The back of my mouth, by the entryway to my throat, hurts on one side. It is very aching to the touch and affects what I consume. Ive had many tests and tried a steroid mouthwash. What else can I do?Mrs J. Farmer, through email.Your symptoms are suggestive of glossopharyngeal neuralgia, which triggers unexpected attacks of extreme discomfort in the throat, near the tonsils.Generally, and as in your case, only one side of the throat is affected. The discomfort can be sharp and last only a couple of minutes, or you might have a continuous low-grade ache.The symptoms are set off by swallowing, coughing, yawning or, in some patients, touching the website of the pain. You state that it affects what you consume, and the condition can result in weight-loss if patients struggle with their usual meals (because of the pain when swallowing). The glossopharyngeal nerve carries information from the throat, tonsils, tongue and middle ear to the brain. When this nerve ends up being inflamed in some way– possibly by a blood vessel pressing on it, discomfort such as you explain is caused. Normally, and as in your case, just one side of the throat is affected. The discomfort can be sharp and last just a couple of minutes, or you may have a constant low-grade acheGiven that comprehensive investigations, consisting of an MRI scan and oral X-rays, have stopped working to discover any issue (as you explain in your longer letter), this appears to be the most likely medical diagnosis. I recommend asking your GP to refer you to a neurologist, with this possible medical diagnosis in mind.The great news is that most of the times, this condition can be successfully treated with medication.The first-choice treatment is the drug carbamazepine, which is frequently prescribed for trigeminal neuralgia, another type of extreme facial pain also triggered by pressure on a nerve. The drug interferes with the transmission of pain messages through the nerve however might need to be taken long term. Gabapentin– a drug used for epilepsy and nerve discomfort– is another choice, and operates in a similar way.If these dont work, microvascular decompression surgery might be offered.My sons, aged 45 and 42, have both been detected with low blood platelets. Is it safe for them to have a Covid vaccine, in particular AstraZeneca? My hubby was diagnosed a few years ago with low iron, however was informed he wasnt anaemic. Is this connected?Carol Frankland, Clitheroe, Lancs.Platelets are the smallest type of blood cell and are a vital element of the blood clotting system, binding together and assisting with healing.Low levels of platelets, as your boys have, can lead to bruising and bleeding from the gums, nose and intestinal tract from something as apparently small as energetic usage of a toothbrush or nose blowing that in other individuals would not trigger problems.A platelet count listed below the lower limit of normal (less than 150,000 platelets per microlitre of blood) is known as thrombocytopenia and can result in spontaneous bleeding and– paradoxically– clotting.The condition can be brought on by a number of aspects, consisting of medications such as penicillin, non-steroidal anti-inflammatories and ranitidine (used for ulcers), cancers such as leukaemia, kidney failure and extreme alcohol consumption. Developing thrombocytopenia has– in rare cases– been linked to the Covid-19 vaccine. This is extremely unusual [ File image] Sometimes, thrombocytopenia is not due to among the above triggers, but is an acquired condition– an autoimmune disease where platelets are incorrectly ruined by antibodies (which look for to combat foreign cells in the body and ward off disease). This is likely to be the case with your children as theyre both otherwise in excellent health.Those with this kind of inherited low platelets have a lower bleeding risk than individuals with other causes for the condition, although spontaneous bleeding is still a concern due to the fact that it can trigger severe blood loss in some situations– even a tooth removal or other small injury.Developing thrombocytopenia has– in uncommon cases– been linked to the Covid-19 vaccine. This is extremely unusual.I picture your concern is that the jab may lower your boys platelet counts even more. The existing medical suggestions is that thrombocytopenia should not stop anybody from getting the AstraZeneca vaccine (which has seen the highest incidence of this unusual side-effect, although its worth noting that the other vaccines have likewise caused bleeding and clotting). Whether the AstraZeneca jab appropriates for your kids deserves talking about with their specialist, although provided the option of vaccines offered in the UK, I presume the suggestions may be to have either the Pfizer or Moderna ones.Your partners previous iron levels are probably not appropriate as he was not anaemic.
What else can I do?Mrs J. Farmer, via email.Your symptoms are suggestive of glossopharyngeal neuralgia, which triggers abrupt attacks of extreme pain in the throat, near the tonsils.Generally, and as in your case, just one side of the throat is affected. The pain can be sharp and last only a couple of minutes, or you may have a consistent low-grade ache.The signs are triggered by swallowing, coughing, yawning or, in some clients, touching the website of the pain. Discomfort such as you describe is triggered when this nerve becomes irritated in some way– maybe by a blood vessel pressing on it. I advise asking your GP to refer you to a neurologist, with this potential diagnosis in mind.The good news is that in many cases, this condition can be effectively treated with medication.The first-choice treatment is the drug carbamazepine, which is often recommended for trigeminal neuralgia, another form of extreme facial discomfort also caused by pressure on a nerve.