Today I almost suffocated, on the land. Underwater I would have died

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It doesn't take much acidity to cause the larynx to go into spasm. At least I remember having it happened when a little sour grape juice got into my larynx 2 or 3 times in the pass.

An esophageal problem could trigger it if it allows acidic gastric fluid to come up and into your throat, so that might be the reason why some suggest a reflux medicine that blocks the acid production in the stomach. If you have an esophageal stricture or scar, it might trap food in the esophagus enough causing fluid and saliva to back up into the larynx.

I guess what I mean is, you might want to have it worked up just to be sure. Last time I saw someone with hoarseness for 2 years (his family doctor was not worried about it), I sent him to an ENT. He was dead within 3 months from a laryngeal cancer.

Addendum: Oh, Dr. Mike is here... So, I'll pass.
 
I guess what I mean is, you might want to have it worked up just to be sure. Last time I saw someone with hoarseness for 2 years (his family doctor was not worried about it), I sent him to an ENT. He was dead within 3 months from a laryngeal cancer.

Yup... hoarseness is one of those things that shouldn't be written off without a look at the larynx!


Addendum: Oh, Dr. Mike is here... So, I'll pass.

Hahaha... I'll take that as a compliment!

And here I am, an otolaryngologist working as a camp doc for a week at my son's camp, just WISHING that I had a dermatologist around! Just diagnosed a kid with some sort of fungal skin infection, but what do I know... ? At least I have Internet access so that I can Google for the stuff that I don't recognize, but that isn't enough to warrant a trip into town to the urgent care center...

Maybe if I get real stuck I'll PM you a photo of the rash.. :)
 
Its pretty rare to get skin fungal infections in kids (except the zoonotic type - from cats usually). I tend to think more of juvenile plantar dermatosis when another doc might think athlete foot, and I usually think of granuloma annulare when someone think of tinea corpora.

However, fungal infection of the scalp is quite common in african american, occasionally seen in caucasian children too. With these, they sometime get on the body and face. But athlete foot and jock itch is rare in kids otherwise. An african american child with dandruff is tinea capitis until proven otherwise. One poor child actually had discoid lupus of the scalp, that was mistaken for tinea. So my rule of thumb doesn't always work.

If they have cats, then one have to think of microsporum canis, but haven't seen one in over a year.
 
Well, since we are going a bit off topic here, I will go ahead and PM you, taking your post as implied consent for me to bug you off-thread!

What a great community...

:)
 
If they have cats, then one have to think of microsporum canis, but haven't seen one in over a year.
Ring worm? I remember my brother and I having that, but no cats. Can't you get it from dogs and other kids too?
 
Ring worm? I remember my brother and I having that, but no cats. Can't you get it from dogs and other kids too?

Sorry to hijack the thread. Yes, you can get it from other kids, and even dogs too. But at least in my community, I don't see it that much. Except in the african american community - where it is most prevalent as scalp fungal infection (black dot ringworm). Then it can secondarily infect other sites, usually the face and neck.

Certainly, this prevalence is different in different communities. Farmers can get zoonotic fungus from cattle, sheep, goats. Dogs can be a carrier too, but cats especially kitten are the biggest culprit.
 
Thank you very much!
My guess is that maybe a piece of "sticky rice" was there somewhere at the larynx and confused it!
Thanks again for the background informations.

Hi...

Glad that you are OK now..!

Here is some background.

The main purpose of the larynx is, as you may be surprised to learn, not speech! The larynx (the vocal cords, to be more specific), is a structure that keeps us from choking on food and other liquids (such as saliva, etc..).

Evolutionarily speaking, the larynx developed to allow us to have the food and air passages share a single common space in the back of the throat (the pharynx). Most mammals have this configuration. Food from the mouth, and air from the nose and mouth both pass through the pharynx before being directed into the food passage (the esophagus) or the airway ( the trachea) respectively.

Whales and dolphins don't have this problem, even though they are mammals. The air passage is routed out through the top of the head (the blowhole), although they need another mechanism (the sphincter) to keep from drowning. People who have had their larynx removed because of cancer are in a similar situation, with the trachea routed out of the skin of the neck (a tracheostomy) and being completely sepertated from the food passage.

Swallowing is a fairly complex series of maneuvers that involves the larynx elevating, the esophagus (the food tube) opening, and the vocal cords closing together. Sometimes it doesn't work as well as it should, and you can aspirate (food or liquids going through the larynx into the lungs). We all have experienced this when something "goes down the wrong pipe". This results if food or liquid in the airway (the trachea), causing our next line of defense to kick in - a powerful cough - which usually propels whatever you have aspirated out of the lungs. However, sometimes this backup mechanism fails too. That is when I have to get up in the middle of the night and fish a piece of a toy or a peanut out of some kid's trachea...

In some cases, the vocal cord protection doesn't work well. This can happen after a stroke, when the sensation of the larynx is diminished, or the motion of the vocal cords are impaired. Some stroke patients can't eat without aspirating, or in lesser cases, can't drink think liquids (which are more easily aspirated than thick stuff).

In other cases, the vocal cord protective mechanism works "too well", or rather lasts too long. This is laryngospasm, which is what it sounds like the OP had. Laryngospasm almost always is self limited, since even if it lasted long enough for you to lose consciousness, once you were unconscious (and presumably not diving!), the larynx would open again. Nevertheless, there are reports of people who had emergency tracheotomies for laryngospasm. A variant of this - spasmodic croup - can be similar to this, and even though there is no actual physical problem with the larynx, the patient can feel like they are suffocating. The maneuvers to break laryngospasm described in Wikipedia really apply more to patients undergoing surgery, who often go into laryngospasm as they emerge from the deeper stages of anesthesia.

An ENT exam (flexible fiberoptic examination of the larynx in the office) is usually recommended in these situations, although there usually isn't much to see. It would be important to find out if a foreign body (piece of chicken, etc..) was actually aspirated, since this can cause serious problems if not removed. It can be hard to make this diagnosis without bronchoscopy (examination of the trachea and lower airway under anesthesia), x-rays can miss the signs of a foreign body.

Good luck! Sorry, I don't know any ENT docs in Thailand...
 
It doesn't take much acidity to cause the larynx to go into spasm. At least I remember having it happened when a little sour grape juice got into my larynx 2 or 3 times in the pass.

An esophageal problem could trigger it if it allows acidic gastric fluid to come up and into your throat, so that might be the reason why some suggest a reflux medicine that blocks the acid production in the stomach. If you have an esophageal stricture or scar, it might trap food in the esophagus enough causing fluid and saliva to back up into the larynx.

I guess what I mean is, you might want to have it worked up just to be sure. Last time I saw someone with hoarseness for 2 years (his family doctor was not worried about it), I sent him to an ENT. He was dead within 3 months from a laryngeal cancer.

Addendum: Oh, Dr. Mike is here... So, I'll pass.

It started before I tried the orange juice, I just took the orange juice because it was the nearest fluid I could get.
A bit strange for me, all what I vomit was a clear tasteless fluid (high viscosity) or a foam of it. It did not look like acid from the stomach (but wasn't from the lung as well).
So I don't think it wasn't acid triggered.
I'll simply follow "Web Monkeys" value input "Don't eat under water":popcorn:
 
A clear tasteless fluid is likely mucous or saliva. You might have an esophageal dysfunction, obstruction that did not let the "sticky rice" move down. Stomach juice is usually very harsh and sour.

This fluid could've triggered the spasm. But again, once the ENT clear you, you might want to discuss about the intestinal issue. Someone could order an esophagram - where you swallow food and see how it goes under a fluoroscope, or do un upper GI scope, or get a barium swallow. It can be cheap for the barium swallow, or more invasive like the scope. Depending on your insurance and ability to pay.
 
Someone could order an esophagram - where you swallow food and see how it goes under a fluoroscope, or do un upper GI scope, or get a barium swallow. It can be cheap for the barium swallow, or more invasive like the scope. Depending on your insurance and ability to pay.

Yeah, I agree. I am pretty quick to get esophagrams (barium swallows) on any kid with unexplained swallowing problems, especially if solids are more of a problem than liquids. With kids, it is more likely congenital things (like webs, or abnormal blood vessels wrapped around the esophagus), or foreign objects (kids swallow the most amazing things!). But there are other conditions that can cause progressive problems with swallowing, or with reflux.

Esophagoscopy is more invasive, requires sedation or anesthesia, doesn't give you as much functional information, and is more expensive. More for retrieving foreign objects, or in cases where you need a good look at the lining of the esophagus (for example, if a malignancy is suspected).
 
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