Persistent sore throat

[Wookey]

I have had a sore throat, which causes my voice to 'catch', for about 5 weeks.  Some days it is almost none existent, others it feels quite raw.  I don't have an elevated temperature although on one occasion last week, for no apparent reason, I broke out in a profuse sweat - I was soaked - but recovered within minutes with a drink of water.  I have a slight sensation of cattarh in the back of my throat but not so much as to make me cough, just enough to cause throat clearance every hour or so. I went to my doctor who has sent me for a blood test - ESR(?) and FBC(?).

The results won't be back for 7 days but I am off on holiday in 5, so without the results the holiday will be a worry.  To be blunt, I am terrified that I may have some type of throat cancer.

I am 54, very fit (cyclist with sub two-hour 50 mile time trials to my name).  5 feet 11 inches, 148 pounds, good BP with waking Heart rate of 44.  I neither smoke, nor drink alcohol, nor take any drugs.

I have a slight neck pain at the base of my neck where it joins my right shoulder but have only had this for a few days - not since the onset of the throat pain.  None of my glands feel swollen and my throat looks normal in the mirror.

I have lost a few pounds (4) since christmas but put that down to training hard.

What do you think?  Stupid irrational fear or reasonable concern?  Is there any straw I could grasp at to put my mind at ease and save my holiday or should I cancel it to get the results?

Many thanks.

[Kevin Pho, MD]

I would first rule out infection - such as strep or Epstein Barr virus.  These diseases should be able to be tested for at your physicians office using a throat swab and a blood test.  

If infection has completely been ruled out - I would suggest an ENT referral.  A laryngoscopy can be considered to visualize the throat to ensure there is no mass or anatomical abnormality present.  An ENT can also evaluate the sinuses to ensure there is no post-nasal drip causing irritation in the back of the throat.

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.

Thanks,
Kevin, M.D.

[kevinmd]

Hello,
I'll be away until Saturday, February 28th.  I will answer your questions when I return.

Have a nice week,
Kevin, M.D.

[cc61578]

good evening.  after much deliberation and painful infections, i am scheduled to have my tonsils removed in a few days.  have any of you experienced a tonsilectomy?

what can i expect from the operation?  i am a thiry year old woman in otherwise good health.  i am in better than average physical condition, and this is my first ever surgery.  please give me some idea as to what i might expect.
thank you all!
cc61578

[CaKteacher]

For a while, I had a recurring sore throat (more like the little "knot" feeling you get just before it becomes very sore).  My voice also came and went... got very hoarse and then would return, unexplicably and without rhyme or reason.

Long story short, when I was finally diagnosed with a hypothyroid condition and began treatment, the sore throat feeling and hoarse voice discontinued, as well as major clinical depression I had suffered for 4 years.

Just a thought; one never knows...

Lis

[gt40]

18 M
152 lbs
6’ 1”
Non-smoker
No know allergies
Not sexually active
Active in cross country and track
I have had a persistent sore throat for over 15 weeks.  None of the doctors that I have gone to see can figure it out.  Prior to the sore throat I was constantly tired and missed some school.  In mid December I had an infection in my mouth that hardly allowed me to swallow. My lymph nodes were swollen, and my tonsils were extremely inflamed with white patches on them.  My tongue also got a white covering that was diagnosed as geographic tongue caused by haemophilus.  At that time I had a monospot, a viral test (tested for 3 viruses, one of which was herpes) and other blood test done, all came back normal.  I could literally brush off the skin on my tongue with a tooth brush.  After 2 weeks of this I was put on penicillin for 7 days (I don’t remember the dose) which cleared up all the problems I had in my mouth, but I was still tired.  
After a few days of being off the penicillin the sore throat came back.  I waited a couple weeks and went back in once my symptoms got worse.  This time I had no problems with my tongue, but my tonsils were inflamed with white patches covering them.  I got a prescription for a Z-pack (azithromycin ?), which did nothing.  From there I want to an ENT who prescribed Keflex.  This cleared up everything, and I was feeling really good for three or four days, but the tiredness and sore throat came back.  Again all the same tests were done, and came back normal, except some elevated blood levels that indicated some infection.  
Still having the sore throat, I went back to see the ENT who prescribed Cipro.  This had little if any effect on my throat, and I still have a sore throat.  For the last month or so my throat is only sore when I first wake up, and rarely notice it after 30 minuets of being out of bed, and the tiredness is much less than it has been.  This morning I woke up with a sore throat much worse than I have had for a long time, and my lymph nodes are swollen.
Over the last few months I have had several monspots, two throat cultures, complete blood work three or four times, a complete physical, and chest and abdomen x-rays. There are a couple of things that I am confused about.  Just before all this started a got two stress fractures in my legs, and this was after I had cut my mileage from 60 miles a week to 40 miles a week.  Also my girlfriend has not gotten sick, and we spend lots of time together, although I would avoid seeing her when my symptoms were at their worst.  
I have seen four different doctors, one of which is a ENT, and have gotten basically no where.  I have missed so much school this year and my GPA is suffering severely.  I am a senior in high school, and with prom and graduation coming up I would really like to be able to participate.  Can any one give me some advice?

[vicksslc]

25 F
5' 3"  120 lbs
Stay at home mom of 5yr M, 4yr M, 2yr F, 6mo F.
Husband wks FT.
Strep went through the family in January.  We were all put on Amoxicillan to nix it.  When everyone else got rid of it, I contracted it 2 more times.  Dr. thought one of the others may be a "carrier" (someone who carries the virus but does not show symptoms - very rare)  sure enough the whole family went back in to get swabbed and my husb. and two oldest boys were found to all be carriers.  Two of the carriers (the boys) were put on something strong called P??? and my husband and myself on Augmentin. Seemed to be fine up until last week, now my throat is so sore and my glands swollen.  I went to get swabbed and no strep.  Dr. says it's probably from allergies as I do have some post nasal drip.  I have swollen tonsils, red throat and headaches, not to mention the ache in my throat throbs up into my ears.  My throat burns and then sometimes stings  - pain killers don't help(ibuprofen/tylenol).  My husband sees a little bump on my right tonsil area or behind it.  He doesn't know whether it's my tonsil or not.  I will see a ENT specialist this week...but the discomfort has prompted me to read everything I can on the net.  Any help appreciated.

[BubbaZanetti]

Re the q and a from Wookey on Feb 23rd.

First off I hope he's ok and that whatever it was cleared up.

My main concern here is that what Wookey seemed to be looking for was some reassurance.

The reply gave him none.  It did not answer his actual questions (stupid irrational fear or reasonable concern?/any straw he could grasp at? etc.)despite the fact that a non-smoker who has had a variable if persistant sore throat for 5 weeks is far more likely to have something much less sinister such as post-nasal drip (which the response did mention) or acid reflux.

My main point is (and this seems to me to be a general problem with -in particular - male doctors) that the doctor did not hear what the patient was saying.  The advice given is not unhelpful but it provides no reassurance - indeed it fails to address the question of the patient's state of mind at all.  Advising a patient with these symptoms to have a laryngoscopy to check for mass abmormality without pointing out the far greater likelihood of a less-scary explanation is surely likely to exacerbate the anxiety that the patient is suffering and which might surely have caused the brief sweating symptoms described.

The patient was already waiting for blood test results (surely he must have had a throat swab before getting to the blood test stage) and seemed to me to require a response which gave him some balance of probable causes and THEN the advice about what other steps to take to check these out.

I find myself hoping that Wookey didn't suffer a major panic attack on receiving the answer that he did and fail to make his holiday at all.

Its time some doctors considered that a patient's mind is actually located within their body and that its state might have a significant part to play in their physical health.

[BubbaZanetti]

Re the q and a from Wookey on Feb 23rd.

First off I hope he's ok and that whatever it was cleared up.

My main concern here is that what Wookey seemed to be looking for was some reassurance.

The reply gave him none.  It did not answer his actual questions (stupid irrational fear or reasonable concern?/any straw he could grasp at? etc.)despite the fact that a non-smoker who has had a variable if persistant sore throat for 5 weeks is far more likely to have something much less sinister such as post-nasal drip (which the response did mention) or acid reflux.

My main point is (and this seems to me to be a general problem with -in particular - male doctors) that the doctor did not hear what the patient was saying.  The advice given is not unhelpful but it provides no reassurance - indeed it fails to address the question of the patient's state of mind at all.  Advising a patient with these symptoms to have a laryngoscopy to check for mass abmormality without pointing out the far greater likelihood of a less-scary explanation is surely likely to exacerbate the anxiety that the patient is suffering and which might surely have caused the brief sweating symptoms described.

The patient was already waiting for blood test results (surely he must have had a throat swab before getting to the blood test stage) and seemed to me to require a response which gave him some balance of probable causes and THEN the advice about what other steps to take to check these out.

I find myself hoping that Wookey didn't suffer a major panic attack on receiving the answer that he did and fail to make his holiday at all.

Its time some doctors considered that a patient's mind is actually located within their body and that its state might have a significant part to play in their physical health.

[BubbaZanetti]

Re the q and a from Wookey on Feb 23rd.

First off I hope he's ok and that whatever it was cleared up.

My main concern here is that what Wookey seemed to be looking for was some reassurance.

The reply gave him none.  It did not answer his actual questions (stupid irrational fear or reasonable concern?/any straw he could grasp at? etc.)despite the fact that a non-smoker who has had a variable if persistant sore throat for 5 weeks is far more likely to have something much less sinister such as post-nasal drip (which the response did mention) or acid reflux.

My main point is (and this seems to me to be a general problem with -in particular - male doctors) that the doctor did not hear what the patient was saying.  The advice given is not unhelpful but it provides no reassurance - indeed it fails to address the question of the patient's state of mind at all.  Advising a patient with these symptoms to have a laryngoscopy to check for mass abmormality without pointing out the far greater likelihood of a less-scary explanation is surely likely to exacerbate the anxiety that the patient is suffering and which might surely have caused the brief sweating symptoms described.

The patient was already waiting for blood test results (surely he must have had a throat swab before getting to the blood test stage) and seemed to me to require a response which gave him some balance of probable causes and THEN the advice about what other steps to take to check these out.

[BubbaZanetti]

Re the q and a from Wookey on Feb 23rd.

First off I hope he's ok and that whatever it was cleared up.

My main concern here is that what Wookey seemed to be looking for was some reassurance.

The reply gave him none.  It did not answer his actual questions (stupid irrational fear or reasonable concern?/any straw he could grasp at? etc.)despite the fact that a non-smoker who has had a variable if persistant sore throat for 5 weeks is far more likely to have something much less sinister such as post-nasal drip (which the response did mention) or acid reflux.

My main point is (and this seems to me to be a general problem with -in particular - male doctors) that the doctor did not hear what the patient was saying.  The advice given is not unhelpful but it provides no reassurance - indeed it fails to address the question of the patient's state of mind at all.  Advising a patient with these symptoms to have a laryngoscopy to check for mass abmormality without pointing out the far greater likelihood of a less-scary explanation is surely likely to exacerbate the anxiety that the patient is suffering and which might surely have caused the brief sweating symptoms described.

The patient was already waiting for blood test results (surely he must have had a throat swab before getting to the blood test stage) and seemed to me to require a response which gave him some balance of probable causes and THEN the advice about what other steps to take to check these out.

[BubbaZanetti]

Re the q and a from Wookey on Feb 23rd.

First off I hope he's ok and that whatever it was cleared up.

My main concern here is that what Wookey seemed to be looking for was some reassurance.

The reply gave him none.  It did not answer his actual questions (stupid irrational fear or reasonable concern?/any straw he could grasp at? etc.)despite the fact that a non-smoker who has had a variable if persistant sore throat for 5 weeks is far more likely to have something much less sinister such as post-nasal drip (which the response did mention) or acid reflux.

My main point is (and this seems to me to be a general problem with -in particular - male doctors) that the doctor did not hear what the patient was saying.  The advice given is not unhelpful but it provides no reassurance - indeed it fails to address the question of the patient's state of mind at all.  Advising a patient with these symptoms to have a laryngoscopy to check for mass abmormality without pointing out the far greater likelihood of a less-scary explanation is surely likely to exacerbate the anxiety that the patient is suffering and which might surely have caused the brief sweating symptoms described.

The patient was already waiting for blood test results (surely he must have had a throat swab before getting to the blood test stage) and seemed to me to require a response which gave him some balance of probable causes and THEN the advice about what other steps to take to check these out.