Pleuracy? Sharp Chest Pain

[rae]

I am a normally healthy and happy 38 yr old female from canada. I am living and working in sweden. I have had this sharp terrible pain when breathing deeply in for the last three weeks. When I first got it I thought I was having a heartattack as it woke me from my sleep. The pain was in my chest on my left side sort of at the bottom of my ribs, and it travelled down my left arm and up into my shoulder, neck and face. I went to emergency where they gave me blood thinners and pain medication and kept me overnight at hopsital. They gave me an ECG and a lung xray and CT scan which were all normal. After two nights I was released after one doctor said it was possibly a problem in my back. I of course left there simply not buying it.

I have shortness of breath and can't get a full breath in or even out. I shake involuntarily (convulse) if I attempt to breath all the way in, and sometimes the pain even cuts into the halfway mark of breathing in. Hunching over helps. Laying down or standing especially for too long is agonizing. I haven't had a cold or anything other than a small cough about a month or two ago.

Over the past three weeks I have spent three separate occasions overnight in hospital. I have seen 8-10 different doctors (some were students). They have tested my heart and lungs, CT scans for possible bloodclots in the lung, they have said that it could be broken ribs or a pulled nerve in my back, but weren't 100% of that either since my pain seems to be coming from my lung. No xrays for broken bones have ever been taken, but two of the doctors I saw ruled this out anyway. The pain has been also through to my back (the back side of my lung) and has slightly moved down toward my kidneys. They ruled out any kidney problem because my bloodwork showed that was normal.

I have unfortunately been at the mercy of the hospital here in sweden because I do not have a regular family doctor here. My left arm had been slightly purple (off and on over the past few weeks) which they have told me is from lack of oxygen. The doctors found a slight infection in my bloodwork and I had a slight temperature while in hospital during the first week of this.

I have been seen by a neurologist also who thought perhaps this was spinal meningitis, and also wanted to check me for an aneurysm or stroke. One doctor (the head doctor? in emergency) who did not even meet me or examine me sent me without my knowledge (until arriving there) to the phyciatric ward of the hospital, after making the pathetic comment that this could all be in my head. Of course I have made a complaint about this and he has admitted to making a huge mistake by doing this. It comforts me to see that there are others on this forum with the same pain as me. This is not in our heads. I can validate that!

I have passed out once from the pain, and blacked out completely and had to be taken by ambulance to the hospital. I have also been forgetting things which frightens me. The doctors here blame it on lack of sleep. I have lost confidence in the hospital here and have been desperately searching for a north american doctor that may now be practicing in sweden. I am considering going to canada to get help but I work here and am also afraid to fly with this. During one of my visits to the hospital I was given an anti-inflammatory injection, but the nurse who gave me this hit a nerve causing paralisis in my right leg for about 5 hours. I have yet to return to the hospital since this, even after spitting up blood due to the lack of care performed there.

I have contacted my family doctor in canada by phone. She said that it sounds like pleuracy. She told me that an antibiotic could be prescribed... BUT swedish doctors do not give antibiotics if you can believe it, telling me that no antibiotic could be given for this anyhow. They have yet to even mention pleuracy to me here, even though I have mentioned it to them. They said they would have seen it in the lung scan, however my doctor in canada said that this isn't always the case. The doctors here have me on tons of pain medication which is not helping. In the hospital morphine barely took the edge of the pain I am experiencing. Another shot they gave me which was stronger than morphine (similiar to morphine) gave me some relief with breathing in, but this isn't a drug that they can give me to take home they tell me. I hope someone can help me, I am so exhausted with this. I have averaged 3 hours sleep nightly since this began.

[Dr. Tamer Fouad]

Hello,
I am sorry to hear about your continued suffering. I agree with your doctor in Canada, it sounds like a classic case of pleursiy. Pleurisy is quite tricky however, it could be a diagnosis in itself and heal with anti-inflammatory drugs and antibiotics when appropriate. However, it could also be a manifestation of a more serious disease. Pleurisy may develop in the presence of lung inflammation (pneumonia, tuberculosis), rheumatic diseases, chest trauma, certain cancers, and asbestos-related disease.
Its a good thing that the CT turned out normal that would exclude many of the above causes.
Infective causes are curable. I would like you to elaborate on two points: You mentioned "The doctors found a slight infection in my bloodwork and I had a slight temperature while in hospital during the first week of this." What were the exact results. If that is the case did you discuss taking an antibiotic to treat this infection. It could very well be the causative agent.

Another thing, you said "up blood due to the lack of care performed there." What do you mean by that? Were you coughing blood? Or is this related to a procedure performed at the hospital.

[rae]

Hi again.. and thank you so much for writing back to me. I am sorry it has been so long since last looking in. I have been in the hospital since last posting. I am still quite ill. I am on morphine patches now (which have the side effect of shortness of breath.. unfortunate since my problem is with pain when I breath.. now I just can't breath at all). I will get back to you with the exact levels in my blood that we found. I met one pulminary specialist doctor here who has worked in canada for one year. He said lung sack inflammation.. which seems to be pleuracy.. but he said he can't say for sure because he can't see anything on my lung scan. Is it true that if I had this it would show? I have seen claims of both over the internet. I have heard that dry pleuracy is hard to see.

Another thing that is really concerning me is that I am forgetting things, fainting and have been throwing up (very rare for me.. I hardly ever throw up). You asked about the spitting up blood. No, it wasn't part of the hospitals treatment.... but rather I did not go back immediately to the hospital when that happened because I was so discouraged with the lack of proper care I felt I had received, I just as well thought not to go back at that time. I went to another hospital an hour away, that is where I have stayed for the past few weeks. I am down to 46 kilos (I am 164cms/5.4). I am still so sick and this has been since december 29th or earlier. It is so exhausting. What else can I ask the doctors here to do? I was so desperate that I went to a homeopathic doctor who gave me some herbs two days ago. I still haven't felt any different. Also, when I eat (I can only eat a little) I feel like my stomach or diaphram is pushing against my lungs or heart and taking my breath away even more. Please help me. I am so scared now. My work friends saw me and said they were shocked that they don't recognize me and that my skin looks grey. I myself don't see the same person in the mirror also. It is frightening me, and just getting worse. How long will this last if it is pleuracy?

Thanks for any help or advise you can provide.

[ice-cube]

Hi,
I came across your message as I was searching for causes of shortness of breath, a symptom that I have been suffering for a year a half now. I live in San Diego. Things you mentioned in your post are very similar to what I have been experiencing. I too have told everything is normal and all the tests (echocardiogram, aspirometry test, etc) show no signs of heart or lung problems.

I am very interested to hear what was the end result of your situation.

thanks

[rae]

Hi,

I totally understand. I hope I can be of some help here for you.

After not receiving any help in Sweden I went back to canada to see my own family doctor (doctors in sweden are a joke!). As it turns out I have two things.

First off they found a minor heart condition, nothing major but does explain some of the symtoms. I am quite annoyed that they didn't see this in Sweden, but then again I didn't see a proper Cardiologist in Sweden, I only had emergency nurses and doctors. My family doctor in Canada sent me to a very good Cardiologist who did some different types of testing to look for problems such as these. She found this immediately. Actually the second thing that I have is the one that is more likely to be causing all the problems, so please don't worry about your heart being the culprit.

She told me It is likely congenital (from birth) and is of course non life threatening. It is a regurgatation in two of the three valves in my heart. I am a non smoker and quite healthy otherwise so they think it is something that can be monitored. They also saw that I had some thickening of two arteries aswell.

The second thing: My doctor also sent me to a Rheumatologist where I was told that I have Fibromyalgia and probably something called Costochondritis which is in the same family of illness. This can often come to the surface as a result of other things happening in the body. It can be quite painful and cause all sort of symptoms that mimic other illness, and especially because Costochondritis is in the chest. It is related to arthritis and can make your entire body ache, you can even think you are having a heart attack because of the pain and shortness of breath. It can be quite scary.

Apparantly people who have this are often misdiagnosed. It can last for a few months or longer. I had the first period of pain for close to 4.5 months. I recently got very bad chest pain this past week with the whole shortness of breath thing too, so I pulled out this prescription and took a few of the tablets over the course of two or three days. The doctor prescribed me something called Amitriptyline 10mg's. I took them for a short period in May, but stopped once my chest pain stopped. These seem to aid things.

I have recently had surgery for something unrelated and have had some trouble with that which could explain this sudden revisit from the chest pain (costochondritis). With this illness it is related to stress in the body for one reason or another. Apparantly the best thing for Fibromyalgia/Costochondritis, and those related illnesses is to keep moving. Don't knock yourself out with physical activity like a huge workout or anything, but DO take a walk. I know you want to stay in bed probably if you feel at all the way I did, but this can actually have the opposite effect. I think the best thing to do is to see more than one doctor, and of course be sent to some specialists.

I am no doctor but I do understand and completely sympathize with you. You can write me back at any time. I will respond asap and offer any help or information I can offer. I do hope you feel better soon. Please let me know how things are. I will be thinking about you. Kindest, Rae

[AngelVoices]

Hey,

I am new here so just seen the post about fibromyalgia and costochondritis. I have both. I have had fibro for Several yrs now. I used to live in Ohio and in 1995 I went to see a Rhuemotologist for pains I was having. He also gave me Amitriptyline 10mg's. It helped me sleep I know that, and from what I can remember it might have helped with the pain too.
Well I sense moved to Ga. I have no regular dr yet. I have seen many specialists here trust me. I gave birth to my daughter in 2004 and sense the epidoral wore off I felt an immiditate tightness/pressure in my chest/rib cage. Then came the god awful pain. It was unbearable. I was freaked let me tell u. I thought for sure I was dying and having a heart attack. After all I had heart failure from a condition brought on by pregnancy called Cardiomyopathy. That has sense improved. After leaving the hospital after the birth of my child, I still had that terrible pressure./tightness and pain. I went back to my cardiologist who performed a muga scan on me and an ultra sound. I was healing up not worsing. He told me looked like my cardiomyopathy was healing and going away and my heart was doing fine. Still I complained of this. I got scared and let me tell u after going through what I did I was thinking daily I was dying. I later seen someone cause I was having even more and more pains. Found out I had to have gall bladder surgery. I thought AT last maybe that is the reason for this and if it is removed it will all go away!!
Well, it didn't. I have had CT scans, Xray's, blood tests you name it all come up normal. TO make a long story short... So far I have seen 6 different dr's. Most of which are specialists of some sort. They range from Rhuemotologist, 2 regular internal medicine doctor, a surgeon, my Cardiologist, an acupuncturist/internal med. Dr, and tomorrow I see an Orthopedic Dr. I have yet to have my acupuncture, I begin that on Tuesday of this week, will let u all know if it helps. Out of all these dr's not one can actaully help me get a grip on the pain. The either look at me like oh you couldn't be in that much pain, or some feel so sorry for me they write me out a script and send me to someone else.... then the rhuemotologist wanted to just drug me up even more so and that cause great stomach upset. I mentioned this to him he basically yelled at me and said he was the dr not me and he knew best and to just shut up and deal with it. I left there last month.... Hence my venture out to see the acupuncturist and Ortho. I run out of pain meds and I have no where to really turn. I promise you I do not wish to take them. But I have no choice. I have a daughter that needs constant care and with this it's impossible to even function. I hope the Orth dr and acupuncturist combined can help me. Should I mention the Amitriptyline to the Ortho tomorrow and maybe try that again? Someone please offer me some advice and hope. Oh and I wanted to say I did find a natural herb that helps a little bit with pain it's called DL-pheynalalaline. <SP? or known as DLPA complex. You can get it at any herb store. It's allows your brain to produce more of the brains natural morphine to help fight off pain. I only been taking this for 3 days. I will keep you posted on that as well.
God Bless,
Karen