Paging Dr.House

[buddscreekman]

I'm hoping someone here can help my wife. She's seen a dr.,and collectively,we cannot figure out what is wrong with her.

For the past two days,she is having these "attacks"..she will usually start having upper abdominal pain,followed/preceded by a cough. Cough ALWAYS happens during these attacks. This pain then becomes chest pain that is like a band crushing her,upper abdominal pain continuing. Pain goes into her back,between her shoulder blades.It all continues simultaneously. Then comes the throat pain. This is not like a sore throat,reflux-y stinging. This is a feeling of pressure she says feels like a hand closing around her throat. She keeps coughing intermittently. Ready for the real stumper? It then goes into her face. Always on the right side - she says it is a feeling of pain/pressure in her sinuses as well as in her nose and cheek.

First attack of this was yesterday - she swore she was having a heart attack. So naturally,she refused to go to the hospital. Went to the dr. today and had an EKG...all normal. Tonight,she has another one of these attacks.

Couple other interesting factors - she feels it is related somehow to eating/being hungry. She describes a feeling of intense hunger pain,yet feels food will make it worse. This happened once on an empty stomach,once full. She also refuses to bend over during these attacks as she says she wants to stay as straight as possible - she says bending forward will make it worse. When it ends,after about 20-30 minutes start to finish,she is usually shaken up and says her head hurts. The coughing goes away with the pain.

Doc says it almost certainly isn't cardiac,that the ekg would have shown something if she had had a minor heart attack even after the fact,and to just let them know if it happens again. Well,second time in as many days...we'll be calling back in the morning. Any guesses? It's the facial and back involvement throwing us all.

 

[lmor]

I am not a doctor, but I have heard that reflux can casue pain in chest, throat, jaw, and ears. Try a pepcid; it might help. I hope you wife feels better soon.

 

[twinoaks207]

I'm hoping someone here can help my wife. She's seen a dr.,and collectively,we cannot figure out what is wrong with her.

For the past two days,she is having these "attacks"..she will usually start having upper abdominal pain,followed/preceded by a cough. Cough ALWAYS happens during these attacks. This pain then becomes chest pain that is like a band crushing her,upper abdominal pain continuing. Pain goes into her back,between her shoulder blades.It all continues simultaneously. Then comes the throat pain. This is not like a sore throat,reflux-y stinging. This is a feeling of pressure she says feels like a hand closing around her throat. She keeps coughing intermittently. Ready for the real stumper? It then goes into her face. Always on the right side - she says it is a feeling of pain/pressure in her sinuses as well as in her nose and cheek.

First attack of this was yesterday - she swore she was having a heart attack. So naturally,she refused to go to the hospital. Went to the dr. today and had an EKG...all normal. Tonight,she has another one of these attacks.

Couple other interesting factors - she feels it is related somehow to eating/being hungry. She describes a feeling of intense hunger pain,yet feels food will make it worse. This happened once on an empty stomach,once full. She also refuses to bend over during these attacks as she says she wants to stay as straight as possible - she says bending forward will make it worse. When it ends,after about 20-30 minutes start to finish,she is usually shaken up and says her head hurts. The coughing goes away with the pain.

Doc says it almost certainly isn't cardiac,that the ekg would have shown something if she had had a minor heart attack even after the fact,and to just let them know if it happens again. Well,second time in as many days...we'll be calling back in the morning. Any guesses? It's the facial and back involvement throwing us all.

Not to be Captain Obvious or anything but it really might be very helpful in diagnosing this problem if she goes to the ER while it is happening! There may be something that can be picked up by testing at the time that it is happening, that is not showing up when it is not happening. :shrug:

 

[Retrodeb54]

Hiatal Hernia? ...

 

[buddscreekman]

Not to be Captain Obvious or anything but it really might be very helpful in diagnosing this problem if she goes to the ER while it is happening! There may be something that can be picked up by testing at the time that it is happening, that is not showing up when it is not happening. :shrug:

The episodes last about a half hour. 25 minute drive to the e.r.,plus waiting around - no way to catch it. It's pretty unpredictable.

 

[buddscreekman]

I am not a doctor, but I have heard that reflux can casue pain in chest, throat, jaw, and ears. Try a pepcid; it might help. I hope you wife feels better soon.

I have heard that too - but when we mentioned that to the dr. she said no to it being in the face/ears. Said that was essentially "in her head",and from the stress of being worried.

 

[buddscreekman]

Hiatal Hernia? ...

Googled it...most everything I read said they are for the most part not symptomatic.

 

[jazz lady]

I'm no doctor and don't pretend to be one but that sounds an awful lot like a gallbladder attack. I'm surprised that isn't one of the first things the doctor checked on, if nothing else to rule it out.

 

[Pete]

I suspect esophageal spasms. Does she feel like food gets "caught" or any difficulty swallowing when eating? Does she have to drink plenty of liquid to get food down at mealtime? Have them write me a consult. In the meantime have them do an upper GI- barium swallow and try to trigger an attack while they are viewing.

I prescribe nitroglycerin tabs 5mg, no more than 3 per day

Dr. Pete

 

[RoseRed]

I suspect esophageal spasms. Does she feel like food gets "caught" or any difficulty swallowing when eating? Does she have to drink plenty of liquid to get food down at mealtime? Have them write me a consult. In the meantime have them do an upper GI- barium swallow and try to trigger an attack while they are viewing.

I prescribe nitroglycerin tabs 5mg, no more than 3 per day

Dr. Pete

:bow:

 

[mamaof1]

I'm no doctor and don't pretend to be one but that sounds an awful lot like a gallbladder attack. I'm surprised that isn't one of the first things the doctor checked on, if nothing else to rule it out.

This is just what I thought too!!! I just had mine out a few months ago- and it caused some very strange symptoms my doc called "referral" pains. And they effect each person differently. Hope you feel better soon.

 

[smts]

Absolutely sounds like gallbladder. If she has stones, especially small ones, she is probably passing them. This sends the gallbladder, common bile duct and pancreas into major spasms. Passing stones can mimmick a heart attack and that is why it is missed quite often. If she doesn't have stones, the gallbladder may not be working/functioning correctly which can also cause many problems. Once she eats bile is supposed to be released by the gb into the bile duct and then pancreas, if it's not working then that bile backs up and it to causes many pains/spasms. The fact that all of our digestive system, including the throat and mouth are somehow connected and nerves run through them all, it can explain the radiating pain. Hope this helps
(Ultrasound and/or HIDA scan would help)

 

[buddscreekman]

I'm no doctor and don't pretend to be one but that sounds an awful lot like a gallbladder attack. I'm surprised that isn't one of the first things the doctor checked on, if nothing else to rule it out.

Nope-removed it years ago.

 

[twinoaks207]

The episodes last about a half hour. 25 minute drive to the e.r.,plus waiting around - no way to catch it. It's pretty unpredictable.

ambulance?

 

[buddscreekman]

ambulance?

She and I both tend to think those are for emergencies. A pain that has happened a couple times,and almost certainly isn't her heart,that goes away on it's own really isn't one. It sucks,and it's a mystery as of right now,but it isn't a reason to have them roll through the neighborhood lights and sirens on making a big spectacle.

 

[aubriana]

I'm hoping someone here can help my wife. She's seen a dr.,and collectively,we cannot figure out what is wrong with her.

For the past two days,she is having these "attacks"..she will usually start having upper abdominal pain,followed/preceded by a cough. Cough ALWAYS happens during these attacks. This pain then becomes chest pain that is like a band crushing her,upper abdominal pain continuing. Pain goes into her back,between her shoulder blades.It all continues simultaneously. Then comes the throat pain. This is not like a sore throat,reflux-y stinging. This is a feeling of pressure she says feels like a hand closing around her throat. She keeps coughing intermittently. Ready for the real stumper? It then goes into her face. Always on the right side - she says it is a feeling of pain/pressure in her sinuses as well as in her nose and cheek.

First attack of this was yesterday - she swore she was having a heart attack. So naturally,she refused to go to the hospital. Went to the dr. today and had an EKG...all normal. Tonight,she has another one of these attacks.

Couple other interesting factors - she feels it is related somehow to eating/being hungry. She describes a feeling of intense hunger pain,yet feels food will make it worse. This happened once on an empty stomach,once full. She also refuses to bend over during these attacks as she says she wants to stay as straight as possible - she says bending forward will make it worse. When it ends,after about 20-30 minutes start to finish,she is usually shaken up and says her head hurts. The coughing goes away with the pain.

Doc says it almost certainly isn't cardiac,that the ekg would have shown something if she had had a minor heart attack even after the fact,and to just let them know if it happens again. Well,second time in as many days...we'll be calling back in the morning. Any guesses? It's the facial and back involvement throwing us all.

Sounds like gall bladder attack to me... but I see you just stated she had hers out... weird

 

[luvmygdaughters]

I'm no doctor and don't pretend to be one but that sounds an awful lot like a gallbladder attack. I'm surprised that isn't one of the first things the doctor checked on, if nothing else to rule it out.

My ex had the same sypmtons, turned out to be gall bladder. Had to have it removed.

 

[SoMDGirl42]

Panic attacks?

Have a friend that has them and she describes them very similar to that. She doesn't have the face pain, but I'm thinking that could be from your wife hyperventilating. :shrug:

 

[buddscreekman]

Panic attacks?

Have a friend that has them and she describes them very similar to that. She doesn't have the face pain, but I'm thinking that could be from your wife hyperventilating. :shrug:

No. The first time this happened,she was chatting on the phone. Relaxed,fine. She was mid-sentence and started to cough,and then it went from there. Second time,had just had dinner a few minutes before,sitting watching t.v. It happened again this morning,and the pattern seems to be food. Either being hungry,or having just eaten. She describes a feeling of intense hunger when it starts,and this occurs even if she's just eaten. I also noticed this morning when she was taking a vitamin,she went for a second glass of water. She often does,and this time I asked why and she said it always feels stuck. She also chokes often when she eats,and clears her throat constantly. We attributed the clearing to allergies,but now more and more this looks like a gi issue. Called the dr. to see if she can get an upper gi done.

 

[SoMDGirl42]

No. The first time this happened,she was chatting on the phone. Relaxed,fine. She was mid-sentence and started to cough,and then it went from there. Second time,had just had dinner a few minutes before,sitting watching t.v. It happened again this morning,and the pattern seems to be food. Either being hungry,or having just eaten. She describes a feeling of intense hunger when it starts,and this occurs even if she's just eaten. I also noticed this morning when she was taking a vitamin,she went for a second glass of water. She often does,and this time I asked why and she said it always feels stuck. She also chokes often when she eats,and clears her throat constantly. We attributed the clearing to allergies,but now more and more this looks like a gi issue. Called the dr. to see if she can get an upper gi done.

STRICTURE

or

Esophageal spasm

Diffuse esophageal spasm; Spasm of the esophagus
Last reviewed: November 11, 2010.

Esophageal spasms are abnormal contractions of the muscles in the esophagus (the tube that carries food from the mouth to the stomach). These spasms do not move food effectively to the stomach.

Causes, incidence, and risk factors
The cause of esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people.

Symptoms
•Difficulty swallowing or pain with swallowing

•Pain in the chest or upper abdomen

It can be hard to tell a spasm from angina pectoris, a symptom of heart disease. The pain may spread to the neck, jaw, arms, or back

Signs and tests
•Esophagogastroduodenoscopy (EGD)

•Esophageal manometry

•Esophagogram (barium swallow x-ray)

Treatment
Nitroglycerin given under the tongue (sublingual) may be effective in an acute episode of esophageal spasm. Long-acting nitroglycerin and calcium channel blockers are also used to treat esophageal spasms.

Long-term (chronic) cases are sometimes treated with low-dose antidepressants such as trazodone or nortriptyline to reduce symptoms.

Rarely, severe cases may need dilation (widening) of the esophagus or surgery to control symptoms. However, it is not clear whether these procedures will help.

Esophageal spasm - PubMed Health

bill is in the mail.