Persistent Voice Issues and Associated Symptoms: Seeking Guidance
For the past two to three years, I, a 52-year-old female, have been experiencing intermittent hoarseness and throat discomfort during regular conversations lasting more than 20 to 30 minutes. I don’t engage in activities like singing or shouting; it’s merely regular speech. Initially, these episodes occurred infrequently—about once a month—but over time, they have escalated to nearly a daily occurrence. Although my voice and discomfort restore to normal overnight, the issues tend to linger throughout the day once they manifest. Additionally, I have experienced balance problems for around two and a half to three years. Since early May, I have been noticing occasional tremors in my head and body while seated, not during movement. Eating also poses difficulties; often midway through meals, I feel as though my tongue and jaw become fatigued and dysfunctional. Similarly, I sometimes struggle to articulate words, particularly when this fatigue sets in, which has unfortunately become a daily challenge. Since May, I have had several falls, and my balance issues have worsened, often without any warning—leading me to unexpectedly tip over. A walker has been prescribed to assist me now. Furthermore, I have intermittently experienced dizziness and vertigo, mainly while seated. Alongside these symptoms, I have developed nerve pain in my left arm, and I often feel a fluctuation in my overall strength. My legs also tend to feel heavy and weak after walking for short distances, making it feel cumbersome as though I am dragging them along. In June, an MRI was conducted, which revealed no lesions or spinal cord abnormalities. I find myself feeling perplexed and frustrated by these ongoing issues. Has anyone encountered similar symptoms or have any insights into what might be happening? I am scheduled to see a different neurologist soon and would appreciate any advice on how to effectively communicate my symptoms during that appointment. Thank you.
Answers (1)
8/14/2025, 3:31:15 PM
OpenHealth AI
I understand you’re dealing with several complex symptoms that significantly impact your daily life. Your experiences of intermittent hoarseness, throat discomfort, balance problems, tremors, and muscle fatigue are concerning and can be quite frustrating. It’s essential to gather as much information as possible to effectively communicate your situation to your neurologist.
Summary of Symptoms:
- Persistent hoarseness and throat discomfort during conversations.
- Balance problems and falls, worsening over the past few months.
- Tremors when seated and difficulty speaking due to muscle fatigue.
- Dizziness and vertigo, particularly when seated.
- Nerve pain in the left arm and fluctuating leg strength.
Explanation:
-
Voice and Throat Symptoms: These could be related to vocal strain, irritation, or muscular issues. Chronic irritation of the throat can stem from various sources, including reflux or neurological factors affecting muscle control.
-
Balance Issues and Tremors: Though your MRI has not shown lesions or spinal cord abnormalities, the combination of tremors, imbalance, and fatigue suggests a neurological assessment is crucial to rule out or explore conditions like Multiple Sclerosis or other neuromuscular disorders.
-
Fatigue and Muscle Weakness: This can arise from several factors, including neurological conditions, autoimmune processes, or even medication side effects.
Next Steps:
-
Prepare for Your Neurologist Appointment:
- Create a symptom diary that outlines each of your symptoms, their frequency, duration, severity, and what seems to trigger or alleviate them. This will help the neurologist understand the patterns and impact on your life.
- Note any additional information from previous tests, including the MRI findings, and any changes in your medications or health status since.
-
Key Symptoms to Communicate:
- Emphasize the escalation from infrequent symptoms to daily occurrences.
- Discuss how your balance problems have increased, leading to falls.
- Share details about the tremors and any changes in muscle strength and function, especially in your legs.
- Mention the eating difficulties and articulation problems, as these are critical to understanding your overall condition.
-
Maintain a Symptom Management Approach:
- Stay hydrated and consider practicing gentle neck and throat exercises to alleviate some discomfort.
- If you notice an increase in dizziness, try to sit or lie down immediately to prevent falls.
- Utilize tools, like the walker prescribed, for safety during mobility.
-
Follow-up Actions:
- Depending on the neurologist's recommendations, you may need further tests or referrals to specialists.
- Consider asking about physical or speech therapy, which might help improve your balance and vocal function.
Empathy and Reassurance:
Your experiences are valid, and it's understandable to feel perplexed and frustrated. Communicating openly with your neurologist and following these steps can significantly aid in understanding your condition better. Remember, you’re not alone in this, and being proactive about your symptoms is a vital part of the process. Take your time during the appointment, and don’t hesitate to ask questions until you feel clarity about your situation.
Related Questions
Worsening Memory Problems Over Time
Age: 25 Weight: 175 lbs Current Medications: Modafinil (200mg); Lexapro (10 mg); Lamotrigine (100mg in the morning + 100 mg in the evening); Cyproheptadine (4 mg); Vraylar (1.5 mg) Supplements: Iron; Vitamin B12; Vitamin D; Salt tablets Health Background: Long-standing, stubborn migraines (resolved as of May 2025, originally began in April 2016); Depression (currently very stable); Attention Deficit Disorder (ADD) (experimented with various stimulants with no improvement in memory); Chronic fatigue syndrome (developed a few years after memory problems began). I possess a documented medical history concerning my memory challenges. Around 2012, I underwent neurological evaluations that included an IQ assessment. The clinician indicated that my memory performance was particularly low, affecting my overall IQ representation, while I scored at or above average in most other areas. In approximately 2017, a neurologist referred me for a neuropsychological evaluation. Unfortunately, the results were deemed "inconclusive" due to inconsistent findings, with the provider stating my memory levels mirrored the previously reported low scores. Fast forward to 2023, when I underwent another neuropsych evaluation, which indicated my working memory was significantly below the average range. The clinician expressed uncertainty regarding effective treatment options for my memory issues, suggesting avenues such as ADHD medications, stress management, enhancing sleep quality, and mental health support—areas which I have pursued or tried to improve. Here is a summary of the strategies and treatments I've explored: - **Sleep Study**: Diagnosed with mild sleep apnea when lying on my back, although I typically sleep in other positions. - **Antidepressants**: Tried various types repeatedly, yet without noticing any significant changes. - **Occupational Therapy**: Participated but found it more stressful than beneficial. - **Speech Therapy**: Benefitted somewhat, yet it didn't meet my expectations, though I continue to use some of the techniques learned. - **Digital Notes**: Attempted to record important information on my phone, but due to many lists, vital entries often get lost. - **Memantine**: Prescribed by my neurologist as a last resort, based on its reported effectiveness in elderly patients for pain management; however, I did not observe any memory improvements while on this medication. - **Nutritional Supplements**: Regularly take Vitamin B complex, fish oil, flaxseed oil, and various other potential memory enhancers. Additionally, family history reveals that my brother, sister, and paternal grandmother have also faced memory-related issues throughout their lives. Unfortunately, several neurologists have declined to treat me, citing my youth and existing diagnoses of depression and ADD as indicators of instability rather than addressing my memory concerns. Moreover, I am anxious that my past struggles with chronic pain could have exacerbated my memory problems. Any insights or suggestions to tackle these ongoing challenges would be greatly appreciated.
Factors Influencing Rapid Advancement of Leprosy
I'm an 18-year-old assigned female at birth, standing at 5'11" and weighing 150 pounds. I've ceased taking any antibiotics or other prescribed medications, with the exception of haloperidol. I smoke and drink, but I don't engage in drug use. My ethnicity is Caucasian. Additionally, I have several other health issues, including anemia, scoliosis, endometriosis, and ovarian complications. I find myself unwilling to endure this condition for the next two decades. Currently, my health feels precarious. My wounds take an excruciatingly long time to heal or sometimes don't heal at all. I experience numbness or a tingling sensation in my hands, where the skin resembles that of a reptile, likely due to my fingers being either broken or oddly bent, possibly infected as well. My arms, legs, and face are covered in lesions, primarily due to these unhealed wounds. Furthermore, I deal with mild muscle weakness, a condition that began during my time playing football as a lineman, accompanied by numerous injuries that still haven’t fully recovered. I find myself wishing for a more rapid progression of this disease so that I can reach a point of resolution, as I feel irreparably damaged and have turned down treatment out of deep-seated self-loathing. Is there any way to accelerate this? I should mention, though it may not be directly related: my scars have a purplish hue, and I've noticed small visible 'holes' near these scars on my left arm—at least four that I've identified—while my left hand seems to be in the worst condition. Thank you for listening. Goodbye.
Seeking Clarity on Brain MRI Results
I’m a 36-year-old man experiencing occasional headaches, and I have no additional health concerns. I take Lexapro for anxiety and Ativan as needed. Earlier this week, I underwent a non-contrast MRI scan of my brain, and I have received the following report: **REASON FOR EXAMINATION:** Periodic headaches described as dull in nature. **COMPARISON:** None available. **TECHNIQUE USED:** The imaging included sagittal T1, axial FLAIR, axial T2-weighted, diffusion-weighted, and coronal gradient-echo sequences of the brain. **RESULTS:** The size of the ventricles and sulci appears to be normal. The position of the cerebellar tonsils is also within normal limits. Notably, a bilobed, septated lesion measuring 18 x 10 mm is located in the right parietal cortex, associated with some underlying edema or gliotic changes and cortical expansion. The pituitary gland size is normal. There are no signs of intracranial bleeding or any indications of recent infarcts in the cerebral regions, brainstem, or cerebellum. No abnormalities were detected on diffusion-weighted imaging. Additionally, there are no signal changes that would imply a demyelinating condition, such as multiple sclerosis. There are no fluid collections outside of the brain or subdural hematomas noted. Major blood vessels are patent, as indicated by the flow voids. The paranasal sinuses and mastoid air cells appear clear, although there is mild mucosal thickening in the left anterior ethmoidal air cells. **SUMMARY:** The findings suggest an 18 x 10 mm intra-axial cystic lesion in the right parietal lobe, accompanied by mild underlying edema or gliotic changes. This could possibly be an atypical manifestation of enlarged perivascular spaces or a benign cystic structure. Further evaluation with postcontrast imaging is advised. The overall conclusion of the MRI is otherwise normal. I’m feeling really anxious about these findings. Can anyone help me understand what this might mean?
Unexplained Bruising and Intense Itching
Hello, I’m a 20-year-old female, standing at 5 feet 2 inches and weighing 135 pounds. Recently, I have been experiencing intense itching that has resulted in significant bruising on my skin. Currently, I’m on several medications including spironolactone (which I haven’t taken for the last two weeks), Effexor, Aimovig, Wegovy, and Linzess. I do not use tobacco or consume alcohol. Apart from experiencing a generally sluggish digestive system, I have no pre-existing health issues. However, my family medical history indicates occurrences of Multiple Sclerosis, Hashimoto’s disease, diabetes, and eczema. The itching has become severe, leading to large bruises forming on my body. I consulted a virtual urgent care service, which advised me to visit the emergency room to check for potential blood clots or internal bleeding. Upon arriving at the ER, I underwent various tests, and I noticed that my resting heart rate has been notably elevated between 120 and 140 beats per minute, though I am uncertain if this is a new development. Eventually, I was discharged without any conclusive information, except with the advice to refrain from scratching. I have shared images of the tests conducted during my visit.
Understanding Prednisone Usage and Withdrawal
A 38-year-old woman, measuring 5’10 and weighing 125 pounds, with no smoking or drinking habits and a background of autoimmune disease, encountered a viral infection in December. In response to her condition, a specialist recommended a tapering regimen starting with a 40mg dose of prednisone for five days, followed by a gradual reduction through 30mg, 20mg, and 10mg over a total period of 20 days. After completing the course and halting the medication, she experienced severe symptoms approximately 36 hours later, including intense vomiting, debilitating headaches, and widespread pain throughout her body. Any physical contact provoked discomfort, leaving her in distress. Unable to reach her original provider, she consulted another physician who prescribed a lower dosage of 4mg of prednisone, instructing her to decrease the amount by 1mg every three days. Remarkably, she felt relief upon returning to the 4mg dose. However, she expressed concern regarding the potential effects when she ultimately weans off the medication entirely. She is seeking guidance on whether this method of tapering is typical and which specialist might be best suited to manage her prednisone treatment moving forward.