Has my ENT may has diagnosed me wrong... twice. What do you guys think?

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I'm a 22 year old singer and began having throat issues in January 2018. Notcing a lump in my throat, frequent throat clearing, raspy singing voice (my speaking voice isn't affected) and occasional wheezing.

I was reffered to an ENT and saw one in March. He took a look at my vocal cords and diagnosed me with sinusitis and said my left vocal cord was swollen due to the sinusitis. He prescribed me with nasal sprays which I took over the course of about a month. I continued having the same issues so I returned to see him in May. I asked him if he could check for signs of silent reflux and he said "You're at very low risk for that. You're not pregnant, you're 22 and you're not 200lbs overweight." He took another look at my vocal cords and said that the sinusitis had all cleared up. He asked me to do a few singing scales and said that my singing technique had been altered due to the sinusitis and advised me to see a vocal coach for a few weeks to correct my technique. I asked him if that is the case, then why am I still experiencing throat clearing and wheezing. His reponse was "the throat clearing is probably some left over mucus from the sinusisits and the wheezing is in your chest and is most likely allergies." I have done what my ENT asked and started seeing a vocal coach. I've only had one session so far but today my throat hasn't been feeling great. I've been clearing my throat frequently and when I was singing my voice just felt weak and raspy. It's really getting me down and I can't help but have question marks everywhere. I am convinced that I have LPR but I don't want to go against the word of my throat doctor. Does anybody have any advice? What do you guys think about this? I was thinking of trying some Zantac to see if that makes a difference. I feel at a loss. My life has pretty much been put on hault since these issues began.  

PS: I just want to add.. what is baffling to me is that I stopped drinking coffee, no tomatoes, onions, chocolate, mint etc for one month to see if I would notice any change and I didn't. When I went to see my ENT the second time and he told me it was just my technique I began drinking coffee again. Surprisingly, my singing voice had been okay, I thought I was seeing improvements. But today, it was raspy for no apparent reason. My diet hasn't been any different today than the last few days when I felt like I was improving.

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  • Posted

    Yeah, it sounds like classic LPR to me -- trust your gut.  Most people do a low acid diet for a couple weeks to help the throat heal (Koufman "induction" phase).  Basically, cut anything with a low pH: all fruit (except melon), juice, sodapop, tomato-based products, yogurt, etc.  Might also want to add in alkaline water (high-pH over 8.0).  That just helps the throat...after that, it's anybody's guess what will work for you to contain the actual reflux as each person is different.  For some people it's specific trigger foods/groups.  For others, it's carbohydrates.  For others, it's fat.  Reflux meds do very little for LPR -- and that's been clinically proven in studies.  Personally, I"m finding a low-carb, almost ketogenic diet to be helping heal my reflux/LPR.  I also sleep with the head of my bed elevated and have stopped eating at least 3 hours before bed...both of which help a lot.  Good luck!  Stress definitely makes the condition worse, so try to relax and find some peace in your life.  Personally, my faith has been a huge help, but if you're not spiritual then perhaps yoga or meditation will help.  

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    • Posted

      Hi Nick. Thanks for the response. I thought fruit like banana's and also greek yoghurt was acceptable for reflux sufferers. As I just said in a previous response, as well as being a singer I'm into fitness and working out. I currently follow a diet where I have to hit a certain amount of calories, protein, fat, carbs per day. I fear that by following a diet where I can't eat many carbs, etc. i may hurt my fitness progress. With that being said, I am a singer for a living, not an athlete. My voice is much more important to me.

      I currently sleep with my bed elevated and also don't eat 3 hours before bed. The unfortunate thing is I find it very hard to tell if things are actually helping and my throat feels better or not. If it is in fact LPR that I am experiencing, the symptoms aren't as easy to notice as GERD.

      Thank you for your advice! Hopefully I can get this sorted. It has put my life on hault!

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    • Posted

      LPR is notoriously tough to heal.  You can have one little incident of reflux that gets up into your throat and suddenly bam, you're back to square one with healing those very sensitive tissues.  Most people with LPR speak publicly for a living.  I'm college professor, for example.  Many people on the Facebook group I belong to are teachers, singers, tour guides, etc.  Basically we notice the throat problems more because we're using them all the time.  That still doesn't change the fact that reflux is at the heart of the problem -- sending those stomach contents up into your throat.  So the key is definitely the figure out what's causing the reflux.  It might not be carbs for you...it could be a specific food, additive, or family of foods that you're sensitive to.  You could also have SIBO...or a gallbladder problem...or H Pylori...or a million other things.  That's part of what makes LPR so darn frustrating.  I've been trying very hard to figure mine out for about 5 months and so far the low-carb diet has helped the most but I'm still not totally better...I had a bad day today, for example and am trying to figure out what caused it.  It's maddening.  Do try to relax, however!  Get alkaline water and Gaviscon Advanced -- those help protect your throat.  And at least try something to pinpoint the cause of your reflux.  Making an appt with a gastro is never a bad thing, but my guess is they'll just tell you to take PPI's and not make many recommendations for the reflux -- unless they're very good, that is.  Anyway, continued good luck!

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  • Posted

    I would ask your primary doctor or whoever referred you to the ENT if you can see a gastro doctor to check and make sure that it's not LPR. Let your doctor know what you want, tell him or her that you want to make sure that it isn't anything like the ENT is saying. You have heard what your ENT is saying, but you want a second opinion. That  never hurts. Going back and forth with your throat doctor isn't working. I'd recommend taking Zantac before you go to bed and see if it makes a difference.

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    • Posted

      Thank you for this advice. I think I will try what my ENT suggested for a few more weeks and if I don't notice a change I will ask my doctor for a gastro referral.

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  • Posted

    I have acid reflux ( silent ) along with the exact same symtoms u getting. Does ur wheezing when u finish deep inhaling like right at the end when u inhale it sounds pffssss or anything the point is right when. Ur lungs are filled??
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