Looking for relief (well... maybe more venting that anything)

[HealthyinMN]

Uh oh... this might turn into a novel!

So, about 2 months or so ago, I had a weird "tingle" in my throat that would come and go. I didn't think much about it, but about a month ago, it became more and more present and then I started to feel like there was "something" in my throat. My throat kind of feels tight, in a sense, where as other times it feels like there is a golf ball just sitting there (around and down by my adams apple) and no matter how many times I swallow it won't go away.

I saw my regular doc and she though it might have something to do with allergies and post nasal drip (though, I've never had issues with allergies, but it has been a really bad season around here). She put me on claritin and flonase which was suppose to clear up the drip. Unfortunately, I still had my throat problem - I was sent to an ENT who looked me over in about 7 minutes and declared I had something called LPR (Laryngopharyngeal Reflux). He gave me a trial supply of nexium and then said to take prilosec OTC once the nexium runs out... he said to wait 6 to 8 weeks and see what happens - he then sent me on my way. When I got home and looked up LPR, the symptoms do concur with what I am experiencing, but I just didn't feel all that comfortable with his answer as he really ran no tests or anything. I talked to my doc and she referred me to another ENT to visit on Monday for a second opinion. I guess it is somewhat similar to GERD, but I have none of the heartburn symptoms that come with acid reflux. Besides starting the nexium, I have been trying to follow what is recommended as to what foods to eat, not eating before bedtime and raising the back of the bed 6" while sleeping. Some have recommended chewing gum to help create saliva to help counter act any acid which I've been doing, but I don't have a clue if it makes a difference as I have no other stomach issues.

I just don't know how much longer I can take the tightness and constant feeling like there is something stuck in my throat... it really grates on my nerves! I found myself trying to clear my throat often, but I think I have that under control as I was nervous I would get a sore throat on top of everything else!

Has anyone else gone through something like this before? I'm anxious to see what the new ENT will say and ask him to at least run a PH test or something to see if I do indeed have reflux.

Sorry for the long post... I think I just needed to write this out as I'm almost at my breaking point! 6-8 weeks seems like such a long time away when this issue in my throat is there 24 hours a day.

[DmOrtega]

Since nothing has been found as an obstruction, I'd take a deep breath. Throat irratations can cause a cough or strange feeling because it is sensative. A long period of coughing or throat clearing can cause the throat to become spasmodic (spelling?) and will make us cough or feel like there is something there, at the slightest tingling. Acid reflux can create this feeling. If you can eat and drink OK, then follow what the dr recommends. Give it a week, if it doesn't change then talk to the dr again.

[Cookin4Love]

Joe, I know how frustrated you must be to look at weeks of misery without meaningful hope of relief. Just curious--did your doctor check your thyroid levels? An enlarged thyroid can cause that obstructive feeling, too. Please keep us informed about how you're doing. Sending good thoughts your way.

[LakeMartinGal]

Unfortunately, it could be something more serious, too... not trying to alarm, but get yourself to that second opinion guy! Can the doctor palpate the stricture that you feel? <concern>

[sneezles]

Being married to a man whose life depends on his nexium I can empathize a little. Richard, before the nexium, would describe his worst symptom as not being able to swallow, as if the food was stuck. He does suffer from acid reflux because he has a rather large hiatal hernia (odd for a man who has never been overweight).
I don't see how much Nexium the ENT gave you but I can tell you that prilosec OTC does absolutely nothing for Richard.

I hope that you get some answers!

[HealthyinMN]

Since nothing has been found as an obstruction, I'd take a deep breath. Throat irratations can cause a cough or strange feeling because it is sensative. A long period of coughing or throat clearing can cause the throat to become spasmodic (spelling?) and will make us cough or feel like there is something there, at the slightest tingling. Acid reflux can create this feeling. If you can eat and drink OK, then follow what the dr recommends. Give it a week, if it doesn't change then talk to the dr again.

I didn't really have a long period of coughing or throat clearing though, but I know what you mean.

Joe, I know how frustrated you must be to look at weeks of misery without meaningful hope of relief. Just curious--did your doctor check your thyroid levels? An enlarged thyroid can cause that obstructive feeling, too. Please keep us informed about how you're doing. Sending good thoughts your way.

I actually had my levels checked when I had my physical a couple weeks ago - they came out ok! Good call though, I've read some about how that can cause issues.

Unfortunately, it could be something more serious, too... not trying to alarm, but get yourself to that second opinion guy! Can the doctor palpate the stricture that you feel? <concern>

He didn't try - the first ENT only looked in my throat with one of them small mirrors. I don't think there is a physical lump there, but I guess I can't be for sure! I hope tomorrow's ENT will be a little more involved.

Being married to a man whose life depends on his nexium I can empathize a little. Richard, before the nexium, would describe his worst symptom as not being able to swallow, as if the food was stuck. He does suffer from acid reflux because he has a rather large hiatal hernia (odd for a man who has never been overweight).
I don't see how much Nexium the ENT gave you but I can tell you that prilosec OTC does absolutely nothing for Richard.

I hope that you get some answers!

Thankfully, I don't have any problems eating or sleeping - the only time I get any relief is actually while I am eating... but then the feeling creeps back over about a period of 15-30 minutes and won't go away. :(

[BucknellAlum]

This is a long shot, but have you had any anxiety symptoms? A tight throat and a feeling of a lump are classic anxiety symptoms. Are you under any unusual stress?

If you check WebMd or Mayo Clinic sites, you can see a list of anxiety symptoms and both of these are on there.

[mbrogier]

You're not taking any muscle relaxers are you?

I get that something's stuck in my throat feeling and also that I can't swallow. I take the muscle relaxers for my pelvic floor muscle disorder and for old trauma to my neck that is causing some of my migraines.

I have a weird pressury pain in my left rib cage, and my doctor said that it could be from acid reflux. I don't feel like I have gerd--I don't have the burning sensation that I did in college. Foods don't make it worse. My doctor said that you can have reflux and not have normal symptoms. I never knew that until a few months ago.

Acid reflux can be proven with an upper GI scope. Before I stopped looking for diagnoses I'd get a GI to run an upper scope to see into the stomach and esophagus--you'll want to know if you have damage that would keep you from taking certain meds (since certain pain meds like aspirin and ibuprofen can make ulcers worse) or if you need to be on a course of drugs to cure esophogeal erosions. If everything looks peachy, then I'd find a throat specialist if no one can give you a concrete diagnosis.

[TKay]

Just checking in to see how you're doing and what--if anything--you found out today. Let us know. It's good that you're pushing for answers. Even if it turns out to be as simple as taking the meds, it's better to be safe. Good luck and keep us posted.

[BaileyJune]

Hi HealthyinMN,

Just wondering what you found out about your problem. I am having a similar problem, with the addition of a chronic, non-productive cough. My doctor (asthma and allergy doctor) has me on asthma medication but I've been doing a ton of research and think it may not be the cough variant asthma he originally suspected. My doctor has even suggested it might be LPR or a vocal cord disorder because of the chronic cough and that sensation of always having something stuck in my throat. If I'm still having trouble in a week, he wants me to have a cinefluoroscopy to see if my vocal cords are in proper alignment. It's very frustrating, all this experimentation!

Hope you're feeling better.

B.

[wallycat]

First I'm sorry you are dealing with this! How annoying.
I don't think I can offer any info than has already been posted.
Too bad you're not female because this is a common perimenopause symptom!! Could it be andropause :eek: :D :p ;)

There was actually an article about a swimmer who was thought to have asthma...the attack in her throat and feeling of choking ...and she was finally sent to a vocal coach and finally diagnosed her with her voice box going into spasm.
Once she mastered the calming technique, she never suffered again...and she did not have asthma.

Not sure that is helpful....
hope you feel better soon.

[mbrogier]

How did you like the second doctor?

[HealthyinMN]

I apologize for not getting back to this thread, but I've been trying to avoid any thinking about my issue and partially because we ended up moving in the middle of this and we had to switch doctors.

So, here I am, how many months later and have pretty much gone no where =(.

I've had several tests since then done - I've had a CT scan of the throat, Esophagram, Upper GI Endoscope and an ultrasound done. All have come back "normal", except for the ultrasound which noted a tiny nodule in my thyroid. They sent me to an Endocrinologist who said the nodule was nothing to worry about as it was too small to do anything. She rechecked my numbers and noted that at some point I had an episode of "thyroiditis" which may have enlarged my thyroid. However, the ultrasound didn't show anything about that and she seemed fairly confident that this is not the issue. Since I did test positive for the antibodies in that test, she is willing to start my on Synthroid to see if it would shrink my thyroid. Again, she is grasping at straws at this point and doesn't think this will work. I'm not sure I'm game at playing with hormones unless this is my last resort? I don't have anything stressful in my life and I don't think I have any anxiety issues.

My current PCP had my try out a three-week dose of Flexeril on the off chance that it could be a muscle spasam, but I just finished that and there has not been much change.

I was on 40mg of Prilosec 2x/day for just about 6 months and without much different, my doctor decided that was long enough at that high of a dose and suggested I drop down to 20mg 2x/day which I've done. My PCP is out of ideas and I think is setting up a referral with another ENT to get their opinion.

After doing a multitude of research, the LPR diagnoses does fit my most of my symptoms, but so far the PPIs have not cured anything. The PCP wants me to follow a strict avoidance/elimination diet of all chocolate (*heavy sigh!!!), peppermint, caffeine, carbonated products, tea, fatty foods and fried foods. I have had the head of our bed raised 6" (weird at first, but have gotten used to it!) and have been sleeping on my left side, rather than right, to help prevent any night time reflux. I've have also started making sure that I do not eat at least 2 to 3 hours before going to bed or lying down at all.

Sorry for venting... I'm just extremely tired of dealing with this and not sure what else to do! :(

[VAcooker]

Sorry that you are going through this Joe. I just did a quick search on LPR and saw that there is some kind of 24 hour monitoring that can be done to confirm the LPR diagnosis...a test called Ambulatory 24-hour pH Monitoring (see http://www.nycornell.org/ent/Laryngopharyngeal.reflux.html)...have you had this test done?

Please keep us posted...I hope that you get some relief from your symptoms...

[Robyn1007]

Ah, Joe, I'm so sorry to hear that you haven't had any relief. I hope they figure something out soon!

[KimK]

I am so sorry to hear of your problems! I can feel for you, that is for sure. Chronic, unresolved problems like this are extremely depressing.

I was diagnosed with LPR last year, but have been unable to find a cause or completely treat it. I have been on Nexium for months, along with a multitude of other medications. I have been scoped a ton, had xrays of everything, an Upper GI that showed a hiatal hernia (but not believed to be the cause of my problem), and an endoscopy that showed nothing. Next up, in March, is another endoscopy with the 24-pH monitoring, called the BRAVO test. That is the one that measures acid coming up into the esophagus.

My wonderful ENT and gastric docs are helpful, but not coming up with much.....the one thing they both agree on is it might be caused by allergies. Have you pursued that avenue? How about stress?

If this is something you want to research more yourself, I have some great web sites book marked, including lots of info from leading LPR and voice/throat experts.

Hang in there,
Kim

[HealthyinMN]

Ah, Joe, I'm so sorry to hear that you haven't had any relief. I hope they figure something out soon!

Thanks Robyn!

Sorry that you are going through this Joe. I just did a quick search on LPR and saw that there is some kind of 24 hour monitoring that can be done to confirm the LPR diagnosis...a test called Ambulatory 24-hour pH Monitoring (see http://www.nycornell.org/ent/Laryngopharyngeal.reflux.html)...have you had this test done?

Please keep us posted...I hope that you get some relief from your symptoms...

We have not had the PH test done, but we asked about it @ the ENT we went to in MD. They said it was not necessary. I have another ENT visit next week and am planning on bring it up then!

I am so sorry to hear of your problems! I can feel for you, that is for sure. Chronic, unresolved problems like this are extremely depressing.

I was diagnosed with LPR last year, but have been unable to find a cause or completely treat it. I have been on Nexium for months, along with a multitude of other medications. I have been scoped a ton, had xrays of everything, an Upper GI that showed a hiatal hernia (but not believed to be the cause of my problem), and an endoscopy that showed nothing. Next up, in March, is another endoscopy with the 24-pH monitoring, called the BRAVO test. That is the one that measures acid coming up into the esophagus.

My wonderful ENT and gastric docs are helpful, but not coming up with much.....the one thing they both agree on is it might be caused by allergies. Have you pursued that avenue? How about stress?

If this is something you want to research more yourself, I have some great web sites book marked, including lots of info from leading LPR and voice/throat experts.

Hang in there,
Kim

Thanks Kim. I don't really have anything to be stressed about as other than this, my life is pretty darn good. They have put me on regular Claratin, Allegra and I've been through flonase and another nose spray at the thought it was some sort of allergy. I've not had any actual allergy testing done though. The sensation in my throat seems to go from worse (tighter/more constricting feeling) to just an annoying "fullness" and back again - however, we haven't been able to come up with anything we've done differently.

We've actually been on a waiting list at the Mayo clinic and were accepted yesterday with an appointment for Mid Feb. While I need to get this resolved, I don't have a clue at what going there would cost. My INS has said it may be covered, but I would need a referral from my PCP. I have not brought that up to her and I really need to - I like her, but don't know how to ask without insulting/offending her. Does that sound stupid?

[Gecko]

We've actually been on a waiting list at the Mayo clinic and were accepted yesterday with an appointment for Mid Feb. While I need to get this resolved, I don't have a clue at what going there would cost. My INS has said it may be covered, but I would need a referral from my PCP. I have not brought that up to her and I really need to - I like her, but don't know how to ask without insulting/offending her. Does that sound stupid?

It doesn't sound stupid at all. But I am confident that she would put the interests of her patient before any resentful feelings that she may, or may not, have. I am sure that if you ask you will have no problems getting the referral you need, and she will understand.

I hope that you are able to find relief from this ongoing condition.

[Robyn1007]

Joe, as far as insulting your PCP with the Mayo Clinic request don't sweat it. Ask her, if she is truly a compassionate doctor she will be all for it since she doesn't have a good lead on the condition. If she isn't, well, better to find out now and find a new PCP now. This is about you, not the doctor, remember that. You are your best advocate!

[mbrogier]

Joe, I'm sorry you're still having this issue. How awful.

Your doctor shouldn't have an issue with you going to the Mayo Clinic. NO doctor should have an issue with a second opinion. period.

I went to Mayo after I had complications from gallbladder surgery a few years ago. My primary actually suggested it and got me in within a couple of weeks... but I was extremely sick.

As far as insurance, we had pretty crappy coverage then, and they paid most of the costs, and I had an invasive procedure which was planned, stayed in the hospital overnight and had to go to their ER when I had uncontrollable pain. They were excellent and knew exactly what was wrong. I was no longer a medical mystery. *That* was a good feeling after almost 8 months of misery, hospital stays, transfers, etc.

I know you're within a day's driving distance, but make your appointment a romantic getaway. The Raddison has an indoor walkway to Mayo. You can upgrade to the club floor with sleep number beds and high quality linens. (the hotel is also very quiet and the staff is sooo friendly) Free upgrade by getting a free membership at www.mypoints.com I had their card in my wallet and the desk clerk upgraded us free on the spot!

There is a wonderful bistro near the Mayo doctor's complex. It's on a small street near the complex where the Barnes and Noble is. (Facing Mayo, go left) It's very small in a brick building. All the menu items are written on a blackboard. Lunch is more reasonable than dinner with most items less than $10.

The sit down restaurant that everyone flocks to inside the mall complex isn't good. Think 50s overcooked veggies, cold rolls, etc. The prices were kinda high as well.

I hope they can fix you quickly without any surgery. Everyone was soo professional and pleasant there, though. I would recommend them again and again.

[HealthyinMN]

Thanks for the support - we called back to our PCP and she thought it was a great idea. Though, I think she was a little excited because she had never done that before and wanted to see how it all works anyway! ;) We actually have an appointment that we made on our own, but the only way the insurance will pick it up is through a referral so we are trying to figure out with them how to work it out.

I went to one of the "top" ENTs in Minnesota today... I gave him my story (now printed out on an extra long page) and he did a thorough exam with the mirrors and whatnot afterwards. He saw no irritation in my throat (no "cobblestoning" either) and my cords were in good condition. He said he sadly did not have anything to offer. He explained what could be going on and that one reason he might not see anything is because the reflux meds are working. Jeff said he rolled his eyes when I got to the thyroid part and said he highly doubts that could be our issue (we and my PCP agree now).

He said we could try another Gastro doc to see if they would be willing to do the PH studies. I'm tired of being prodded and think we are just going to hold off until the Mayo clinic thing plays out. I did ask if we should continue to follow the "banned" list of foods and he does not see any reason we should and I would just be depriving myself if I did... so that is a little relief - I went home and had a big piece of dark chocolate. :cool:

If this is not a reflux issue, we really don't know where to go next. I'm wondering about some sort of food allergy, but when I've brought that up they have said I would be having some sort of stomach issues. We've also thought about trying out-of-the-box treatment like seeing an acupuncturists to see what happens - I have no idea how to even look for one though!

J
I hope they can fix you quickly without any surgery. Everyone was soo professional and pleasant there, though. I would recommend them again and again.

Thanks!

I actually spent a good amount of time in Rochester @ Mayo when my mom was being treated for Ovarian cancer. This happened in 9th grade and I took time off school so she would have someone with her - we stayed in that Raddison and I traveled all over the city in those walkable subways! Rochester is thankfully only a 2 or so hour drive away.

[Kjente2]

Ask about H-pylori when you see the ENT. Your symptoms sound similar and a course of antibiotics can work wonders.
Hope you're feeling better soon!

[HealthyinMN]

Well, closing in soon on two years of this and not sure if we are near a solution or not. Just updating to keep track of what has been happening.

We worked with the Mayo Clinic ENT for a few months, but he suddenly left the practice and I'd have to start all over again with another doctor. Sadly, the course of meds (Protonix 2x/day along with Zantac at night) really didn't do much for my issues, other than give me a daily headache. I was talking with a friend about all of this and she suggested I seek out a Gastro Doc friend of hers. We did, actually felt like we were listened to and he gave us quite a few options. The first thing he had me to was stop all the meds. Woo!

After checking to make sure it wasn't something in line with food allergies or whatnot, I had those tests done, along with a Celiac test, and all came back normal. He then did an EGD (upper GI endoscope), along with a biopsy to check for esophagitis... both were normal.

Next, what we did last week, was the Bravo PH test. They implanted a PH probe in my esophagus (so not fun when they don't sedate you first!) and I wore a monitor on my hip that recorded the readings for 48 hours. Apparently the probe falls off after 5 or so days. It was pretty uncomfortable as it felt like something was tugging in my chest. Anyway, I got a call this morning from the doctor saying that after going through all of the readouts that it showed I do in fact have acid reflux. This time I'm on high dose of Aciphex, 4 pills a day, and will have to see how it goes for a month or two. After that, I have to do another Bravo test (...) to check and see if the medicine has cut off the acid or not.

I guess I'm one of the ones that has fairly atypical reflux symptoms since I have no heartburn, cough or hoarseness... if that is truly what is happening. If this doesn't work, I'm not really sure where else we can go as we have exhausted most of the options available.

[Goin' Coastal]

I'm sorry you are going through that - it sounds miserable! Hopefully doctors can come up with a workable solution for you.

[mbrogier]

Joe, I'm sorry you're still having problems. I've had a tube put down my nose into my stomach when I had an ulcer and was vomiting blood, and it was not fun at all. I can't imagine having something for 24 hours.

I'm glad they found the reflux. I have a friend that has bad reflux, and there's a higher risk of esophogial cancer with untreated reflux.

So you got the allergy testing for food allergies? I have food allergies, and I did *not* have gastrointestinal issues with all of them. One affects my sinuses and makes me sound like I have a nasty cold instead of making me itch or causing tummy trouble.

I have fibromyalgia and a bladder disease, and part of that is muscle tightness. I've tried several different muscle relaxers, and they don't all work the same. There are actually different types of muscle relaxers. My pain management doctor has prescribed me some different kinds that I can take together as needed. Some can make you really tired, and my doctor uses one to help me sleep since regular sleep meds don't work well for me. I think maybe trying another muscle relaxer might be an idea for you... even with the reflux, if the esophagus is irritated it could spasm, causing the sensation you're feeling.

Rob gets a really irritating chest pain/spasm that comes and goes. He takes reflux meds and has a hiatal hernia. His doctor prescribed Ativan, and that really helps. Valium would be another drug that might help since it can help loosen muscle spasm. Ativan and Valium are in the same family of drugs.

I know you've got to be really irritated to have no better answers. I wish I could help you more, but the only thing I can think to suggest would be to keep a food diary if you haven't already. You might find a trigger or a pattern.

[GingerPow]

Joe, I know how frustrated you must be to look at weeks of misery without meaningful hope of relief. Just curious--did your doctor check your thyroid levels? An enlarged thyroid can cause that obstructive feeling, too. Please keep us informed about how you're doing. Sending good thoughts your way.

Also thinking thyroid. I remember the feeling of constriction before I was diagnosed with hypothryoid. Find an endocrinologist to get that checked out. Good luck with this and persevere - you'll get this taken care of.

[HealthyinMN]

I'm sorry you are going through that - it sounds miserable! Hopefully doctors can come up with a workable solution for you.

Thanks! I think I am just frustrated that we can't nail down exactly what is wrong.



I know you've got to be really irritated to have no better answers. I wish I could help you more, but the only thing I can think to suggest would be to keep a food diary if you haven't already. You might find a trigger or a pattern.

Thanks for those suggestions. I don't seem to have any trigger foods as it seems to just be there constantly. I've tried elimination and keeping a diary, along with eliminating what "should" be trigger foods to no avail. We've actually tried another muscle relaxer, but it didn't seem to do much, other than make me feel tired.

Also thinking thyroid. I remember the feeling of constriction before I was diagnosed with hypothryoid. Find an endocrinologist to get that checked out. Good luck with this and persevere - you'll get this taken care of.

See post 13. I've also been rechecked and the tiny nodule has not changed in size and my numbers are still well within range.

[Terri_A]

Hey Joe -

I'm glad to hear bit of progress has been made. I just thought I'd chime in that the weeone has atypical reflux as well. It doesn't bother her in the least, other than the fact that it exacerbates her asthma, so we have to treat it. It took a while before it seemed to level out and resolve and she didn't have issues with it.

Anyway, I hope that relief is soon in sight and please keep us posted if this latest treatment finally resolves the issue!

[LakeMartinGal]

Fingers crossed that the new regimen will work for you. It's so frustrating when there don't seem to be any answers! I'd feel discriminated against by my body!:(