Posted by Henry F. on September 26, 19102 at 11:15:00:
In Reply to: LORAZEPAM CURED THE LUMP IN MY THROAT!!! posted by Suzy on February 17, 19102 at 04:29:14:
:How bicycling helped my cricopharyngeal spasm / lump in throat.
I’m a 42 year old male who incurred an injury to the vocal cords
through improper singing technique. I continued the pejorative
singing practice for several weeks and then continued to speak softly
after seeing a doctor. My vocal cords only healed when I ceased
from speaking altogether. A feeling of a lump in the throat remained.
It would show up as I spoke. This was several months after the initial
damage. After my doctor pronounced my vocal cords healed he
informed me that I had bowed vocal cords. This produced a hoarse
voice. A speech therapist was recommended. The doctor suggested
that the injury had weakened the muscles of the vocal cords and that
careful vocal exercise would rebuild that muscle helping to close the gap
between the cords. Adducting the cords to form a sound strained the cords.
I would feel a twinge in the throat within the Adams apple. This
would spread to other muscles and even up under the chin and around
the front and side neck muscles. Posture also had an influence. If I
craned forward over the computer keyboard the same spasm would
result. In that case I could slow the spasming process by straitening up
or leaving the computer and walking about. I was intent on seeing the
therapist only after the feeling of a lump and spasming in the throat had
subsided. It occurred to me that cycling might have a good
effect on the problem. My reason was that if I could get more blood
supply to the throat and even to the vocal cords by a good physical
workout, this would help with the healing and the spasms. I knew that it
would take more than just a mild ride in the country. I would need
over an hour of cranking pedals at a moderate rate to get any results.
I chose a mountain bike with street tires and kept it in the lower gears
to emphasize the cardiovascular action. I drank a lot of water.
I rode at a moderate speed of between 8 and 12 miles per hour for 16
miles late at night. After the first few miles I experienced discomfort
in the throat but was confident that I was not doing serious damage
because a doctor had assured me that the cords were healed. I
proceeded cautiously still maintaining a steady pace. Some discomfort
was experienced in the throat on and off throughout the first trip.
The result of the first ride was a slight waning of the intensity of the
spasm. I awoke that night having to fight for breath once or twice.
I thought this might be due to the tiredness of the larynx muscles after
the workout. I also used the bike to do some short trips around the
neighborhood at nearly the same speeds. After doing that exercise for
several days, I noticed a slight improvement in the throat. I also noticed
that I had more energy. The muscles within the larynx were also getting
a good workout holding the vocal folds open for more air flow. Most of
the brain activity will be used to signal the skeletal and cardiovascular
muscles as opposed to the swallowing muscles. Interestingly enough,
I managed to control the spasming until an unrelated injury forced me to
stop riding the mountain bike. The spasming returned so I switched to
a recumbent bicycle with very good results. No more spasming occurred.
The bicycle exercise was certainly responsible for relieving the spasms.
The most effective things to halt my lump in throat problem were:
1. Prayer
2. Drinking lots of water.
3. Starting a good cardiovascular exercise program.
:
: Hi,
: In an earlier posting, someone mentioned having a lump in their throat when they were very anxious, which wouldn't go away. In my response, I explained to her that I had a similar experience, which to me was so disturbing, that I wore myself out trying to fight it, til I developed a very severe depression. With the lump was a feeling of anguish and despair. After some research, I found out that this lump isn't always a psychological thing, and wanted to share this with others who might be suffering from this problem. This what I wrote her:
: You didn't mention if you're on any medication. I want to share with you my experience with the lump in my throat. I used to get it from time to time when I was very anxious or sick, even as a kid, but it usually would go away. That's what another person at this site wrote about, called globus, or globus hystericus, which in Mosby's Medical Dictionary is described as follows: a transitory sensation of a lump in the throat that cannot be swallowed or coughed up, often accompanying emotional conflict or acute anxiety. The condition is thought to be caused by a functional disturbance of the ninth cranial nerve and spasm of the inferior constrictor muscle that encircles the lower part of the throat.
: I got the lump in the throat you describe, that this time wouldn't go away, from an antidepressant (Elavil). It was first prescribed for me for severe anxiety and depression, quite a while back, before Prozac, Zoloft, and the new SSRI Antidepressants came out. The higher the dose, the worse it got. My doctor just ignored it for 5 months and kept increasing the Elavil, making my throat feel even tighter. It finally became so unbearable, and I became so obsessed with it, that I was really thinking of suicide, since no amount of relaxation exercises, will power, chewing gum, or focusing on other things helped. I even tried hypnosis. The only time I didn't feel it was when I slept, when my muscles were completely relaxed. I wore myself out trying to fight it on my own. My doctor finally changed my medicine to Nardil (An MAO Inhibitor - not for everyone - too many warnings about food and drug interaction).
: It was great for me though, as I follow the warnings to a tee and have been on it for over 20 years. In addition to helping calm the severe anxiety, it actually made me feel a little high, at the higher dose on which he first started me, and reduced my phobic thinking, where I didn't feel quite as bad when I was around other people - not feeling as shy or inhibited. For the first time, I had hope I was going to be fine. It even helped me with my irritable bowel and my anorexia where I couldn't keep my food down. It also lowers the blood pressure, as a side effect, which is good for people who have hypertension. I started therapy too, and the comforting words from the doctor and the hope he gave me that I was going O.K. also helped (the placebo effect). Two months into taking the Nardil though, the lump in the throat came back. I became hysterical, until I started to do some reading and came accross the words: extra-pyramical reaction. It seems some medications cause this as a side effect (nervous spasms).
: The PDR (Physician's Desk Reference Manual) also describes swelling of the glottis (the back of the throat), as one of the side effects with some antidepressants and other psychotropic drugs. Some medical conditions, by the way, can also cause this feeling, like an enlarged thyroid, some neurological disorders, food or other types of allergies, etc., and anxiety can make the symptoms worse. You should have all these checked out just to be sure. I started seeing a new doctor who added Ativan(Lorazepam), to the Nardil, and miraculously, the lump went away, since it helped my muscles to relax. Ask your doctor about it. Even though Ativan is an antianxiety drug, a Benzodiazepine, it seems to work as a muscle relaxant. Some other Benzodiazepines do the same thing. I know Valium does, but I'm not sure about Xanax, since I never took it, and haven't read about it. Without the Ativan though, I don't believe any amount of refocusing or will power would have helped.
: From time to time, I still get the fear that the lump will come back, since it had become a phobia, and I start to panic. But then I get busy and think about other things, or refocus, and sure enough, it always goes away. Of course, still being a phobic personality, I always think "WHAT IF" the next time it doesn't go away?" I also found that slow, deep breathing from the diaphragm also helps with all types of anxiety. I never believed it would work when my doctor suggested it til I tried it. I was really surprised. Trying to relax through your fears and facing them instead of running away from them like we all tend to do gives you a feeling of control over them, whereas running away really does reinforce them. You should also have a good checkup to see if anything organic can cause what you're feeling.
: I hope my advice helps. Good luck.
: Suzy
:
: Following is an article written by an M.D. I just found on this site, who mentions treating patients for the "lump in the throat" with Valium, a good muscle relaxant, as I stated in my post. It's in the same family as Lorazepam/Ativan, the antianxiety medication which helped me relax my throat muscles or spasm:
:
:
: Cricopharyngeal spasm
: Information for patients with a lump in the throat sensation
: Causes of a cricopharyngeal spasm
: Symptoms of a cricopharyngeal spasm
: Why did I get a cricopharyngeal spasm?
: A management program
: Benefits of managing cricopharyngeal spasm
: Causes
: This syndrome results from a spasm in the cricopharyngeus muscle. It is a self limiting disorder that will resolve on its own. The symptoms are so characteristic that as soon as a patient tells me they have a lump in the throat, I can describe all of their symptoms to them.
: Symptoms
: Lump in the throat sensation
: feels like a golf ball, tennis ball ... is stuck in my throat
: feels like my tie is too tight
: my throat feels swollen
: The symptoms can be mimicked by pushing on the cartilage in the neck just below the Adams apple.
: The lump comes and goes depending on the day.
: Symptoms are usually best in the AM and worse later in the day
: Stress aggravates the symptoms.
: Saliva is difficult to swallow yet food is easy to swallow.
: Eating, in fact, often makes the tightness go away for a time.
: The symptoms are similar to getting choked up at a wedding or a funeral.
: Physiology 101
: There are two valves in the esophagus or swallowing tube. The are normally contracted and they relax when you swallow so that food can pass through them going to the stomach. They then squeeze closed again to prevent regurgitation of the stomach contents. If the normal contraction becomes a spasm, like a charlie horse of the calf muscle, these symptoms start. Stress often makes these spasms much worse. Many people have experienced neck tightness when stressed and this is similar. Even if not caused by stress, stress will make the spasm much worse.top
: A management program
: An exam of the neck and throat is extemely important to eliminate serious problems. In fact, it enters most peoples minds that a lump in the throat might be a cancer. In practice, real lumps in the throat, such as a cancer are not felt. It is one of the reasons that a cancer can get so big before it is discovered. It probably is fortunate that we don't have great sensation in the throat as we would then feel every particle of food, with every meal as it travels down the throat. So lacking great sensation in the throat, problems are a little mysterious there.
: Unfortunately, many physicians are not familiar with how symptomatic a cricopharyngeal spasm can be and I often see patients who have been extensively tested with Barium swallows, esophageal endoscopies, pH testing, CT scans, xrays, MRI scans and they all come back normal or possibly with some finding that is completely unrelated to the lump in the throat sensation. Really, just a good exam of the throat, voice box and neck is all that is necessary and it is sufficient as well. You should know the following:
: Just knowing the tightness is not a sign of cancer frequently helps relieve the discomfort.
: You will get better. Often improvement is over several weeks or even a few months, but occurs once one knows what the problem is.
: Warm fluids should comfort the throat. Consider a cup of warm tea when the lump is bothersome.
: If stress lets up, the symptoms improve. Think about what stress might be making this lump worse.
: Muscle relaxants, such as valium, would be a good treatment, except for their addictive properties.
: Medication
: I sometimes dispense several valium (perhaps 4) as a test to prove the symptoms are from muscle spasms. I recommend taking one of the Valium on a weekend, when being alert is not important. When the lump occurs, one takes the Valium. Within an hour, there should be significant improvement in the lump sensation. If the symptoms improve after taking the muscle relaxant, then the symptoms are reasonably from a muscle spasm. Again, the knowledge that a muscle relaxant makes a lump disappear can help confirm that the cause of the lump is from a muscle and not an actual lump.
: I have also tried injections with a local anesthetic, often with good, but temporary results. It does help to confirm in the patients mind, there is the possibility of relief.
: If a local anesthetic injections helps, I have with inconsistent results injected botulinum toxin into the cricopharyngeus muscle, sometimes with prolonged relief.
:
: Benefits
: The symptoms go away. top
:
:
: Contact the author: James P. Thomas, MD
: Updated 1 November 2001
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