I had a little medical thing happen yesterday. Probably at some point I mentioned that the reason I ended up diagnosed with GERD/reflux, despite never noticing anything like heartburn except when I was pregnant, was that on several occasions I had taken a perfectly normal bite of food and it had not gone down right: I could breathe, but the food felt stuck for a couple of minutes. Which makes it sound like the kind of thing where you just need to take sip or water or something, and downplays how extremely painful it is, combined with a feeling of needing to burp and/or throw up, combined with the urgent feeling of The Body Is Having An Emergency Right Now, combined with any sip of water either refusing to go down or else increasing the pain. Really, very uncomfortable, do not recommend. Anyway, I got on a daily medication for GERD/reflux (omeprazole, if you are curious) and the swallowing thing stopped happening, and the medication also stopped my incessant light dry cough that I’d thought was a sign of my family’s pervasive asthma/allergy issues but turned out to be unnoticed heartburn also.
ANYWAY. Yesterday morning I had one of those painful “food is stuck” things, but I hadn’t had anything to eat yet, just coffee (but: acidic; also: hot, which apparently can sometimes trigger such things); and also, instead of for a couple of terrible minutes, it went on for over an hour at a “Do I need to go to the ER?” level of pain/weirdness, and then it was at a milder level for an hour or so after that, and then for the rest of the day it wasn’t happening anymore but my esophagus felt sprained, and there was discomfort every time I swallowed (new awareness: how often I swallow). I could theoretically eat and drink, but it was much too unpleasant to do it. I did try two doses of baking-soda-in-water early on in the process (thinking it might be a big acidic overreaction to the coffee), to no effect.
From online research, it seems to have been an esophageal spasm. It looks like generally it’s not dangerous, but it’s very uncomfortable, and not very treatable. Or rather: there are a lot of articles online with, like, the same three things doctors can try (including, inevitably, have the patients lose weight! and eat bland soft food! and avoid foods that seem to make it happen more often! yay medical science!!), plus a couple of medications and procedures, but then hundreds of message boards saying NOTHING WORKED AND I CAN’T LIVE LIKE THIS. I am going to try not to assume this will be my life, since apparently a person can also have one esophageal spasm and then no more.
The likelihood of having them is thought to be increased by stress and anxiety, isn’t that funny? Ha ha ha ha ha! Ha ha ha!
One thing I have learned about myself is that I will eventually take a child to the ER, because I can take being thought of as an over-fretful mother, and I can’t take wondering how I’d feel if I should have brought them but didn’t—but I will apparently never take myself to the ER unless I have broken a bone (well, not if it’s a toe bone, but anything larger), have internally acquired a bullet, or have lost, at minimum, a finger or toe. Not only can’t I believe something is Actually Happening, I can’t handle the way the medical staff make you feel bad if you’re right (“Why didn’t you come sooner??”) or bad if you’re wrong (“Yeah, next time this happens? Try having a couple of Tums and a glass of water, mmkay?”) (not to mention the way if you show up with any complaint of pain they treat you as if you’re lying to get pain medication). I will gently die first. Apparently. My hope is that if something happens to me that is life-threatening and also treatable, that I will briskly lose consciousness and someone else will be there to make the ER decision on my behalf.
I WILL, it seems, after half an hour or so of chest pains on the level of labor pains, casually and with reluctance (and only after he’s told me all about the project he’s working on) notify my husband that something medical is happening that is probably not a heart attack because it is not on the left side and not involved with my arms; and that the only way in which it is “spreading to my jaw” is that I have the barfy/tingly feeling I always have with this swallowing problem; and that I am not dizzy or short of breath or sweating; and that really it feels more like my THROAT than my HEART; and also because it’s been going on for awhile and nothing further, such as passing out / perishing, has occurred; and that the MAIN reason I’m concerned is that (1) it’s been going on so long and (2) it’s so painful and (3) I HADN’T TAKEN A BITE OF ANYTHING. (And also secret concern 4: I am picturing the ER nurse saying “And you had intense, regular chest pains? And you didn’t come to the ER…why, again?”) (And then, later on: “So, next time this happens, try an antacid mmkay? Maybe lie down, put your feet up, have a little water.”)
And in a pandemic, it’s so much more fraught. In normal times, I would at least be calling my primary doctor today to see if she wanted to take any action, or maybe want to send me back to the doctor I saw for my endoscopy. But as it is, I’m hand-wringing. I don’t want to start messing around with various medical buildings and medical staff if this was a one-time thing. It wouldn’t just be “Oh, okay, come on in and we’ll have a quick check”; it would be first to the primary doctor, then to the lab, then to a specialist, then back to the specialist for a scheduled test/procedure, etc. That is a LOT of exposure. And my endoscopy was less than a year ago, so I’m not super-worried that there’s something new in there; more like thinking this is typical of the kind of issues the doctor who did the endoscopy said people in my situation might have. (He also mentioned my STOMACH MIGHT TWIST AROUND, TYING ITSELF OFF FROM THE ESOPHAGUS.)
Not to muddy the waters or make you fret any more but it could also be thyroid related. If you haven’t had a physical exam lately (where they feel your thyroid gland in your neck) or blood work to check thyroid levels maybe that would be something to ask about at your next well check up. I didn’t have that set of symptoms but I did find out I have multiple thyroid nodules of which one larger one ended up needing a biopsy- and it’s fine (of course I had to wait 4 months between the discovery and the biopsy due to the pandemic shut down of non emergency procedures) But in actuality, many if not most of the people in the fb group for thyroid nodules or thyroid problems have trouble swallowing and feel thing stuck in their throats, some all the time, some intermittently. A simple ultrasound of the thyroid is a good way to check if your dr is concerned.
About a year ago I started feeling as if I had a lump in my throat all the time. (“You know, like when you’re about to cry?” is the way I described it to my doctor.) Yup, thyroid nodules. Which everyone apparently lives with, except that I hate feeling like I’m going to cry all the time, and it just feels wrong. Also, I can’t sing any more and much of the time my voice is croaky. Aging stinks.
your symptoms are exactly like my mom’s. You can get your esophagas stretched. It is easy and relatively painless and works fantastically.
Second this comment – my husband has to have his esophagus stretched every so often. It’s an outpatient procedure (at least here in NYC) and they give you The Good Stuff to knock you out.
Came down here to say this. My mom has this exact issue and gets her esophagus stretched every so often. It helps a lot.
Also, as long as you are nice to them, medical people are often really kind when you have overreacted about something confusing and scary but relatively benign.
That’s what I was going to say. My brother had it done and has felt so much better.
I think the thing is that we (medical providers) pretend like it’s easy to know when you need help when it is actually REALLY HARD and requires all sorts of knowledge and equipment you don’t have. KNOWING WHO NEEDS THE EMERGENCY ROOM IS A WHOLE JOB. That is all.
(So the condescension is real, but largely undeserved, is what i’m saying).
This story made me nervous, so maybe call your PCP and see if you can get checked out in a less-emergent way? I am not 100% convinced that we know what this is. And that’s a nice middle option which involves less annoying people.
Ugh, this sounds so terrible and scary! I’m so sorry! Your description of avoiding the ER resonates with me so much. I hate the idea of overreacting – hate! it! – and only tell my husband about things just in case I die so he can know the cause.
Oh I’m so sorry. That sounds terrifying.
My beloved dad was a doctor and he gave me a checklist for when to go get seen if you weren’t sure (and he was very much a rub-some-dirt-in-it, you’re fine type)
1. Any pain that you don’t understand the source of, where you would want to take a prescription strength painkiller, if you had access to one.
2. Any breathing or heart rate trouble where you can’t talk easily, go immediately. If you can talk but it persists and doesn’t get better for half an hour, go in.
3. Any bleeding that doesn’t stop after 20 minutes of pressure and elevation, unless it’s a finger, fingers can bleed a ton. Give fingers extra time.
4. Anything to do with your eyes. “You only get two just go see the eye doctor.”
5. Fevers in babies. High fevers in kids. Any adult in New England with a fever in the summertime (he described that as “it’s Lyme disease until proven otherwise.”) (I guess covid changes that formula a bit, now.)
Hope that is a little helpful for when you’re unsure?
This is helpful, Laura! Especially the part about fingers.
I get esophageal spasms! For me, they are usually triggered by eating something with little jagged bits, or by swallowing an uncoated pill. I suffer through increasingly ridiculous levels of pain, standing over the sink to spit out all the saliva I can’t swallow, until I force myself to gag enough to reset all my throat nerves. Or something.
My secret weapon: try to persuade your doctor to give you a prescription for a bottle of liquid topical lidocaine. Buy a bottle of over the counter mylanta. Next time it happens, mix yourself a “GI cocktail” (google it, although personally I call it a Green Goddess because a doctor called it that once and obviously it’s better) but leave out the other prescription med. All you need is the lidocaine to calm your spasming throat, and the mylanta as a vehicle so you can swallow it. Bonus: topical lidocaine is handy for little dental pains like canker sores.
Disclaimer: not a Dr, no medical training, and I would feel really bad if something I said caused someone to ignore a heart attack.
You described in the first paragraph what I do too when this happens to me.
This post is meeeee! Also: “internally acquired a bullet” killed me! Hahaha!
“I will gently die first.” Oh man. This is gold :D
I am so sorry you are experiencing this though, it sounds absolutely awful! I like Laura’s (dad’s) list about When To Take Something Seriously – very helpful.
Oh! I have very similar symptoms! I think I commented on your last post, because there are so many similarities.
I have achalasia. Originally diagnosed as GERD and esophageal spasms. They same tightening in the chest that you noted, and the “food stuck” feeling. For me, the only thing that works is to drink ice cold water immediately. Like, I have about 5 seconds when I feel the tingling starts to get water, before I feel like I’m having a heart attack.
A couple people above mentioned esophagus stretching. I had the full surgery (Heller’s myotemy), which made a HUGE difference. Also botox shots supposedly help.
I would schedule an appt with an endocrinologist. Tell them your symptoms and specifically mention both the spasms and achalasia. It took YEARS before I got an accurate diagnosis, so hopefully yours is quicker and you can find something that works. I also tried a couple medications that didnt work for me, but may work for you (in addition to the omeprazole, I tried a muscle relaxer, low dose antidepressant meant to relax the muscles, and nitroglycerin tabs which give you a huge headache within about 10 seconds but would have been totally worth it to stop the “heart attack” feeling. Unfortunately, none of them worked for me.)
I agree with Kerri. I also have achalasia. For me, it started with me thinking I hadn’t chewed properly or too fast. I finally went to the doctor when I couldn’t swallow my own saliva one night — that was really scary. It took more than an endoscopy to diagnose it. I needed a bariatric swallow and a manometry before they figured it out. https://www.mayoclinic.org/tests-procedures/esophageal-manometry/about/pac-20394000
Scary…..hopefully you don’t have the spasms again.
I’ve read your stories about this with great interest because I have something similar, but different. Occasionally when eating, it is almost like my throat closes up and I pretty much have to throw up or spit up the food that I ate. I’m not sure why it happens but it seems to be when I either have to eat quickly or am sitting at a different angle or possibly swallow some air?
Speaking up here, because it’s a post of YOURS that got ME to go to the ER. The anaphalaxis post. The two systems engaged post.
Itchy ears and asthma = whisked back immediately for LOTS of IV benedryl and getting to know a nebulizer really well.
So, here’s my general rule: If I’m worried about a symptom (or symptoms), and it’s during doctor office hours, and your doctor’s office has a nurse advice line (“is this an ER visit or an office visit or, better yet right now, a telemedical visit?”), then I CALL. If it’s after office hours, but my insurance company has a nurse advice line, I CALL. Otherwise, I go straight to urgent care or the ER.
Do not mess around. So they tsk at you. We will embrace you and lift you up.
I am SO SORRY you’re having this problem! I’ve known three people in Real Life (my husband is one of them) who have had this: one had the stretching procedure done and said it was excruciating; one cut everything out of her diet except some beans and rice and then she became a rabid Trump supporter and we lost touch and I don’t know what happened next. As for my husband, he had this “choking problem,” as we call it, for years and then we went vegetarian 3 years ago, and since then he only very rarely has trouble. When he does, it’s usually because he ate too quickly, or was trying to swallow a too-large pill.
I hope so much this goes away for you. I know for my husband it was alarming, painful, and embarrassing. :( So sorry!!
Well now I’m having a very vivid imagining of the sad life of a rabid Trump supporter who subsists on a diet of rice and beans and has drifted away from her saner friends.
HA! This comment made me cackle.
This happens to me with meat and large pills! I feel affirmed for the embarrassment that it caused in my earlier years when I felt like a weirdo choking in public.
I feel this SO MUCH. Not the specific condition but the overall sentiment.
Lots of comments so far but let me say this: I’ve had this exact issue for 20 years. I always just dealt with it but assumed it was a schatzkis ring, which my mom also gets. I happened to mention my issue with gluten to the doc doing my endoscopy last time and he connected the dots to a symptom of celiac. He noticed scar tissue that he assumed was from reflux (though I never have heartburn) and biopsied it to be safe but in the end it was celiac all along. I became more strict about gluten and it went away. I mention this because I know one of your boys has chrons which also runs in my family and may be connected.
I just wanted to reply and say THANK YOU for making me google schatzkis ring. This is 100% what my mom had/has. She was recently diagnosed with a hiatal hernia as well. She had a long period of time (5 years?) of having the “swallowing thing” where she would take a bite of something and it wouldn’t make the trip down. She’d rub her chest and make terrible noises of distress and eventually have to run to the bathroom / parking lot / somewhere semi-private to hack it back up. Afterwards she would feel normal. It was/is stress/anxiety related but also genetic/anatomical (?) since hiatal hernias run in my family. We are an anxious, short-waisted lot.
Swistles commenters are the best commenters on the internet!
I have tried to train myself to think, “If this was happening to someone else, not to me, what would I do?”
I think in your case, I would tell you to follow up with your PCP this week.
Many women think symptoms of heart attack in women are the same as the ones men typically feel (i.e. the ones we see in movies), and because the heart is veerrry slightly to the left that they’d feel symptoms chiefly on the left. While of course there are overlaps in symptoms the two sexes experience, this is the sort of thinking that can make women miss heart attacks, so I don’t want to give you a new set of symptoms to worry about, but maybe women should check out, for example, this link: https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women
I was especially struck when I read “Even though heart disease is the No. 1 killer of women in the United States, women often chalk up the symptoms to less life-threatening conditions like acid reflux [!!!], the flu or normal aging.”
Oh I should add that I’m not saying I think YOU had a heart attack. Not at all! I’m just trying to raise some awareness of how women experience heart attack. I have my first aid certification and I’ve had this hammered into me at every CPR training.
My stepmother has issues with her esophagus occasionally suddenly not letting her swallow. It’s mild enough and intermittent enough that she doesn’t want anything done about it, but she did mention it to me only yesterday. She thinks she might have the equivalent of a slight hernia in her throat. She seems to think her tonsils might be involved, but tonsils are visible at the back of the mouth / very top of the throat, and she indicated an area closer to her vocal chords as the problem.
Another option to discuss with your doctor is https://www.mayoclinic.org/diseases-conditions/eosinophilic-esophagitis/symptoms-causes/syc-20372197
Which has similar symptoms to those you describe. Hoping you feel better soon!
I’m reading this and thinking with alarm “if anything were to happen to Swistle…” It’s a little over the top reaction since I don’t know you even in the waving as we pass each other way, but it is real. Do take care of yourself. And do look into the stretching esophagas idea that several people said was easy and sounded the same as your situation. I hope that’s it! And requires only one doctor interaction! Sending lots of good thoughts to the person who allows me to “acknowledge my luckiness, without giving up my claim to the suckiness.”
Oh, I am so sorry you are dealing with (or had to deal with) this. I will say I personally have found the sudden introduction of telemedicine really useful and wonder if a quick remote consult with your PCP might be in order? I hope this was a one-time thing that never happens again, but if it is anything you need to be seen for, or have anything done about, I hope it will prove to be diagnose-able and treatable.
As someone who also has issues that are exacerbated by anxiety, hahahaha help me, I just wanted to say I see you. Ugh. Hope you feel better.
Agree with the person up thread who mentioned telemedicine. They can tell you based on your symptoms whether you need to follow up that way you aren’t responsible for the “should I shouldn’t I” dilemma. Had a friend who recently did this, was told to go to the ER (dizziness symptoms that might have been heart problems) and they sent him to a totally empty ER to get tests. Turns out he had stressed induced vertigo. Hope you feel better! Medical stuff on top of all this, blows!
I’ve got zero expertise with either this condition or the US health care system (lived there 2 years, never once even saw a GP. Luckily I was young and healthy!) but I just wanted to say OUCH that sounds unpleasant and scary. I, too, am largely driven by a fear of underreacting when it comes to my kids but when it’s me I’ll hold off seeking advice to a completely ridiculous extent.
Hi! Esophageal spasms here too! I take an anti-anxiety med, get into bed and I find it passes within about 40 minutes — if I’m still awake!
If your endoscopist/GI doc has an RN hotline, this would be exactly the kind of symptom they’re good at triaging. Reassurance, education, guidance, and on a rare occasion, a nudge to the office.
My wife had this and it was helped immensely by a simple procedure that expanded the esophagus again… I think it had to do with inflating a ring inside while she was sedated. She found relief almost instantly. She still will occasionally have issues but it is rare now.
I am echoing the sentiment of the above commenter who said if they tsk at you, so what, we will be here to lift you up. I would rather you err on the side of “have some water” than “gently die.”
I am so sorry this happened! Sounds very scary. My father in law also had this issue while eating. He had his esophagus stretched and it went away. He lived with the problem for years! During those years he swore by drinking a little bit of Coke to help the food make it through. (Sometimes he’d have to leave the room and spit up the food). The family affectionately termed his issue as cat throat.
CAT THROAT!
I came here to say this! I have this, and so does my dad…every once in a while, the food just will not go down. And my dad claims that drinking something fizzy helps him (although I don’t find it to be especially helpful, he does). It happens to me only when I try to eat something dry (chicken breast with no sauce, or plain rice) and don’t remember to drink something between EVERY bite. So very painful.
But dear god, Swistle, I’ve never had an episode without eating something at all! That’s mildly terrifying. I’m so sorry that happened. I’m seeing so many comments here suggesting the stretching thing, which I’ve always cringed at and avoided asking about because I feel like my instances are a little self-inflicted (eating problematic food too fast). But maybe this gives me the nerve to look into it.
I hope you never deal with this again.
Fizzy water and soda have helped my cat throat too.
Also, Apple cider vinegar and water.
Also, changing to pantoprozole- Protonix- from the ompera…medicine. Protonix works faster I have found.
Also, I’ve been pregnant as many times as you and I think that has affected my esophagus. I vomit a lot in pregnancy and also have history of bulimia, but not recently. I think those traumas have affected my esophagus long term. Maybe something to bring up with PCP about if you vomited in preg too?
I am sorry you are dealing with this, Swistle. As someone who also VIVIDLY imagines the dueling judgments of “just stay home next time, you’re fine” and “why didn’t you go straight to the ER!!!” any time I’m stressed about how to respond to health issues, I echo the commenters who have recommended telemedicine appointments with your primary care doctor and/or insurance nurse health lines. Being able to say “I am not sure if this is something to be concerned about, but I wanted to talk to a doctor or nurse about it” without having to leave home is immensely reassuring to me.
That sounds scary and painful. I’m sorry it happened.
Honestly, I would recommend setting up a doctor’s appointment to start getting this better-investigated at the doctor’s office level. If you’re not acutely in pain at this minute, then the emergency room/an urgent care is probably not the place to go, but– that level of sustained pain is not something to just ignore. If it was one of your kids, you wouldn’t. Even in these times. You should treat yourself with the same level of care.
Esophageal spasms ARE treatable! I’ve come off my medication somewhat recently after having reflux surgery, but the first time(s) I had them, I went to the ED for a cardiac workup because I thought I was having a heart attack. I’m an ER nurse and I couldn’t tell the difference!
The medication they gave me in the ED to manage it acutely was nitroglycerin. It results in a wicked headache, but it vasodilates (opens up) and all is good with the spasm stopping. My GI offered me that or Cardizem. I went with Cardizem, a heart medication, that did roughly the same thing without the side effects.
Now, back to the GERD. See a GI. See a good GI. Get an EGD and see what is going on. As others have mentioned, there could be some other stuff going on in there that a dilation or something else could fix. There are also varying levels of medication. I finally failed the top of the line stuff leading to the next level…
I had LINX surgery (magnetic band placed at the lower esophageal sphincter) in February and I’m reflux free. Not all reflux is on the magnitude mine was, but it *can* end up being fixed with surgery.
Thanks for all the info in this post! It’s helping me think through what to Discuss with my doctor.
Could you ask your PCP to do a telemedicine visit? Not that you won’t have to go for all of the other visits, but they could assess whether it’s an emergency room visit type of problem.
One of my local hospitals also has a nurse line that anyone can call and they’ll assess and refer as needed, maybe a hospital in your area has something similar?