throat pain

[zachsan]

this question is directed mostly to doc, but i'd be very interested to hear dao's take on it, and anyone else's for that matter. i've lately been experiencing a sharp pain in my throat. it's not like it's sore or anything, and i'm not really losing my voice, but there's a certain point in my throat that feels like there's a sharp pebble digging in every time i swallow. sometimes i can barely feel it, but sometimes it gets really, really bad, especially when my throat's dry. this has happened to me before, and i've talked to friends who've had it happen to them before, so i don't think it's so unusual, except that it's lasted now for about two or three weeks, i think, and it's never lasted near that long for me.

for dao's benefit (but for all i know doc may find this relevant too), i've also had these two canker sores for a few days now. this probably has nothing to do with the throat thing, but suffice it to say that i'm very disappointed in my mouth and throat at the moment.

any ideas or advice, from anyone, would be greatly appreciated.

[daodejing]

Go see an acupunturist today. Pain is considered to always be a result of stagnation in chinese medicine. And pain the likes of which you are describing sounds like blood stagnation (xue yu), and blood stagnation is not something you leave untreated.

While it might be to your benefit to see an M.D. about it as well, you're better off with an acupuncturist. Why you ask? Well, let's talk about a symptom sort of like yours (but more qi stagnation than blood stagnation), called "plumpit" qi stagnation. It is literally qi stagnation in the throat which causes the patient to get the sensation that they have a foreign object stuck in their throat, like a plum pit. When they consult their doctor about it, they just look down the esophagus with a light, see nothing, and say the patient has "globus hystericus" which they beleive is a mental disorder where one has an imaginary object in their throat.

So, the real question is, when did this pain start? Have you been trying to train iron neck against wookies? Did a buddy clock you in the neck during sparring? Or did it manifest after you recovered from another illness, perhaps strep throat (Strep throat incidentally is treated much more effectively with antibiotics than with chinese herbs and acupuncture).

Anyways, see a medical proffessional. If the pain is accompanied by a small, hard, palpable mass in your throat at the sight of the pain, seek medical help even quicker.

[zachsan]

really, i just woke up one morning and it hurt when i swallowed. i mean, obviously, it hurt when i did anything, but as the day went on and the usual throbbing head pain went away, the pain in the throat stayed.

i haven't had strep thraot or been sick at all for a few months now. as far as seeing an acupuncturist... i'm not sure my health insurance covers that, and i'm not sure when i'd find time to do it (a schedule gets a lot tighter when you're limited to public transportation to get around a city like philadelphia). i do plan on seeing my doctor sometime next week, though. i guess i was just hoping there was some easy solution to the problem, like, gargle with saltwater.

and there's no palpable mass there. i think that, at worst, it's just some kind of acute swelling or inflammation. obviously not a mosquito bite in my throat, but something like that.

[doc]

Haven't forgotten about this, just want to spend time with it, and I haven't been able to. Been too damn busy here in Beijing with visa issues and other things.

This, and the others, are on the way. Few days. Promise.

[doc]

It was quite a few years ago. I was working in an Intensive Care Unit of a University Hospital during my fellowship training. One of the male nurses, a very amiable funny guy, came up to me and asked me to look into his mouth. He said that he had met this nice girl a few days ago in a bar, and, supposedly, had quite the time with her. One of those famed, one night stands.

He had these small ulderated and non ulcerated blisters over his entire gum line, both upper and lower. The blisters had also spread to the inside of his cheeks and lips, with some on his tongue and soft palate. Very reddish, very painful looking. He wanted to know what this mess in his mouth was.

It was pretty clear to me, that he had gotten a herpes genitalis infection, throughout his mouth. It was the absolute worst that I had ever seen, but, I didn't tell him that. I basically advised him as to what the infection was, and without batting an eyelash, he just asked me what to do about it.

"Well, for one, you might consider changing your eating habits".

I didn't think he got the message.


When it comes to the throat, things can be pretty simple. When it comes to things in the throat or neck, it's either tumor (benign or malignant) or infection. Pretty simple. Diagnosing things can be easy, treating them is where it gets complicated. I'd like to add something to this basic ENT mantra, and that is, allergic disorders, and psychological ones.

Tumors can be either benign or malignant (cancer); when it comes to oral tumors, generally they are associated with smoking, alcohol, and drug use. When you think about it, these oral cancers are easily avoidable diseases. Suspicion of tumor arises when a mass inside the mouth or throat is found, or, an ulcerating condition fails to heal. Canker sores (apthous ulcers) tend to occur in the oral area, tend to recur, usually recur due to recognizable causes, and usually heal within one to two weeks. Larger ones can take up to four weeks. Anything that still resides in the mouth after that time is very suspicious for a tumor. Generally these are diagnosed by biopsy or direct observation.

Infections can be viral, fungal or bacterial. Many years ago, when I worked in an Emergency Room in the inner city of New York, during the pre-AIDS days, homosexual men and prostitutes used to come in with syphillitic and gonorrheal infections in their mouths and the back of their throats. Again, easily diagnosed diseases, upon direct observation. After AIDS became prevalent, and my career advanced from the ER to the ICU, (during the heyday of prevalent untreatable AIDS), we saw a lot of Kaposi's sarcoma, occasionally in the mouth and the throat.

Allegic disorders, such as subclinical and clinical anaphylaxix, can present themselves as a swollen tense feeling in the base of the neck, and the tissues surrounding the larynx. Though not painful, these disorders tend to be anxiety producing and uncomfortable. The sensation of a "mass in the throat" is common. Also, there is a psychological disorder called globus, whereby sufferers, usually female, tend to experience a sensation of swelling in the back of the throat.

Any sensation of pain or mass in the throat should be evaluated. Even a simple sore throat could be a streptococcal infection, which needs to be treated with antibiotics; failure to do so could lead to kidney disease. Persistent ulceration or mass sensation that does not go away needs to be evaluated. Looking down the back of the throat is actually pretty easy. A physician can do a simple oral exam with a flashlight and tongue depressor, or, a specialist can evaluate deeper in the throat and the larynx with either a small mirror (indirect laryngoscopy), or small fiberoptic scope passed easily through the nose (direct laryngoscopy). Observation of masses or ulcerations can generally be diagnosed easily via these methods. Scapings of the mass or ulcer can be evaluated microscopically for diagnosis.

MRI's of the neck are done to see the extent of masses and their metastases, if present.

If this thing comes back, get it looked at.

[zachsan]

i think doc is hinting that i shouldn't drink or smoke so much.

anyway, it's long gone at this point, fortunately, but it was there for around 4 weeks or so before. i'll get it looked at if it happens again, even though i hate going to the doctor.

[zachsan]

Well, it's back. Mother****er. I'm going to the doctor tomorrow, which I hate, but I'm happy I wrote my complaints down and they were dated, so I can compare. It's pretty much exactly what I was describing back in July '04, only now I think the location of the "point" has changed a bit to the left side of my throat, and I think it's even more painful, although that might just be my memory playing tricks on me.

Again, I haven't been sick at all, and lately I've been pretty tame with the alcohol and other substances (at least relative to how I was back then). And I haven't been clocked in the head or neck at all recently. Hopefully the doctor can give me something good so it just stops, but I know that's probably not what's gonna happen.

[doc]

Did I ever mention that you should not drink or smoke so much?

Get it looked at. Remember, these things tend to be simple, and common, such as canker sores or viral sores. But you have to have them looked at when they're active, so that they can be "seen". Common things are common; but it's the rare oddity that pops out and surprises everyone, usually with not so good results. Ignoring things can lead to problems.

[onesp1ng]

zach, for future reference... there are several reputable acupunturists located on chestnut st. in chinatown. you don't need insurance; it's only twenty to forty dollars per visit. might have to walk from city hall but it's worth it.

[zachsan]

Good to know, thanks. Chinatown's actually pretty easy to get to but I wouldn't know who to trust.

[doc]

Plus the whole idea of sticking acupuncture needles into the back of your throat....

See a doctor. Don't mess with this. Make sure it's nothing serious.

[daodejing]

Theres no acupuntcure points commonly used in medicine which are in the back of your throat. Its probably an infection of some sort. Good friend of mine had an infected cyst in her throat which caused what you describe only more severe. Couple days of bedrest and a course of antibiotics cleared it up.

See an acupuncturist and an MD. If its viral, theres probably not a lot the MD will be able to do for you, while the acupuncture can still stimulate your immune system and send you home with an antiviral antifungal antibacterial herbal formula. Something like (sp?) Pu Ji Xiao Du Yin. But have a doc look at it anyways. Good for posterity.

Acupuncture treatment, if it is an infectious inflammation, will most likely include points aimed at clearing heat, eliminating toxins, and possibly strengthening the wei qi, and moving qi and blood. They wont be sticking any needles in your mouth, more like the arms and legs and back or abdomen.

And stop smoking till it goes away. And cut your drinking back to beer only, and no more than 4 beers in a sitting. I know that may be asking alot, but if you want it to heal, do those 2. Hard liqour and tobacco smoke can really burn the hell out an area thats already inflamed.

And do not under any circumstances seriously entertain anything said by BL.

But yeah, if this hasnt cleared up yet, see an md, see a tcm practiioner, and stop smoking, and stop drinking hard alcholol or beer in excess.

[doc]

Theres no acupuntcure points commonly used in medicine which are in the back of your throat.

Just for the record, I was being sarcastic.

Gonna have to come up with a sarcasm smilie...

[zachsan]

So the "point" I was talking about turns out to be my left tonsil which is officially inflamed. The culture came back and the doc thinks it's a virus, and like you said DDJ, she just told me to wait it out. However I don't think I'll see a TCM person because it seems to be on the decline (fortunately), and so is my cash at the moment (****in Christmas).

I'll keep hydrated and... reduce the carcinogen intake a bit. After all, it is Christmas. Thanks for all the advice.

[doc]

You never mentioned you still had your tonsils, LOL...

Always the simple things.