Medical Mysteries: How a sore throat led to life-threatening bleeding - WaPo

For more than a year, Arthur L. Kimbrough had done everything he could think of to find out what was causing the stabbing sensation that radiated from his throat to his neck and down his left shoulder. He had seen anesthesiologists, an ear, nose and throat doctor, a neurologist and neurosurgeons in Florida and Maryland; undergone tests and scans; and taken a variety of drugs that failed to alleviate the intensifying pain that baffled his doctors. It wasn’t until February 2022, after Kimbrough suffered a life-threatening hemorrhage in a hospital waiting room, that the cause was finally identified.

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Sitting in the waiting room, Kimbrough started sipping a Coke. Without warning, blood began gushing out of his mouth and nose. Someone handed him a stack of napkins; it was drenched in seconds. As he coughed and spat out some of the blood and blood clots that were cascading down his throat, Kimbrough remembers thinking, “I’m drowning in my own blood.” For years, he had taken a blood thinner to treat an irregular heartbeat; the drug can exacerbate bleeding.

“The worry was that he could die of asphyxiation” by aspirating his own blood, said otolaryngologist R. Alex Harbison, the head and neck surgeon who met him in the ER. Harbison examined Kimbrough and saw a huge six-centimeter mass — at its widest point, the height of an egg — extending from the roof of his mouth over his tonsils to the back of his tongue.

He suspected the mass was cancerous and that it was caused by the human papilloma virus (HPV). The mass, which had been growing for more than a year, had become entwined with a nerve and had irritated the left lingual artery in the throat until it ruptured, triggering the bleed. Pathologists would soon determine that Kimbrough had Stage 3 squamous cell throat cancer caused by HPV-16, the most common type.

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Kimbrough says he wants other men to benefit from his ordeal by learning about HPV, vaccinating their children and questioning assumptions that may turn out to be erroneous, as they were in his case. Although he now regards it as crucial, Kimbrough said it simply didn’t occur to him to get a second ENT opinion for his sore throat, partly because the focus had been on his spine. “Everyone was doing their best with the best of intentions,” he said. “There was a fork in the road and we didn’t go down that other path.”

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