Chronic Sore Throat for One year

[naveea]

Hi

I have had sore throat for  over a year now...am 27 year..smoker

It started last year around april 2009, had a sore throat after unprotected oral and protected vaginal exposure..took antibiotics..it went away...then came back after a month...started recurring every 3 weeks,,,after which it became constant

I had tried loads of antibiotics ,dint help ..quit smoking..dint help either

So 6 months back had my tonsils removed, corrected my deviated septum and cleared my sinuses

The surgery dint help,it just made my condition worse..I have tested negative for Sypllis,Heb-B and HIV(tested on 26th may 2010,6 weeks from my protected vaginal and protected oral exposure)

Doc put me on antidepressants..Dint help either...

Endoscopic biopsy of my stomach was +ve for H.Pylori.. was again put on antibiotics and PPI's...dint help either

My Random Blood sugar was weired,,,once it was 50...next time it was 133,...last time i checked it was 114..Doc said not to worry

I now have sore chest,tongue and throat ,achy armpits,cobblestone throat,postnasal drip,painful lymph nodes(below ears),feverish(98F) ,Upper arm and upper back pain,stiff neck

Sinus rinse and nasal spray has helped to some extent..so am on this for 1 month....have had 25% reduction in pain

I get up in the morning with no sore throat or any other symptoms,...It just gets worse as the day progresses

Sore throat subsides for 15 mintues after i eat,,,then it comes back...feel nausea..

Latest CBC

TEST                        RESULT  NORMAL
WBC                         6900      4500-10500            
NEUTROPHILS            66          50-65 %                 (Elevated)
EOSINOPHILS             06           3-5 %                    (Elevated)    
LYMPHOCYTES           27           25-35                    
PLATLETS                   1.8         1.5-4.0                     ( Has gone down from my previous tests)

Urine had traces of RBC.. 2-4

Any Suggestions would be helpful..Am from india...My doc thinks its all in my head,,,,well i dont think so

[throaty85]

hi naveea, first of all, i believe im the only one here that has the some of the same symptoms as you!

here's what i have for about 14 months.

- nausea is prominent frequently. sometimes this nausea will escalate to a very light headedness, dizziness, weariness.
- one side of throat pain, not too much pain when swallow at times, but if i flex my throat and turn my head to 1 side, i can feel a distinct sore object lining the throat. Some spot everytime. So i know something is there. Sometimes it will throb just to remind me its there :p
- slight aching lately in my upper chest and arms

I too am heavy smoker. I do not think its mono or anything like strep etc.

I believe Doctornee Medical is right. We may be having "smokers throat". I say this beacuse when i completely lay off smoking, the symptoms subside. I have not quit and the symptoms obviously havent gone away.

One thing i know is that this smokers throat can get much worse than it is currently if i continue puffing. So if you havent quit, we better do soon.

I suggest you not think of all the other pain you are having. If you purposely want to believe a pain is stemming from your arse, i guess your arse will start to throb. My meaning is that alot of the pain is all in the head.

I for sure know its smoking related and remember that i have the same nausea and fever as you recurring for "no reason". And by the way, i dont think you have HIV or anything std related. If you have HIV, lymph nodes that swell are prominent in many parts of the body at any single time, not just the throat.

I went for an endoscopy with my ent about 3 mths back prepared for the worse. my ent said its not lymph nodes after pressing my throat like a maniac. he said he saw remaining tonsils, and that the tonsils were sore. So again, back to smoking issue.

Let me know your progress man.

[naveea]

Ok I tested negative for HIV @ 12 weeks... whats wrong with me,.... why am i having recurrent fever,sore throat, painful lymph nodes,sore ribs,,,,,

I have been sick for a year,,,, i cant even work properly nowadays,,its effecting me so badly,,,

[naveea]

Thanks for your reply doc

Am not anemic, I know that for sure,,, because my in my latest blood test my RBC,Haemoglobin,PCV was normal ..

And I did have H.pylori confirmed from an stomach endoscopy biopsy for which i had been treated with antibiotics and PPI's

Can acid reflux cause all my symptoms  sore throat with cobblestone appearance,painful lymph nodes without swelling in neck and armpits,feverish ,nausea ans sore chest ?

Can acid reflux cause infection,my latest blood test was not normal as seen below

TEST                        RESULT  NORMAL
WBC                         6900      4500-10500            
NEUTROPHILS            66          50-65 %                 (Elevated)
EOSINOPHILS             06           3-5 %                    (Elevated)    
LYMPHOCYTES           27           25-35                    
PLATLETS                   1.8         1.5-4.0                     ( Has gone down from my previous tests)

Urine had traces of RBC.. 2-4

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
What you have is acidity and smokers throat. There is probably some reflux because of smoking and this could also be contributing to the sore throat. Chest pain, pain in arm and achiness could also be due to anemia, often seen in smokers due to invisible GI bleeds. Hence get blood test for anemia, stool test of hidden blood and a carbon urea breath test to identify H pylori infection in stomach. You could also be having low BP, and low blood sugar if you do not eat at regular intervals.
Try a combination of medications like a proton pump inhibitor such as omeprazole,  lansoprazole or pantoprazole empty stomach in the morning and an antacid gel after meals for complete relief. Also give up smoking (I am sorry if you have given it up and I missed the point while reading this thread). Also avoid too much of caffeine, tea, smoking, fried food and drinks both alcoholic and non alcoholic fuzzy ones. Avoid heavy meals and eat frequent small meals.
Hope this helps. It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!

[naveea]

Guess i celebrated too early,,, all my freaking symptoms are back, sore throat,painful lymph nodes wothout swelling in neck and armpits,feverish ,nausea

I dont know what to do

[naveea]

Hi guys

Went to my doc again, He looked at my throat and examined me and told me am fine,,,Gave me anti-depressants,.... On my insistance he has ordered All std panel blood test,which i will take in august(12 weeks after my protected exposure)..am praying to god its all negative

Well One my friend suggested COD LIVER oil capusles which i have been taking from past 4 days... guess what..my symptoms have subsided

1st time in 1 year,my throat is better.. i still have slight achy armpits but my lymph nodes in neck dont pain at all,...

[Ahmed34]

naveea,

I think the latest reply from the doctor here makes a lot of sense. There are a lot of differences in the kinds of diseases and illnesses and their prevalence in the Indian Subcontinent vs the US and the Europe. I thought the links are a good read. I don't quite understand how does Indian physicians migrating to the US relate to your condition here or the standard of medical care in India, but I have never come across a situation where I felt as if I should be in the US to get a good medical advice from a qualified doctor!

I personally think research studies are more for the benefit of patients, even though, somehow, it seems they are accessible so easily to patients. And I don't believe there is any disadvantage that you are seeking medical help in India, as is evident from the proportion of US and European people seeking out information on sites like this.

Londres70,

What do you mean when you said you know 'a lot' of Indian physician go to the USA to practice? And I think the number of doctors moving out to the US is minimal compared to those who stay back and work in India itself.

[Londres70]

At this point I think you should reconsult your IM(Internal Medicine) Physician and if he is not providing proper guidance/recommedation and/or your problems are not being investigated or resolved, I would seek the opinion of another IM.  You need someone IN PERSON who can sort all of this out; not reading research studies that you are probably not going to have a clue how that relates to you.

That is my recommendations at this point.  

I am not a physician, but I am an RN (Registered Nurse) with a Master's Degree who has worked with many different kinds of physicians in an Inpatient (hospital) and outpatient settings for the last 12 years.  (worked in the USA and in Europe).   I am not knowledgeable about the medical care in India.  I do know ALOT of Indian physicians go to the USA to practice.      

[naveea]

Thanks for replying doc

Its the lymph nodes which i am worried about most, because Pharyngitis only causes painful lymph node in neck,but i also achy armpits where i believe lymph nodes are also present

[naveea]

Thank you both ,

My MD is an Internist.. and he is from manipal hospital, bangalore

Well only condition i had from childhood was chronic sinusitis,only in winters...but never had a sore throat

The rash was all over the palm,on fingers and sides of my palm..I still have scars which i can see in dim light

Regarding the RA factor which came as positve,my doc says its false postive ....

[OHNS2010]

Hi,

I think the forum is being dragged into different aspects clinging to a particular set of symptoms or tests as you go on mentioning each time you put a post. All these are speculations, but only after a thorough examination your problem can be diagnosed and solved amicably.

“CHRONIC PHARYNGITIS” is a broad terminology it might be because of various reasons. It might be secondary to DYSPEPSIA termed as LARYNGO PHARYNGEAL REFLUX. You are very apprehensive about your condition. The painful nodes are probably because of acute exacerbation of chronic pharyngitis.

There are fewer chances of you getting infectious disease after a protective performance. Infectious mononucleosis is less common in India compared to that of US; your physician would have definitely picked it up when the tests were done.

• The overall percentage of EBV specific heterophile (Paul-Bunnel) antibody positivity was found to be 11.1% (194/1741). The average Paul-Bunnel antibody positivity between 1986 to 1990 was 20.5% which declined drastically to 5.7% during 1991-2000. Males comprised of 55.2% of the serologically proven IM cases.
(http://www.ncbi.nlm.nih.gov/pubmed/14979379)

• In a research conducted in 2002, it was found that about 95 percent of adults of the age group 35-40 years had been infected by mononucleosis in the United States. When Epstein-Barr Virus (EBV) infection occurs during teenage or young adulthood, in 35 to 50 percent cases it causes infectious mononucleosis.
(http://www.tarunaoils.com/articles/mononucleosis-causes-mononucleosis-statistics.asp)

Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis. (An antibody is a special protein made by the immune system that normally helps fight foreign substances in the body.) Not all people with rheumatoid arthritis test positive for rheumatoid factor, and some people test positive for rheumatoid factor, yet never develop the disease. Rheumatoid factor also can be positive in some other diseases; however, a positive RF in a person who has symptoms consistent with those of rheumatoid arthritis can be useful in confirming a diagnosis.

Positive RF test results may also be seen in healthy people and in people with conditions such as: endocarditis; systemic lupus erythematosus (lupus); tuberculosis; syphilis; sarcoidosis; cancer; viral infection; or disease of the liver, lung, or kidney. The RF test is not used to diagnose or monitor these other conditions.

As you were diagnosed of having Mitral valve prolapse there are chances of you developing Infective endocarditis which would give rise to most of your complaints.
http://emedicine.medscape.com/article/155494-followup
http://emedicine.medscape.com/article/896540-overview

This seems to be less of ENT/Infectious disease. I would recommend you to consult a good Physician (Not General Practitioners).

Regards
OHNS2010

[Ahmed34]

It seems there are ID specialists in your city. Google search referred me to Manipal Hospital, Bangalore. I am not sure as it's only a Google search. You should check out if you can.

Do you have any long standing allergy problems? We usually call them sinus problems (sinusitis). To me it seems like a manifestation of allergy. Even the rash you described on your palms can occur in allergic conditions. Are there any particular areas on the palms where you got the vesicles ... like sides / edges of the fingers/ palm? Anxiety and stress may increase the problem further, but they don't cause it. Your whole immune system may be activated. It may be autoimmune, too, as mentioned by Londres70. And as mentioned by OHNS2010, you could still be carrying a pharyngitis, reason being something unknown yet. It may just be your immune system acting smart here.

Just don't give up. Keep on exploring. Don't be afraid of consulting new doctors. You'll get your answers.

[Londres70]

Viral does not necessarily mean HIV.  Your last test was negative, correct?

Is your MD an Internist or Family Practice?  An Internist can follow up infectious diseases as well.

Have you ever seen a Rheumatologist for the elevated RA Factor?  As I stated in my previous post, this could be autoimmune.

Whatever this is it has got to be infectious or autoimmune; I don't think this is "all in your head."

[naveea]

Thank you for replying

By viral,do you mean HIV?

My latest doc is an M.D (Unfortunately ,We dont have ID Specialist in india )

[Londres70]

Well, an ENT Specialist and Dentists are NOT the appropriate physicians to be consulting in your case.  As I mentioned in my previous post you should be following up with an ID Specialist; that would be my next step.  

Something is causing your immune system to go "haywire."  Usually, a systemic infection does this (bacterial or viral).  If it is viral, it will NOT, repeat, NOT respond to an antibiotic. On the other hand, they may have prescribed antibiotics that are NOT effective against the bacterial infection you may have.  I chose the words "systemic infection" because your complaints are generalized.

After reading your last post, this could also be something autoimmune going on.  Once again, an ENT Specialist and a Dentist will not be able to help you.  An IM (Internal Medicine) and/or a Rheumatologist would be of more help.  

Totally DOUBT any Chronic Pharyngitis going on.  

  

[naveea]

Hey Doc,

One more thing

My Endoscopy report also says persistant dypepsia(if i remember it correctly).. My lymph nodes are not swollen,but painful....

I have been trying Himlaya Septilin over a month too..

Also two months after the sugery i had a rash( hard Non breakable white fluid filled bumps on my both palms,they broke on thier own and there was lot of skin peeling and it went away..Doc said it was due to anxiety)

The Blood tests which i have taken so far are

1. HIV (6 weeks from my last protected exposure)
2. VDRL (5 weeks from my last protected exposure)
3.HEP -B (In feb 2010)
4.ASLO( Feb-2010)
5.WIDAL(Feb 2010)
6.Throat Swab(Feb 2010)
7. TB  (June 2010)

Yeah, In feb 2010... My CBC had elevated ESR -30 and RA factor was positive(did have pain in fingers,arms and shoulder joints).........My ESR in latest CBC was 10..Dint check RA this time

Not sure if its relevant..My pre-surgical check accidently discovered Mitral Valve Prolapse with No MR...


Everyday is such a pain for me,,,. Thanks in advance for replying

[naveea]

Thank you both for replying

OHNS2010 - I was diagnosed with Chronic Pharyngitis before the surgery and thats reason i had the Septoplasty and tonsillectomy along with sinus surgery in first place .Can Chronic Pharyngitis cause achy armpits,sore chest and upper back pain too?.. Do you think i have HIV though i used a condom?

Londres70 - I have been to 2 ENT's and 1 dentist ,all i was prescribed was Antihistamines,Antibiotics , Nasal Sprays and PP's.. What do you mean by systemic infection?

[OHNS2010]

Hi,

It is unlikely to have infectious diseases hidden in your body undiagnosed by the doctors.

Decide yourself, following links are for your information:

1. http://www.medicinenet.com/infectious_mononucleosis/page2.htm

2. http://emedicine.medscape.com/article/222040-overview

3. http://hcd2.bupa.co.uk/fact_sheets/html/pharyngitis.html

All the Best

Regards
OHNS2010

[Londres70]

The treatment for mono is supportive and limited, but exists.  

[Londres70]

Chronic Pharyngitis is NOT going to cause all the symptoms you are experiencing.  I would recommend following with an ID (Infectious Disease)Specialist vs ENT.   There is some type of systemic infection going on with you.

[OHNS2010]

Hi,

The chances of Infectious mononucleosis are unlikely. Early in the course of the mono, blood tests may show an increase in one type of white blood cell (lymphocyte). Some of these increased lymphocytes have an unusual or "atypical" appearance when viewed under a microscope, which suggests mono.

More specific blood tests, such as the monospot and heterophile antibody tests, can confirm the diagnosis of mono. These tests rely on the body's immune system to make measurable antibodies against the EBV. Unfortunately, the antibodies may not become detectable until the second or third weeks of the illness.
In most cases of mono, no specific treatment is necessary. The illness is usually self-limited and passes much the way other common viral illnesses resolve. Treatment is directed toward the relief of symptoms.

You are probably having chronic pharyngitis. It is caused due to various reasons like allergy, acid reflux disease, sinusitis, etc. I would suggest you to drink plenty of warm water take medicines like proton pump inhibitors (Esomeprazole), and also use saline nasal drops. Hope this will reduce most of your symptoms. Remember! Stop smoking; avoid chilled items, oily, spicy food, coffee and tea for few days.

Any more doubts you are welcome.

"Jai Karnataka"

Regards
OHNS2010

[Londres70]

Yes, it it possible.  

[naveea]

Thanks for replying

No i have not been checked for Mono.. I was not aware mono can cause all the my symptoms for 1 year,,,

[Londres70]

Yes, when the answer is not easy, some physicians will just conclude "it is all in your head" unfortunately.

Have you been checked for EBV/Mono?