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Dr. Saha
Dr. Saha, Doctor (MD)
Category: Health
Satisfied Customers: 17824
Experience:  35 years of experience
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I have an entire list of bizarre symptoms and I'm just going

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I have an entire list of bizarre symptoms and I'm just going to go ahead and list them here along with some worries I have. I have been to urgent care, they have given me a chest x-ray and an EKG. I have an appointment with a new PCP on Monday, but I'm curious to see what you think and carry your opinions with me into the appointment on Monday. Symptoms I've experienced over the past year or so (they somewhat wax and wane): Chest tightness, Chest Congestion, Throat tightness, sorts of itchy skin symptoms mostly mild, heart palpitations (not very often), some congestion, ear pressure, headaches, feeling like I have some sort of pressure on my throat, throat clearing often, sometimes a light unproductive cough. Along with this, not sure if it would matter for you, but I have also been diagnosed with a right-sided varicocele and underwent an abdominal ultrasound with a urologist to make sure there were no blockages causing it - there weren't. Not sure if it's relevant, but since I'm listing symptoms I figured I'd include it.
I know that I have anxiety, but I don't want that to continuously discount symptoms that are very real for me. If all these symptoms ARE caused by my anxiety, then I can handle that. In fact, if I could know that they were it would probably HELP my anxiety. Mostly I'm worried that something sinister is going on beneath all these symptoms, obviously, but I'm looking for some opinions on the matter. The chest x-ray was clear, but I'm fairly certain, I think, that a small mass in my chest (not shown on xray) in my chest could cause a lot of these symptoms, right? Should I push for more tests on Monday, and if so, which ones?
Thank you for your question,
I’m Dr. Saha and I’ll try to help you.
How was the EKG? Was it normal?
Did they take any other test besides X ray & EKG?
What treatment was given?
Why do you think there is a mass in chest?
Customer: replied 4 years ago.

Hey Dr. Saha:

The EKG was totally normal, in fact that pretty much said: everything on it looks fantastic. No other tests besides the X-ray and EKG - both were fine. The treatment given, or recommended, was a few things: They thought it could be post-nasal drip, some sort of reflux, or caused by anxiety. I've tried taking Guaifenesin and it didn't really do all that much, as well as 3 or 4 days of Prilosec that didn't do anything either. The reason I would think there is a mass in my chest (and this could sound ridiculous, I understand) is because of the chest tightness, feeling the need to throat clear, un-productive cough, added with the mild itching. I don't know, maybe I AM over-reacting, but I'm just worried that there's some stuff going on in my chest that wouldn't have been seen on the x-ray. If you think that reasoning is absurd, please say so. Ha.

Hi Jeremy,
Thank you for the information.
Did you have any other illness before those symptoms start?
How frequently do you feel those symptoms?
Customer: replied 4 years ago.

No, I don't even think I've had a cold in over a year. I first went to urgent care for chest tightness about 1 year ago, actually, and they did the exact same tests with the exact same results. I've experienced the chest tightness on and off for the past year definitely and it might actually stretch out beyond that. The mild itching has been something I've experienced since January or so, that is also off and on. The throat tightness/congestion/throat clearing/mild need to cough is from the past 3-4 weeks and even THOSE symptoms come and go. I am well aware that anxiety can cause ALL of these things, and I'm willing to accept them as anxiety, I just don't want to miss something in doing so - all the horror stories of things actually being wrong but being chalked up to anxiety for a long time.

Thank you for all the information,
I would say you should not worry about a mass in the chest.
X ray would show a mass.
If it misses one it is likely to be small & that should not cause such tightness.
CT scan can be taken, if your doctor thinks necessary.
The tight feeling can occur from a few other conditions.
Anxiety, stress are common ones.
There can be allergy, post nasal drip.
In allergy, there can be post nasal drip, skin itching.
Reflux can also cause it as you know already.
Heart diseases can cause a feeling of tightness, but your EKG was normal & the doctor did not find any abnormality on listening to chest.
However, you should have the follow up with your PCP as scheduled.
You can get tested for allergy.
I hope this information helps.
I will be happy to assist, if you need any clarification.
Please feel free for any follow up query.
Best wishes.
Customer: replied 4 years ago.

I see that you say, "CT scan can be taken if doctor thinks necessary." By saying that, are you saying that I should suggest that I'd like one to rule all the more sinister things out? Would you, although I know you haven't physically examined me, suggest a CT scan or no? So, with the chest mass stuff, you don't think a mass would be causing that because a mass big enough to cause that would definitely show up on an xray? Thanks for clarifying.

Though I have not examined you personally but from all your history, I think that there is no mass & CT scan is not necessary.
A mass in the lungs which causes tightness in the chest would cause more persistent symptoms.
You are feeling the tightness intermittently.
I feel you should not suggest your doctor to order a CT.
If he feels after examining your chest & reviewing the X ray, he would write it himself.
Dr. Saha, Doctor (MD)
Category: Health
Satisfied Customers: 17824
Experience: 35 years of experience
Dr. Saha and 2 other Health Specialists are ready to help you
Customer: replied 4 years ago.

I'm not sure if you're actually online still, but I wanted to add more to the last question - about the itching. I've been feeling more and more itchy today and it's the most bizarre thing: I feel the itch, but then when I go itch the itch it just disappears - none of that satisfying feeling of when you scratch. I also have some places (mostly on the back of my shoulders) that feel almost sunburned and sensitive. I know this sounds nuts, nonetheless, it's what I feel. More anxiety, you think?

Customer: replied 4 years ago.
Relist: Incomplete answer.


May i help you dear?

Do you have associated rash on skin? Neck stiffness? Have you undergone thyroid function test,CBC,ESR,etc or other blood work? Loss of appetite? Do you have dry skin? Are you taking any medications for anixety? What is your occupation? Thanks.

Customer: replied 4 years ago.

I don't have any rashes, no neck stiffness besides my neck feeling tight in the front, I had a bunch of thyroid tests about 2 years ago and they all came back fine (the ones where they test T3 and T4, or something like that), haven't had a CBC or any type of blood test in some time. I've been eating as much as normal and if I haven't been it's probably because I'm been anxious about all these annoying things lately. I don't take any medications for anxiety beyond St. John's Wort. I'm just a lowly food delivery driver. Ha. Thanks for the concern, look forward to hearing back from you. I'm assuming you saw the whole list of exchanges from earlier, right?

Firstly sorry for misspell(anxiety)
Thanks for providing more information.
I have read your detail medical history and it's my privilege to help you in every aspect.
As you describe,your symptoms like throat tightness/congestion/throat clearing/mild need to cough,heaviness in chest,feeling mass/lump in chest can be caused due to Gastroesophageal reflux disease/Laryngopharyngeal reflux and before considering anxiety is the cause of your symptoms,i suggest you to consult a Gastroenterologist for a clinical examination and further upper GI scopy,Laryngoscopy should be advised for further evaluation and management.
As your symptoms are not relieving with Prilosec so you may require other prescribed medications which may include H-2-receptor blockers,Prokinetics.
Apart from this,feeling itching on skin without rash can be caused due to various causes like allergy,dermatitis,Anxiety,stress,dry skin or seborrhea or increased sweating in that areas,iron deficiency, liver,kidney disease,hormonal abnormalities.
Sometimes urticaria which occurs after contact with water,exercise,stress,excessive sweating,heat can cause itching.
You can try tablet fexofenadine 180 mg once in the morning and tablet levocetrizine 5 mg once daily at night.
You can apply calamine lotion on the body to soothe it.
Also you could try to bathe with lukewarm water as sometimes hot water may also stimulate it.
Wear cotton clothes.
Hydrate yourself with plenty of fluids.
Avoid spicy,fried foods.
Start a multivitamin supplement.
Even St.John's Wort can cause allergic reaction like itching.
So you should discuss every possibility with your doctor on Monday for proper evaluation and management.
I hope this helps.
Please rate me highly (Star 5 Great Service), if you are satisfied with our conversation.
If you have any further query then feel free to ask.
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Thank you.
Customer: replied 4 years ago.

So, what types of tests do you think I should ask my doctor to perform on Monday? Should I insist on her doing some blood work? Thanks for the thorough response.

Thanks for the follow-up.
You should ask your doctor for blood work like Complete blood count,ESR,Liver function test,Absolute eosinophil count,Thyroid function test(as St/John's wort sometimes interfere with thyroid function).
A referral to a gastroenterologist and further Upper GI scopy should be advised by your doctor.
I hope this helps.
Please rate me highly (Star 5 Great Service), if you are satisfied with our conversation.
If you have any further query then feel free to ask.
Bonus and positive feedback are highly appreciated.
Thank you.