Personally, I love it when people attempt to self diagnose, but ONLY if they are good at it. The reason why doctor’s are dismissive of self-diagnosers is because individuals with histrionic or hypochondriacal personalities often self diagnose and they often want invasive or deleterious medical procedures performed that are not indicated given their presentation. That being said, if a patient has a background in science, and provides rational, thought out reasons for their beliefs, I am more inclined to listen to them rather than if they come in holding a wikipedia printout.
That being said, really a doctor has three options when dealing with a self diagnosis. Your either humor it, agree with it, or dismiss it. If you think the patient doesn’t really have the expertise required to understand their disease fully, and if you just want to avoid a confrontation/maintain good rapport, you humor them so long as their beliefs don’t lead to self injurious behaviors (taking unneeded meds, undergoing unnecessary surgery, etc.) If you think they are right, then obviously you agree with them. If they are wrong, and their beliefs would lead them to harmful consequences, or you have other compelling reasons to do so, you try and explain why their beliefs are incorrect and you try to educate them as much as possible.
In your case, I would have humored you. It sounds like your first doc dismissed you. Here are the reasons why I would have probably humored you.
Carotidynia just means carotid pain. Caroti = carotid artery, and dynia = pain. Slinging words around which seem impressive to laypeople, but are common use to doctors, erodes your position and makes you seem less credible. I’d avoid doing so at your ENT visit. You would be much better served by saying, “My neck hurts here, and here are some other symptoms I’ve been having.” From your explanation, it seems as though you are also confusing carotidynia with carotid arteritis. While carotidynia is a very nonspecific term, carotid arteritis is a very specific clinical entity which is an uncommon form of a relatively common vasculitis, which are in and of themselves uncommon. It is also a clinical emergency because giant cell arteritis can cause blindness.
The second reason I would have humored you, and probably the biggest, is that you wanted prednisone. Prednisone is a bitch. A big, big, big bitch. No one likes being on prednisone because it makes you feel horrible. No doctor likes prescribing prednisone because it makes patients feel horrible. However, sometimes we have to because it is the big gun of big guns to stop inflammation. The fact that you wanted to take prednisone would have told me that you probably have a tenuous grasp of what you are talking about. Prednisone isn’t something to be excited about, its something to dread.
That being said, you should have mentioned the veins on your chest. Furthermore, take pictures! Its really hard for a doctor to ignore physical proof. Just from your description, I can’t comment on whether your self diagnosis is correct or not, but it is certainly worth checking out with your ENT.
BTW, I’d suggest that you ask your ENT if getting an Erythrocyte Sedimentation Rate (abbreviated ESR) would be OK. If you explain your symptoms, including the veins in your chest, your ENT will probably agree to do the test. They will probably agree because it’s cheap, simple, noninvasive other than a blood draw, is strongly positive in most cases of giant cell arteritis. Also if they miss giant cell artertis, it could have HUGE implications including a malpractice suit.