Breathing Difficulties: Causes and Solutions for ENT Issues

Hello, doctor. Regarding shortness of breath?

Hello, Doctor.
Allow me to describe my situation briefly.
Over the past two years, I have experienced more frequent and pronounced shortness of breath.

1.
Twenty years ago, I was hit in the left side of my nose, about 5 cm below the corner of my eye, with a water-filled plastic bottle.
Recently, I was diagnosed with a deviated septum, and my right nostril is narrow.

2.
I have been recovering from a foot injury for a year and a half, during which I have not worked or engaged in any physical activity, leading to uncontrolled eating habits.
My weight has increased from 75 kg to 100 kg.
I also have hypertension, hyperlipidemia, and diabetes, with elevated blood sugar levels (117 mg/dL fasting, 190 mg/dL after eating two slices of toast) and a high hemoglobin A1c (9.4%).
3.
A pulmonology examination revealed chronic lung inflammation, but there are no signs of fibrosis or other symptoms.
In the past two years, I have frequently experienced difficulty breathing.
Previously, if I had nasal congestion, it would resolve quickly, but now it seems to persist almost daily, causing a constant feeling of discomfort while breathing.
I experience alternating nasal blockage (both inhalation and exhalation feel obstructed), and I feel as though I cannot get air into my lungs.
At times, I have experienced dizziness and other uncomfortable symptoms.
Could the breathing difficulties caused by the nasal injury from 20 years ago be ruled out due to the time elapsed, or is it still a potential factor? Are the other factors (such as my weight and chronic conditions) more significant contributors to my breathing difficulties? What recommendations or directions do you have for me, and what should I pay attention to in order to assess the possible causes of my shortness of breath? I apologize for the lengthy message, and thank you, Doctor.
I appreciate your help!

Axiang, 30~39 year old female. Ask Date: 2022/08/02

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on the description, there should be a relationship with the departments of Otolaryngology, Pulmonology, and Cardiology.
If the symptoms persist, it is advisable to visit an Otolaryngologist for a nasopharyngolaryngoscopy.
Wishing you peace and good health.

Reply Date: 2022/08/02

More Info

Hello! Thank you for sharing your concerns regarding your breathing difficulties. It sounds like you have been experiencing a complex interplay of factors affecting your respiratory health, and I appreciate the detailed background you've provided. Let's break down the potential causes of your breathing difficulties and explore some possible solutions.

Understanding Your Symptoms
1. Nasal Obstruction: You mentioned a history of nasal trauma from an incident 20 years ago, which has led to a deviated septum and narrowing of the nasal passages. A deviated septum can significantly impact airflow through the nasal passages, leading to chronic nasal congestion, difficulty breathing, and a sensation of not being able to get enough air. This can be exacerbated by other factors such as allergies or sinusitis.

2. Weight Gain and Comorbidities: Your significant weight gain (from 75 kg to 100 kg) and the presence of conditions like hypertension, diabetes, and chronic lung inflammation can also contribute to breathing difficulties. Obesity can lead to a condition known as obesity hypoventilation syndrome, where excess weight restricts lung expansion and can cause sleep apnea, further complicating respiratory issues.

3. Chronic Lung Conditions: The chronic lung inflammation you mentioned could be a result of various factors, including smoking, environmental pollutants, or even the effects of obesity. Chronic bronchitis or other forms of chronic obstructive pulmonary disease (COPD) could also be at play, especially if you have a history of smoking or exposure to irritants.

Potential Solutions and Recommendations
1. Medical Evaluation: It is crucial to follow up with an ENT specialist regarding your nasal obstruction. They may recommend imaging studies like a CT scan to assess the extent of the deviated septum and any other structural issues in your nasal passages. Surgical options, such as septoplasty, may be considered if the obstruction is significant and affecting your quality of life.

2. Weight Management: Addressing your weight through a structured weight loss program can have a profound impact on your overall health and respiratory function. Engaging in a balanced diet, possibly under the guidance of a nutritionist, and incorporating physical activity as tolerated can help manage your weight and improve your metabolic health.

3. Pulmonary Rehabilitation: Given your history of chronic lung inflammation, participating in a pulmonary rehabilitation program could be beneficial. These programs typically include exercise training, nutritional counseling, and education on managing lung conditions, which can enhance your lung function and overall well-being.

4. Monitoring Blood Sugar Levels: Managing your diabetes is essential. High blood sugar levels can lead to various complications, including those affecting your cardiovascular and respiratory systems. Regular monitoring and adherence to your prescribed medication regimen are crucial.

5. Breathing Techniques: Practicing breathing exercises, such as diaphragmatic breathing or pursed-lip breathing, can help improve your lung capacity and efficiency. These techniques can be particularly beneficial if you experience anxiety or panic related to your breathing difficulties.

6. Lifestyle Modifications: Avoiding allergens and irritants, such as smoke or strong odors, can help reduce nasal congestion and improve your breathing. Additionally, staying hydrated and using saline nasal sprays may help keep your nasal passages moist and clear.

Conclusion
In summary, your breathing difficulties may stem from a combination of anatomical issues related to your nasal structure, weight gain, and chronic lung conditions. It is essential to work closely with healthcare professionals, including an ENT specialist and possibly a pulmonologist, to develop a comprehensive management plan tailored to your needs. Addressing your weight and managing your diabetes will also play a significant role in improving your respiratory health.
Please do not hesitate to reach out to your healthcare provider for further evaluation and support. Your health is paramount, and taking proactive steps can lead to significant improvements in your quality of life. Thank you for sharing your story, and I wish you the best on your journey to better health!

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