Doper Physicians: help me figure out what's going on with my throat / neck.

In My Humble Opinion
1

Yes, you aren’t my doctor, I’m not your patient, your responses are not to be taken in lieu of an official Dr. visit.

In brief:

Sometime in the first or second week of June I noticed a pain or pressure in my jaw – under my tongue, on the right side. It would appear for a few hours, then disappear. This happened for a few days before I decided to go to my doctor. They sent me to the local urgent care clinic due the fact that they didn’t have any opening for a couple weeks.

At urgent care the Dr. felt around my shoulders, neck and jaw and felt nothing (I cannot feel anything from the outside, only the sense of or presence of something from inside. Even poking around my mouth I can’t feel anything). The urgent care Dr. attributed it to allergies, but advised me to keep an eye on it. I made an appointment with my PCP and at that appointment (end of June) he ordered a CBC and Chem 14, Liver test as well as an ultrasound of my neck. The CBC, Liver test and chem 14 came back with everything normal except Bilirubin was slightly elevated, which my PCP (who is a PA, not an MD) attributed to an error in the lab, since he felt that there was no reason for it to be elevated and everything else was normal.

Since I could still feel this thing, (it feels like a s small lump somewhere under my tongue) he ordered a CT scan. The CT scan was done and all findings negative. The CT scan looked at the sinuses, throat, salivary glands, lymph nodes, and thyroid. I don’t have the report in front of me, but it looked at some other things that are in the same area. My PCP basically said ignore it for six months, reduce stress and lose weight, and come back after Christmas if it’s still bothering me. I asked him point-blank what HE would do in this situation, and he said he would do exactly that – get on with his life, while adopting a wait-and see approach.

Sometimes, like today, I can feel a pressure in the back of my throat and maybe my sinuses, almost like a bit of indigestion or an allergy attack. Sometimes I feel pressure on my neck or around my collarbone, where wearing a t-shirt feels like a turtleneck. It’s slightly pronounced, but not painful, when I swallow.

Some additional info: I’m a mathematics major, two and a half years into my degree with another year to go just to finish my associate’s degree. I don’t like math at the moment and am having a very serious crisis of faith – it’s too late to change my major, I’ve put too much time and money into this and I don’t like it. It’s causing my to literally cry with the stress and fear of failure.

My wife and I recently moved. We moved from a big house in the woods by the river to a small mobile home on a dirt lot next to a busy and dangerous road. I don’t like it. The previous tenants left it dirty and we’ve been scrubbing mold out of the corners since we moved in (I wonder if this is a contributing factor, but we moved in the last weekend of June. My symptoms, albeit not the pressure in my throat, began before that). I question our ability to pay our bills and feed our two children.

At least three people I know are suffering from cancer, and a fourth may be – he gets tested this week. Two of the three are terminal.

So. Two medical professionals say they can’t fell anything. Two medical imaging appointments showed nothing of concern. PCP says don’t worry about it. Urgent care Dr. said it’s likely allergies. Both of them advocate a wait-and see approcah. My Ct scan was two weeks ago today, so it hasn’t been long.

Right now I’m sitting at my desk at school, tears on my face. I’m freaking out. Something is wrong with me, I know this. Maybe it’s depression… I’ve suffered from depression since I was a teenager and this move has brought what was background noise into something that is a daily struggle. Maybe it’s allergies. I usually have hay fever in the spring, but I feel it in my lungs, not my throat and sinuses.

I don’t know what to do. For the first time in my life I’m turning to prayer. I need some advice.

Lancia, aka Nathan

2

All I can do is offer my support. I’m sorry.

3

IANAD, but I do have some advice for you. It sounds like there is not a lot more that you can do about the throat situation. But there is something you can do about the stress and depression, which is affecting how you are handling the throat situation. If you are not already seeing someone for the emotional issues, you should find someone. Tell them everything that you put in your OP. It may even help you just to be taking definitive action, even if it’s not to deal with the throat issue. At the very least, you should be able to alleviate the freaking out and sense of daily struggle.

I’m not going to tell you not to worry about your throat, because I know how scary these types of situations can be. But a good therapist should be able to help you think about things in a more constructive way.

I wish you luck, and hope that this turns out to be something easily treated.

4

I also offer that as a former math major myself in community college, you still have a ton of time before you have to commit to your major. I majored for years right up until I found out I had enough credits to graduate with a general transfer degree. I opted to do that and move on to university instead of getting the last two classes I needed for a math associate’s.

Having a strong math background will open a lot of doors for you in any science. I am infinitely glad I went that route, and I think you’ll find it’ll pay dividends for you as well. I don’t know your personal situation, but I would check out other programs if I were you.

5

Thanks. I’ve had some bad luck in the past with antidepressants, and never have had any kind of therapy. Perhaps my years in hospice are starting to catch up to me. It is worth a try, though.

Also many thanks. I’m lucky in that my degree is a general transfer degree, not math specific. However, I’m taking a lot of math (as electives) that aren’t needed for my degree – tric, calc, vec calc, etc. This is in prep for declaring a major in mathematics when I finally get to university.

I chose math for two reasons: the first, which is my stock answer when people ask, is that math provides some job security. Math majors are not common (around here), and jobs in teaching and insurance are plentiful.

The second is feather-fluffing pride. I’ve always felt socially inferior, and I feel that having a degree in mathematics will allow me to prove (to myself) that I’m not the drooling simpleton that I usually feel that I am. Perhaps a poor reason, but there you go.

6

My Dr. advised me when I was having neck and throat problems similar to yours. Check your saliva by spitting on the end of your finger when you are having one of these episodes. If your saliva is foamy you mayb be swallowing excessive amounts of air which can produce symptoms similar to what you describe. He advised me to carry a handkerchief and simply wipe my mouth instead of swallowing to see if the symptoms would subside. It eliminated my problem very quickly. The pains can increase anxiety which exasperates the problem. Might not hurt to try.

7

All of your calculus and statistics are requirements for any science. Again, you can still change and the great majority of your math classes will still be usable for credit. You might have taken a few courses that won’t count, but every college student who changes majors has experienced that.

The field of mathematics is extremely unforgiving for those who don’t already have a great love and devotion to the subject. I became a math major for the same reasons as you: I felt it made me look smart and was impressive to people who asked what I was majoring in. But those are absolutely the worst reasons to be in the program.

8

This is going to be a woo answer, but for some reason I feel compelled to offer it. Ignore if you wish.

Do you have anyone to talk to about your fears? If not your spouse or a therapist, a friend, a priest(ess), a bartender (order soda), a barber, a counselor at school, anyone? What I hear is a lot of unexpressed fear, and your throat - the thing that moves and opens to speak - is feeling blocked. Call it a chakra thing, or a storing of stress thing, or whatever you like, but I wonder if you need to express your feelings rather than, literally, swallowing your fears.

Failing that, try singing in the shower, and then let out a good, loud primal scream. And then do it again, and again, until you start crying or laughing. I suggest doing this when no one’s home to terrify.

9

IANAD and I want to preface this with you have great advice up thread and I am 99.9999999 percent nothing is wrong your throat.

HOWEVER, I need to add this part because I think it’s important (for anyone really). A few years ago, my aunt thought there was something wrong in one of her breasts. She had an exam, mammogram, ultrasound, etc and the doc found nothing to be concerned about.

So she went to another doctor to get a second opinion. Second doc agreed with first doc. Aunt still felt – knew – something was wrong.

So she went to third doc who found the growing tumor that the other docs missed. Double mastectomy and she swears to this day that third doc saved her life (which is probably true).

So while I DO think you are absolutely fine and it IS stress induced or some such, I was struck by your strong feeling that something is really wrong and it reminded me of my aunt and want you to pursue it with another doc if you just can’t let go of the feeling something is really medically wrong.

Good luck and please keep us posted :slight_smile:

10

Globus pharyngeus comes to mind as a phrase that more or less fits what you are describing. Usually though the description is the sensation of a lump in the throat. Sometimes GERD is a factor and that article suggests a trial of GERD treatment. It is highly associated with high emotional stress and anxiety episodes and cognitive behavioral therapy is commonly advised.

11

As a rule I don’t offer specific medical advice over the internet. Therefore be aware that this advice is not designed to diagnose or treat any specific disease. Please consult your own physician.

However, if it were my patient I would recommend that you see an ENT if you have not already done so. They are experts in this area and may diagnose things primary doctors miss. I would also like to know whether the pain increases with sour foods. If it does you may have a partial salivary gland obstruction which may not always show up on X-rays.

12

I agree with this advice.

A submandibular or sublingual salivary gland obstruction with a small calculus should be in your differential diagnosis.

A qualified ENT is the correct specialist.

Most of your symptomatology appears secondary to an anxiety reaction or underlying depression or the like.

13

I’ll third the above advice if you haven’t seen an ENT already. Bring the old records, especially the CT if you have it.

14

Nathan,

Psychobunny is right. See an ENT. I am having a similar problem. The cause of
the problem (leukoplakia lesion on tongue adjacent to 2 amalgam fillings) was
ignored by 2 dentists and one oral surgeon. My PCP referred me to an ENT.
The ENT established the connection between the tongue lesion and the
amalgams. I KNEW the amalgams were causing the extreme pain in the
tongue area beneath the lesion. After 20 years of exposure to metallic silver
and mercury, my system (salivary glands) figured out how to turn the amalgam
into electrolytes. The pain began to subside as soon as the amalgams were
replaced by porcelain crowns.

Briefly, the two main symptoms of cancer are PAIN and a HARD MASS. The ENT
guidelines are not to excise a leukoplakia lesion until 60 days after removal of
the irritation UNLESS there is a palpable hard mass.

This doe NOT apply to your problem. Your problem is more internal.

15

See ENT doc—check (suggested many times above.)

Then move, dude! Obviously your surroundings are freaking you out.

#3 Don’t chain yourself to where you are, career-wise. Where you’re going to be is going to last a whole lot longer than where you are now. Make it someplace where you’d like to visit and enjoy life rather than endure it.