Q: Years ago my doctor sent me for a gastroscopy (the opening to my stomach was inflamed). I was prescribed lansoprazole, which has been beneficial, but my problem is breathing. Initially I had breathing problems while eating — I’d get food stuck in my throat. Recently this happened when I wasn’t eating and I struggled for breath for five minutes. I’m 63, otherwise healthy and active; I walk my dog five miles every day.
Stephen Larkin, Newcastle upon Tyne.
A: The frightening symptom you’ve described is laryngospasm — essentially, the vocal cords suddenly seize up, temporarily blocking the airway.
First, let me reassure you that while this can be terrifying, it is not life-threatening, but I do sympathise with your anxiety.
The cause undoubtedly lies in your long history of acid reflux (for which you were prescribed the lansoprazole).
This is where stomach acid or undigested food comes back into the throat, causing the sensation you describe of having food stuck in your throat (a symptom known as dysphagia). Sometimes the acid or food comes into contact with the larynx (or voice box), triggering a laryngospasm.
Although food and drink are swallowed down one tube (the oesophagus) and air is breathed in through another (the trachea) they share the same initial pathway. This is why acid rising up the oesophagus can spill over into your voice box.
DR MARTIN SCURR: Sometimes the acid or food comes into contact with the larynx (or voice box), triggering a laryngospasm (stock image)
Your previous swallowing difficulties will probably have been linked to inflammation in your oesophagus due to the stomach acid — lansoprazole is a powerful drug, which works by suppressing acid production.
I suspect your laryngospasms occurred because, as you say in your longer letter, you only took the lansoprazole intermittently.
You should consult your GP about this, but I would expect regular use of lansoprazole should prevent further recurrence.
Q: Since having the plaster removed from my broken wrist, I have been experiencing unbearable pain at night. And in the daytime my fingers tingle and I have no feeling to pick anything up. Why am I still experiencing these symptoms?
Linda Gill, Twickenham.
A: It sounds like the nerves in your wrist have been damaged, which is not an uncommon complication of wrist fractures.
Three nerves run through the wrist and into the hand: the median (which helps you move your forearm, wrist and fingers), the ulnar (which helps with fine hand movements and grip), and the radial (the largest nerve in the arm, which is responsible for extending the wrist and fingers).
I suspect you’ve fractured your radius, the larger bone of the forearm and wrist joint. This type of fracture also damages nerves in 6 per cent of cases, typically the median nerve (the pain, tingling and weakness you’ve experienced are consistent with this).
As these symptoms were present from the start, it is likely that the injury itself caused fragments of bone to press on the nerve.
DR MARTIN SCURR: A radius fracture damages nerves in 6 per cent of cases, typically the median nerve (the pain, tingling and weakness you’ve experienced are consistent with this) (stock image)
My advice is to ask your GP about being referred to a neurosurgeon for assessment of the nerve damage in your wrist. This should include an MRI as well as nerve conduction studies (where tiny electric shocks are used to assess the function of each nerve in turn). This is painless.
Once the diagnosis is confirmed, treatment may include wearing a wrist splint, or you might need surgery to relieve any compression on the nerve. This should be followed by physiotherapy to restore muscle strength in the wrist and hand, which will have weakened.
In the meantime, you can buy a removable wrist splint from your local pharmacy to immobilise the wrist. This can be very helpful in minimising this kind of pain.
Ask the pharmacist to help you to choose the most suitable version: the splint must be firm, chosen for size and carefully attached to make sure that the wrist does not move. Wear this every night until you see the specialist.
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: [email protected]. Dr Scurr cannot enter into personal correspondence. Replies should be taken in a general context. Consult your own GP with any health worries.