Conflicting Diagnoses: How to Choose the Right ENT Specialist?

There are many versions of diagnoses from different physicians. Who should I trust?

Hello Dr.
Tsai,
About a year ago, I accompanied a friend to the hospital and seemed to have inhaled something that left a scratchy feeling in my throat.
I wasn't very sure about it.
After returning home, I started experiencing severe pain 2 to 3 days later, so I visited a family medicine doctor at Renai Hospital who prescribed painkillers.
Although the pain subsided, I gradually felt an increase in phlegm.
Not long after, I went to see an ENT specialist at Renai who diagnosed me with chronic sinusitis.
After taking medication, I felt better, but shortly after stopping the medication, the phlegm returned, and it became more severe.
I then sought help at Taichung Hospital, where the chief physician suspected I might have a lung issue.
An X-ray was taken, but nothing was found.
The doctor couldn't provide a diagnosis and prescribed medication, which helped for a while, but the symptoms returned and worsened.
I was almost constantly coughing up phlegm.
I then visited another ENT clinic near Daya Road and Chongde Road, where I was told I had tonsillitis.
After some treatment, I felt better, but after stopping the medication for a month, the symptoms returned, and I started feeling like there was something stuck in my throat.
This cycle of treatment has continued for over six months, and I feel like a regular visitor at the clinic.
However, the doctors keep telling me that my condition is not serious.
A few days ago, I went to Cheng Ching Hospital and saw a highly regarded chief physician.
After a long wait, he told me that I have naturally enlarged tonsils and that I don't need medication.
He mentioned that having secretions from the tonsils is normal.
He also said that there was another patient with similar concerns and that there are only two options: surgery or just accepting the condition.

I can't just accept this; I feel like I'm constantly clearing my throat and have seen many doctors over the past year.
My throat feels almost ruined, and I am not upset about the possibility of surgery; I just want to be treated properly.
I genuinely don't know which doctor to trust anymore.
Could you recommend a patient doctor in Taichung? I don't want to feel rushed during my visits; I really want to understand the cause of my illness rather than just being given medication to try.
My condition is worsening, and when I look in the mirror, I see many lumps in my throat, and my tonsils have numerous holes and look quite terrible.
Yet, the doctors say it's just a natural condition.
I don't believe that I was born this way.
Is it possible that I have a viral infection in my throat? Also, is it normal to have a lot of secretions from the tonsils?
I apologize for writing such a long message and taking up your valuable time.
I hope you can help me.
Thank you very much.

Xiao Wen, 20~29 year old female. Ask Date: 2005/01/09

Dr. Cai Hongyan reply Otolaryngology

Hello,
1.
It is difficult to provide treatment without seeing the patient.

2.
If the hospital clarifies that surgery is an option for treatment, it indicates that there are specific indications for it.

3.
Symptoms persisting for more than three months suggest a chronic condition, which is often related to inflammation.
Infections typically present more acutely.
Chronic diseases are usually associated with lifestyle factors, immune dysregulation, or long-term stimuli (such as smoking).
Please discuss this with your physician during your outpatient visit.

Reply Date: 2005/01/09

More Info

It sounds like you have been through a challenging and frustrating journey with your throat and respiratory issues over the past year. The conflicting diagnoses from various specialists can be overwhelming, and it's understandable that you are seeking clarity and effective treatment.
From what you've described, it appears that you have experienced a series of symptoms including throat pain, increased phlegm production, and a sensation of something stuck in your throat. These symptoms have led you to consult multiple healthcare providers, including family medicine and ENT specialists, who have given you different diagnoses such as chronic sinusitis, tonsillitis, and enlarged tonsils.
Firstly, it's important to understand that the throat and respiratory system can be affected by a variety of conditions, including infections (viral or bacterial), allergies, and anatomical variations. Chronic sinusitis, for instance, can lead to post-nasal drip, which may cause throat irritation and increased phlegm. On the other hand, enlarged tonsils can also contribute to similar symptoms, especially if they are obstructing airflow or causing recurrent infections.

Regarding your question about whether tonsil secretions are normal, it is common for tonsils to produce secretions, especially if they are enlarged or inflamed. However, if you are experiencing significant discomfort, persistent symptoms, or visible changes in your throat (such as the "bumps" you mentioned), it is essential to have a thorough evaluation.
You mentioned the possibility of a viral infection affecting your throat. Viral infections can indeed cause inflammation and discomfort in the throat, leading to symptoms like pain and increased mucus production. However, if your symptoms persist or worsen, it may be necessary to consider other underlying issues, such as allergies or even gastroesophageal reflux disease (GERD), which can also lead to throat irritation.

Given the complexity of your symptoms and the conflicting opinions you've received, it may be beneficial to seek a second opinion from an ENT specialist who has experience in managing chronic throat conditions. Look for a physician who is known for their thoroughness and willingness to listen to patients' concerns. You might also consider asking for a referral from your primary care physician or seeking recommendations from trusted sources, such as friends or family.

In addition to seeking a new specialist, you may want to ask for specific tests that could help clarify your diagnosis. For example, a laryngoscopy can provide a direct view of your throat and tonsils, allowing the doctor to assess any abnormalities. Allergy testing may also be useful if allergies are suspected to be contributing to your symptoms.

Lastly, it's crucial to advocate for your health. If you feel that your concerns are not being adequately addressed, don't hesitate to express this to your healthcare provider. A good doctor-patient relationship is built on communication, and you deserve to have your symptoms taken seriously and to receive a treatment plan that addresses your specific needs.

In summary, while it can be frustrating to navigate conflicting diagnoses, seeking a second opinion from a patient-focused ENT specialist may provide you with the clarity and treatment you need. Remember to discuss all your symptoms in detail and consider asking for additional diagnostic tests to help pinpoint the underlying cause of your discomfort. Your health is important, and you deserve to find a solution that works for you.

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