Persistent Ear and Throat Pain: Seeking Medical Advice and Next Steps

Q: Persistent Ear and Throat Pain: Seeking Medical Advice and Next Steps

Dear Allen： <br>Hello, if you have already seen multiple doctors and undergone endoscopic examinations, ruling out the presence of tumors, the pain may be caused by chronic tonsillitis or chronic pharyngitis on the right side. <br>It is recommended that, in addition to taking ant

Ear, nose, and throat symptoms. Please help clarify and provide some advice, thank you?

Hello Doctor: My symptoms started at the end of August with a feeling of pressure and pain inside my right ear, and pain near the right side of my throat, particularly around the Adam's apple, which worsened when swallowing.
I visited an ENT specialist who performed a nasal endoscopy and examined my oropharynx, but said everything looked normal and prescribed pain relievers.
I took them for four weeks, but the pain returned when I stopped taking them.

At the end of September, I began experiencing a rapid heartbeat, insomnia, twitching in my middle finger, soreness in my right foot, and occasional numbness in both hands.
I then consulted an endocrinologist for thyroid issues, where I had blood tests and a nuclear iodine-131 scan, but the doctor also said everything was normal and advised me to return to the ENT specialist.
In early October, I went back to the ENT department and saw three different doctors at the same hospital.
They only reviewed my medical history, palpated my neck, and looked inside my mouth, concluding that there was nothing wrong.
When I expressed my concerns about the possibility of cancer or a tumor, the doctor told me that cancer or tumors typically do not cause pain.
I requested further examinations, but the doctors disagreed, suggesting that if we continued testing, I might as well work at a nuclear power plant due to excessive radiation exposure.
Now, at the end of October, it has been almost two months, and I still have pressure and pain in my right ear and persistent pain near the right side of my throat.
Every night, as I try to sleep, my throat feels tight, and the pain in my throat or ear wakes me up, causing insomnia.
Recently, I noticed that my tonsils are swollen, and there are various-sized ulcers and redness around the soft palate, resembling inflammation.
My uvula seems to have dropped down to my tongue.
I would like to ask the doctor for advice on what I should do.
Thank you.

Allen, 30~39 year old female. Ask Date: 2014/10/23

Dr. Zheng Jueyi reply Otolaryngology

Dear Allen:
Hello, if you have already seen multiple doctors and undergone endoscopic examinations, ruling out the presence of tumors, the pain may be caused by chronic tonsillitis or chronic pharyngitis on the right side.
It is recommended that, in addition to taking anti-inflammatory medications, you should avoid staying up late and consuming irritating foods or beverages.
Drink plenty of water, and if you smoke, you should quit.
Adjusting your lifestyle and maintaining a regular schedule can help.
Additionally, you should monitor for any signs of gastroesophageal reflux, as long-term exposure to small amounts of stomach acid can also trigger chronic pharyngitis.
If this is the case, you may want to consult a gastroenterologist for evaluation.
Wishing you peace and health,
Dr.
Jue-Yi Cheng
Director, Department of Otolaryngology
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2014/10/23

More Info

I'm sorry to hear about the persistent pain and discomfort you're experiencing. It sounds like you've been through quite a journey with your symptoms, and it's understandable to feel frustrated when you don't receive clear answers or relief from your healthcare providers. Let's break down your situation and discuss potential next steps.

Firstly, your symptoms of ear pain, throat pain, and the recent discovery of swollen tonsils with ulcers are concerning and warrant further investigation. The fact that you've been experiencing these issues for nearly two months, along with additional symptoms like rapid heartbeat, insomnia, and numbness in your hands and feet, suggests that there may be an underlying condition that hasn't been fully addressed yet.

1. Persistent Pain and Swelling: The swelling of your tonsils and the presence of ulcers could indicate a chronic infection or inflammation. Conditions such as chronic tonsillitis or even a viral infection could cause these symptoms. It's essential to have a thorough examination by an ear, nose, and throat (ENT) specialist who can perform a detailed assessment, including a throat culture to check for bacterial infections like streptococcus or other pathogens.

2. Neurological Symptoms: The numbness in your hands and feet, along with the rapid heartbeat and insomnia, could suggest a neurological issue or anxiety-related symptoms. It's important to discuss these symptoms with a healthcare provider who can evaluate for conditions such as anxiety disorders, which can manifest physically, or other neurological conditions that may require imaging studies like an MRI.

3. Further Investigations: Since you've already seen multiple doctors without satisfactory answers, consider seeking a second opinion from a different ENT specialist or a multidisciplinary clinic where specialists can collaborate on your case. You might also want to ask for specific tests, such as:
- A complete blood count (CBC) to check for signs of infection or inflammation.

- Imaging studies like a CT scan of the neck to evaluate the tonsils and surrounding structures.

- Allergy testing if you suspect that allergies could be contributing to your throat and ear symptoms.

4. Management of Symptoms: While you're seeking further evaluation, there are some strategies you can employ to manage your symptoms:
- Pain Relief: Continue using over-the-counter pain relievers as directed by your healthcare provider. If the pain is severe, discuss stronger medications with your doctor.

- Hydration and Humidification: Staying well-hydrated and using a humidifier can help soothe your throat and reduce discomfort.

- Warm Compresses: Applying warm compresses to your neck may help alleviate some pain and swelling.

- Avoid Irritants: Stay away from smoke, strong odors, and other irritants that could exacerbate your throat pain.

5. Mental Health Considerations: Given the stress and anxiety that can accompany chronic pain and uncertainty about your health, consider speaking with a mental health professional. They can provide support and coping strategies to help you manage anxiety and improve your overall well-being.

In conclusion, it's crucial to advocate for your health and seek the appropriate care until you find a resolution. Don't hesitate to express your concerns and insist on further evaluation if your symptoms persist. Your health is paramount, and you deserve thorough care and attention. Best wishes for your recovery, and I hope you find the answers and relief you need soon.

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