Tracking down the cause of a throat tickle
DEAR DR. ROACH: I am 74 and in very good health. I’m active and walk twice daily.
Maybe a few times a day I get a tickle in my throat that causes me to cough a few times. If I suck on a hard candy or take a drink of water, it is soothed. It is never a deep cough or one that goes on and on. But it is annoying. I take amlodipine, levothyroxine, Zyrtec and pantoprazole. I had my thyroid out two years ago, my only surgery. I have a hiatal hernia and pre- Barrett’s esophagus. -- D.M.
ANSWER: The throat tickling sensation and cough have several possible causes, and you have three or four of them. It may be a combination.
The first is gastroesophageal reflux disease. This is when acid from the stomach goes into the esophagus and causes damage. It often causes a heartburn sensation, but not always, and cough is a frequent symptom.
Too much acid for too long can cause permanent damage to the esophagus, a condition called Barrett’s esophagus.
This is dangerous because it predisposes to cancer of the esophagus, and people with Barrett’s esophagus need screening to evaluate for cancerous changes. The pantoprazole you are taking may help prevent further damage to the esophagus.
The amlodipine you are taking makes GERD more likely, since it relaxes the lower esophageal sphincter, the muscular valve that is supposed to keep acid in the stomach where it belongs. I suspect this is the main cause in you, as you seem to get relief from swallowing, which is common with reflux.
A hiatal hernia, where the stomach partially goes into the chest, may also cause cough.
Postnasal drip, from allergies or other nasal irritation, is another frequent cause of cough and throat tickling. You are taking Zyrtec, an antihistamine, so I suspect you may have some issues there.
Finally, in the rare case, thyroid surgery can cause damage to an important nerve (the recurrent laryngeal), and cough is a possible symptom of this. If the cough started after surgery, it would be appropriate to do an evaluation.
DEAR DR. ROACH: I am recovering two weeks after an evidently milder case of COVID. I am over 65. Should I get the vaccine when it’s available to me, or can I wait a while and let others get it ahead of me if I now have natural immunity against reinfection? If so, how long? I am guessing I can wait upward of six months.
P. S. Even a mild case is no fun to have, and quarantine for 14 days is really boring. So follow advice to avoid getting in first case. -- N.R.B.
ANSWER: I am glad you had a mild case. Most people do, but severe cases can cause many complications and persistent symptoms.
The risk of developing another case of
COVID- 19 is low in the 90 days after infection, so you may defer the vaccine until after that time. However, you may also get the vaccine now. I would not wait any longer than 90 days, if possible, as even people with a history of COVID-19 may get the disease again. Natural immunity is not long- lasting in everyone.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell. edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
MOSCOW (AP) — Russian President Vladimir Putin ordered his nation’s top counterintelligence agency Wednesday to redouble its efforts to address what he described as Western attempts to destabilize Russia.
Speaking at a meeting of top officials of the Federal Security Service, or FSB, the main KGB successor agency, Putin pointed at the “so-called policy of containment of Russia,” charging that it includes efforts to “derail our development, slow it down, create problems alongside our borders, provoke internal instability and undermine the values that unite the Russian society.”
The Russian president added that those activities by foreign powers, which he didn’t name, are aimed at “weakening Russia and putting it under outside control.”
The United States and its NATO allies have rejected similar previous claims by the Kremlin that they were seeking to undermine Russia.
Russia’s relations with the West plummeted to post-Cold War lows following Moscow’s 2014 annexation of Ukraine’s Crimea and Russian meddling in the 2016 U.S. presidential election. The recent arrest of Russian opposition leader Alexei Navalny and a sweeping crackdown on protesters demanding his release has been another source of tension.
Speaking in Washington, White House press secretary Jen Psaki noted that when U.S. President Joe Biden recently had a call with Putin, he “did not hold back in expressing his concerns about the actions of his government.”
Psaki said that Biden has asked his national security team to look into reports of Russian hacking around the 2020 election, the massive SolarWinds hack, as well as information that Russia had offered bounties to the Taliban for killing American troops in Afghanistan. “It will be weeks not months before it’s concluded and we have more details about our response,” she said.
Russia has denied involvement in any of those activities.
Navalny, Putin’s most prominent critic, was arrested on Jan. 17 upon returning from Germany, where he spent five months recovering from a nerve-agent poisoning that he blames on the Kremlin. Russian authorities have rejected the accusation and accused Navalny of cooperating with Western intelligence agencies — claims which he has ridiculed.
Earlier this month, Navalny was sentenced to 2 1/2 years in prison for violating terms of his probation while convalescing in Germany. The sentence stems from a 2014 embezzlement conviction that Navalny has rejected as fabricated and the European Сourt of Human Rights has ruled to be unlawful.
Navalny’s arrest has fueled a wave of protests that drew tens of thousands to the streets across Russia. The authorities have detained about 11,000 people, many of whom were fined or given jail terms ranging from seven to 15 days.
In the wake of the demonstrations, the Kremlin-controlled parliament has toughened the punishment for disobeying police and introduced new fines for funding demonstrations. Putin on Wednesday signed those new bills into law.
Without naming Navalny, Putin assailed those in Russia who allegedly serve foreign interests.
“It’s necessary to draw a line between natural political competition, competition between political parties, ideological platforms, various views on the country’s development, and the activities that have nothing to do with democracy and are aimed at undermining stability and security of our state, at serving foreign interests,” he said.
The Russian president emphasized the need for the FSB to shield the parliamentary election set for September from any “provocations.”
Putin hailed the agency for disrupting the activities of foreign spies, maintaining it unmasked 72 foreign intelligence officers and 423 of their informants. He ordered the FSB to tighten the protection of the country’s latest military technologies, saying, “You all understand that we have a lot to safeguard.”
Putin also commended the FSB for its efforts to combat terrorism. He said it prevented 72 terror attacks last year. He instructed the agency to “uncover contacts between terrorist groups and foreign special services.”
“Unfortunately, anything goes, and they also use terrorists,” Putin said without elaborating.
CONCORD, N.H (AP) — A self-proclaimed white nationalist was sentenced Wednesday to nearly three-and-a-half years in federal prison for threatening to rape the wife of a man who was part of a separate racist group that he believed was harassing him.
Christopher Cantwell, a 40-year-old New Hampshire resident and radio host, was found guilty in September of extortion and threatening to injure property or reputation, but not guilty of cyberstalking related to a series of threats he made toward a Missouri man over the Telegram messaging app.
Cantwell previously pleaded guilty to assault in 2018 after he was accused of using pepper spray during the deadly white nationalist rally in Charlottesville in 2017. He didn’t serve additional jail time but was barred from Virginia for five years.
Judge Paul Barbadoro acknowledge that Cantwell has faced harassment but said the 41-month sentence reflected the nature of the threat against the woman.
“The threats made here by the defendant are abhorrent, shocking and extremely damaging,” Barbadoro said before handing down the sentence that also includes two years of supervised release.
Cantwell told his defense team that he wanted to appeal the sentence.
Dressed in a prison shirt and wearing a mask, Cantwell briefly spoke before the sentencing. He apologized to the woman for his comments and said his actions were driven by the months of harassment he endured at the hands of the Bowl Patrol, of which her husband was a member.
The group’s name is inspired by the haircut of Dylann Roof, sentenced to death for fatally shooting nine Black church members during a Bible study session in Charleston, South Carolina.
Members disrupted his radio show for months with pranks and defaced his website with pornography and violent content, Eric Wolpin said during the trial.
“The Bowl Patrol were constantly harassing me and threatening me and trying to destroy my business,” Cantwell said, adding that he went to law enforcement with his complaints.
Authorities say Cantwell used the Telegram messaging app to convey a threat in 2019 that he would rape the man’s wife if he didn’t give up information about the leader of a white supremacist group of which the man was a member, authorities said.
The Associated Press is not naming the man to protect the identify of his wife.
Cantwell was arrested in January 2020 and has remained in jail ever since.
Cantwell is also accused of threatening to expose the man’s identity and warning “you will lose everything you have” if he didn’t provide the personal details about the leader of the Bowl Patrol.
Cantwell followed through on another threat to report the Missouri man, who has several children, to the state’s child welfare services division for drug use and racist views. But an agency official testified at the trial that it did not feel the complaint justified further investigation.
Cantwell’s defense attorneys requested his client be sentenced to time served and argued he had already su ered enough.
“He has lost his house.
He’s sat in jail. He got COVID. This has been seriously impactful on his life,” Wolpin told the court.
But prosecutors, who requested a sentence of 51 months, said Barbadoro had to take into consideration how Cantwell’s threats impacted the victim’s family and how it was part of a long-running ef
fort by the defendant to use threats against Bowl Patrol members to get personal details on their leader.
“The court should consider the lasting implications for her and her children,” Assistant U.S. Attorney Anna Krasinski told the court. “Even now, it’s too painful for her.”