A Medical Success Story Thanks to Gut Feelings

We are told to listen to our physician because physicians usually know best what is right for us… But what do you do when your gut tells you that your physician is wrong?

Sometimes, you must listen to your gut feelings and go against medical advice.

This is what I did six months ago.

My story

For many years, I have had bilateral ear pain during plane travel, especially on descent. In the last few years, as I needed to travel more and more for work, the pain has increased to the point that I only fly when travel is really important. The rest of the time, I favor long car trips to avoid flying.

The long car trips worked until my husband and I went to Mount Baldy in California for a hike. On our way back home, as we were driving down 7,800 feet from the ski resort area, my left ear started aching. By the time we were back home, I had intense left ear pain and was still not able to equalize after one hour of being back home.

I was stunned. Not only was I having ear problems in planes during descents, but I was starting to have problems in cars when driving down from a high altitude!

Enough was enough. I had heard about a new surgical procedure called eustachian tube balloon dilation, which had only been done in the last eight years. I looked for ear, nose, and throat specialists in Los Angeles who were performing that procedure and made an appointment with one of them.

My gut feeling was telling me that I had a problem with my eustachian tubes, the little canals going from the back of the nose to the middle ear, conduits that allow people to equalize pressure when there is any change of altitude, whether it is flying or diving.

The same gut feeling told me that eustachian tube balloon dilation was the right surgery for me because it was very simple and not aggressive: The surgeon puts a balloon in the eustachian tube to dilate it, keeps it inflated for two minutes to make the opening bigger, and then deflates it.

When I went to see the ear, nose, and throat (ENT) surgeon I selected, that surgeon told me that I had fluid in my middle ear behind my tympanic membrane and that I needed steroids for six weeks to decrease the eustachian tube inflammation.

When asked about eustachian tube balloon dilation, he said he had done a little less than one hundred of those procedures and strongly recommended against it, saying that it would not improve my situation, that the surgery would have to be done under general anesthesia in the operating room, and that, if I really wanted to have that surgery, it would not be covered by my insurance.

I was very disappointed. I completed the six weeks of treatment and then went back to the office to check on my ear. I heard the good news that my ear was back to normal with no more fluid in my middle ear, but… how about flying and driving up and down mountains? Again, I was advised against surgery, so I decided not to fly for a while.

As days and months went by, my gut feeling telling me that eustachian tube balloon dilation surgery was the right surgery for me became stronger and stronger.

I researched ear, nose, and throat surgeons who had specialized in eustachian tube balloon dilation and had written research articles about it. I found a surgeon in Texas who was trained by the pioneer of this surgery and who had done hundreds of those surgeries in the last eight years.

I made a virtual appointment with him, expecting he would confirm what my ENT in Los Angeles had said, that I was not a candidate, and that the surgery wouldn’t work on me.

To my surprise, this new ENT surgeon in Texas said I was an excellent candidate for that surgery, that he had done eustachian tube balloon dilation surgery with success in several airline pilots and flight attendants who had the same problem as mine (a significant number of pilots and crew members are disqualified every year because of eustachian tube dysfunction [1]). Some of them were now eight years out, and they were still very happy with the surgery.

In addition, my Texas surgeon said that he could perform the surgery in his office (it didn’t need an operating room), under conscious sedation (it didn’t need general anesthesia), and it would be completely covered by my insurance (my Los Angeles surgeon said it would not be covered by my insurance).

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I was ecstatic. I booked a day and time for surgery right away.

Everything went as my new ENT surgeon said. I had bilateral eustachian tube balloon dilation done in his office in Texas four months ago under conscious sedation with no pain whatsoever afterward, and everything was covered by my insurance.

In the last three months, I have taken 14 plane flights with no problem equalizing pressures at descents. I am happy I can fly again and probably scuba dive again [2], which I couldn’t do before.

What is the moral of my story?

1. Listen to your gut feelings: If a physician gives you a recommendation that your gut feeling strongly feels is wrong, trust your gut feeling and get a second and even a third opinion. Your body knows much more than you think it does, and your physician knows much less about your body than you think he or she does. But always make sure you see reputable physicians who have expertise in your condition. Ideally, you should choose a physician who pays attention to you and respects your gut feelings. A 2022 study [3] shows that paying attention to patients’ gut feelings improves primary care decision-making.

2. Never lose hope: If you suffer from a condition for which there is no treatment yet, don’t lose hope and keep checking for new treatment options. New medications and new surgeries are approved by the FDA every year.

3. Choose wisely: When having surgery, choose a surgeon who has a lot of experience, a surgeon who has done hundreds of the types of surgery you need, and who does that surgery often. Studies [4] show that the rate of complications from surgery depends on the surgeon’s experience. There are fewer complications, and surgeries are often more successful when done by a very experienced surgeon. I don’t mean to say that having your surgery done by a physician who just graduated is bad. Those surgeons can be excellent, but in general, it is a good idea to ask how many similar surgeries your surgeon has done in the past before signing up with that surgeon.