Dear Dr. Roach: You probably have never gotten a question like this. How much mercury is in an old thermometer? A month ago, I wasn’t feeling well, so I took my temperature with an old thermometer that seemed to be taking too long to work. Long story short, I broke it into my hot cup of coffee, which I drank before I realized that I had broken the thermometer. I didn’t finish the whole cup.
What happens to mercury when it’s in hot liquid? Does it sink or float? Is it visible? Does it have a taste or smell? What will happen to me? I didn’t call the poison centre or my doctor because I was embarrassed.
I did end up being sick for a long time. I had a fever (I got a new thermometer), sore throat, terrible headache that lasted for days, my blood pressure was elevated and I vomited on the fifth day after ingesting the mercury.
I don’t know if some of the symptoms were from a reaction to the Nyquil I had taken, which has never bothered me before. Any suggestions?
Anon.
You should have called your nearest poison control centre. (On Vancouver Island, call the B.C. Drug and Poison Information Centre at 800-567-8911.) I phoned. They confirmed the teaching I received: The mercury in a thermometer is elemental mercury, not the toxic organic mercury salts, so it would not normally be absorbed. Mercury is very heavy, much denser than water, so it would have sunk to the bottom of the coffee quickly, and odds are you didn’t ingest much, if any. It stays bright silver, but you probably would not have seen it through the dark coffee.
The expert I spoke to was concerned about the broken glass you might have swallowed. I suspect the symptoms you describe have nothing to do with the mercury.
I still advise you to go to your doctor and discuss it. If someone came in to me with these symptoms, I would look for other reasons for them, not mercury.
Dear Dr. Roach: I am a 68-year-old man with numbness in my hand for the past seven years. A neurologist diagnosed carpal tunnel syndrome and prescribed special gloves. I have no hand pain, only numbness when I elevate my arms, which also causes neck and shoulder pain. What can I do to get some relief?
B.W.
Carpal tunnel syndrome is caused by compression of the median nerve in the wrist. It may cause numbness and pain in the hands. The pain can travel up the arm, but rarely affects the arm above the elbow. Neck or shoulder pain makes me concerned that the nerve compression causing your hand numbness might be originating in your neck. It is possible you have both carpal tunnel syndrome and a ”pinched nerve” in the neck, but compression of the nerve in the neck could cause all the symptoms you are telling me about. A careful exam usually sorts this out, but an MRI may be necessary to confirm.
Dear Dr. Roach: I have been suffering about three years from burning mouth syndrome. I am female, age 73. Seeing four ear, nose and throat specialists, I was prescribed amitriptyline; Nexium, since it was thought that GERD was the culprit; a mouthwash with prednisolone; and another mouthwash that I rejected, because I frequently use liquid Benadryl to reduce the burning temporarily.
I take Ativan (.5 mg) every morning for anxiety. I live with stress and intermittent depression caused by loneliness; I lost my husband three years ago and have no family.
U.E.
Burning mouth syndrome is characterized, as its name implies, by a burning sensation in the mouth, with no other dental or medical cause identified. It is most common in older women, and often is worse in the evening. Several conditions, such as dry mouth and vitamin deficiency, can cause a burning sensation, but in BMS, none of these is present.
There is an association between depression and burning mouth syndrome. You may have some element of depression. You are on an antidepressant, amitriptyline, but you are probably on the dose for nerve pain (usually 10-50 mg) not the antidepressant dose (often 300 mg per day or more). Amitriptyline isn’t a great choice for depression for a woman in her 70s due to side effects at a high dose, including dry mouth.
I would consider a different medication, such as venlafaxine or duloxetine. These can reduce pain directly as well as treat your depression. An internist or neurologist may be able to provide expertise complementary to that of your ENT doctors.
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 [email protected]
