What is the reason for the feeling of windpipe compression in a pregnant patient?

Hi doctor,

I have had some problems with swallowing for about a year. At first, it was happening with solid food and only occasionally. Then it started to appear more often. I have seen my general physician about that, and they advised me to see a psychologist in case it was due to anxiety because it was not happening all the time. I have seen a psychologist for ten sessions, and he said I do not have more anxiety than other normal people out there. He advised me to search for the solution to my problem in my physical health. My general physician did not see anything major and did not give me a referral to any specialist. I have seen a dentist, and he commented, I have a dry mouth, but we did not go further from it. After six months, I started to have problems with swallowing saliva. I have been in the hospital for an unknown reason due to a very high pulse. They did a computed tomography scan of my chest and said they had seen some mass in the neck and advised me to see an endocrinologist in case it was a multi-nodular goiter. I have seen an endocrinologist and had an ultrasound. All was good with the thyroid. I also was checked for Sjogren syndrome and rheumatoid arthritis. I do not have them. I discovered a lumpish mass in my neck, under the right jaw. Endocrinologist touched the lump and commented it might be something wrong with the salivary gland. I noticed that the color inside my cheeks and my mouth's roof changed to yellowish, and my palate was whitish.

I do not have any soreness, just a bit of feeling that my soft palate and tongue are a bit swollen. I have seen a few general physicians about that, and they all said I am fine. Only one general physician said it could be laryngitis, and the lump was swollen lymph node. So they prescribed me antibiotics. I did not have any reaction. Then, they gave me Erythromycin 400 milligrams four times a day for two weeks. I noticed the lump got a bit smaller, but that was it. My mouth's color did not return to its pale pinkish normal color. I also had an ultrasound of soft tissue. They said I do not have lymphadenitis and did not say anything about the salivary gland. Yesterday, I noticed blood vessels under my tongue got swollen and looked blackish at the end of the day. I thought maybe it was because of my blood thinner. In the morning, it looked normal, but today the same happened. I am four months pregnant, and doctors do not want to give me any referrals to specialists. I was asking about a referral to an eye, neck throat specialist, but they said all procedures would be invasive, and you do not want to have any problems with your baby. I have a feeling that something is compressing my windpipe at night. I wake up coughing as I am not able to breathe. I also have some tickling in my throat. So I cough often, my voice is hoarse, and I get tired quickly. My main concern is if it is serious and if those problems harm the baby in any way. Kindly help me.

Hi doctor,

Thank you for the reply.

Honestly, I do not understand why they would not give me this referral. I appreciate they do not want to cause any harm to my baby. I wanted to see an eye, nose, and throat specialist to ensure I have no infection that can be bad for the baby. I had low iron a year ago, but recent iron studies are good. I also had some folate anemia six months ago, as I am homozygous for the C677T MTHFR mutation, but I am taking supplements for that. As it is also considered to be a blood clotting disorder, the gynecologist prescribed taking Aspirin and Clexine throughout pregnancy ( I have had a few miscarriages before). I am 17 weeks pregnant and in the process of transitioning from being a private doctor to a public hospital at the moment. They would like to evaluate themselves if I need to take blood thinners any longer. I have an appointment with the doctor at the end of the month when I hope to get a new script as my last was taken at the chemist. So, unfortunately, I do not have a copy of the script at the moment. First, a problem with swallowing happened about four years ago. But it was while eating solid food, so I do not know if it is even related. The dentist commented about dry mouth about three years ago, but at that stage, I did not feel it much. Last year, I had to see the dentist six times. He was not happy with my teeth, but I did not change anything about my oral hygiene routine. About six months ago, I felt that my mouth was really dry, and I thought my difficulty in swallowing and teeth problems were because of that. Five months back, I had flu, and there was a bit of post-nasal drip for some time, but never before. Four months back, I was at the hospital, and they did CT scan with contrast for my chest. A few days after I noticed this discoloration, I thought maybe it was some reaction to iodine contrast. I asked my general physician, and they said I have a normal-looking mouth. About two months back, I found a lump in my neck. Since I became pregnant, I have had more saliva now, but I still have difficulty swallowing and discoloration of the oral cavity. I feel that it is a bit swollen there. I have some seasonal allergy, but it was always an itchy rash on my arm and stomach, which went quickly with one to two pills of Telfast. A week back, I had this rash again. The general physician said it is common in pregnancy and prescribed 1 % Hydrocortisone ointment, and the rash was gone in two days. I did not have any symptoms of sinus disease in the past, same as runny nose, reduced sense of smell, and watering of my eyes. But yes, I have sneezed more than usual for at least four months. When I had the flu, I had a very dry nose, and even a few noses bleeds due to that. My general physician did not give me copies of ultrasounds. He just said all is fine. I only have copies of my analyses for the hospital.

Hi doctor,

Thank you for the reply.

I have seen an obstetrician. He said I could take Montelukast if needed. I also finally got a referral to an eye, nose, and throat specialist (ENT). But I have got an appointment only at the end of December. I also had an appointment with the dentist and used the opportunity to ask about my lump. The doctor said there was something wrong with the submandibular gland and that I should see someone from oral medicine and advised ENT is no help with it. I bought readymade salt sachets and did douche as you advised. It really helps to breathe better, and swallowing the next day is better too. I still have post-nasal drip, hoarseness of voice, and some cough, though. I feel tingling deep in my throat and have to cough. I do not have a runny nose or itchy eyes, though. I have all the medications you prescribed. I am willing to take them at least until my ENT appointment. Should Montelukast be taken for just four days? And how long does it take to use Fluticasone Furoate? Thank you so much in advance.

Hi doctor,

Thank you for the reply.

Hello doctor, I have finally seen an eye, nose, and throat specialist (ENT). He did nasal endoscopy and a flexible laryngoscopy. The doctor said I have a big tongue and irritated vocal cords due to acid reflux. Also, the doctor checked my lump in the neck and stated it was an inflamed submandibular gland together with a lymph node. More than a year ago, I had chest pain, and my general physician thought it was GORD and prescribed Esomeprazole for 30 days. I remember it really helped me, and for some time, I did not have any symptoms. It is obviously related to my problem.

I am taking 300 milligrams of Ranitidine daily and Mylanta double strength after every meal. I still have all the symptoms. I am 25 weeks pregnant. And now I also have acid coming up to my throat during the day and have burning pains in my throat. It looks red, inflamed, and swollen. My tongue is a bit swollen, too, with prints of teeth on it. Maybe it is big, but earlier I did not have that problem. The doctor did not prescribe me anything else even after I said that I did not find Ranitidine and Mylanta helping me much. He just gave me some advice not to sleep on my back (which I do not do for five months now), eat small meals (which I do), and not to have acidic food and drinks (which I also do). I asked if there was another drug Esomeprazole which I could take while pregnant. The doctor said there was not any. I would like to ask your opinion on that matter. I am also considering getting a referral to a gastrointestinal specialist, maybe to have a gastroscopy to check what is the reason for this GORD disease. Suppose I have problems with my stomach or esophagus. While I am pregnant, they will be reluctant to do any procedures. Thanks so much for your help.