Just the thought of a throat culture makes me gag

May 14, 2008 7:22 AM

Can I train myself to tolerate throat cultures?

I have a very bad gag reflex and have never been able to tolerate throat cultures. Just the thought of one has always scared me. As a kid, one nurse had to hold me down while the other one shoved the big q-tip down my throat. As an adult, I just refuse the culture, to the annoyance of my doctors. They either have to prescribe antibiotics without knowing if I have a bacterial infection, or they tell me to just wait out the sore throat and accompanying sickness.

I'm sure I've had many strep infections without knowing it, and this can't be good for me. I'd like to be able to tolerate a throat culture so the doctor can know whether or not I need antibiotics. But since I've had this fear since childhood, by now it's a full-blown phobia and I can't even imagine letting someone swab my throat.

Am I the only one with this problem? Is there any way to overcome it?

posted by bluekrauss to health & fitness (14 comments total)

Am I the only one with this problem? Is there any way to overcome it?

Alas, I can only answer the first question. No, you're not alone, and I have favorited this thread. I have the worst gag-reflex of anyone I know. Whenever I go to the dentist, he marvels that my teeth are in such good shape, except for the ones way back in my mouth. That's because I can't brush them without gagging. My dentist gets the point when he tries to take x-rays. I gag almost to the point of choking when he puts those x-ray plates in my mouth.

It took me ten years to be able to swallow pills.
posted by grumblebee at 7:37 AM on May 14, 2008

Yeah you're certainly not the only person with this problem. I don't let doctors or nurses do throat swabs--I immediately start gagging and it's extraordinarily unpleasant for me.

But unlike grumblebee I don't have trouble with tooth brushing or pills.
posted by aerotive at 7:46 AM on May 14, 2008

You're definitely not alone. I give my doc's fair warning to be ultra quick and that they won't need the tongue depressor. They get what they need and it happens fast enough that I don't notice. The tongue depressor bit needs practice in a mirror to see as far down as possible so they won't need the depressor.

Basically tilt your head as far up as you can to create a straighter path, bend forward at the waist so you can still see (and so the doc won't need to reach oddly), open your mouth as wide as possible, figure out where to put your tongue so it's out of the way, and open your tonsils if you've got them. They're the flaps on the left and right sides of the throat way at the back by the uvula (the teardrop shaped thing) and they're controllable via some muscles (or whatever) back there. I think docs just need to get behind the uvula so if you've got a clear view of the wall behind that, you're done.

As was said in another thread yesterday, the back of the throat doesn't trigger the gag reflex. It's the uvula and the tongue. Practice holding the above for 10 seconds and you'll never have a problem.
posted by jwells at 8:00 AM on May 14, 2008

Some tips in this (NSFW) askme from yesterday.
posted by Static Vagabond at 8:13 AM on May 14, 2008

When I was about 10 I fought off a couple of nurses in my pediatrician's office that were trying to do a throat swab. My Mom made me write a letter of apology to them. Now I just warn them and tell them to be really quick. Apparently, I'm not the worst out there, some people will actually projectile vomit. So just think of that "I'm not the worst". Close your eyes and try to not think about it. Mind over matter.
posted by Green Eyed Monster at 8:14 AM on May 14, 2008

When I was a musician, I began to develop nodes on my vocal chords. I also had a strong gag reflex. The doctor gave me two options: control it or get a local so that he could have a closer look. I was being trained at the time as a vocal performer and hated injections. I managed to keep an open diaphram for swabs and a camera. It could have easily become a massive gag scene except for my vocal coach's training.

It takes a lot of, very deliberate, focus to avoid the gag reflex. An extension of jwells comment above is to become aware of the muscles and mechanisms of the throat. It won't get rid of the gag reflex, but it will give you tools to control the area.
posted by michswiss at 8:23 AM on May 14, 2008

Just to add... It still drives me crazy!
posted by michswiss at 8:25 AM on May 14, 2008

I noticed that when I started brushing my tongue-- including all the way in the back-- sometimes it makes me gag a bit-- my gag reflex substantially diminished the next time I needed a throat culture. I didn't even gag when the q-tip was in my throat. I think all the pressure from the toothbrush desensitized my gag reflex.

Maybe you could try some physical desensitization with the old toothbrush?
posted by paddingtonb at 8:42 AM on May 14, 2008

Deep, even breaths, taken through your nose, starting about a minute before. That's the advice I got from my orthodontist's assistant when getting dental impressions made about 20 years ago.
posted by deadmessenger at 8:44 AM on May 14, 2008

I have heard (maybe read?) that humming (or making the "aaaahhh" sound) gives those muscles something else to focus on, temporarily distracting them from the vomit reflex.
posted by phunniemee at 8:45 AM on May 14, 2008

The hygienist at my former dentist's office always gave me a salt packet to swallow before x-rays or dental impressions, and while it tasted gross, it did dull my gag reflex enough so that I wasn't pulling the x-ray plates out of my mouth before they could get the shots. I still carry salt to the dentist, even though they think I'm kind of insane for doing it. I don't know if salt would cause problems with a throat culture, but if the doctor says it's ok, it might help.
posted by capsizing at 8:56 AM on May 14, 2008

Start brushing your tongue. Go as far back as you can without a powerful retch, but do let yourself gag a little. Do it every single day, very gradually brushing farther back and farther to the sides. I started doing this as a child (when my gag reflex was super sensitive), and I still gag every single solitary time I do it. However, I'm so used to the gag at something near the back of my throat feeling that even though I feel it, it doesn't upset me anymore. I haven't been able to train it away (although I can get the toothbrush awfully far back now), I've just sort of conditioned myself to feel it without freaking out.

Side note: Last year I had one of those terrible gastrointestinal deals where you know you're eventually going to throw up so you'd just like to go ahead and get it over with. I discovered, rather to my surprise, that I couldn't do it. I shoved all sorts of things back there to tickle my uvula and though powerful gagging occurred, it seemed I'd trained away the gag = barf reflex.
posted by mostlymartha at 10:12 AM on May 14, 2008

Seconding capsizing.

My dental hygienist put a little bit of salt on my tongue so she could take xrays. Didn't totally suppress the gag reflex, but definitely helped.
posted by NoraCharles at 2:32 PM on May 14, 2008

Reaffirming that salt can really help.
posted by jefftang at 5:04 PM on May 14, 2008