Severe anxiety from possible chronic illness (Hypochondria?)

AnthonyMG said:

Hi everyone,

Just a quick message to leave an update.

I've been feeling better in the last 10 days. At least I've been less anxious and sleeping better. The problem is still there, but even the symptoms are a bit softer, or maybe I have been dealing better with them. So, the nightmare is still playing, but it hasn't been so hard lately.

In one week I'm going for the magnetic resonance of the neck, which will help in the diagnosis. Most likely it is not going to show nothing, but know that is also helpful.

Next I will visit a neurologist to discard the nerve damage possibility and then I will visit an alergology specialist to for an opinion about the diagnosis of severe allergic reaction with damage of the epiglottis, as I think that an alergology specialist should have an important opinion about this diagnosis made by the second otorhinolaryngologist.

And that's pretty much it. I really hate to live like this, with this horrible sensation and strange pain in the throat and it will be very hard if this is for life, but at least when I have some days like I have been getting lately, I can find some strength and believe that even if this does not go away, I can live with it. It's just hard because more than 50% of my quality of life will be gone for such a stupid situation, but I might be able to deal with it...

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AnthonyMG said:

Hi everyone,

I'm not sure if my terrible anxiety situation can be considered hypochondria. If someone here could help me find out and share some advice on how to handle with this situation, I would be very grateful.

The issue is that I don't have a final diagnosis yet. And I'm not sure if I'll ever have one. And as the symptoms are obviously real and not caused by anxiety, I think it's probably not hypochondria, or it might have something about it, but not exactly hypochondria.

I'm sharing the situation with you...

4 and a half months ago I suffered some sort of accident (still to determine what actually happened) when I was eating hard shell seafood, as lobster, crab, etc. A piece as sharp as a needle and as hard as a rock pierced my tongue. It was not from one side to the other, but it was a deep pinching. It was painful (as you easily understand) but I got no more than a few seconds of pain from it.

After this I also started feeling that maybe a fragment of the shell was probably stuck somewhere in my throat. After finishing dinner, I felt like something was not right. I assumed that a fragment got stuck in my throat. It was not very painful and did not make me feel as if something was pinching my throat (as a stuck fish bone) but definitely something was wrong. Between the 2nd and the 4th day after this, I felt pain in the throat going down to the chest.

And a lot of times it was very clear to me that there was something stuck in there, probably in the area between the throat and esophagus. It even really felt like the material of the crab shell. I was 99% sure that something was stuck in there. I waited for it to go away, which never happened. I went to an otorhinolaryngologist 20 days after the episode. Laryngoscopy found nothing. Then CT scan found nothing either.

But I still have it, it's basically the same symptoms of the first month, not much difference, if any. But it is horrible and it's driving me mad, giving me a lot of anxiety. I'm totally exhausted and tired of this situation that is ruining my life...

I'm 40 and I already had to deal with a few hard and painful health conditions in the past, but I never had something as bad as this. It's so horrible that since the first weeks that I've started thinking that I just wanted to kill myself, which was never a robust idea because I have a lot of good reasons to keep alive and I always had the expectation that some doctor would manage to help or that it could go away on its own with time. But, continuing...

After the exams and consultations with that first otorhinolaryngologist, without getting to any diagnosis, I decided to visit a second otorhinolaryngologist in the beginning of this month, about 4 weeks ago. His diagnosis was:

Severe allergic reaction to the sea food that made my epiglottis shrink in one of the sides. As I actually really have an asymmetric epiglottis, smaller in the left side. And he says that the symptoms are due to this damage, it is for ever and there is no treatment or operation possible to treat it or soften the symptoms. He says I will have it for ever and it will not improve. This diagnosis increased my anxiety even more, to some very torturous levels. I basically couldn't deal with the possibility of having to live with this sensation in my throat forever.

And as I was not totally convinced, as many things didn't match up (I can list a lot of things that seem to be incompatible with this diagnosis), and as I was very anxious the days after I received that diagnosis, I decided to see a third otorhinolaryngologist.

This one has a different theory. As I have (for a long time now) poli-sinusitis, which he says includes a lot of "dirt" in the maxillary sinuses, as well as nasal polyps (a lot of them) and nasal septum deviation, he believes that all this has a direct relation with the problem and symptoms.

He assumes that I really had a fragment of the shell in my throat at some point in the beginning which then came out but the injury that it made created a susceptible site for colonization of bacteria coming from the nose, due to the sinusitis and polyps.

He asked for a CT scan of the sinusal area and for some blood tests. Already did that but still waiting for the results. He prescribed me antibiotics (cefuroxime), nasal wash and Aeromax (budesonide). Fourth day of this medication and no signs of improvement. Actually, the last 4 days have been terrible. Sometimes the symptoms become lighter and more bearable, but the last days they have been very intense and the medication didn't have any impact so far.

He said that with this medication I will improve and feel better. So lets see what happens, as the antibiotics have to be taken for 8 days and the nasal washes and budesonide for 3 weeks. He seemed very convinced, but so did the previous doctor in regards to his diagnosis of the damaged epiglottis.

I want to have faith and believe that this treatment will help, but each day that passes, I loose a bit of it and get more anxious and depressed. I have 3 kids (daughters) with which I spend most of the days, and that's what's giving me some strength to hold on and have a bit of faith. They're also the only thing now that can still make the smile.

As I pointed out in the beginning of this post, I got my tongue pinched and it was right after this that the symptoms of something wrong in the throat appeared. So I'm also starting to think that it could be that it pinched (and damaged) a nerve in the tongue that is connected with the throat area. But maybe that's just a silly idea.

So, in conclusion, I'm between two different diagnosis, one of which is terrible and I hope is wrong, the other one is too good to be true and I hope that it is correct but I doubt it is. I know that there are only 3 options. One of the two diagnosis is correct or there is a third option that the doctors have not considered yet.

But the symptoms are very real and I'm sure that they are not exclusively psychosomatic nor caused by anxiety itself. The anxiety comes from worrying with a real situation, as although the diagnosis is not precise yet, all I know is that whatever the problem is, if it is chronic and I will have to live with this forever, it will be very hard to deal with.

So maybe there's some level of hypochondria, but that is not all. If the onset of the symptoms came from nothing, as if they did not appear after I had that meal, I would accept that it could all be psychosomatic and that anxiety was the origin of the problem. But as it is, I see anxiety as a consequence of the problem which then makes it even worse.

I just don't know to which extent does the anxiety makes it worse. I tried (for the first time in my life) a benzodiazepine about 2 weeks ago, like only 0.75mg of bromazepam, and I really relaxed a lot and became more calm. The sensation in the throat was there but it was much easier to deal with the anxiety out of the scenario. But I don't want to engage in benzo's. I'm looking for a psychologist that can do psychotherapy these days so I might start seeing one the next few days.

But this is such an unpleasant feeling that I'm really very afraid that psychotherapy can't do anything to help. I was feeling so good and so happy before this happened almost 5 months ago... Now I'm all the opposite, it's so hard... and I have so much to loose if this does not go away, it really makes me sad and depressed.

What do you think of my situation? Any advice?

Thanks and king regards,

Anthony.

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AnthonyMG said:

Well, a few more information on the ongoing diagnosis...

The mechanism was probably a bit different. When the lobster spicule pierced my tongue, that's where the bacteria (Pseudomonas aeruginosa) found a way to enter the body. Then the bateria quickly migrated and colonized the best place for it to thrive, which was in the pharynx and/or upper oesophageal sphincter.

Then, one of 2 things (or maybe even both) happened:

1 - The "silent" colonization of that area, which then became chronic but without infection (colonization without infection). This is possible as I already found evidence in scientific articles online. So, I might be still dealing with that and the symptoms may come from that colonization. Chances are small, but it is possible and it's maybe my last hope that this could have a treatment;

2 - The bacteria colonized that area and the immune response sent high numbers of neutrophils to fight it. The neutrophils not only fought the bacteria but also damaged the elastine material from the epiglottic cartilage. Damaging the epiglottis and that's what explains the symptoms. In this case, it is a permanent damage and can't be repaired nor treated. I might have to deal with this forever, but I'm not giving up yet and if this option is confirmed I will insist with the doctors to see if they can do anything to treat or at least soften the symptoms.

And also, of course, it can be both things. The damage and the colonization with bacteria still present there. In this case, the symptoms may come from both situations. The unpleasant sensation when swallowing may come from the epiglottic deformation and the pain and discomfort may come from the bacterial colonization in that area.

Next Tuesday, in one week, I'm going to the gastroenterologist (as recommended by the allergy doctor and another internal medicine specialist) to see what he thinks about this and to probably schedule further analysis and an upper endoscopy with biopsy of that area.

The nightmare continues. And euthanasia is not yet approved in my country. It has been a few months ago, but the major court (or whatever they call it) refused it for some reason.

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