Help me question my Doctor a little

In My Humble Opinion
1

I’m not asking for medical advice here. I know that even those of you who are MDs are not my MD, and diagnosis over the Internet is a bad idea. And my milage may vary. A lot.

I’d like to get some ideas of good questions to ask my doctor before I decide what to do.

I have nasal allergies that have gotten worse over the years. Last spring I got an ear infection, and that ear has been stuffy ever since. Even after three courses of antibiotics. My GP and my ENT have both seen clear fluid behind the ear drum. I would like the ear stuffiness to go away. It’s been a year, and having fluid behind my ear drum has lost its charm. I’m also staying on my allergy meds (Both OTC and Rx - but under a doctor’s care. Actually, under two doctors’ care now.) all year now. I used to be able to stop them in the winter.

My GP ordered a CAT scan of my head[sup]1[/sup], and referred me to an ENT. The ENT examined me, took my history, saw the CAT scan, and ordered allergy tests. Sure enough, I’m allergic to various plants - trees, grasses, etc.

It looks like my options are allergy shots[sup]2[/sup], surgery un-deviate my septum, surgery to clear out the clogged sinus(es) and swollen passages (seen in the CAT scan), or some combination. The surgeries that I agree to would probably all be done in one operation, I think. Somebody mentioned ear tubes as a possibility. I’ve heard of ear tubes, but since neither I nor my kids needed them, I don’t exactly know what they are.

While I’m having more bad allergy days than I used to (headaches, sinus pressure, sneezing), mostly it does not seem bad enough that I want to get cut over it. Except for times like three nights ago when my sinuses shut down like the Beltway on a rainy Friday night before Labor Day, and I couldn’t sleep. Spring is coming soon and I’ll be outdoors more. I’d like to be able to do that and breathe AND not have to take meds around the clock.

Allergy shots concern me. I can handle getting shots fine, it’s mainly the scheduling I’m worried about. Getting a shot every single week for years seems a bit much to me. It’s been hard for me to find time to read the SDMB once a week, I don’t know if I would stick with going to the doctor’s office for a shot. I’m not sure how much benefit there would be. Mama Zappa thinks allergy shots helped her, but she did have several years’ worth.

The med tech who did my allergy testing said that the shots these days are once a month, with an expectation of 60-80% improvement in 3 months. Is that right? Has the technology improved that much? The ENT (the guy who’s an MD) said weekly shots, maybe the med tech was mistaken.

So, Dopers, what questions should I have for my ENT before I see him next, to figure out which options are best for me? I’ve got some questions about length of surgery, length of recovery time, costs, etc… I feel like I’m missing some useful lines of questioning.

By the way, is it weird that the places I got my allergy tests two weeks ago have gotten itchy just in the last two days? They didn’t itch when I had the tests. (I’ll ask the ENT that also.)

[sup]1[/sup] I was shocked when they X-Rayed my head and found


anything

inside.

[sup]2[/sup] True to my Dopername, I initially had an “i” for the “o” in “shots”. “Allergy What!?! - NO WAY!!!” :eek:

2

Here is some general information on chronic sinusitis.
http://www.emedicine.com/med/topic2556.htm

How strong is the link between your allergies and your complaints?
What is the cost of the surgery?
What is the proposed success rate of each intervention?
What are the risks?

Sounds like you’re already asking some of the right questions. Make sure the diagnosis is the right one.

3

My own personal experience with my allergy shots is that they are once a week at a bare minimum. I get them once a week, but hopefully, I’ll be starting to get them twice a week soon. Each visit, they inject you with a stronger allergy cocktail (yes, as a matter of fact, that is the technical term :D), until you get to a what they call a maintenance dose. I was told that it would be 40 to 60 injections until I got to my maintenance dose. I’m at shot 25, and I’ve definitely seen an improvement. After the maintenance dose, I was told that I would go every two weeks, then they would taper me off to every month from there. It is an investment of at least 20 minutes each week because they need to keep you in the office for a little while to make sure you don’t have a bad reaction to the shots.

From talking to other people in the waiting room, this seems pretty standard, but these are just the observations of a patient who sits in the allergy office a lot, not a doctor. I am pretty happy with the shots so far. It seems to be a friggin miracle that I can wake up in the morning and breathe through my nose, as well as be in the same zip code as a cat without going through an entire tissue box. I’ve even been able to cut down on my allergy meds, amazingly.