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Dentist Visit, Throat Lump, Lost Voice, Fast Heart Rate, Blackout, High Sugar And White Count, Lisinopril, Antibiotics, Xanax, CPAP. Opinion?

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Posted on Mon, 21 May 2012
Question: I went to the dentist on the 4th and after third shot got shakes started to feel like passing out. reaction stopped after 20 min, tired the rest of day. That night had feeling of bread stuck in throat. I did choke and cough at dentist but i think from the slaiva. The feeling of stuck in thrat has never left. went to dr on 6th, given antibiotics and inhailor to treat swollen red thrat no real sign on inf but covering all areas. 6th night lump in thorat feels bigger loosing voice , no pain. sent to er, treated for reaction to lisinopril htct, given 20mg steroids three pills a day for 5 days and benadril every 6 hours. took that night no prob. took next day and had to go to er again. felt like I was stopping breathing even though wearing my c-pap mask, had confusion and lost 4 hours of memory. thought it was 5 when it was 8. had mild heart acceleration with feeling of passin out heart rate 137, lasted only minutes and would pass. dr said having withdrawl to xanax and reaction to benadril told stop taking benadril and take xanax. I have been weened of xanax by family prac long before and last dose taken was .125 of a mg , only at night one time day but had stopped that 8 days earler and had no prob. I do not believe it was xanax withdrawl and do not take there pills. dr sent me home after drugging me. 7th slept most of day have black out periods in morning and lengthy conversations that later that night i have no recolection of. monday go for follow up dr desides to send me to ear nose and cadio however have not been able to soo them as of yet. the 13 go to see my family prac, She looks at hospital report and finds sugars were 237 in hospital and white count was up. I am waitinf to see ear nose dr and cardio still . I still feel a constant feeling of somthing stuck in throat , there is no pain but uncomfortable to swallow around it and there is no relief from it. it has been 12 days non stop. My dr is rechecking sugas for diabetes. this is something that i have never had before and it came on all of sudden. Please tell me your opinions , thank you, Tanya.
doctor
Answered by Dr. Tulasi Raman.P (2 hours later)
Hi XXXXXXX

Thank you for the query.

First of all I want to appreciate you for giving symptoms in order with the dates.

Let me address your queries one by one.

1. The shake you got at the dentist could probably be due to drug reaction (local anesthetics)

2. Feeling of something in the throat is probably due to congestion of the pharynx. But if you are definite that you have something there you can always get an X-ray done as it would show up in it.

3. Voice loss is also due to congestion of the throat probably of the larynx(voice box). Your voice will return to normal once the congestion comes down.

4. Breathing difficulty in ER though you were wearing C-PAP mask could be due to laryngeal edema again a symptom of probable drug reaction.

5. Confusion and memory loss is due to the effect of the treatment of laryngeal edema it is a side effect of the sedatives.

6. Sleeping most of the day on 7th, black outs, and loss of recall is again the due sedation.

7. Regarding Diabetes, as it is a silent disease its possible that you had it long before these events which was discovered during these events. Have a regular follow up with your doctor to keep sugar levels in control.

So in summary all your symptoms in my opinion are due to reaction to the drugs and its treatment, but I am not able to exactly point out to which drug this could be.

Regarding the consultation of various specialist as advised by your doctor I suggest you to get their opinion as well.

I hope my answer has been adequate and informative. If you have any follow up queries I will be available to answer them.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Tulasi Raman.P (2 hours later)
The dr in er said I had angio edema caused by a reaction to lisinopril. The first symptoms started on the 4th evening after my dentist and my visit was on the 6th to the er. I took the steroids from the 6-10th. That has been the only medican I have been on, I am completly medican free. Do you think that I should still be having a feeling of somthing cought in my throat? the symptoms have not changed since the 4th evening. The voice gets raspy at times, however there is no time when i do not have the sensation of somthing in the midle front of throat. I did have a small nodule in my thiroid that has been monitored by ultra sound and has not changed in size over the last two years. I had it checked as recently as three months ago. I have been going to the dr for a long time complaining of fatigue and swelling on my outer ear. I have had a multitude of sympoms mostly a feeling of having flue like syptoms, cold hands and feet, tingling in toes and back, face twitching, head aches, upper back tention and soreness. times of feeling hot flushed in the face, irreg periods, heavy clotting, and my right eye has been blurry for thre months. I have been to the eye dr and had complete exam and vision is 25/20 both eyes , does not see anything wrong with eyes except for some floaters and mild 25/20, however right eye continues to bother me and is blurry to me while left eye seems normal. I have some straining pulling sensation in it as well. My dr before this has sent a referal to a nuerologist to rule out ms, she does not believe it is that but trying to find answers. I have been tolerating being off lisinopril htct very well and my blood presure is better now then when i was on it. My readings are ave 120/80 on the lisino were 130/85. I originally went on it over two years ago when my presure was 170/110, at that time had a problem with heart and undiagnosed sleep apnea. I had heart surgery a couple years ago to correct the problem. I had and extra pathway in the upper right chamber of my heart. I had an ablation and they used radio frequency to close the pathway and am completly healed. I also when to a sleep dr and recieved a mask and use it everynight . My past history of health is the heart and before that I was hospitalized for a severe lung infection and was in intesive care . My family was told that I was not expected to survive however I am a fighter and did. It was later told to me by my dr that he believed what i had was sars. He made refernce to this in my chart. after that I ended up with erathmia nordosum in my legs and had to be put on steroids to make it go away. I had had erathema one other time 3 years earler. I was pregnant with third shorly their after when I developed complecations and was told i had gestational diabetes. I managed it well with diet. when she was 4 months old I was hospitalized with virial menegutious diagnosed through a needle in my spine. Healed after a week in hospital. that led to the heart surgey and then the sleep apnea and now here I am with this feeling of somthing in my throat. other things I have had are mono as a teen and belspaulsy at 11. I have pseriousis that is in remition after a low coarse treatment of antibiotics for a few months 4 years ago,I also have rosacea. that is all the things i can think of. I know that most of these do not contribute to this feeling of something in my throat, however i never get to tell a dr everything as there is not enough time for them. I just want to know how to be healthy and to get rid of this feeling in my throat. I have not felt healthy for years and when i have attempted to excersice I get a feeling of having the flue. I weigh 183 pounds and i am 5.3 this is the heaviest i have been since i was pregnant with third child. I am not a lazy person but am very sedentary due to feeling ill most of the time. Please dr help me and tell me what can I do to get rid of this feeling in my throat? there is no pain but it is very uncomfortable. Thank you, Tanya
doctor
Answered by Dr. Tulasi Raman.P (4 hours later)
Hi XXXXXXX

Thanks for writing back.

You really have a long list of medical conditions.

I will try to answer your query in a step by step pattern.

Yes, it could have been angioedema which is a form of adverse hypersensitivity reaction to the drug. This explains you breathing difficulty inspite of wearing CPAP mask.

Treatment for this is steroids, which was rightly administered to you.

During the dental procedure there could have been a minor injury/infection to the throat. Usually this heals by itself without causing symptoms.

Now here is the catch. It is the steroids. One of the side effect of steroids is it inhibits healing process of an injury and exacerbates the infections anywhere in the body. So this could be a potential cause for the sensation in the throat.

As you have said the thyroid nodule has not increased in size since two years that should not causing any symptoms now.

Regarding the eye problem I cannot say much because it needs a thorough eye examination before I can say a word about it.

Your Blood Pressure has been under control with the help of Lisinopril but it seems that you drug reaction is mainly due to this drug so I suggest you switch to a different and better class of drug to control Blood Pressure.

You have had extra-nodal pathway in the heart that has been adequately dealt with Radio Frequency Ablation.

You have had an amazing recovery following lung infection which probably could have been SARS.

Erythema Nodosum was treated with steriods.

During pregnancy you had diagnosed to have Gestational Diabetes. Most of the patients with Gestational Diabetes become overt Diabetes after a certain age as seen in your case.

Childhood history of Mononucleosis and Bells Palsy (Viral aetiology)

Psoriasis presently in remission. Rosacea is also present.

After going through the entire summary of what you have written I can't help but think that you also would have gone through a great deal of mental trauma associated with you condition. So it is possible that you could have some mild clinical variant of depression.

So there is a strong possibility of mental ill-health you could be suffering from. I suggest you to seek professional help from a Psychiatrist who might provide some help to improve your life in general.

I hope my answer has been adequate and informative.
Wish You Good Health.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Tulasi Raman.P

General & Family Physician

Practicing since :2010

Answered : 126 Questions

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Dentist Visit, Throat Lump, Lost Voice, Fast Heart Rate, Blackout, High Sugar And White Count, Lisinopril, Antibiotics, Xanax, CPAP. Opinion?

Hi XXXXXXX

Thank you for the query.

First of all I want to appreciate you for giving symptoms in order with the dates.

Let me address your queries one by one.

1. The shake you got at the dentist could probably be due to drug reaction (local anesthetics)

2. Feeling of something in the throat is probably due to congestion of the pharynx. But if you are definite that you have something there you can always get an X-ray done as it would show up in it.

3. Voice loss is also due to congestion of the throat probably of the larynx(voice box). Your voice will return to normal once the congestion comes down.

4. Breathing difficulty in ER though you were wearing C-PAP mask could be due to laryngeal edema again a symptom of probable drug reaction.

5. Confusion and memory loss is due to the effect of the treatment of laryngeal edema it is a side effect of the sedatives.

6. Sleeping most of the day on 7th, black outs, and loss of recall is again the due sedation.

7. Regarding Diabetes, as it is a silent disease its possible that you had it long before these events which was discovered during these events. Have a regular follow up with your doctor to keep sugar levels in control.

So in summary all your symptoms in my opinion are due to reaction to the drugs and its treatment, but I am not able to exactly point out to which drug this could be.

Regarding the consultation of various specialist as advised by your doctor I suggest you to get their opinion as well.

I hope my answer has been adequate and informative. If you have any follow up queries I will be available to answer them.