The limitations of modern medicine

September 20, 2014

I-have-no-ideaSaw my Stanford-affliated ENT yesterday to follow up on the ear that’s been blocked on and off for the past six weeks. The ear that looked perfect when I saw her last month, but remained blocked for days at a time. The ear that was within normal limits when the audiologist tested my hearing, but hours later was blocked again. The ear that I will have to fly to Sicily with in 10 days.

Doctor J. looked in both ears, my nose, my mouth. She pushed a button to move my chair back so she could examine my ear under the microscope. When she finished, she maneuvered the exam chair so I was seated normally, rolled her stool back and said:

“I’ve gotta be honest with you, Carol.  I have no idea what the hell’s going on with your ear. It looks perfect.”

It made me laugh, first, because of her delivery, which was New Jersey perfection itself, and then because of its honesty about the limitations of modern medicine. I really do love this doctor’s style.

She went on to say that most people are born asymmetrical. She reminded me that I had a deviated septum on that side and that a former ENT had told me that it was pretty close to my Eustachian tube on that side.

“Eustacian tubes are only about a millimeter across,” she said, ” so it doesn’t take much to block them. It could well be that as your head grew, that’s the way it developed. After all, it happened to you once before.”

Ok then!  So after a month of prednisone, during which I tried to eat everything in the house, almost including Riley’s food, I’ve had 5 days of just about normal hearing. But my problem could come and go a few more times before I have an extended period of time during which my left ear does not feel like it has a conch shell attached to it.  Whoooosh!

Medicine is more an art than a science and neither can explain all things.  Not yet, anyway.

What was going on with my ear is simply not evident with the tools we have today. So she didn’t know what it was. This was an assessment I could accept. After all, it was just a blocked ear. If it had been something more serious? I  might have more trouble. But in the end, what can you do? Modern medicine is still imperfect.

I know plenty of people who would’ve argued with the unknown nature of my diagnosis. Or non-diagnosis.But having a hard time with the limitations of modern medicine doesn’t change the fact that it IS limited.

My doctor shared her fantasy, too: “I can see a day when we will be able to thread a tiny camera up your nose and see exactly what is going on. But we’re not there yet.”

Then, I remembered something I wanted to run by her:  “A friend had a similar problem and her doctor said that Eustachian tubes can sometimes get floppy as we age.”

My doctor laughed. “Someone made that up.”

“How about those pressure-equalizing ear plugs, called EarPlanes?” I asked.

“I’ve had patients for whom they worked well and others who scratched their ear or blew out their ear drum. I think you’re safest with Sudafed and Afrin on the flights. You’ll probably do fine.”

She paused.

“I can’t tell you with 100 percent certainty you won’t blow out an ear drum. You could get a bad cold on your trip and have to fly.”

She closed my file.

“And also sometimes airplanes do a big drop without warning,” she said, “and you might be unprepared.”

“If that happened, Dr. J,” I said, “I’d be at bigger risk of a coronary. How about a prescription for nitroglycerine?”

She laughed, stood up, held out her hand for me to shake.  “It’s been a pleasure,” she said, “but I hope I never see you again.”

“The feeling’s mutual,” I replied.

And that was that.


23 comments on “The limitations of modern medicine
  1. Laura Kennedy says:

    Something that might help, if you get a sympathetic flight attendant: I once had to fly with allergies flaring up, and was in excruciating pain during a landing. A British stewardess (long ago~) put damp washcloths in the microwave for a few seconds, put them in two cups, and had me hold the cups over my ears. The heat and moisture instantly relieved the pain/pressure.

    Made for a comical, less-than-grand entrance for my first trip to Britain, but it was a blessing. Dunno whether you could get anyone to do it for you today. (Maybe if you brought your own washcloths?) Anyway, wishing you luck.

  2. Now THAT is an awesome doctor. Wish there were more like her.

    Best wishes on the flight with an effed-up ear. Crazy, I know (tho you surely get it), but flying with congested ears is one of my phobias… though I won’t say why because you really don’t wanna know.

  3. I have similar problems. They are horrible. My ENT wants to do more CT scans. I have boney growth on my jaws. Deviated septum surgery may have saved my life as I can breathe again and no longer have apnea, can actually sleep, and have other physical problems get much better or disappear. Hope your flight goes well. Crossing my fingers.

  4. Ear issues are one reason I really hate to fly! I have had issues since I was a kid with it. I will say that for me the EarPlanes work, but I also bring the meds that your doctor suggested. I’m going to send you very good thoughts that your ears and your trip will be perfect!!! xoxo

  5. Carol Graham says:

    Don’t want to step on any toes but, yes, doctors are limited by their lack of nutritional education.

    • Well…let me say that the first time this happened my ENT in Florida and I thought it was aspartame. I haven’t had an iota of that since, so it wasn’t that this time. I am pretty sure it’s the deviated septum being too close to the tube. But the funny thing is that on exam it looks fine and it comes and goes. But Carol, if you have more info on nutrition, I’ll take it!

    • Carol Graham says:

      If it is a deviated septum, then yes, surgery. If you get an accurate diagnosis, and it is not, let me know. What I can do is send you a symptom analysis and do an appraisal on that to see if any lights come on. If you want to, PM your email address.

  6. Lana says:

    I’ll be sending good thoughts that your trip goes smoothly, with no problems. My hubby has developed terrible motion sickness the last few years, without ever having experienced it before. The doctor thinks it has something to do with his inner ears, but they can’t find anything specifically wrong. The final word – deal with it. I feel bad because he is no longer able to go ocean fishing – one of his favorite hobbies. Maybe someday medicine will catch up!

  7. Laurel Regan says:

    Loved that exchange. Nice when they can admit that they don’t know what’s going on! Hoping for a safe and comfortable flight for you.

  8. I like the sound of your doctor. I like when they admit, they just don’t know.
    Hope you figure it out and your ear feels better soon my friend!

  9. Shailaja V says:

    That doesn’t sound very good! I hope your problem clears up and that you have a safe and enjoyable trip, sans ear issues.

    P.S. Came across your blog on the Write Tribe page.

  10. I wish more doctors were like her! We expect doctors to know everything and they just can’t. I hope you have an easy, uneventful flight.

  11. Diane says:

    Hmm . . . I think I like this doctor. Willing to admit. Willing to talk. Here’s to more like her. Oh, and have fun on your trip . . . 🙂

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