FOOD GETTING STUCK TROUBLE BREATHING

[crablekid]

IM A 28 YEAR OLD MALE WHO HAS HAD DYSPHAGIA SINCE NOV 20. FIRST STARTED WITH FOOD GETTING STUCK IN MY STERNUM. WENT TO ER AND THEY SAID IT WAS GERD GAVE ME PRILOSEC. TOOK IT EVERYDAY NEVER GOT BETTER. A WEEK LATER FOOD STARTED TO GET STUCK IN MY THROAT AND FELT LIKE I COULDNT BREATH AFTER I SWALLOW. WENT TO ENT GOT LARYNGOSCOPY SAID WHAT HE COULD SEE WAS FINE. SENT TO GET A VIDEOSWALLOW AND ESOPHAGRAM. BOTH NEGATIVE, BUT SHOWED MILD POOLING IN VALLECUL AND PIRIFORM SINUSES WHICH CLEARS ON SUBSEQUENT SWALLOWS AND THICKENING OF SOFT TISSUE IN PROXIMAL ESOPHAGUS THEY THOUGHT IT WAS NORMAL. WAS SENT TO GASTROENTEROLOGIS GOT AN EGD WHICH WAS NEGATIVE. HE TOLD ME TO START EATING SO I ATE FOR TWO DAYS BUT AFTER EVERY SWALLOW WOULD FEEL SHORT OF BREATH AND FOOD STICKING IN THROAT.CALLED DOC BACK SAID THERE WAS NOTHING HE COULD DO BY THIS TIME I HAD LOST 30LBS. BEEN LIVING ON BOOST AND ENSURE. ONE DAY WENT TO TAKE A DRINK AND COULD NOT SWALLOW AT ALL EVEN WITH THE LIQUID IN MY MOUTH. WENT TO ER GOT AMITED TO HOSPITAL THEY DID ANOTHER VIDEOSWALLOW AND CAT SCAN OF NECK. BOTH NEGATIVE. SEEN ENT THERE SAID SYMPTOMS ARE FROM POST NASAL DRIP WHICH I DONT BELIVE. ITS BEEN TWO WEEKS SINCE THEN AND I HAVENT GOT ANY BETTER. SEEN THROAT SPECIALIST YESTERDAY HE WANTS ME TO GET ANOTHER VIDEOSWALLW AND ESOPHAGRAM. I FEEL LIKE THEY ARE MISSING SOMETHING IS THERE ANY OTHER TEST THEY COULD DO. OR ANY THING ELSE THAT COULD CAUSE THESE PROBLEMS. THIS HAS RUINED MY LIFE I DONT WANT TO LEAVE THE HOUSE. I FEEL LIKE IM GOING TO STARVE TO DEATH. HAVE NOT EATING IN OVER A MONTH EVEN APPLESAUCE GETS STUCK.

[Enoch Choi, MD]

I'm glad your condition isn't "life threatening" but i wish your docs were more empathetic about the risk to your sanity...

a nissen fundoplication is pretty intense treatment for GERD. it must have been really bad.

what's your treatment now?

[acidboy]

living la vida loca.  Been there, done it all, still looking for an answer after 15 months and 2 surgeries.
Acid has been eliminated by a nissen, lingual tonsil on the right is enlarged from prolonged acid exposure.  Next issue is whether the swallowing trouble for me is from the tonsil (where I can taste old food and crud, plus I bring up tonsilloliths from time to time) which I never did before, or related
to a possible cricopharyngeal spasm again related to prolonged acid exposure.  The first gastro doc
assured me that "It's not life threatening".  I guess it takes a lot to put your life in jeapordy, but my
sanity has been threatened over time.  What I'm saying is that it takes specialists a long time to
diagnose and treat these types of problems, especially when they have to be conservative.  I think the best immediate goal is to consider survival a success, and drop expectations related to previous
times when you felt better.  this is even more difficult during the holidays.  Everywhere you look someone is sticking food in your face that you can't eat, not that you wouldn't like to.  Listen to
Queen - "keep yourself alive!" and stay focused on the puzzle.  Best of luck.  Tom

[borninquisitive]

In case you didn't catch it, I posted a new thread to you.

[sgru75]

Kate ~  First of all, I want to THANK YOU so much for responding to me and explaining everything so clearly.  You are the first person that I have had to really talk to about this that totally understands and is going thru the same things.  My husband will listen but it is so hard for him because he doesn't understand and when they don't understand, they too, get frustrated and just don't know what to do or say.  After 10 months of feeling this way, it is starting to really get to me and my quality of life.  I still have a few questions for you, I hope you don't mind.  

I had a CT scan of my sinuses a month ago and then met with my ENT and that is when she told me that she feels I should have my sinuses done.  I am not real sure what the terms are for my sinus problem but I do know it is NOT a deviated septum (which so many people have I understand) but it is that I have bone/cartilidge in my nose that has grown wrong (she thinks due to I broke my nose in high school high jumping) and it is blocking off my sinus passageways.  I most always have a stuffy nose, and stuff running down the back on my throat all the time.  I NEVER literally never have to blow my nose....never have that feeling at all.  Anyway, when the barimetric pressure changes is when my sinuses are the worse and she says that I do not have enough space in my sinuses to allow for the air change to compensate when the enlarge so therefore they are mostly blocked at that time and I get pressure in the front of my face, above my eyes, back of my head, headache, and swallowing becomes more difficult, ears will feel pressure, eyes will feel funny and I will get dizzy, off balance feeling.  So, she felt that since she wanted to biopsy my lingual tonsil then she would do my sinuses in my nose and also take my tonsils out at the same time so to only be put out once.  She said and has said from the beginning that my tonsils are really enlarged and red as well but I don't really have a sore throat that often.  I just have this swallowing problem ALL THE TIME!!  Sometimes it is worse but it never goes away.  Like I said, I have started to eat right by the acid reflux...started on Sunday and so far I notice some change but not a whole lot.  This is what I have been eating..example..decaf tea, herbal only...I know tea is one of the bad things but someone said decaf is fine.  This morning I am sitting her drinking hot water only....can you imagine??  Trying to stop the tea..just blows my mind that you have to get up in the morning and there is nothing that you can have hot that does not bother GERD...anyway...my diet has consisted of dry english muffin or toast, plain cheerios dry, bananas, saltine crackers, turkey sandwich with lettece and I did put a pickle on them, may I shouldn't have that...only olive oil slightly drissel on the sandwich...haddock broiled nothing on it, mashed potatoe and baked potatoe dry nothing on it, greeen beans with nothing on them....salt and pepper which perhaps I shouldn't use pepper either and water, water and more water..oh and I did have frozen yogurt...which after I ate it realized it had some cream in it so that is a no no....anyway, that is my diet and I don't see much of a difference in my throat with the swallowing....just so discouraged!!  Why is this lingual tonsil so swollen??? Is it because of the acid reflux and it just takes months of eating correct to heal it??  I just wish I had an answer.  It scares me half to death!!
I am sure that what I am feeling is the lingual tonsil swallow that it why it is hard to swallow all the time.  The ENT said that is the reason.  I just wish it would go down.  

Oh wanted to mention as well, I did have a complete hysterectomy in 1998 and have been on hormones until this past Nov. and then I stopped.  Just know that it is time to get off from them.  Perhaps, after what you mentioned this is causing some problems with hormone imbalance.  I went to my obgyn dr. and she said that we will give a couple more months to see how I do and then talk about what we should do from here.  The only thing I am noticing is that I get hot and then cold quite often.  More hot than cold but it does happen quite a bit during a day.  Mostly at night.  I wonder if there is a test to show how out of wack my hormones are?  I just know that I can't keep being on HRT forever....not good.  They say no more than 5 years.  

I also wanted to mention that back 10 months ago this whole thing started with me swallowing something very sharp and large.  I was eating pork fried rice and I didn't bite onto anything but all of a sudden I swallowed a WOW something felt very sharp and big, probably a pork bone I figured....4 days later this swallowing thing started.  I went to the ER and they took an xray of my throat and they said they saw no foreign object in my throat so that was that.  I have mentioned it to ENT dr and she says that she feels that is not the problem.  I just keep going back to that because I didn't have any problems swallowing until after that.  

Anyway, even before you posted and explained a tonsillectomy I am having such SECOND thoughts on having this done...perhaps I should just have her biopsy the lingual tonsil and then go to the GI dr and have the upper GI endoscopy done first and then go from there on what the results are from those tests.  What do you think?  Having my tonsils out is such a major thing at my age and I really can't be down and out that long.  I know it is my health I am dealing with and my husband says we will do what we have to do.  I do babysit my grandchild which is 1 years old in the afternoons and I work in the mornings.  I have just 10 that I can take off from my job.  I deliver mail and I have a contract route so I have to hire someone to do my job when I am out and the person that covers for me is only available for 10 days total so that would be it.  It sounds like a major operation as far as recovery time.  People said your throat would be sore but I had no idea it would put you down that bad.  My husband will have a few days off to watch our grandchild and I can get another relative to help if need by with her but I with also have sinuses done at the same time....it just doesn't sound like I will be up and adam anytime soon....Do you think I should do the other tests in your opinion and then go from there???  I know this is my decision and really no one can make that for me but it sure does help to have someone else who has been thru something to talk to.  My husband thinks I should get the tests done and then go from there.  The only problem is she can't fit me in for surgery again until Mar 19th.  This one is scheduled for Feb. 5th.  I called the GI dr. yesterday and his scheduling lady did not get back to me so I will call again today to find out when I could get in to have that upper GI scope done.  

Kate I soooo appreciate your help....you don't know how much!!  Thank you again for taking the time.  I will watch for your reply and I will make a new post later if I go thru with this because I am sure I will have questions.

Take care.....Shanon (sgru75)

[borninquisitive]

Re: tonsil removal:

Before surgery: if you have a tendency to get motion sickness (dizzy when reading in a car etc) and they don't ask if you experience this prior to surgery, tell them!
They didn't ask me and just after the surgery was done and upon wheeling me out...oh lord, I felt sick! I began burning up and told them I was about to toss my cookies.
The nurse asked, "Are you prone to motion sickness?" I said yes. She was upset because this question did not come up and my reaction could have been prevented. They inserted a Promethazine suppository up my rear and that nixed the nausea. What you don't need after tonsillar removal, is vomit/acid thrusting up your raw throat.


I was given Vicoden (for pain) & Ativan (for nerves and kept me asleep).
I think Tylenol 3 is common but for me, T3, in the past, gave me bad headaches. If you are at all prone to nervousness, I would inquire about Ativan.

Give yourself a solid 2 weeks to heal. Take it easy! If you have a family, tell them to simply consider you out of commission for that long. Sguru will do what she feels up to but won't feel any guilt WHATSOEVER for not doing what she isn't up to. Plain & simple.
If you work outside the home, you need time off.

The pain, when trying to swallow water, was terrible the first few days but I was kept mostly knocked out.
You need to drink water, no matter how you feel. You will have to force yourself. I was starving but couldn't eat the first few days.
For the first few days, I found placing a ice bag over the front of my throat (while laying on my back inclined ) helpful. The hospital provided one for me, that had a cloth like material over it.
By day 7/8 I felt worse. This is common. This may not be you but it was me, when it came time to try to eat, I felt discomfort, frustration, anxiety and weepy.
A total sense of helplessness and inferiority, made worse because I couldn't control it.

If you plan to be on medication similar to mine, you need an over-seer. Making sure you are taking your medications, drinking water and waking you to do just this if need be.

When you are finally up to eating, if need be...go to a quiet room to do so. If there is any tension/stress within the home, it makes eating that much more difficult.

On the 3rd week, I found a disturbing taste within my mouth and seemingly a-lot of saliva, too. It made me gag and...I did toss my cookies on account of it.
The only thing I found helpful was Trident Peppermint gum (in the blister pack) as the best thing for this.

Mind you, I would consider myself one of the most difficult cases post tonsillectomy. This may very well will not be your case.

If you are alone, purchase yourself a cooler to place by your bedside. In it, plenty of little bottled water, nutritional drinks & applesauce.
If under medication that will cause you to sleep, you'll need an alarm clock to wake you up to remind yourself to take your medication and to drink/eat. That is, if you don't have an over-seer.

To be honest, in having taken both Vicodin & Ativan...I wasn't fit to operate a dishwasher! I think taking half of Ativan would have sufficed. My Dr. wanted to make sure I was knocked out. lol

Anyway. After tonsil removal, you will find greenish/white scabs for some time. This is normal, don't pick at them. In fact, don't expect that you will be brushing your teeth for a-while.

I wish you well, sguru. In saying all that I have, must remind you once again that I think I am the toughest of cases.
Whether you are or not...do give yourself time to heal. Take a break, don't feel hurried to resume a "normal" schedule.

If you don't have anyone to commiserate with, feel free to post here (new thread) and I will help walk you through the healing process.

Best,
~Kate

[borninquisitive]

First of all, I have to say this: beings that you are having your palatine tonsils removed- give yourself plenty of time to heal. The older we are, the harder it is to deal with tonsillar removal. Swallowing didn't "pan out" for me until 4 months after surgery. Hopefully your recovery will be much faster.
I was feeling very ill before hand and so, perhaps that slowed down the healing process. Not to mention the anxiety that came with it afterwards. Further, I think I have other problems and wonder, if they had contributed to the slow healing process.

Expect to lose weight. Have on hand the liquid drinks, Boost or Slim Fast.
The things I found easiest to eat were soft, scrambled eggs & soft, boiled red potatoes.

Yes, I did experience lingual tonsil swelling and am wondering if they are still swollen (compared to people in general) and I will be bringing this question up to my ENT on Feb. 5th, when he will be in my town.

From what I understand, lingual tonsils may swell a little after palatine tonsil removal. I am sure that your Doc will want to keep an eye on them. It is possible to have lingual tonsillitis. When they are swollen enough, it makes swallowing difficult. Food has a tendency to get hung up on these.

Post nasal drip can cause inflamation, as well as reflux (GERD or LPR). Earlier, I was experiecing this. I think it has abated. I am going through other problems: hormonal and have read that hormonal imbalances can cause problems (worsening of alergies, reflux, sinuse issues etc.)Too, I think being anxious about this, promoted poor digestion.
Acid reflux is very common. I have read that there are procedures for those who continue to suffer, despite medications and lifestyle change. This would have to be taken up with a G.I. specialist.
Outside of what they have already done, the only thing I can think of is upper G.I. endoscopy. From the sounds of it, you have a good set of doctors on your side.

As for telling if your tonsils are defective: I think they usually look at the frequency of tonsillitas. If they are heavily pitted, large and causing discomfort. Sometimes they take out tonsils due to sleep apnea.
My tonsils were quite large and when I became ill, nearly blocked off my airway.

I am simply a layperson who is driven to learn all that I can about things that interest me. In regards to this issue, because I have had to deal with it.

If anything comes to my mind, that I think will help you in regards to your upcoming surgery, I will post them. I certainly wish I had heard from other adults who went through the same.

[borninquisitive]

I will respond as soon as I can. Perhaps later this day.

Best.

[sgru75]

Please real about post....thanks

[sgru75]

borninquisitive - Kate ~  You were mentioning in this post about lingual tonsils.  I have been having alot of trouble swallowing and been to the ENT several times and she says my lingual tonsils are really swollen.  Have been on Prevacid and Zantac and after 3 or 4 months it went down a bit but now it is back up there again.  She said that she wants to do some work on my sinuses, biopsy the lingual tonsils and remove my regular tonsils.  She says they are swollen as well.  Have you had any experience with this situation.  I have acid reflux and have had a hard time coming to terms with it and have not been eating like I should so with it getting worse and worse, I have finally realized that I need to stay away from all the foods that bother me because I am having real trouble swallowing every day.  It doesn't get better.  She said that she thinks with the drainage from sinuses running down the back of my throat and the acid reflux coming up that it is causing my throat to be so raw and inflammed.  She thinks that I don't have anything serious like Lymphoma because if I did my lymph nodes would be swollen and stay that way but they are not.  If you have any experience with this situation or can shed some light I would surely appreciate it.  Also, how do they tell that your regular tonsils are no good and if they arn't working properly could they cause swallowing problems.  I am 50 and am scheduled to have surgery on Feb 5th.  Am hoping I am making the right decision.  I have had a barium swallow, ultrasounds of throat, PH Probe and Mamometry done as well as the ENT going down my throat with scope in office several times.  Are there other tests of the esphogus that I should be having??  Thanks for any help!!

[borninquisitive]

Meant to add in (the example)-
For example: TSH 2.1 [range .5 - 5.0]

[borninquisitive]

They will reveal to the doctor whether or not s/he needs to take a closer look at your thyroid.
Thyroid dysfunction can cause all kinds of problems and if goiter is present, can interrupt breathing/swallowing. If a goiter (or nodules)is thought to exist, from what I understand, an ultrasound is used to image this.

If you type in search substernal goiter (or just goiter), you will find other's experience who have been diagnosed with one.

Here you can read about it: http://www.emedicine.com/ent/topic293.htm
If you do not understand the word (terminology) highlight the word with the mouse and the definition will come up.

When you get your results back, post to the thyroid support forum. The members there will ask about your lab's range. So, do be sure to get those as well from the lab. Simply ask, "What is the lab's reference range for each?"
For example: TSH 2.1 <range .5 - 5.0> Many there, in the forum, have become their own experts regarding their condition.

You've had what I would consider comprehensive tests regarding the swallowing and gastrointestinal.

If the thyroid is ruled out, I would seek the attention of a Neurologist. This, I would think, would be your last step. You may need a referal.

There is a Neurology forum here but in looking at it, doesn't appear the Dr. has been responding for quite some time.

In going to a new doctor (if it warrants it), I would get copies of your medical records pertaining to this issue and give them to the upcoming doctor. If anything has been imaged, requests copies of it as well.
Draw up a timeline, when this began and what you've experienced.

That was quick re blood tests! Where I live, we don't get treatment near as quickly. I'm glad for you that you are getting this done. Did the doctor as why in regards to the lab?

I'll be rooting for you!

~Kate

[crablekid]

HAD BLOOD WORK DONE TODAY FOR THYROID. THEY ARE TESTING TSH, T1 AND T3. WILL THESE SHOW IF I HAVE A SUB STERNAL GOITER?

[borninquisitive]

You are welcome.

I think of the two, might try the xanax.

A little reading, regarding the drug xanax: http://www.drugdigest.org/DD/DVH/Uses/0,3915,19|Xanax,00.html

If you are not comfortable with either, ask about Ativan. It can be taken "as needed."

Both xanax & Ativan can cause dependency. It's something you have to be aware of.

I took Ativan for a short time, after I had my tonsils removed. I was experiencing laryngeal spasms and that, combined with discomfort made eating difficult. In taking the Ativan, I did find some relief in the area of swallowing, while also calming my nerves some.

[borninquisitive]

As an addition because I don't know about Xanax but you might call the Dr. who prescribed this and ask if it can simply be taken "as needed." If so, ask how long it will take to experience the "effect."

If this is a medication that you can take "as needed" yet you are still nervous about it (some folks really fret about side affects)...and this may sound corny but you can have your friend drive you to a hospital. Just keep parked. Take your medication.
I found that Ativan began working in about 15-20 minutes.

If all is well, have your friend drive you home. Try eating. Applesauce is an easy one. The other things I found easiest to swallow was soft, scrambled eggs and soft, boiled red potatoes. You might want to bypass the skins.

The things I found most difficult to swallow were dense foods: breads, cakes and such and dry foods.

I can understand your anxiety with your problem. I don't care who you are...a man with nerves of steel but swallowing problems will reduce you down to a nervous wreck!

With the exception of no mention of lingual tonsils (food can get hung up on these if they are swollen) or thyroid check, again...the next step would be to seek a Neurologist. Nerves work with your muscles. You can google this.

If you are up to it, post an update. I sincerely wish you the best.

~Kate

[crablekid]

THANK YOU FOR YOUR ADVICE. I WILL DEFINITELY HAVE MY THYROID CHECKED. AS FOR CALMING MED THEY GAVE ME ZANIX AND PAXIL WHICH I HAVENT TAKEN YET.

[borninquisitive]

>NEVER HAD TONSILS CHECKED.<

I would ask your ENT if this was considered.

>NEVER HAD BLOOD WORK DONE FOR THYROID, BUT DOC SAID IT FELT FINE.<

I think it would be worthwhile to have blood work done for this.
Goiters (including sub-sternal)on the thyroid can cause problems with both breathing and swallowing.

Outside of this, I would think your next step would be a consultation with a Neurologist.

>IVE LOST SO MUCH WEIGHT WORRIED IF I CAN KEEP GOING ON BOOST FOR TWO MORE WEEKS.<

Has any doctor thought to giving you a prescription for something like Ativan, to help calm your nerves a little in the meantime and possibly...make it easier to eat?

I would bring these considerations up with your next visit SOON.

Best.

[crablekid]

NEVER HAD TONSILS CHECKED. NEVER HAD BLOOD WORK DONE FOR THYROID, BUT DOC SAID IT FELT FINE. IVE LOST SO MUCH WEIGHT WORRIED IF I CAN KEEP GOING ON BOOST FOR TWO MORE WEEKS.

[borninquisitive]

>BUT SHOWED MILD POOLING IN VALLECUL<

Did the ENT check your lingual tonsils? They reside at the base of your tongue and above your epiglottis.

As to the rest, did you have your thyroid checked. Both in physical examination and blood test?