A 33F suffering from Throat Pain and Hypothyroidism
This is the case of a 33-year-old female, resident of West Bengal, and Home Maker by occupation. The following history was taken through a telephone conversation. The patient was explained about confidentiality and written consent was taken to create the following case report.
This case report aims to record the patient's journey.
CHIEF COMPLAINTS:-
- The patient complains of having Throat pain since 10th October 2022.
- The nature of the throat pain (as the patient describes) is irritating, prickling, rough and itchy.
- This "prickling" Sensation is also spread out to the posterior surface of the tongue.
- She also complains of occational itching sensation in the ear canal, alongside with muscle strain from both sides of the neck till the shoulder and the upper half of her chest.
History of present illness:-
The patient is suffering from Hypothyroidism since 2019. She is still suffering from the same.
On 3rd May 2022, the patient's husband was in a bike accident, which had caused considerable amount of mental distress to the patient, leading to her experiencing chest and back pain. The patient's CT scan and chest X-ray was taken, to which the local doctor examined to be normal. Although, the fear of the accident seems to have made a considersble impression on her.
The patient is suffering from Anxiety since June to July 2022. She first noticed the onset when her thyroid levels were extremely low. On August 2022, she reports of shivering of legs and arms due to anxiety. She also reports that she is also suffering from insomnia and has gained 3-4 kgs during the month. She was prescribed sleeping pills, which she took for one month but discontinued thereafter due to increased duration of sleep.
The patient is suffering from a muscle strain since August 2022. This strain started from her arms, which later spreads to the left earlobe till the upper half of her chest. This strain seemed to have reduced after taking homeopathic medications and pranayam but it has increased ever since the onset of the throat pain. This strain also increases when the patient wakes up in the morning.
The patient complains of having Throat pain since 10th October 2022. The nature of the throat pain (as the patient describes) is irritating, prickling, rough and itchy. This "prickling" Sensation is also spread out to the posterior surface of the tongue. She mentions the feeling to be like "something is stuck in her throat," and a "bitter aftertaste". Due to this pain, which is causing significant distress to the patient, she reports of loss of appetite and interrupted sleep patterns since 10th October 2022. She also mentions that the pain increases in the morning time (especially after she wakes up) and reduces when it is evening. The pain also increases when the patient is under pressure or if she is talking too loud. However, if she is speaking in a normal tone, the duration of her talking does not aggrivate the pain. She also mentions that comsuming hot food helps in easing The pain but consuming something cold aggrivates it. The patient mentions not having dry cough, and she does not have any problems in breathing, talking (in a low tone) and eating. She was taking homeopathy medicines but those had no effect on the throat pain. She is also gargling using salt mixed in water, which is a habit since childhood (she used to sing and due to that, she reports having developed a "fear towards catching cold and straining her vocal cords"). She has stopped singing a few months ago.
History of past illness:-
The patient does not have any history of TB, HTN, DM, Epilepsy and asthma.
In the year 2017, she has had a successful C-section delivery.
In the year 2005, she has undergone a breast tumor removal operation. The lump that she had was enlarged and there was no pain in the lump. This pattern of the appearance of tumor is also seen in the family wherein the grandmother had a tumor removed from the stomach and her father had a tumor removed from his thigh.
Personal history:-
Water intake:- normal
Appetite:- reduced
Diet:- mixed (also specifically mentions having fruits after every meal)
Bowel and bladder movement:- normal
Addictions:- consumes pan minimum once in a day. This consumption increases whenever there is a stressful situation, such as the bike accident.
Alcohol:- none
Smoking:- doesn't smoke
Allergies:- none.
Exercise status:- Does walking occationally in the evening. Does yoga in the evening for 10-20 minutes but it is not continuous.
Menstrual History:-
In the month of June 2022, after her periods were over, ten days after, the patient observes light bleeding that continues for around 3-4 days.
This condition also continues in the month of July. But it stops in the month of August and September.
At around 8th-9th October, the patient observes increased white discharge for 8 to 9 days. This condition was present ever since she has undergone C-section. The patient took homeopathic medicines but those did not have any effect on her.
Update 16th October 2022
The patient complains of excessive itching in the genital region since yesterday (I.e.15th October). This onset of itching has begun in the month of September, 3-4 days after her periods have stopped.
Reports:-
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