Failing to be reassured - frustrated

[JB33]

I'm fairly frustrated with myself these days - I am aware this is likely further reassurance seeking; however, would like to express as an outlet - maybe there are some words or others who can relate? Or maybe just me typing this out could help me and then for me to read it all back? Why can't I take comfort from the below? I mean, this looks like an extremely thorough examination and evaluation to my neck and throat.

I have caught myself Googling and looking up various throat and neck muscles and conditions, I am hyper aware of swallowing now and on the lookout for pain or discomfort. I am also wondering if this is a control thing for me? Personal current stressors are out of my control so I am focusing on these sensations and symptoms as a means to control something as I am currently unable to control the other things going on in my life?

Personal Background:
- long term HA sufferer along with somatic symptom disorder
- history of visiting multiple Dr's for same concern and ending up with scans/invasive testing all turn out to be negative
- multiple ongoing stressors currently (new job, IVF, COVID and vaccine worries)
- tendency to grind my teeth and tense throat muscles

Current concern:
- left-sided throat pain for 4 months. Sometimes an ache that lasts for hours, can also be intermittent, occasionally I get ear and jaw pain too not not often.
- triggered on swallowing (saliva, solids, liquid). Feels like the food is rubbing of something that shouldn't be there around the adams apple area, but deeper in toward the throat.
- pain can feel like a short stabbing, sharp sensation that lasts a split second when swallowing but can be intermittent, mostly to the left of the adam's apple, sometimes feels like back of throat too.
- feeling of tension/foreign body in left throat, made worse sometimes by turning head to the left, an awareness of a fullness.
- yawning, talking or sometimes stretching can trigger the pain. Turning head to the left can trigger what feels like tension/globus/fullness in adams apple area
- when I place a finger into my throat and reach further down beyond the tonsil, I can feel a hard cartilage-like lump sticking out on the left side, but not sticking out as much on the right. I am assuming this is thyroid cartilage
- pain can range from sharp short 8/10 (happens rarely) to a 2/10 that can happen more frequently (almost like a typical sore throat pain but one sided - this can also be intermittent).

Investigations done on current concern:
- 4 private referrals to two ENT within 2 months, two separate ENT surgeons (2 opinions).
- First Dr felt my neck, looked into my mouth with a torch and said "no need for scans or testing, some evidence of teeth grinding - a scan would show nothing at all"
- I then went back 2 weeks later to the same Dr as I thought "what if I didn't tell him everything?", "what if I missed some important info?". He said "no further testing is needed, no scans" and he is happy with his assessment.
- The thoughts continue - so I seek a 2nd opinion. The 2nd ENT Dr offers an MRI scan which scares me and my psychologist said that some Dr's will do this but not realizing this is making your anxiety worse.
- I decline the scan and explain my HA fear, he said "there is less than a 1% chance of something being found of concern but it's there is you want it, I am simply offering it to you as an option but as it will offer such a low yield and make your anxiety worse, lets park it but keep it in your pocket should you want it" - he then examines my neck and throat again, but also this time does a mirror exam of my throat and has a feel of the structures at the back of my throat with his finger and listened to me. He said "I hope not to see you back in the nicest way possible". This Dr also couldn't find anything of concern. He said there was some tenderness and tension in the styloid apparatus and pterygoid muscles. I am aware that accepting the scan is feeding into my anxiety and reassurance checking and that this behavior is history repeating itself and is not helpful.
- I then send an email to this Dr as the thought entered my mind "I never asked him what that lump feeling was below my tonsil? What if that's the cause of my pain im feeling?" He said he would type up a response to me to which I am waiting.

Other relevant Info:
- I had a nasal endoscopy for a globus sensation by another ENT dr on the NHS 7 months ago which shown reflux and thrush and some swelling in the throat tissues but nothing of concern.
- the 1st Dr (above) I had seen 2 years ago for what he said were "similar symptoms" then but I can't remember exactly
- knew someone diagnosed with stage 4 tonsil C
- had family member mis-diagnosed with C

[sel123]

Hi there!! One of the hardest parts about HA is accepting drs results. My therapist said to me, once you have all the all clear from the dr and you’re still worrying, then it’s your HA you have to work on, not the medical issue you think you have.

So much of your post resonates with me as I am going through a similar time not accepting results. From what you have written out, it really seems like you are fine and don’t need any additional testing which will likely just reinforce your HA more!

[JB33]

Hi there!! One of the hardest parts about HA is accepting drs results. My therapist said to me, once you have all the all clear from the dr and you’re still worrying, then it’s your HA you have to work on, not the medical issue you think you have.

So much of your post resonates with me as I am going through a similar time not accepting results. From what you have written out, it really seems like you are fine and don’t need any additional testing which will likely just reinforce your HA more!
Thanks,

I agree about not reinforcing the HA. part of me wants the scan but I know that’s feeding the anxiety by confirming that I do not trust the dr and that I am incapable of working through my thought process and trusting the doctors.

I also have thoughts such as “I read about this condition, maybe the dr thinks it’s that but didn’t say? Maybe they never even thought of it, should I make another appointment?” I am slowly trying to work through the thought process.

I appreciate you replying :-)

[sel123]

Yeah I do that too. I leave the drs office and think “oh I forgot to tell them this...” and also think I should have suggested something to them. My therapist reminded me before that I don’t have an medical degree which put that into perspective! Ugh. HA is the worst!

[JB33]

Yeah I do that too. I leave the drs office and think “oh I forgot to tell them this...” and also think I should have suggested something to them. My therapist reminded me before that I don’t have an medical degree which put that into perspective! Ugh. HA is the worst!

But at least we know we’re doing it and what it might signify, lack of trust, racing mind, catastrophic thinking, what if’s … all signs of an anxious mind :-). We can then learn to try and dampen those thoughts down by intercepting them and challenging them when they arise …. As they always do lol

[NoraB]

Other relevant Info:
- I had a nasal endoscopy for a globus sensation by another ENT dr on the NHS 7 months ago which shown reflux and thrush and some swelling in the throat tissues but nothing of concern.
- the 1st Dr (above) I had seen 2 years ago for what he said were "similar symptoms" then but I can't remember exactly
- knew someone diagnosed with stage 4 tonsil C
- had family member mis-diagnosed with C

Far from being lumped in at the end with 'other relevant issues' - for me, this is the primary cause of your throat HA.

Throat symptoms are common with anxiety. You've heard the terms, 'lump in throat' when used to describe intense emotion, like fear?

Swallowing issues. (lump in the throat, tight throat - the sensation of something stuck in the throat)
Excess saliva
Not enough saliva
Excessive throat clearing
Excess phlegm

To name but a few...

Reason in an otherwise healthy person - ANXIETY. (fight or flight)

During the stress response, our muscles tighten - including throat muscles. Think about what would happen if you woke up to find an axe murderer staring at you? Your body would go into fight or flight and one of the symptoms is that your throat muscles would tighten up. With you, there is no axeman. Your throat is tightening up because of your thoughts. With chronic anxiety, we become hyper-aware of these symptoms and sensations - which this makes symptoms like this one a recurring one, and this all feeds into the 'it's always there so there must be something wrong with me!' In your case, you knew somebody who had tonsil cancer and so you're making a connection between normal anxiety symptoms and those of cancer. That's how HA works. It's all over this forum!

The reflux, thrush etc can be caused by stress - but they are real symptoms none the less. The anxiety symptoms are also real, but none of this adds up to cancer.

P.S do you honestly expect not to have any kind of discomfort when you are shoving your finger down your throat? :unsure: Unless you've put the hours in at med school and understand the physiology of the human body - then prodding about your body parts will only serve to ramp up this MH condition. For all you know, you could be poking at a muscle.. :shrug:

I can't see anything in your MH 'CV' about therapy? What (if anything) have you done to address this MH condition?

Bottom line: you can't take comfort from what you've written because you've not addressed the real problem here - which is a mental health condition, not a physical one.

You need to understand that while doctors are not infallible, ENT specialists see thousands of people a year. They are experts in their field and know what to look for with cancer. They will have examined you and asked you questions and found no 'red flags' which would suggest cancer. An MRI scan is harmless in the physical way but imaging should only be used when necessary imo - not simply for reassurance purposes. This is because they cost a lot of money, are time consuming (making those who need one wait) and more importantly with HA - there's such a thing called 'incidental findings'...

The other issue is that HA can be so convincing that a clear MRI or CT scan won't do the job because our minds will convince us that 'they missed something' or the radiographer was crap or the consultant looking at the results wasn't experienced enough etc. Any reassurance and comfort from a clear scan can be very short lived if HA has a tight enough grasp on you...

You might not be able to control what's going on around you in your life but you can learn to control this MH condition if you put the effort in, and to start with you need to stop Googling. It's prime HA fodder and will only serve to ramp up your anxiety which will in turn keep those stress hormones flowing and these unpleasant symptoms going...

[JB33]

NoraB - thanks for the detailed response. Part of me knows that it’s a mental health related issue, the other part of me swallows food, feels some pain on the left side and then panics again. It’s difficult when there are physical signs and discomfort with what should be an enjoyable process, eating.

I did get a further write up from the consultant to explain what I’m feeling at the back may be a ligament or possibly an arm of the hyoid bone but nothing to report either way.

I am going to try and focus more on relaxing and dealing with other life stressors.

[AnxietySufferer]

This very much sounds like hyper-fixation to me. Also if you are poking your tonsils and looking for lumps it’s no wonder your throat is in pain.

But it’s much easier said than done to stop hyperfixation (I know becuase I’ve been stuck in the same loop for months now). I hope you feel better soon :)