Undiagnosed Sinus Case Study – Background

Stephen had experienced symptoms of his sinus being persistently blocked and his nose was almost constantly running.  He described it as “having a cold 24/7.”

After a month with symptoms, his GP sent him to a specialist on Harley Street in London who was unable to provide an accurate diagnosis.

The Harley Street doctor recommended another specialist in the US who instructed him to have a sinus washout where the patient undergoes general anaesthetic and a metal tube is inserted in the patient’s nose and aggressively washes the sinus out with saltwater.

Stephen undertook this uncomfortable procedure with temporary positive results.  Sadly, Stephen’s sense of taste and smell only came back for about three weeks before the symptoms returned.

It was supposed to be a cure, and when it hadn’t it left him dejected.  He had tried nasal spray steroids, hay fever tablets, not eating dairy, not eating wheat and even cutting out meat but nothing seemed to work.  He had not had a drop of alcohol in 3 years because it made his symptoms worse.

Stephen lost a lot as a result of this situation. By losing his taste buds completely, Stephen was unable to truly enjoy his passion and business as a restaurateur.

He was diagnosed with depression, gained weight and couldn’t sleep in the same room as his wife because his snoring was so loud due to his blocked nasal passage.

All of this because of an undiagnosed medical condition that appeared as a common cold to many.

The Diagnosis

After engaging Alivia, our first step was to sift through the numerous medical files, journals and images that Stephen’s various doctors had produced during the many years Stephen had tried to cure his condition.

A thorough analysis of the condition history is also an opportune time to identify overlooked steps – even great doctors sometimes miss important clues.

In this case Alivia’s Medical Intelligence Unit (MIU) realised from the beginning that a multi-disciplinary approach was required to get to the root cause of the condition.

What Alivia Did

Alivia’s internal research team – the MIU – reviewed all the relevant files and researched medical literature to ascertain which doctors and specialists had published about conditions with similar rare symptoms.  The initial list was around ten doctors internationally.

Selecting a Physician:

Dr. Tomas Norlindh, Alivia’s Medical Director, used the MIU’s analysis and his and Alivia’s International Medical Advisory Board’s formal as well as informal networks to get list down to 5 names of who could be relevant for Stephen and his symptoms.

At this point, Dr. Norlindh returned the final list back to Alivia’s MIU.  The MIU in turn began to research these doctors/hospitals, checking various kinds of statistics, success rates, patient reviews, and of course communicating with the doctors and asking them specific questions as to how they would approach Stephan’s case.  Would they recommend operating on Stephen’s sinus or have they done any other research that suggests a particular course of action would be advisable in this case.

The Result

Fast forward three weeks from when Stephen first came to Alivia.  The MIU informs him they have identified a leading international specialist surgeon and instructs him to see a specialist clinic in Zurich, Switzerland for a consultation with a renowned ear, nose and throat doctor.

The Swiss specialist had recognized that Stephen had a genetically defined disease and to resolve his loss of sense of smell would require revision surgery.

Alivia arranged for Stephen to fly to Zurich with his wife and children and he was initially given a Triamcourt injection in his sinus which gave him significant relief.  This was meant as an initial measure to test the hypothesis of the Swiss specialist prior to the next recommended step which was a frontal sinus drainage operation.

Since the initial drugs recommended got Stephen back breathing properly in the night and also gave him a significant but not total improvement in his sense of taste and smell, it was decided that Stephen would head back to Switzerland for the final operation. He is now symptom free and living a very normal life.