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Suggest Treatment For Intermittent Hoarseness While Having Acid Reflux

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Posted on Mon, 4 Jul 2016
Question: Doctor, I have a history of hoarseness that comes and goes but can last as long as months. Since September, 2015, I was hoarse when speaking. I went to my doctor and she gave me prednisone and it helped so that I had a couple of weeks before Christmas where I could speak. The day after Christmas, 2015, I was hoarse again and then in the beginning of April, I was having a problem with mucus and coughing to the point of not being able to speak. My husband even called the paramedics because I couldn't catch my breath. They treated me as having a panic attack. Before the EMT call, I had taken two types of antibiotics, a prescription cough syrup, and Prednisone. I still cannot raise my voice above a whisper. I saw an ENT and pulmonologist but the tests were normal. It is now the beginning of XXXXXXX and I still can't talk but I discovered that I can sing higher pitched songs but the inability to talk normally is still not there. What type of doctor should I see? I am retired, thank the Lord, but I still have a child and grandchildren, friends along with a husband, with whom I would like to communicate. Thank God for texting. Do you think I will regain my speech or will it require something more than those doctors proposed, which was nothing when they got the tests back (CT scan of sinuses and throat)? Thank you very much. Regards, XXXXXXX

I remained hoarse since the day after Christmas, 2015 until the episode on April 3rd.
I have been taking medications for acid reflux for years. I also have problems with my legs and back since I had two spinal fusions and other back surgeries from 2008 until 2011. My legs are stiff and often spasm. I have seen neurologists and orthos but have no help and no real diagnosis as they say I should not have this problem. I am very frustrated and discouraged. Thank you.
doctor
Answered by Dr. Suresh Heijebu (8 hours later)
Brief Answer:
Vocal Cord Narrowing is needed.Spinal MRI is needed.

Detailed Answer:
Hello, Madam

I can certainly understand your concern.

I have worked through your query in detail.

As per your history, you possibly seem to have Vocal Cord Paralysis.

I advice you to get a Direct Laryngoscopy .

You need to get a vocal cord medialisation procedure to get the cords closer.

This will set right the annoying hoarseness which you have been experiencing.

Acid reflux needs to be under control.

CT will not give full information.

it's important that you consult an ENT surgeon who has specialised in Vocal Cord surgery.

Once vocal cords are set right, you will tend to enjoy normal voice again.

Pertaining to the back surgery and leg stiffness, it's important to get an MRI scan of the lumbar spine to assess the state of post fusion finer details and risk of any osteoarthritis.

Further management if any is based on test results.

Additionally, I advice you to get a complete blood picture/CBP and update me with the test results.

Post your further queries if any.

Thank you.




Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Suresh Heijebu (10 hours later)
Thank you, Doctor. I have learned more from you than the doctors I have seen for my voice issues. I have been given many reasons for my back pain, leg spasms, and stiffness. Basically, I think it comes down to scar tissue affecting a nerve or nerves. When I see neurologists, they seem to be looking for diseases and dismiss my leg limitations. A pain doctor said she believes I have a structural problem but that is out of her realm. I see another pain doctor for my medications to control the worst of the problems--Percoset, Valium, Cymbalta, and Tizanadine. They help but do not cure. I don't know if I should see an orthopedic doctor or keep trying neurologists. My ortho surgeon said that I will probably always have a problem even if I have surgery again, with scar tissue. It isn't the scar tissue, it is the nerve or nerves that are being impinged by the scar tissue and there is some stenosis. This has been going on for 8 years and I feel like I have no life. When I go out, I have to go in a wheelchair because my legs will freeze up at times and then I cannot move. My last MRI was in 2014. They can't seem to find what is causing this. Thank you for your efforts.
doctor
Answered by Dr. Suresh Heijebu (3 hours later)
Brief Answer:
Further management is based on test results.

Detailed Answer:
Hello, Madam.

I can certainly understand your concern.

Yes, indeed the possibility of a nerve impingement is high rather than a scar tissue.

it's important to consult an Orthopaedic surgeon followed by a Neurosurgeon with the latest MRI scan to reassess the spine situation.

Likewise, it's very important to reschedule the dosages of all the pain medications in consultation with your pain doctor to minimum required dose.

Blood hemoglobin need to checked via CBP test.

Many of your symptoms can be reversed.

It's important to update your relevant doctors with all the test reports.

Post your further queries if any.
Thank you.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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Suggest Treatment For Intermittent Hoarseness While Having Acid Reflux

Brief Answer: Vocal Cord Narrowing is needed.Spinal MRI is needed. Detailed Answer: Hello, Madam I can certainly understand your concern. I have worked through your query in detail. As per your history, you possibly seem to have Vocal Cord Paralysis. I advice you to get a Direct Laryngoscopy . You need to get a vocal cord medialisation procedure to get the cords closer. This will set right the annoying hoarseness which you have been experiencing. Acid reflux needs to be under control. CT will not give full information. it's important that you consult an ENT surgeon who has specialised in Vocal Cord surgery. Once vocal cords are set right, you will tend to enjoy normal voice again. Pertaining to the back surgery and leg stiffness, it's important to get an MRI scan of the lumbar spine to assess the state of post fusion finer details and risk of any osteoarthritis. Further management if any is based on test results. Additionally, I advice you to get a complete blood picture/CBP and update me with the test results. Post your further queries if any. Thank you.