First, Be a Good Doctor (Part Two)

I help to keep Annie more comfortable for a month until her discectomy. Recovery is prolonged, probably because of the delayed surgery. A year after surgery and more than six months of PT, her leg symptoms finally leave. I didn’t see her again until about two – three weeks ago.

Annie now has had headaches, neck stiffness and fatigue for 1 full year. She thought the fatigue was “just stress”. With the headaches, she says, “Adjustments might help me.” Her current doctors, as far as she can gather after multiple doctors office visits (not once with her doctor), think the cause is stress, and “probably perimenopause”. In her history, which she did not even associate with her chief complaints, she says she has had five recurrent “colds” and bronchitis in the last year, with four rounds of antibiotics.

Annie still feels like crap. On the verge of tears, Annie now says, “Dr Hayes, I know you can tell me what’s wrong with me.”

So, during her exam, after my staff does their part, I listen to her chest. It sounds clear. Her throat is mildly injected. I go to look in her ears, and now she says “Nobody’s looked in my ears, just treated my cough”. Then I put on clean specula and examine her sinuses.

She has fluid in both ears, scarring in one and nasal turbinates on one side that look like ground beef. Now she’s perplexed. “Why didn’t anybody else do this type of exam?” Says her husband will be really pissed. Wants to circumvent any more HMO crap, does not want me to call her PCP, and so I referred her right to Mass. Eye and Ear @ MGH. Meanwhile, I order all her labs, put her on immune stimulating supplements, adjust her and train her on sinus acupressure, which really facilitates sinus and Eustachian drainage. She’s feeling better in about two days.

(To Be Continued)

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