Undiagnosed Problem

[lweldon]

This is comprehensive report on my long term problem, I hope somebody can relate to or have some opinions or ideas to what my undiagnosed problem might be.

I’m male and 25 years old and for the past 3 years I have been suffering with a problem that has taken over my life. I always have a feeling of a sticky substance on the right side of my throat in the top right hand corner of my adams apple (just below where you find your pulse). When I swallow it down or attempt to cough it up it reappears. If I do bring some up it is usually a thick viscous cloudy milky white substance (higher viscosity than spit).

When I breath out I can often hear and feel wheezing coming from the same area in my throat (not the chest). I continuously hear gurgling in my throat which sounds like air trying to escape like a burp but again comes from the same area in my throat. It feels as though air is trapped and I can literally feel it pushing its way out from the area in my throat upwards. My girlfriend has commented on this and it can be quite loud. When I drink a fizzy drink I often burp up froth which again seems to come from the same area, I do not burp up food though.

Other symptoms I have developed which may or may not be affiliated with this problem include, constant tiredness and not being able to get up in the mornings (I never used to have trouble with this), my mind feels cloudy and I find it hard to concentrate or motivate myself to do so. I often feel hot and sweaty when other people say it is cold. My sex drive has lowered considerably.

Example of problem interfering with my life:

When I exercise this area will become irritated and will become very painful which makes breathing hard. The wheezing becomes very bad but still comes from the area mentioned before and not the chest. The area initially feels as though it has become red raw and inflamed, painful and swollen (I’m not saying it has become red raw or swollen but it feels that way). Breathing becomes harder due to the same area developing a sharp pain when only half a breath has been taken and I start to cough, the feeling of a substance in the same area attributes towards my coughing. I become dizzy, light headed and my legs can become to feel weak and shaky.

After time passes the area seems to become less inflamed but is still very painful, lots of coughing continues I feel generally ill. I get very dizzy and the wheezing becomes very bad to the point where I visited an out of hours GP to get some advice as I was wheezing very badly. He said he could definitely hear wheezing and it could be asthma and gave me a blue ventolin inhaler to try to ease my wheezing. It didn’t really seem to help and he sent me on my way along with some steroid tablets and pain killers, panic and being so tired of this ailment may have been an attribute towards such a rash visit to the out of hours GP.

The next day after this happens I will almost certainly get ill with what seems like a chest/throat infection and I cough up green phlegm all pain and phlegm comes from the same throat area described before. This illness can spread out to my chest and become quite bad before eventually going after a few days and just the sticky substance remains described in the first paragraph and the cycle starts again.

What has been done?

I really do not think that it is asthma because the pain, the wheezing and thick substances all originate from the same area in my throat. I have been to a chest doctor who took blood tests for allergies, took chest x-rays and put me on lansopazole in case of possible acid reflux causing the pain. I also had a methacoline challenge test which produced negligible results. Then after becoming increasingly tired of this problem I visited a private ear/nose and throat doctor who was pretty rude. He put a camera down my throat and said it was all fine and continued to tell me that people often complain of such symptoms and nothing is ever found (very reassuring doctor, thank you very much for charging me a vast amount of money to tell me that). He proceeded to get me an appointment to have a throat xray which is in a few months. I am also waiting to see an NHS ear/nose and throat doctor but the wait is extremely long.

Can anybody help?

Does anybody have any idea of what this might be, all I want to do is get fit and exercise without getting ill like I used to and not be the weird guy who is coughing and clearing his throat all the time. Could the other symptoms have anything to do with the problem I described? I am at the end of my tether and am getting poor help and uninterested responses from doctors and so called specialists.

[selfdiagnose]

I have perhaps reached a conclusion about my own condition which corresponds with many of your symptoms.

I am 51 (tomorrow) and a smoker and otherwise a healthy person except for this nocturnal problem I have with waking up with mucous in my throat.

I first noticed my condition around 5 years ago as I was frequently travelling and was self conscious of neighbouring hotel guests having to put up with my hacking as I woke in the middle of the night with coughing up mucous that just required to be expectorated as I could not swallow it  would go on for an hour plus each time during the night and upon waking in the morning. I then began to collect the stuff I was expectorating into a clear half pint glass and would see that my saliva was exceptionally frothy and sticky (refused to go down the sink and I have to help it push down with hot water from kettle.) Sometimes I could collect over half a pint and grossed out all my specialists by taking the previous nights and mornings sample in a jar. They all said they found the quantity was exceptionally high and that my case was unusual and did not have any immediate answers.

1. The first ENT specialist sent me to a gastro specialist as he believed my sample was acid reflux. That was 15 months ago.

2. The gastro specialist found some slight evidence of reflux but could not suggest the mucous was from my stomach. My mucous was investigated and was found to be salivary flora. He sent me to a respirologist.

3. The respirologist said I had a clear chest following an X-ray and MRI of chest and was baffled by my reproductive cough and amount and consistency. He did find that my breathing was not at its optimum and i was not circulating oxygen through my system. Gave me stuff to breath easier that I have stopped taking now. I can now explain the dizzy spells I also suffer from to lack of oxygen, constant ear aches to my left ear (unlike you I have my issues on the left) and anaemia discovered through my blood tests.  

4. I saw an endocrinologist as my blood was showing indications of fighting a condition that was not evident to anyone. He too was baffled as my blood results went off scale for many readings and then settled back to normality.  He told me to lose wight and come back and see him in 6 months if condition had not improved!

5. I was during all this time seeing an ENT specialist as I have a recurrence of salivary stones and did not brief him about the mucous collection in my throat (because his colleague had passed my problem on as a gastro issue)

Fast forward to now after having seen by these specialists with associated tests (o'scopies,MRI's, X-rays, barium swallows) I returned to ENT specialist and decided to tell him my story. He immediately had my mucous flora checked for acidity and it was mucosal flora from mouth. Then he organised an MRI of my throat and salivary glands and a barium swallow.  I picked up both results of barium swallow and MRI came back fine except it showed up my salivary gland problems resulting from the salivary stones issue (no surprise there). The barium swallow came back fine except for one small comment relating to evidence of residue of barium in my valleculae. My ENT specialist also baffled but on the day I went for the MRI results, he checked my throat as I told him I had found a tonsil stone on my tonsils. He checked the way docs check your throat and told me I had a cyst and that it would go away by itself (probably). He has now arranged for a sleep study for me which is happening at the end of this month.

HOWEVER, I decided to google valleculae and Eureka, I think I know what is going on.

The cyst is on my valleculae or thereabouts (check it out so it makes sense to you) and every time I lie down this is made heavy with my mucous production which is heavy anyway because of my salivary gland issues. My swallowing function is impaired as barium swallow shows and typically I will wake up at night to cough because when I move in my sleep the mucous that has collected in my throat blocks up my airways and chokes me and I have no choice but to sit up and expectorate slowly small amount a time till I feel I have cleared the area in my throat where the blockage is.

There are a few items on valleculae on google and here are some links that may speak to you about your condition. I believe you will need to get checked out like me with a barium swallow to see if you have the same issues as me and if I have correctly diagnosed myself, it seems there is a possibility of successful treatment of the mucous build up and coughing.

http://memo.cgu.edu.tw/cgmj/2504/250409.pdf

http://faculty.ksu.edu.sa/12493/Publications/Pharyngeal%20Problems/Haemoptysis%20in%20an%20Adult%20with%20a%20Vallecular%20%20Cyst.pdf  

Now it also makes sense that my blood was showing like it was fighting a condition that none of my specialists could find because noone checked my throat (incredibly) to discover the cyst and perhaps that is what my blood has been fighting. Also, mucous is another major defence programme and therefore because of the cyst in the throat, there is an abnormal mucous presence there.  

I therefore now suggest to you to check your throat yourself (I found the cyst myself by looking and ENT guy confirmed. Go back to your GP and ask them to check your throat and ask for an MRI and barium swallow. I am sure they will arrange this for you. And I hope you find another ENT specialist who is more responsive.

By the way, I found salt water and apple cider vinegar gargles helpful.

Good luck.

Let me know what happens.

I will also periodically update.

[hava]

You have reported your problem very well. Keep a numbered list of all your symptoms.Let me know what symptoms have improved after 4 weeks or whenever you want.
I have something you can do yourself to get better.
Check the thyroid point, do Ujjayi 21 times daily, do anulom vilom for 20 minutes, twice a day. Drink warm water(at least 6 glasses a day), and avoid cold drinks. I have included kapalbhati, which you can try for up to 5 minutes, and if you can do it without pain, then do it. All this will help you in different ways, so keep a journal of what you notice and feel, as you will be able to help others, as you get better.
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Thyroid point – press  the fleshy bit on palm between  the base of thumb and wrist on both hands. If you feel pain when you press, then press this point 50 times daily, on both hands.
Ujjayi pranayam
Procedure: While breathing in, tighten throat(contract glotis) and there will be sound from back of throat, then drop chin(rest chin on chest), hold breath as long as possible.Then  chin up, close right nostril and slowly breath out through left nostril.
Duration: 5 – 21 times

How to do Ujjayi
When you clear your throat, you tighten your throat and breath out, twice, with a pause in between. . Now if you reverse this, that is, tighten the throat and breath in continuously for abour 8 to 12 seconds, then hold your breath for 4 seconds with the chin down, then  chin up, close right nostril and slowly breath out through left nostril, you have just done Ujjayi pranayam.You will feel like coughing initially.
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Anulom Vilom pranayam –
Build up your timing gradually.If you feel tired or dizzy, stop and resume after one minute.
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 15 to 30  minutes twice a day.
Children under 15 years – do 5 to 10 minutes twice a day.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.
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Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 20 to 30 minutes twice a day. Children under 15 years – do 5 to 10 minutes twice a day.
Not for pregnant women. Seriously ill people do it gently.
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January 10 ,2012

[Margot49]

Wish I could help you but can certainly understand what you are going through as I've been dealing with my own throat/mouth and now ear issues the ENT docs can't seem to figure out and have pretty much dumped me.  Too bad you have to wait so long for an appt.  I have seen many doctors in many specialties and had many tests done. I go again tomorrow to see an ENT doc I saw before because now my throat problems are worse and chronic and now my ear is involved.  Have you tried seeing a good Internist?  Someone also suggested to me possibly seeing an Infectious disease specialist.
I truly hope you can get some answers.  Yes, this just impacts one's life.