Voice hoarse, but specialist says I'm OK.

[giddyup]

I mentioned before that I had a problem with my voice getting hoarse over a few months period. Needless to say it was causing me some concern, so I went and saw an ENT specialist at BKK/Pattaya hospital, where she stuck a laryngoscope down my throat and inspected my vocal cords. She said there was a thickening/furriness of some cords that would cause my hoarseness, an age related symptom and no cause for concern. However, the condition continues, sometimes worse than others, when I get quite croaky, accompanied with a feeling of dryness. Is this something I just have to live with, because the specialist didn't offer any solutions.

[tolsti]

If you don't mind my asking...''age related''...How old are you?...I am 55 and my voice has become more hoarse over the past year and am considering getting it looked at.

[giddyup]

If you don't mind my asking...''age related''...How old are you?...I am 55 and my voice has become more hoarse over the past year and am considering getting it looked at.

73. I was a bit nervous about having a camera stuck down my throat, but the doctor sprays your throat with something that numbs it and I didn't feel a thing. You can watch the whole thing on a TV screen as well, and they also gave me a DVD of the procedure, to show any future changes if I need another examination.

Edited October 22, 2015 by giddyup

[oncearugge]

If you don't mind my asking...''age related''...How old are you?...I am 55 and my voice has become more hoarse over the past year and am considering getting it looked at.

Good idea you should.

[MaeJoMTB]

Throat cancer or Esophageal cancer spring to mind.

Esophageal cancer is often missed until too late.

[giddyup]

Throat cancer or Esophageal cancer spring to mind.

Esophageal cancer is often missed until too late.

Surely an ENT specialist would pick up something like that.

[MaeJoMTB]

Throat cancer or Esophageal cancer spring to mind.

Esophageal cancer is often missed until too late.

Surely an ENT specialist would pick up something like that.

One would think so, but then again this is Thailand.

Took my wife to a Thai hospital for pregnancy test, not pregnant they say ....... she was.

Took my son to a Thai hospital for stomach ache, appendicitis they say, we cut out ...... I didn't agree, and it wasn't.

Took me to Thai hospital for sharp pain in my stomach, gall bladder they say, we cut out ...... they didn't, four years later no problem.

It depends on the competence of the doctor, and the lab technician.

Not to mention the number of drinks they had the night before and the number of other jobs they are working.

You really need two or three opinions, from doctors that don't know each other, and don't know you have seen someone else.

Then a bit of personal research using each doctor's opinion on the internet.

That's what I did in each of my medical incidents, saved me a load of money, if not a life.

What your current doctor said,

If you are a heavy smoker maybe,

If you don't smoke, unlikely.

Edited October 22, 2015 by MaeJoMTB

[Sheryl]

As he had a laryngoscopy any tumor of throat should have been evident. And esophageal cancer will usually present with trouble swallowing and will not cause hoarseness until or unless it extends to the larynx. I think OP has adequately excluded such issues.

OP: are in a/c most of the time? As dry air could be part of the problem and either turning off a/c or addong a humidifier to your bedroom might help (no guarantee but may be worth trying). Steam inhalations may also help.

Do you have a copy of the report from the laryngoscopy? Would be helpful to see exact wording of the findings.

And are you on any medications? Some can cause or worsen this problem.

Lastly as far as you know do you have any gastric reflux?

[oncearugge]

+1

[giddyup]

As he had a laryngoscopy any tumor of throat should have been evident. And esophageal cancer will usually present with trouble swallowing and will not cause hoarseness until or unless it extends to the larynx. I think OP has adequately excluded such issues.

OP: are in a/c most of the time? As dry air could be part of the problem and either turning off a/c or addong a humidifier to your bedroom might help (no guarantee but may be worth trying). Steam inhalations may also help.

Do you have a copy of the report from the laryngoscopy? Would be helpful to see exact wording of the findings.

And are you on any medications? Some can cause or worsen this problem.

Lastly as far as you know do you have any gastric reflux?

Haven't used aircon for a while, and then only during the really hot weather and not at night. I'm on Allopurinol for gout, Metroprolol and Hydrochlorothiazide for high blood pressure, that's all. The doctor I saw was a Dr Nucharut Pruksaboonkosol and her report just says for Physician Evaluation "Level 1 B OPD Simple disease", also a DVD of the procedure was provided. No gastric reflux that I'm aware of.

Edited October 22, 2015 by giddyup

[oncearugge]

As he had a laryngoscopy any tumor of throat should have been evident. And esophageal cancer will usually present with trouble swallowing and will not cause hoarseness until or unless it extends to the larynx. I think OP has adequately excluded such issues.

OP: are in a/c most of the time? As dry air could be part of the problem and either turning off a/c or addong a humidifier to your bedroom might help (no guarantee but may be worth trying). Steam inhalations may also help.

Do you have a copy of the report from the laryngoscopy? Would be helpful to see exact wording of the findings.

And are you on any medications? Some can cause or worsen this problem.

Lastly as far as you know do you have any gastric reflux?

Haven't used aircon for a while, and then only during the really hot weather and not at night. I'm on Allopurinol for gout, Metroprolol and Hydrochlorothiazide for high blood pressure, that's all. The doctor I saw was a Dr Nucharut Pruksaboonkosol and her report just says for Physician Evaluation "Level 1 B OPD Simple disease", also a DVD of the procedure was provided. No gastric reflux that I'm aware of.

Metoprolol can indeed be a (rare) cause of hoarseness.

Speak to your Doctor about a possible change of medication.

[giddyup]

As he had a laryngoscopy any tumor of throat should have been evident. And esophageal cancer will usually present with trouble swallowing and will not cause hoarseness until or unless it extends to the larynx. I think OP has adequately excluded such issues.

OP: are in a/c most of the time? As dry air could be part of the problem and either turning off a/c or addong a humidifier to your bedroom might help (no guarantee but may be worth trying). Steam inhalations may also help.

Do you have a copy of the report from the laryngoscopy? Would be helpful to see exact wording of the findings.

And are you on any medications? Some can cause or worsen this problem.

Lastly as far as you know do you have any gastric reflux?

Haven't used aircon for a while, and then only during the really hot weather and not at night. I'm on Allopurinol for gout, Metroprolol and Hydrochlorothiazide for high blood pressure, that's all. The doctor I saw was a Dr Nucharut Pruksaboonkosol and her report just says for Physician Evaluation "Level 1 B OPD Simple disease", also a DVD of the procedure was provided. No gastric reflux that I'm aware of.

Metoprolol can indeed be a (rare) cause of hoarseness.

Speak to your Doctor about a possible change of medication.

I showed the doctor the exact medication I was taking and she thought it highly unlikely that any of them would cause my hoarseness. I do know it is mentioned in a very long list of possible side effects of Metroprolol.

[Sheryl]

Might be worth trying a change of BP meds. In my experience Thai doctors tend to be insufficiently aware of medication side effect/tend to dismiss the possibility. It is a long shot but certainly worth trying, discuss with whomever manages your BP issues. But don't let them change you to enalapril or other ACE as these also can cause hoarseness (and frequently a persistant cough) ditto calcium channel blockers An Angiotensin II inhibitor such as losartan (available in inexpensive local brands) would likely be better.

You didn't answer re reflux, I assume that means not that you are aware of, but you might try elevating the head of the bed (or yourself via pillows) anyway just in case and see if that makes a difference after a few weeks. Sometimes there is reflux into the throat which will inflame the vocal cords and it can occur without your knowing it - though if so the inflammation should have been apparent on the examination. You might try contacting the hospital and asking for a written report of the findings or copy of your records. "Level 1 B OPD Simple disease" is just a billing code.

The other thing if all the above fail would be to get a second opinion for which I would suggest going to Bangkok. Prof. Songklot at ST Louis Hospital is good. I think you can assume there is nothing major like a tumor present but depending on the skill level of the doctor more subtle findings could be missed (including the aforementioned reflux).

[giddyup]

Might be worth trying a change of BP meds. In my experience Thai doctors tend to be insufficiently aware of medication side effect/tend to dismiss the possibility. It is a long shot but certainly worth trying, discuss with whomever manages your BP issues. But don't let them change you to enalapril or other ACE as these also can cause hoarseness (and frequently a persistant cough) ditto calcium channel blockers An Angiotensin II inhibitor such as losartan (available in inexpensive local brands) would likely be better.

You didn't answer re reflux, I assume that means not that you are aware of, but you might try elevating the head of the bed (or yourself via pillows) anyway just in case and see if that makes a difference after a few weeks. Sometimes there is reflux into the throat which will inflame the vocal cords and it can occur without your knowing it - though if so the inflammation should have been apparent on the examination. You might try contacting the hospital and asking for a written report of the findings or copy of your records. "Level 1 B OPD Simple disease" is just a billing code.

The other thing if all the above fail would be to get a second opinion for which I would suggest going to Bangkok. Prof. Songklot at ST Louis Hospital is good. I think you can assume there is nothing major like a tumor present but depending on the skill level of the doctor more subtle findings could be missed (including the aforementioned reflux).

Thanks a lot for all your info. Will see about changing meds first.

[Nick167]

Thai Doctors or Specialists.....lol! I have had enough of bad experiences at BNH, Bamrungrad , Paolo, Samitivej. These days if I ro my loved ones are sick or worried about something, we will fly to Singapore where Mount Elizabeth, Gleneagles, or NUH Hospitals are simply the best in terms of Doctors and services.

[giddyup]

Thai Doctors or Specialists.....lol! I have had enough of bad experiences at BNH, Bamrungrad , Paolo, Samitivej. These days if I ro my loved ones are sick or worried about something, we will fly to Singapore where Mount Elizabeth, Gleneagles, or NUH Hospitals are simply the best in terms of Doctors and services.

It's not always convenient to jump on a plane at every sign of a possible problem and fly to Singapore, especially at my age when the body is wearing out and new problems appear more frequently, and if you aren't happy with one specialists diagnosis you can always get 2 or 3 opinions.

[abbeymike]

I have had similar problems. I had Sore throat, hoarseness and fatigue when talking for about 4 months. I saw a specialist several times and treated for laryngitus. It didn't get any better so I had a CT Scan which showed I had tonsil stones deep in tonsils. This was causing infections etc. Therefore, had a tonsilectomy last Wed(in a lot of pain at momemt Day 5- awful op at 55).

I am hopefull this will also clear up the chronic laryngitus problem. Will have to wait and see.

Thought I 'd share just in case any similarities.

Hope you sort it out!

[alyx]

Thai Doctors or Specialists.....lol! I have had enough of bad experiences at BNH, Bamrungrad , Paolo, Samitivej. These days if I ro my loved ones are sick or worried about something, we will fly to Singapore where Mount Elizabeth, Gleneagles, or NUH Hospitals are simply the best in terms of Doctors and services.

f

Yeah, right, depends on your insurance

It cost me 10.000 Euros in April 2014 for a scan, a biopsy and a night at the Mount Elisabeth

Actually this cost could have been avoided as the specialist who performed the biopsy had already stated, the morning before, that it would be too late for a surgery, but he wanted to make sure (555). And when one takes care of a someone dear, one trie to put money second in line. ( in that case I got a mere 200 euros back by social security standards )

So, maybe Thai doctors push a lot when it comes to tests but it is way cheaper than in Singapore, and some of the doctors are, mind you, competent ( although I wouldn't make it a norm)

Edited October 25, 2015 by alyx

[scoutman360]

I suffer from the same problem, but only in Bangkok. Also, it comes and goes every week. When traveling abroad, and when on vacation (anywhere), it doesn't seem to materialize. I get hoarse voice for a few days, then it clears up. The doctor put me on meds for acid reflux, but no improvement. I also got the camera down the throat. "Yes, I can see inflammation".. really? I think that was a given.

Not sure where you live, but for me, I am wondering if it is the city pollution.

[giddyup]

I suffer from the same problem, but only in Bangkok. Also, it comes and goes every week. When traveling abroad, and when on vacation (anywhere), it doesn't seem to materialize. I get hoarse voice for a few days, then it clears up. The doctor put me on meds for acid reflux, but no improvement. I also got the camera down the throat. "Yes, I can see inflammation".. really? I think that was a given.

Not sure where you live, but for me, I am wondering if it is the city pollution.

I doubt it. I live out of Pattaya, little traffic.

[cdnvic]

Please don't post medical advice based on unqualified opinion. Quackery doesn't help anyone and can cause harm by directing people away from proper medical attention.

Also, please report these posts when they come up. Don't start arguments over them.

[aneliane]

I am sorry but this is no quack, unless you are calling quacks all these institutions among many that claim the same thing

- The Voice Institute of New York : Koufman J. Low-Acid Diet for Recalcitrant Laryngopharyngeal Reflux: Therapeutic Benefits and Their Implications. Ann Otol Rhinol Laryngol 120:281-287, 2011. Results :There was 12 males and 8 females... 19 out of 20 improved on low-acid diet and 1 got worse.

http://www.voiceinstituteofnewyork.com/wp-content/uploads/2011/01/Koufman-Low-Acid-Diet.pdf

http://www.voiceinstituteofnewyork.com/wp-content/uploads/2011/01/Koufman-7-12.pdf

- The Department of Otolaryngology, Hospital of Rio de Janeiro LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. Treatment of LPR consists of dietary changes and changes in habits such as weight loss, quitting smoking, avoiding alcohol, and not eating immediately before bedtime. Dietary restrictions include caffeine, chocolate, gasified beverages, fat, tomato sauce, and red wine.^{1 19} These modifications have been shown to be a significant independent determinant of the response to medicamentous treatment.³²

http://www.scielo.br/scielo.php?pid=S1809-48642014000200184&script=sci_arttext

- Central California, Ear, Nose and Throat : LARYNGOPHARYNGEAL REFLUX You have been diagnosed with laryngopharyngeal reflux, or LPR. This condition is due to a small amount of stomach acid and enzymes making their way into your larynx, or voice box. The condition is treated with medications as well as behavior and diet changes.

http://www.ccent.com/webdocuments/lpr-ccent-document.pdf

- The Emory Health Care Voice Center in Atlanta

http://www.emoryhealthcare.org/voice-center/diseases-conditions/laryngopharyngeal-reflux.html

Acid reflux can also cause problems in the larynx (voice box) or the pharynx (back of throat). This can happen to someone even if he or she is not aware of any heartburn and is called silent reflux, atypical reflux, or laryngopharyngeal reflux.

Eating habits, diet and obesity all can contribute to larngopharyngeal reflux (LPR). Eating fewer, larger meals can lead to the disorder, so it is best to eat three of four smaller meals each day. Certain foods and products should also be avoided, including:

• Carbonated beverages
• Coffee or tea
• Orange juice and other acidic beverages
• Spicy food
• High-fat foods
• Alcohol