Sore Throat Causes and Sleep Issues: A Patient's Journey

Q: Sore Throat Causes and Sleep Issues: A Patient's Journey

● There is a strict definition for contacts of tuberculosis： individuals who have been in contact with an index case (such as a colleague with pulmonary tuberculosis) for more than 8 hours in a single day, or a cumulative total of over 40 hours during the infectious period. <br>I

Causes of sore throat and issues related to insomnia?

Hello Doctor: In February, I had a cold and felt unwell, so I went to a clinic to see a doctor and took some medication.
My throat still felt a bit uncomfortable; initially, I thought it was due to a fishbone, but after examination, there was nothing inside.
Later, I even noticed blood in my sputum.
Since some of my colleagues had tuberculosis, I went to a large hospital for a chest X-ray.
The doctor said my lungs were fine, but there were white spots on my chest.
They took a lateral X-ray to further examine my chest, and no abnormalities were found.
I was prescribed medication and scheduled for another X-ray in three days.
By that time, there was no blood in my sputum, and the follow-up X-rays showed that the white spots had disappeared, with no issues in my chest.
The doctor prescribed me more medication.
After returning home, I had another two X-rays taken three days later.
I was very concerned about radiation exposure, and I heard online that eating seaweed could help prevent radiation, so I consumed a lot of seaweed.
The next day, I noticed my stool was black, and I was hesitant to take medication.
However, my stool returned to normal after that.
Nevertheless, my throat still feels strange, as if there is something stuck or a prickling sensation.
Sometimes the feeling is quite pronounced, while other times it is not noticeable.
Drinking warm water helps alleviate the discomfort significantly.
Additionally, I have been experiencing frequent nightmares over the past few months.
Sometimes I don’t have nightmares, but I still wake up around one or two in the morning and find it difficult to fall back asleep.

Niming, 30~39 year old female. Ask Date: 2017/03/26

Dr. Chen Taicheng reply Family Medicine

● There is a strict definition for contacts of tuberculosis: individuals who have been in contact with an index case (such as a colleague with pulmonary tuberculosis) for more than 8 hours in a single day, or a cumulative total of over 40 hours during the infectious period.
If there is a risk of transmission, local public health officials (usually public health nurses from health centers) will conduct further examinations on the contacts.

● It is not uncommon for a cold to cause blood-streaked sputum, but if you are frequently coughing up blood, further medical evaluation is necessary.
Your symptoms have improved, and the white spots on your chest X-ray have disappeared, so there should be less concern.
● Eating seaweed to prevent radiation exposure is likely intended to utilize the iodine in seaweed to protect the thyroid gland in case of exposure to radioactive iodine.
However, the radiation dose from a single X-ray is very low (approximately 0.02 millisieverts), which is more than 50 times lower than the annual acceptable radiation dose of 1 millisievert for the general population (excluding natural background radiation and medical radiation).
The radiation dose from two X-rays is also not high, so there is no need for excessive worry, and the effectiveness of eating seaweed for radiation protection is limited.
● Black stools should be evaluated to determine if they are due to dietary factors.
If they occasionally appear as dark as hair or asphalt, it is important to consider the possibility of gastrointestinal bleeding.
● If you are experiencing throat discomfort, it is advisable to consult an otolaryngologist for further examination.
Keep an eye on the situation of your colleagues with tuberculosis; if needed, you may follow up with a chest X-ray in 1-3 months.
If you are having trouble sleeping, please consult a family medicine physician, neurologist, or psychiatrist to explore any stress or other physiological or psychological discomfort factors.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department is concerned about you.

Reply Date: 2017/03/26

More Info

Dear Patient,
Thank you for sharing your journey regarding your throat discomfort and sleep issues. It sounds like you've been through quite a lot, and I appreciate your willingness to discuss these concerns. Let's break down the various aspects of your situation to better understand what might be happening.

Sore Throat and Its Causes
From your description, it seems that your sore throat began after a cold in February. While it's common to experience throat discomfort following a viral infection, persistent symptoms can sometimes indicate other underlying issues. You mentioned initially suspecting a fish bone lodged in your throat, which is a common concern, but since you confirmed there was nothing there, we can rule that out.

The presence of blood in your phlegm is understandably alarming. However, it’s reassuring to hear that subsequent X-rays showed no abnormalities in your lungs and that the blood has since disappeared from your phlegm. The “white spots” on your chest X-ray could have been benign and may have resolved on their own, which is often the case with transient conditions.

Your ongoing throat discomfort, described as feeling like something is stuck or prickling, could be due to several factors, including:
1. Postnasal Drip: This occurs when mucus drips down the back of your throat, often due to allergies or sinus issues, leading to irritation.

2. Gastroesophageal Reflux Disease (GERD): Acid reflux can cause a sensation of a lump in the throat and can also lead to chronic throat irritation.

3. Anxiety or Stress: Sometimes, psychological factors can manifest as physical symptoms, including throat discomfort.

Sleep Issues and Nightmares
Your sleep disturbances, including frequent awakenings and nightmares, can be linked to several factors. Stress and anxiety are well-known contributors to sleep problems. Given your recent health concerns and the stress of worrying about potential serious conditions, it’s understandable that your sleep might be affected.

Here are some potential reasons for your sleep issues:
1. Anxiety: The fear of health problems can lead to heightened anxiety, which can disrupt sleep patterns and contribute to nightmares.

2. Sleep Hygiene: Factors such as irregular sleep schedules, excessive screen time before bed, or consuming stimulants (like caffeine) can impact sleep quality.

3. Physical Discomfort: The ongoing throat discomfort may also be causing you to wake up frequently, as any physical discomfort can disrupt sleep.

Recommendations
1. Consult a Specialist: Given your persistent throat discomfort, it may be beneficial to see an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination and possibly recommend treatments to alleviate your symptoms.

2. Manage Anxiety: Consider speaking with a mental health professional about your anxiety and sleep issues. Cognitive-behavioral therapy (CBT) is particularly effective for insomnia and anxiety management.

3. Improve Sleep Hygiene: Establish a calming bedtime routine, limit screen time before bed, and create a comfortable sleep environment. Techniques such as meditation, deep breathing exercises, or gentle yoga before bed can also help.

4. Monitor Your Diet: While you mentioned eating seaweed to combat radiation fears, it's essential to maintain a balanced diet and stay hydrated. If you notice any unusual changes in your bowel movements or overall health, consult your healthcare provider.

5. Follow-Up: Keep track of your symptoms and follow up with your healthcare provider if your throat discomfort persists or worsens. Regular check-ins can help ensure that any underlying issues are addressed promptly.

In conclusion, while your throat discomfort and sleep issues may be interconnected, addressing each symptom holistically will be crucial in your recovery. Remember, you are not alone in this journey, and seeking help is a strong and positive step forward.

Wishing you good health and restful nights ahead.

Best regards.

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