Gifted Sherlock Doc Solved My Life Ruining Sinusitis Mystery Without Prescribing More Antibiotics
The problem: onset of chronic sinus from dirty tonsils
Sometime during my college years I started to get sinusitis frequently. The frequency increased until I was down for a few days about every 6 weeks. Only antibiotics could knock it out. After it started to affect my graduate work and my job, I knew I had to get to the source of the problem and fix it. Many Doctors were reluctant to prescribe antibiotics and this complicated the matter... often I was sick for days and days until they believed me and gave me the antibiotics. Eventually the antibiotics were making me sick.
The feeling of 100% health
Instinct, intelligence, and self-awareness failed to find the solution thanks to the U.S. medical system and its busy, timid Doctors
Had I been able to really focus with one Doctor and make a list of possible causes, my own research skills and self-examinations would have ended the suffering much sooner. I made a list of about 30 possible causes, and my swollen, porous tonsils were in that list. After noticing getting food in my tonsils and having to work to get it out, I was on the right track.
But Doctors each spent only about 3 to 5 minutes (never more, often less) talking to me about it. I spent 70 dollars for each time. For some reason it was taboo have email contact, and follow ups would always require an office visit. Being that I missed work so many times going in there to convince them that yes, I DO need antibiotics, I didn't have the time off to go in again and again for another short discussion that gets nowhere. I had to spend 70 dollars for each visit even when they didn't believe me, sent me home, and saw me again 5 days later, when I was sicker. To their credit, all of them came around eventually and stopped charging me for some of those visits. It would reset with each new Doctor, the frustration and convincing would begin anew. This happened a dozen times at least.
Basically the medical system wasn't going to help me, and I kept my list of possible causes and ongoing investigation to myself. To my credit, I eliminated most of the other 29 or so causes over time. I did this by my own experimentation and keeping a journal. Finally, the only cause left unexplored was that I couldn't get my tonsils totally clean of food.
As my wife was visiting a Doctor often while pregnant, she recognized him at a festival in the small town where we both lived. Uncomfortable about it, I used the opportunity to summarize to him my situation and convince him to try to help. I agreed to an appointment and met him to discuss the matter. He suggested using a water pick and gargling with saltwater to clean my tonsils. It was difficult to do and moderately effective. I only got sick about every 8-10 weeks as long as I did that.
When I finally had a Doctor who would prescribe antibiotics over the phone it afforded some more relief from the burden. Not visiting the Doctor repeatedly was a respite I needed to keep my career on track, but it ended the important face-to-face talking with a Doctor. Not that the short "investigations" they offered would every lead to the root cause and permanent fix anyway. But I was glad for some relief.
It came a bit late, as my reputation for taking off sick days caught up to me I had to put my career on hold anyway. I started a business doing construction work since I could make my own hours, working around the sick times. I no longer was even using my undergraduate degree. I was making a lot less money. It felt good for a while to not have to answer to anyone about taking a day off. I revised my plans and returned to my Engineering career. It was a tough process but I found that through contract work I could hide the fact I was often off sick.
The painful but glorious solution is painfully and gloriously found
Finally, with my graduate degree on hold so long it looked like I'd never go back, and when it seemed all the years of my frequent sick days (and very little actual vacation) were catching up to me and ruining my career again, the solution I had come up with so long ago was suddenly back on the table.
It happened when I was struck with an extra nasty case of sinusitis coupled with strep throat. It was a Saturday and my normal procedure of getting an antibiotic called in for me couldn't be done, and couldn't wait until Monday. I went to an urgent care facility where a super-intelligent, assertive Doctor with the last name of Nissen had the curiosity that geniuses share and most everyone else lacks- including the 25 or so Doctors before that glorious day.
She, yes SHE (and beautiful and blonde too! take that stereotypes!) asked how many times I had infected sinuses, and when I took a minute to think and answer "at least sixty", she immediately snapped to attention and started asking questions rapidly like a Naval Officer in charge of the bridge at the beginning of a sea battle. What struck me is that she actually believed me, never doubting my unusual but absolutely true answers.
This established the basic facts of the case well enough that she realized the hell I had been through and seemed to want to fix it as much as I did. What she did next showed an ability you rarely see in life, she expertly examined the facts and began using brilliant problem solving exercises to get to the root cause. She wasn't merely going to win this battle, she was going to win the war!
Very shrewdly, she began to rule out possibilities and pieced the puzzle together, asking me a question or looking in my throat during a moment of hesitation. Like a Sherlock Holmes (without Mr. Watson, or did I fill that role?) she got to the bottom of the case and named the killer - tonsils with cavities that hold bacteria. The bacteria had been hiding out while masses of indignant antibiotics marched by repeatedly, only to sneak out days later and terrorize my sinuses again. No more would I have to accept the failure of my host of other Doctors who (like Doyle's Scotland yard and Inspector Lestrade) incompetently mucked about the matter naming the wrong killer by flawed logic or worse, unsolvable, as they offer me only minutes of their own lazy research and ambivalently non-motivated, often suspicious, off-target questions.
Then I couldn't believe my ears as she asked me using strong language "why the hell any of the other Doctors didn't have my tonsils out LONG AGO". I was so sick, in pain, but grinning ear-to-ear as I told her how I brought it up before and they didn't invest the thought, time, or risk to go that far. I knew what she was doing next but asked anyway "what are you writing?"
It was a letter to my Primary Physician to take out my tonsils after I recovered from this most recent bout of strep throat. As she handed me the letter she told me to contact her directly if I didn't get confirmation from them that a tonsillectomy would indeed be scheduled. I had the feeling if I did have problems getting a yes, she would willingly take them out herself. And I'll bet she would have done a perfect job too.
Hack job tonsillectomy worked
I finally did get my tonsils out. I was 30 years old, and had to sit in a kid's chair and watch a video made for children about the procedure before they got started. The put me under and cut the nasty things out. Then they cauterized the wound with a hot iron rod. It was too bad that even though I had been given an I.V., the Anesthesiologist forgot to give me ANY painkiller.
I woke up from the operation in the recovery room and screamed from the pain, which though intolerable somehow was made worse by the scream. Not being able to scream I pounded my fist on my hip and looked around for HELP with my eyes as wide as they could open. A nurse looked at me and came back with a vial. She gave me an I.V. push of morphine and assured me it was the maximum the state would allow. Against policy she gave me the push very rapidly (my wife is a nurse and told me this) but I was glad she did.
That took the edge off, but still I was in such bad shape that when my wife the nurse saw me, her shocked face became pale and she fainted, almost hitting her head on the floor as she was caught by the attending nurses. They eventually got her up and laid her down next to me in a recovery room bed, I was glad to see her when they opened the curtain separating us. After some time, orange juice, and a few cookies she helped me to the car for the drive home, no picnic either as I vomited blood on the way. After what we went through earlier, it seemed like no big deal.
Nevertheless, it was one of the best days of my life! Since that surgery I've gone almost a decade with nothing more than the average cold or flu. I think I've had to take an antibiotic once for something chest related, maybe bronchitis. I don't know, it's nice to be able to forget about it. It's also nice to be able to share with you... maybe you can prevent this from happening to yourself or someone you know. Trust me, they will thank you If they get the chance. I tried but couldn't get the chance because she moved on from that urgent care facility. Oh well, you are out there- Thank you Dr. Nissen!
One Beautiful Doctor
What can we learn from the brilliant Dr. Nissen?
Number one, she BELIEVED WHAT I, THE PATIENT, SAID ABOUT MY OWN HEALTH SITUATION. Of course this is not standard practice. Whether she saw something in my character, intelligence, or the damage to my tonsils I don't know. Doctors must proceed with caution or be liable. They are often lied to by some patients. It was a relief to have a Doctor who could tell she was hearing the truth, and that I did not need to be brushed aside, discounted, or treated with suspicion. It would have been safer for her to do so. She would have made just as much money that day if she assumed I was just trying to get attention, or giving a dramatic answer to a question for effect. She could have assumed I was after some prescription drug for no good reason. She didn't assume anything negative about me. Finally someone had the insight to see I'm not making any of this up! She did assume a few negative things about some of the other Doctors. She did this bitterly, as if this happened all too often, and they (the other Doctors) should and do know better. She was very candid about this and I appreciated the honesty. Her interest was in helping me, not helping her profession's or colleagues' images.
Number two, she empathized with me. Whether it was completely genuine or mostly good training in practice, I appreciated the fact she took it as seriously as me. Even more seriously, as I had obviously all but given up from years of frustration.
Number three, she rapidly asked the relevant questions. As fast and efficient as she was, her successful investigation took longer than the 5 or 7 minutes other Doctors gave me before. But it didn't take much longer, in about 10 minutes she pretty much nailed it.
Number four, she was assertive about the fix. She told me what needed to be done and stood by it. I had the feeling that she was going to help me get it taken care of even though it wouldn't profit her financially. She didn't have to write the letter to the other Doctor. She didn't have to offer the follow up support, but she did. It helped me to believe that it really could be fixed. It gave me a sense of relief and hope that I didn't expect going in to Urgent care for a terribly sore throat.
Number five, she was right about everything she asked, believed, said, and did. She went out on a lead and quickly took a path all the way to the end, no other Doctor would go to that point even when I was leading them directly to it. With her, I didn't have to. I never got to tell her how well it worked. I probably don't even have to. She knew it already that day. Brilliant.
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