Oftentimes we are faced with a chronic or nagging health problem that our doctors can’t solve, leading to more tests, more visits to specialists, or repeated attempts trying unsuccessful therapies. At these times many of us turn to the internet in a usually futile attempt to narrow down and discover the true cause of our illness. It can be frustrating and overwhelming sorting through the myriad symptoms, diseases, and diagnoses suggested by these various sources. In the meantime, we continue to suffer the pain and discomfort of our undiagnosed condition, plus the indignity of repeated tests and invasive examinations.
The good news is that many illnesses can be analyzed and evaluated personally by you, oftentimes avoiding the necessity to see your doctor at all, or at least making the doctor visit far less painful and more productive. The secret lies in the specific history and unique presentation of each illness. Like a good detective, the effective diagnostician needs to examine the clues laid down in the course of each illness. Where are the clues and what is the relevant information that can be used to analyze and narrow down the suspects causing your malady?
The first step is to accurately and thoroughly describe what is being affected and what isn’t. Both sets of information are useful in identifying and ruling out possible causes. The first critical question to ask is: who specifically is affected and who isn’t? I once examined a father and daughter who were both afflicted with recurring and painful sinus infections, yet the other two members of the household (mother and other daughter) never experienced similar symptoms. This closely related comparative data helped rule out many possible causes conjectured by their doctors, including allergies to hay, crops, and farm animals (since they all lived on a farm). Our careful detective work focused in on the differences between the affected individuals vs. the unaffected individuals and narrowed in on the true source of the problem: a wood stove used to heat the basement, where only the affected father and daughter worked out on the home gym.
Another important source for revealing the true cause and ruling out implausible causes is the specific nature of the symptoms themselves. I analyzed another middle-aged man who presented with sporadic transient loss of speech (mumbling) and partial face paralysis. His doctors were considering many possibilities including stroke, Parkinson’s Disease, and nerve damage. But the transient nature of the symptoms (typically lasting only a few minutes) and the specific type of symptoms pointed to some kind of internal brain injury—specifically in the left side of the brain which controls these motor functions. Upon closer examination, the patient was found to have a lesion on this side of his brain which was being repeatedly opened (before subsequently clotting over) during periods of heaving movement or pressure changes, often experienced during periodic business air travel.
If these sources don’t reveal the offending cause of your illness, take a closer look into the timing of your health problem. If your illness had a sudden onset, think back to what you were doing differently or being exposed to at or shortly before the initial presentation of your symptoms. In the case of the gentleman with the loss of speech and facial numbness, his symptoms suddenly appeared on the first day of a family vacation to DisneyWorld—specifically after taking a roller coaster ride that jostled his brain and opened the lesion.
Symptoms that come and go with a discernible pattern can provide incredibly revealing clues pointing to a particular cause, and quickly ruling out unlikely causes. A few years ago there was a fairly public case of flight attendants for a particular airline who were coming down with an unusual and painful rash on their face, hands, and neck. A team of medical specialists assigned to the case conjectured a number of possible causes ranging from ozone gas in the cabin air to food allergies to ‘mass hysteria’. A simple vetting of the facts could have quickly and conclusively ruled out most of these possibilities: pilots and passengers weren’t affected, the problem occurred intermittently, and only on specific routes and aircraft. A closer examination of the different materials and procedures on the affected routes eventually led to the source of the problem: a caustic chemical dye used on newly installed life vests only demonstrated on those specific aircraft-equipped routes.
I often use this flight attendant health problem as a case study in my self-diagnosis workshops, because most lay people can solve this problem using public information that was made available in the press soon after the problem started. Yet this same information was available to the team of doctors investigating the incident, who continued to pursue false leads and take many more weeks to find the true culprit.
So the next time your doctor wants to take you down some dubious rabbit holes and subject you to more invasive treatment or tests in the hope that something ‘sticks’, use a little deductive reasoning of your own to help both yourself and your physician find the true cause quicker and less painfully.
By Reid Jenner