YANMD, but please help me figure out how to fix this thing (without insurance) anyhow?
October 12, 2011 1:19 PM   Subscribe

For a week now I've had this pressure/pulsing discomfort in my neck around my carotid area. It's not my throat; it is definitely related to my pulse somehow. The doctor I saw doesn't know what's wrong; who should I see/what should I do now? (snowflake details inside)

I'm 26 y/o, white female, overweight, but otherwise healthy.
Since last Monday(ish), I've felt an intense discomfort on the right side of my throat/neck, directly where you could poke your jugular under your jaw. It isn't pain, per se, but akin to the feeling of pressure in your neck after having run too hard or being upside-down for a bit.

I can never feel anything when I press on the area except my pulse, and the discomfort/pain would be mostly unnoticeable when I was sedate and breathing normally. But every time I breathed in deeply or bent over the pulsing pressure returned and increased.

Because I don't have health insurance, Monday through Thursday I kind of ignored it and avoided doing anything that would cause hard breathing or bending over. But on Friday I woke up with a very painful ear ache on only the right side of my head; it was very intense and the pressure/pain in my neck had spread throughout my jaw, the back of my neck/base of my skull, and down the front of my chest. It felt a little like heartburn, but mostly like this same pressure but amplified and spreading.

I got very freaked out, called in sick, and searched for a place that was sliding scale and would take me on short notice. By the time I was actually able to see a doctor on Friday, the ear ache had mostly gone, and the usual level of discomfort in my throat had returned. She said that my ears looked good, my throat looked good, I didn't have swollen glands, and I was asymptomatic for anything she could think of. The only note-worthy item was that I had large tonsils, not inflamed or bad-looking, just big.

With the knowledge that I had suffered from depression in the past, she ultimately told me that she thought everything was due to anxiety. And while I respect her opinion, I'm pretty sure that isn't it.
Before the throat issue, I had been going through a particularly good spell of life with a happy state of mind. Also, anxiety usually manifests itself through gastro-issues for me anyway.

As I don't have insurance and will be paying for all visits and tests out of pocket, where should I go now to try and figure out this problem?

The discomfort in my neck has felt a little better since that Friday morning, but it is still here and I occasionally feel like it is spreading through to the left side of my throat/neck as well. As it seems tied to both breathing and circulation, it really concerns me, and I don't want to ignore (what I see as) scary symptoms.

posted by elleyebeebeewhy to Health & Fitness (7 answers total)
IMNAD. You mentioned being overweight, I am too and the first and only sign I've ever had of high blood pressure that I had to insist was a serious symptom to my doctor that I could hear and feel my pulse pounding in my neck. They put me on a 24 blood pressurely monitoring thingy basically to shut me up and I walked around in all day and it seems my blood pressure did randomly go up add to that I was also prone to anxiety so when I got put on beta blockers it kind of cured 2 birds with one pill. I am sure this is a long shot, as you said you've seen a doctor and they pretty much always check blood pressure, but home blood pressure gismos are pretty cheap to buy or rent or probably even borrow from someone and you can keep records for a week or so yourself to rule that out.

Again this is all just ideas from an unqualified non doctory person and should not replace what a real medical doctor would suggest, but I can't see it would do any harm.
posted by wwax at 1:57 PM on October 12, 2011

I wonder if this might be caused by muscle tension. Tight muscles can create the most bizarre symptoms. Pressure, aching, burning, referred pain, ear ache... these all could be caused by muscle tension.

I would suggest seeing a massage therapist, if you can swing it. If he or she can't find anything that looks to be the culprit, at least you'll have a little therapeutic relaxation time. Also, I wouldn't be so quick to dismiss the doctor's opinion that it is anxiety-related.

I hope you feel better soon.
posted by Specklet at 1:58 PM on October 12, 2011

I am so not a doctor, but I had some unqualified thoughts, too.

Nthing on the blood pressure. Did the doctor check your blood pressure and tell you the numbers and that it was normal? What was it at?

Whether or not this is anxiety, it's making you uncomfortable. Could the doctor give you a prescription for Xanax or similar, mostly as a test of whether it is anxiety? THis would give you a little relief, and also give the doctor more information. Xanax type pills are very cheap as generics, hence this suggestion. And you could just call her, rather than going into the office again, to ask about this.
posted by Tandem Affinity at 2:00 PM on October 12, 2011

I'm a doctor but I don't want to speculate on the diagnosis here because I don't think it's the sort of thing that makes sense to speculate on over the internet. But if it's as intensely painful as you describe, and it doesn't hurt you to push on it or move your neck around, I think saying it's caused by anxiety is a pretty lame explanation. I think you should get a second opinion.
posted by treehorn+bunny at 2:59 PM on October 12, 2011

Are you ill? Lymph nodes in my neck always swell up when I get sick, usually on one side more than the other. There's also one near my ear that does so.

However, if it's causing this much anxiety, an actual doctor would be a good place to go.

They'll typically work with you on a payment plan, or check out Care Credit.
posted by bookdragoness at 7:44 AM on October 13, 2011

I had a similar issue with tightness in my throat and pulsing, but I had no headaches or anything like that. It ended up being Acid Reflux, or at least it was alleviated quite a bit by my taking omeprazole (Prilosec) once a day.
posted by soelo at 8:58 AM on October 13, 2011

Med student taking the bait to speculate over here. I agree that if it's really bothering you you should get a second opinion. By the way you describe it, whatever it was - muscle tension, a transient infection, etc likely resolved, and so it may hav been difficult for your doctor to attempt to diagnose something that is already better. You mention your carotid artery - if you are concerned about your blood pressure, you should get it checked, and mention your concern to your doctor. They can keep an eye on your vasculature and do a doppler ultrasound if they think something might be wrong, but it is very unlikely that someone your age would have a carotid artery problem.
posted by abirae at 9:02 AM on October 13, 2011

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