Long story, but I will tell it.
When I was a young boy, I would be playing real hard and need a drink. I would drink and my chest would hurt. My mother told me it went down the wrong pipe. Happened maybe 6 times before the age of 10 and never again. Dehydration?
Have been having the chest hurt again over the last 3 years.
In 1994, I was told by an ENT who was evaluating me for Sleep Apnea that he thought I was having a lot of reflux. I told him some heartburn managed with antacids. I would eat late at night lay down and would have some issues with regurgitation. Said my lingual tonsils looked a little swollen and my vocal cords slightly irritated. Put me on Prilosec. No more problems. GP continued the prescription and have been on PPI ever since. Lots of stress and coffee each day.
In 1995, the ENT wanted to do a UPPP to help with the sleep apnea. He also added to this std procedure a notch at the base of my tongue with a laser. Only 2 ENT's in KC were adding the notch. Follow-up sleep study showed my Sleep Apnea was 100% resolved. No more was ever said about reflux. I was thrilled not to have to use a CPAP.
About 3 months later, I was having problems swallowing. I stuck my finger down my throat (no gag reflex thanks to the UPPP) and I had a giant growth at the base of my tongue. Went right to then ENT. He looked at it with his scope and said I had a cyst. Scheduled me for surgery. Took the top half off with the laser. Pathology came back fine.
Six months later the cyst was back. ENT wanted to research as he had never seen or heard of this in adults. I was his only patient having this complication from the surgery. Two weeks later his nurse call and said the doctor wants me to come in the office to inject it with a compound. This compound was Doxicycline with a numbing agent. Reoccuring cysts are treated this way. The compound would shrink the cyst and then turn it into scar tissue.
This lasted 6 months and my little friend was back. Can't tell you the number of times I have had it surgically removed or injected only to have it come back. Keep in mind I'm on a PPI the whole time.
In 2007 and still on a PPI, a local news spot talked about Barrett's Esphogus. Scarred me to know I was on a PPI for 13 years and no one ever suggested doing EGD, even as a baseline to see what was going on. I pushed my way in line to get one done. The GI who did it told me, whatever I was doing to keep it up everything looked great.
Nov 3, 2008 was the biggest wake-up call in my life. I drove myself to the ER complaining of severe left shoulder pain. Five minutes latter they confirmed I was having a heart attack. The fine folks were prepping me to go to the cath lab to see about getting me fixed up, then all of a sudden I heard them yell Vfib and my cardiologist ask me if I could cough. I shook my head no and that's the last thing I remember. I guess they pumped and pumped my chest for 15 minutes while the fought with the equipment to shock my heart back into rhythm. They don't use paddles like on TV, but patches to hook the leads on. They couldn't make good contact because, I'm a hairy guy. So they would pump and shave at the same time. Took 3 times, but finally it worked. When I woke up in ICU they told me they took out a huge clot in my LAD. I asked about a stent. And they said no, didn't need one. New drugs added were Crestor, Co-reg, and Plavix. Later added Trilipix and Niaspan. I went into Vfib because my potassium was low. Strange as it is, I had been taking Lisinopril for about a year which is a blood pressure med that is to spare potassium. FYI - no idea or reason given for blood clot.
Oh, I didn't tell you, but before my heart attack, I had no cyst on the back of my tongue. I was able to drain it the previous summer. A couple days out of the hospital it was back. It was the least of my worries as I began my cardiac rehab. In March of 2009, I went to my ENT, who looked at me as a risk for surgery due to recent heart attack decided to inject it again. This time the injection burnt my tongue, and mouth. Never did this before. It did shrink it, but not completely. He did mentioned that he thought my reflux was back. Lingual tonsils were swollen. I had no other symptom
In May of 2009, my chest was hurting when I swallowed. It hurt continuosly since the heart attack. I just figured the result of all the chest compressions. I did notice one day a twinge of burning 1 time when I swallowed some BBQ at the top of my stomach. So I pushed my way in line for another EGD. It was fine, just a little inflamation at the gastric junction. 20 mg of Prilosec in the morning and 20 mg at night for a month, then back to once a day. Never had the burning again like that. At the same time though I stopped the Plavix and Niaspan. Plavix stoppage was planned and I couldn't take the flushing of he Niaspan. Both are very rough on the stomach and I'm 90% sure was the problem for the burning I felt.
My chiropractor warned me that once I was on a statin, my gallbladder was likely to fail and it did. PIPIDA scan said it was 19. Referred to surgeon who removed it. It was very inflamed. Before going I went to my ENT. The cyst was gone, except for a bump a little higher. I just wanted him to confirm what I felt. He again commented about reflux and inflamed lingual tonsils. Sure enough after the gallbladder surgery the cyst was back. I always wondered if the intubation tube would or the actual process to intubation would injure my tungue. Went back to my ENT and got no where
I did go to anther ENT. We talked about a possible infection prior to me having a wisdom toothe extracted. Dentist had me on antibiotic which reduced the cyst some. He gave me prescription of a broad spectem antibiotic (Augmentin) and it shrunk it some more.
A month later I got this burning going on inside my sternum up high. I gave the old 'drink some wine test" and boy did it ever burn. I have esophagitis. Again, I push myself to the top of the list for an EGD. My GI guy said everything looked good except I had little white plaques up high. He thinks yeast. Would know in 2 days. Sure enough yeast. Probably brought on from the Augmentin. I took an antifungal for 10 days. Burning resolved, but chest still hurt with swallowing. Tongue also seemed to be sluggish. Seemed like I would only use my left side to swallow. My chiropractor notice back at the time of my gallbladder, that it seem I had a bit of a palsy going on with the right side of my face and neck. My first ENT laughed at me when I told him this.
All this time experiencing the swallowing issues, I had all these little balled up muscles in my chest on both sides of my sternum. These were what were hurting' not my esophagus. I tried massage and magnesium to try and resolve these. Nothing worked. I also notice the sides (front half) of my tongue would start aching and hurting midday for the rest of the day. Even the occasional canker soar. Food Allergy?
My wife the other day came home from the chiropractor with a bottle of folic acid. I was interested, so I started poking around the internet to see what it was suppose to do. I was shocked.
Folic acid deficiency may cause:
Diarrhea
Gray hair
Mouth ulcers
Peptic ulcer
Poor growth
Swollen tongue (glossitis)
I've had all but two of the symptoms ( Peptic Ulcer and Poor Growth).
I read other sites that talk about muscle fatigue.
Am I short on Folic Acid (a B vitamin)? What about B12? Certain digestive problems may also occur with a B12 deficiency. These might include heartburn, nausea, vomiting, and diarrhea. Bloating and constipation are other symptoms that may occur.
Looks like to me an absorption problem. I'm taking meds that affect this. PPI's and cholesterol. I've been fighting diarrhea off and on since the mid 90's. FYI - I'm taking large dosages of Vitamin D on my GP's orders because I was low.
So guess what I took a B complex vitamin and the folic acid and guess what? My symptoms have all rapidly resolved in 3 days. If your tongue isn't working right and it starts the swallowing process, things will go down wrong and hurt.
I suggest having your doctor do blood tests to check ALL your vitamin levels, including potassium and magnesium. I've been found to be short potassium and vitamin D. All after taking meds that affect your absorbtion. Why not folic acid and B12?
Think about it. This all affect the way our muscles operate. Whether its your tongue, chest muscles, neck muscles, even your LES. We probably are making things worse by staying on PPI's.
I'm not saying reflux isn't real and maybe is your problem. Just note that acid appears to be needed to for proper absorption, and signaling the LES to close. It makes me think twice about PPI's and their long term use.
