@sophiaurtis
First off, you are an amazing sister! Thank you for caring so much for your brother to seek help for him and his health struggles. You are a true blessing to him! 🙂

Do you know what happened about 4 years ago to trigger his symptoms he has had since 2021? Did he have an accident/injury and/or something happening to significantly impact his life? Did he have a loss of a family/friend or major stressor? Did he have a hard time after graduating high school?

He needs to get to the source of his high arsenic in his urine. I think this toxin can wreck havoc on his health. It is in his vape products. He needs help to stop as soon as possible. It is damaging his lungs and possibly his brain chemistry due to toxic exposures.

1. https://medshun.com/article/why-would-arsnic-show-up-in-urine-sample
2. https://factor.niehs.nih.gov/2022/2/feature/3-feature-e-cigarettes-and-toxic-metals
3. https://publichealth.jhu.edu/2024/researchers-find-toxic-metals-in-e-cigarettes
4. https://cen.acs.org/safety/consumer-safety/Vaping-exposes-users-toxic-metals/98/i12

For your brother’s long thoracic nerve damage, did he have an accident? Did he injure his head/neck at the same time? If he didn’t have a MRI of his cervical spine, he should see an orthopedic spine specialist for this. He can have cervical spinal cord/nerve root compression that is causing him symptoms in his head and below the level of compression (affects arms/hands, legs, etc.). Has he had physical therapy for his shoulder? Did he see a neurologist for EMG/nerve conduction studies of his upper and lower limbs to see if he has any neuromuscular impact.

In addition to stopping gaping, your brother should see a pulmonologist to check in lung health/function, oxygen levels and determine if he has sleep apnea.

Covid and the shot has been known to cause nervous system and heart/lung issues, especially in teen boys and young men. My teen son has a heart defect so I did not get a shot for him but he did have Covid 2 times and has long covid symptoms now.

Your brother may need inpatient mental health support and evaluation and assessment. He matters. He needs to not feel embarrassed for getting him the mental health support he needs. He may need talk therapy and antidepressant and/or antipsychotic medication that a psychiatrist can help him with.

Your brother may also benefit from seeing a dietitian/nutritionist to help him detox the arsenic, etc. from his system.

I pray that God will guide you, your brother and family on the best way forward for better health overall. It is all overwhelming so just take one day at a time while walking closely to God.