The Cough: Up my nose with stainless steel implements

All of this happened between 1997 and 1999, no need to inquire about my current health. [third in a series]

After leaving the hospital that first time, I began the usual asthma regimen of steroid inhalers, prednisone, and antibiotics. I picked up a dust mask to wear when mowing my lawn. I was careful. I was hopeful, even optimistic. This would not last long.

As soon as I was weaned off the prednisone and antibiotics, the symptoms re-emerged in force. Instead of concern about the diagnosis or something missed, I was accused of not following the doctor's orders. I found this dynamic to be common with all the doctors I dealt with over the two years of The Cough. They were never wrong, never at fault, only the patient could be making things worse. Within a month, I was looking for another pulmonologist. That was right after arriving in advance of my appointment and waiting TWO HOURS for him to show up. When he did show up, he (for the second time) accused me of not following his directions and dismissed my denials.

Meanwhile, back at my primary doctor's office, there were regular arguments about the cause of my problems. The doctor insisted I had allergies aggravated by acid reflux issues. This was instead of The Cough aggravating my acid reflux problem. I finally insisted he refer me to an allergist to determine just what these alleged allergies might be.

And so it came to pass that I went to the allergist.

Allergists have an interesting practice. When I walked into the examining room, I was asked to blow my nose into what appeared to be a piece of waxed paper. At one time in my life, I would not have been able to do this. I was terrible at blowing my nose, all I would accomplish is blocking my Eustachian tubes and blunting my otherwise good hearing. But along with this lung problem, I had plenty of sinus mucus. And, due to the prednisone I was now taking on a daily ongoing basis, blowing my nose produced a copious amount into that paper.

The doctor came in and interviewed me about possible allergies I might have. I explained that I had not ever had any that I was aware of. The only thing close to an allergy was my having to sneeze a few times after leaving my workplace when pine pollen was in the air. Here in Florida, pine trees are like weeds. They are everywhere. When they produce pollen, it's almost like living in a yellow cloud of dust. My workplace was climate controlled and intake air was heavily filtered. Dust of any kind is anathema to switching equipment. When leaving the office, I would sneeze three times and never again. That was it, the full extent of my sensitivity to foreign substances. The doctor seemed skeptical.

In due course, he poked my upper left arm with a pin with some substance on it to "get a baseline" for the allergy tests which would be run at my next week's appointment. When I returned for that appointment, I learned that I reacted so minimally to that baseline test that he worried that the allergy tests would not work well. But that didn't stop him. They ran what I like to call the "Porcupine Test" or maybe the "Excessive Acupuncture Procedure." 30-something pins were stuck in my back and left there for many minutes. After they were removed, I was asked to come back in a couple of days to evaluate the results.

There were no reactions. I was then given shots of some other substances in my arm. These also failed to produce any reaction. The doctor was clearly puzzled. He told me there was definitely a problem because my mucus samples were loaded with pus. I obviously had some kind of infection or a reaction to something. He ordered a sinus scan.

A sinus scan, if you have not had one, is done in an MRI. You lie on your back with your head in this large white ring and told not to move. There's a lot of noise, like grinding stones, and it seems to go on forever. It actually only takes about 5 minutes. And a week to get the pictures and analysis. It showed I did, indeed, have a sinus infection in two areas (lower sinus) and a slightly deviated septum. The allergist had me referred to an Otolaryngologist. This is, if you do not know, an ear, nose, and throat (ENT) specialist. Those who specialize in this are as strange to me as proctologists.

Once I went to him, I began to have serious doubts about the medical community. He wanted to take a sample. To do this, he sprayed some kind of painkiller into my nostril and then began stuffing several instruments of torture into it. One of these was a light. It was eerie to have light seemingly come from behind my eye. But he got his sample and asked me to come back in a week to go over the results.

That next visit showed me why I should not trust doctors. He now had those sinus scan pictures in his possession and became fixated with that slightly deviated septum. He could fix that. Sinus surgery was indicated, he said. It would improve the drainage, he explained, which should help to reduce the sinus infections. Those would be the sinus infections which he assumed I was plagued with. But, in reality, were the grand total of two that I had suffered in my lifetime.

I did what I do best, and what doctors fear most, I researched. Specifically, sinus surgery. What I found was that the AMA had taken a new position on sinus surgery in the last few years; they opposed it if the patient could breathe through his nose. Their studies showed that sinus surgery begot more sinus surgery and did not reduce infection rates appreciably over time. My ENT doctor had not heard of this. Neither did his yacht broker, I don't think.

We disagreed about the sinus surgery. Repeatedly. Loudly. He did, however, suggest I get a referral to an infectious disease doctor to treat the pseudomonas infection he had found in my sinus. Which I did. I also considered locating a different ENT doctor.