but I have seen an improvement over that time frame even if progress has been minimal.

Thanks a lot for the information, and I'm sorry for what happened to you, you have my solidarity and empathy.
If it's not a problem for you, may I know the speed and the mechanics of your accident (it was a front o rear collision, were you wearing a seatbelt etc...)
Also, what kind of symptoms have you experienced after the accident and what are your current symptoms?

It is of no value to try to rate trauma forces and tie them to injury level. The experts have found no direct connection. Every head and neck injury is different. Some tolerate very strong forces and other do not tolerate weak forces.

Over stimulation can cause symptoms to return or just trigger an anxiety reaction that can last. The sensory system can easily overload a compromised brain and leave it exhausted for hours or even days.

Sound is the most common sense to over stimulate the brain. From what you have said, your brain is very sensitive to sensory stimulation.

Thanks, I get it, altough I don't think that my brain is so sensitive.
I have managed to endure my neighbouring drilling very loud for more than ten minutes (and me simultaneously being extremely anxious and stressed out of fear of the symptoms coming back due to the noise) withouth having any relapse.

Not every sound causes the same level of stimulation. Sound frequency/pitch and loudness have different impacts. The farther away the sound source is, the more that sound has echoing reverb. This reduces the impact on the ear. Think of it as a fuzzy loud sound. Outdoor sounds are often the easiest to tolerate because of this.

Think of fingers on a chalk board. The wrong frequency can be a struggle.

I know that certain frequencies of buzzing are a problem for me while other frequencies that may be louder are not.

It was a T-Bone accident. The other car hit me driver's side while I was stationary at around 45-55 MPH. I was wearing my seat-belt and during impact I did not sustain head trauma. I must have gone into shock for a few 5-10 seconds after impact but I never lost consciousness and I remember every detail of the accident. The symptoms I experienced came in 15 months after my car accident which included:

• Dizziness (while driving and walking around)
• Fluorescent light sensitivity
• Sensitivity to certain sound frequencies
• Sensitivity to large crowds (malls, grocery stores, etc.)
• Cloudy/foggy brain
• Mild headaches
• Interrupted sleep pattern (likely caused by high anxiety)
• Racing heart (likely caused by high anxiety and phobia of symptoms getting worse)

My current symptoms as of today:

• Dizziness (while driving and walking around) - It has gotten better but I'm hoping for a full recovery
• Mild headaches (they come and go but manageable without meds and don't last long)
• Sensitivity to certain sound frequencies (I can now listen to music at lower/med levels. Switching on my sub-woofer and amplifying lower frequencies tend to make my symptoms worse)

It's also important to note that right after my accident I continued living my life normally as I didn't experience any symptoms right away. I was going to bars, clubs & drinking hard. I was also practicing kick-boxing 3x a week and working on the computer for 8+ hours a day. I never really gave my brain a chance to heal.

15 months is a long time, are you sure that the cause was the car accident and not something else, like a bad hit in kickboxing sparring? (by the way, I also trained MMA and have done a couple of sparring, coupled with partyng and driking, the month after the accident when I still believed that my symptoms were a stress-related psychomatic disorder, so I can emphatize a lot with you, altough my symptoms came right away a day and half after the accident).

Also, did you have not cognitive deficit such as trouble thinking, trouble reading, trouble putting your feelings in actual toughts and sentences and/or memory problems?

As I've never had health issues or surgeries before, the car accident is the only physical event that occurred during that time frame I can use to correlate with my symptoms which are typical for PCS. The only cognitive deficiency I had in the beginning was staying focused. My brain couldn't handle the work load of viewing a computer monitor for more than 1-2 hours without long breaks in between. The psychological issues still linger -fear of my condition getting worse and trying to find the root cause of my dizziness. It is possible that I might've developed something else before my car accident or it could be that my my neck injury was slowly taking a toll on blood flow to my brain in combination with liquor and over-stimulation. All the exams I've been taken (MRI with contrast, CT scan, SPECT scan, VNG, VEMP, BPPV, Heart stress test, EKG, blood work) the results for each have always come back negative for any problems. The last exam I'm going to request is called a "Carotid & Vertebral Dopper Exam" which will determine if there's any issues with blood flow to the brain.

SPNS,

Are you saying that since you never had problems from your kickboxing before the T Bone accident that you don't think kickboxing would be the cause of your symptoms that manifest 15 months after the car wreck? Did you have any other symptoms after the car wreck other than the short lived mental confusion/freeze (that was not physiological shock)?

The mental confusion can just be a moment of startle where you brain has had so much stimulation that it has to stop or freeze to sort it out. It is one part of the fight, flight, or freeze response to trauma and startle. Yes, it can be a concussion, too.

Concussion is a process that happens over a few days to a few weeks. PCS from a concussion does not develop 15 months later unless there has been additional trauma at the 15 month mark.

PCS is when concussion symptoms that first manifested at or closely after the head trauma continue beyond the 6 week to 3 month time frame. Even delayed onset concussion symptoms manifest within a few weeks, usually because of high stress living.

Hi Mark. I did not have any other symptoms right after the car wreck. It was only until the 15th month mark that I had my first vertigo attack (possibly a mini TIA that lasted a few seconds) and developed the typical PCS symptoms. I would like to clarify that the kick-boxing was aerobic, I did not spar with other people or take hits to the head. Now wether or not it's PCS that caused the PCS symptoms, I have not been told that by any specialist I've seen. That is a conclusion I've come up with after researching PCS symptoms. I strongly believe something either affected the blood flow due to the neck whiplash, there's something else the doctors missed or it's become a psychological issue and there's nothing physically wrong with me as the previous exams/tests show.

So, you developed symptoms and researched and chose the accident as the cause and PCS as the diagnosis. I don't think there is any evidence to link your symptoms to the accident.

The typical PCS symptoms can also be caused by many other issues.

My observation is you had a TIA or something similar and were struck hard with a 'What the ..... happened?" anxiety. With this anxiety, you became super sensitive to any sense of dizziness. Now, you maintain this super sensitivity to any dizziness.

I deal with 2 kinds of dizziness. The blood pressure kind that resolves when I give my BP a chance to catch up after getting up from a chair. The other dizziness manifests when I am overstimulated. I can usually overcome it by stopping to focus and catch my bearings. I can also get a sense of dizziness from thinking about dizziness. If I stop what I am doing to check to see if I am dizzy, I will notice some sensation of dizziness. If I ignore it, it goes away.

A similar situation happens with headaches. When somebody on NT complains about head aches, as I write a post, I will notice a head ache.

This is a known phenomenon sometimes called a memorized response. Thinking about a past condition can cause the symptoms of that condition to manifest. Therapy (CBT, Cognitive Behavioral Therapy) can help to break the memorized response.

A large part of balance is dependent on visual perception. Any visual problems can cause a sense of dizziness.

The tests you have already had likely cover any issues the Doppler will find other than imaging plaque that has formed in your arteries.

Mark, your conclusion is that anxiety is creating the sense of dizziness after I had a TIA and that I should seek cognitive therapy? Can we fully rule out PCS as the cause of the dizziness 15 months after my car accident? If this is truly now a cognitive issue would physical or vestibular therapy still be useful? From my research TIA symptoms only last minutes to hours so it couldn't be the TIA causing the dizziness. I do wear glasses when working on the computer but I've never experienced double vision or any other eye problems. I believe you might be right, when I was taking an SSRI my dizziness became less apparent and when I took a valium to treat my anxiety the dizziness was completely gone until the effects wore off. If someone truly had PCS would taking an SSRI or Valium eliminate the headaches, dizziness and other symptoms that accompany a PCS?

Anxiety is causing you to be super sensitive to any sense of dizziness and magnifying it. This process is similar to PTSD flashbacks.

Can we rule out PCS? I say yes, A 99% chance it has nothing to do with PCS. Even if it did, it would not change anything.

Vestibular therapy could cause a placebo effect or it could just show that your dizziness is within the range of normal.

SSRIs and benzos (valium) do nothing to reduce the dizziness, head aches, etc. of PCS from a curative perspective. They do help the mind stop focusing on symptoms and making those symptoms worse due to that focus.

Many with PCS have achieved great improvement with SSRIs because it allows them to forget these memorized symptoms and start a return to normal thoughts and life. It helps to break the cycle so one can move forward.

The acute symptoms of a TIA only last minutes to hours but some subtle symptoms can remain for longer periods. It took my wife a few weeks to get free of the leaning to the left feeling. And, it only takes minutes to hours for the anxious brain to memorize and become sensitive to a symptom.

Don't discount vision issues. Double vision is not the only manifestation of vision that causes problems. A behavioral optometrist can do a thorough assessment. https://nora.cc/healthcare-locator.html Nystagmus, convergence insufficiency and other issues can change the way the brain combines vision with balance. But, it sounds like you have already had a lot of testing in that area.

If you were to just accept your dizziness as a minor inconvenience and your new normal and move on, I bet in a few months, you will not be noticing any dizziness like you do today.

Thank you for your input Mark. I will find a behavioral optometrist as well -this is not something I have looked into yet. You are right, the SSRI's did help with not focusing on the dizziness. It didn't resolve the dizziness 100% but it got me close enough to feeling normal again.

In which position should I sleep to prevent aggravating my cognitive problems and help my neck and brain to recover?
Laying on one side with my head on only one pillow is recommended? What about laying flat on my back with my head on one pillow?tion

The goal is to lay with your head and neck in a straight position. If on your back, use minimal lift from the pillow. I roll the sides of my pillow up around my ears so my head does not role to the side. My head is just about flat on the mattress. I notice that with head lift, I had more problems.

When I sleep on my side, I bunch my pillow so my neck is straight.

I learned my best position by sleeping in a recliner chair. I would wake up feeling great. My wife said my face was totally relaxed. If I was in a bad position, I would show stress on my face.

There is no magic position. You need to experiment and see if you do better one way or the other. For me, the important part was to avoid head lift and tilt. No chin to the chest sleeping.

When I find the right position, I can fall asleep and wake up 6 hours later in the same position. Those are my best nights.