Patient complains of a "corncob" in his throat

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This patient encounter happened back in the late 1980s. I was an early nurse practitioner in an independent practice finding my way and building my reputation in a physician dominated community in New Hampshire. One day a new patient, an old Yankee with a thick down-East accent, came in to see what I might have to offer by way of help. He was seated when I came in the room and without preamble announced, “I got ah corncob in my throat.” I asked some questions, and he squinted at me and said more forcefully, “I got ah corncob in my throat.”

He did not present any further information except to answer in the negative to my questions about heartburn or other GI related symptoms. He told me he had lost quite a lot of weight because he had some difficulty swallowing, and it wasn't worth the effort to eat. He was a wiry, grizzled fellow, who did not look well.

I decided that this sensation of something “stuck” in the throat was possibly secondary to some reflux and proximal esophageal spasm. It has been so many years since that visit, I can't recall any tests that I ordered but will note this took place in a part of the country where fancy testing was not readily accepted! I treated him, and the corncob disappeared. He gained weight and became a devoted patient. It was the first really rewarding patient experience that I had had in my NP career, so it stays in my memory.

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