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Family Medicine (Expert Forum)
No help from local doctors! Feel crummy!
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
No help from local doctors! Feel crummy!
by koenig12, Jun 16, 2004 12:00AM
I am one of those guys that only goes to the doctor when I am really down and out, or when my wife makes me. About 4 weeks ago, my throat started hurting, but not like a sore throat, like on the sides of my Adams apple. It really hurt when I would talk. I have this feeling of gagging a lot when I talk because just above my clavicle, I have a fullness feeling. I have upper chest pain off and on, when I try doing anything physical. I have been very tired, weak and episodes of diarrhea since. I am normally in great physical shape and work out daily, even when I have a cold, but I haven't for the last 3 weeks. I went to my family dr. and he didn't seem to care. I went to a throat and nose dr. that was sure it was thyroid related, but the tests came back normal. I also had a neck ct that the radiologist said was "unremarkable". I have a gland on my neck between my collar bone and neck that is swollen and one under my chin that is noticeably swollen, and minor soreness, feels like I have an ear infection coming on too. For the longest time when I would work out hard I would have a gag urgency and I have had a tough time gaining any weight for quite a few years. I lost 8 pound the last 3 weeks. I just feel worn down and crummy right now and this has gone one for too long. My family dr. said there was no need to refer me to anyone else, but turned around and scheduled a thyroid scan in 6 weeks. I hear so much about cancer that I am scared to death!
about my health: kidney stones, good skin, good weight, IBS when I get nervous, very stressful job, Please let me know your thoughts.
about my health: kidney stones, good skin, good weight, IBS when I get nervous, very stressful job, Please let me know your thoughts.
Doctor's Answer
by Kevin Pho, MD, Jun 18, 2004 12:00AM
, Jun 18, 2004 12:00AM
Couple of things. The first would be the upper chest pain worsened with exercise. Although it is less likely that the heart is involved, this should be investigated with an exercise stress test to make sure.
With the upper GI discomfort as well as the gagging, GERD would be a possibility. An upper GI series can be obtained to see if there are any anatomical blockages. If there continues to be symptoms, a 24-hr pH study should be considered to confirm the diagnosis. GERD can normally be treated with a proton-pump inhibitor such as Protonix or Prilosec.
Regarding the sore throat and fatigue - mononucleosis should be considered and ruled out via blood test.
I would discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
With the upper GI discomfort as well as the gagging, GERD would be a possibility. An upper GI series can be obtained to see if there are any anatomical blockages. If there continues to be symptoms, a 24-hr pH study should be considered to confirm the diagnosis. GERD can normally be treated with a proton-pump inhibitor such as Protonix or Prilosec.
Regarding the sore throat and fatigue - mononucleosis should be considered and ruled out via blood test.
I would discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Member Comments (2)
by ozark, Jun 17, 2004 12:00AM
i hope you dr did other blood work besides a thyroid test...have you been scratched by a cat recently? have you had any other blood work done such as a white count etc....
by koenig12, Jun 17, 2004 12:00AM
To: ozark
I haven't had any cat scratches lately. I work in a very loud manufacturing plant where everyone wears earplugs but I am in the offices. I felt this coming on when I would be in the plant and trying to talk loud. I had them fax me all of my lab documents and all they did was a thyroid test, but you know they never had me fast before it or anything...
