THE ODYSSEY IN SEARCH OF A REMEDY FOR MY DIZZY VISION

PART A – A WILD-GOOSE CHASE

INTRODUCTION

I am lucky to have been blessed with good health since I was young. In those days I had not suffered any serious illnesses or injuries that required specialists’ medical treatments in all my life. Of course in my childhood days there was no medical clinic in the village where I lived. In those days, when one was sick one had to depend on local herbs or conventional methods of treatment like drinking fresh young coconut water if one had a fever. I still remember when I was a little boy and had an attack of asthma I was forced by my mother to swallow a newly born rat wrapped in salted vegetables! But I recovered and the asthma was gone forever.

But on few occasions in my later life I had little choice but to consult some medical specialists here in Malaysia and in Singapore, though I was not sick due to any serious illnesses or injuries due to accidents. In all my encounters with the medical specialists, I am glad to say that a couple of them I consulted - an eye specialist in Singapore, Dr. Arthur Lim and a heart specialist in KL, Datuk Dr. Nik Zainal - were very professional, friendly and compassionate in their dealings with me as a patient and as a human being.

But lately I was totally disgusted in my encounters with a few medical practitioners in Malaysia, including my family GP, an ENT Specialist, a Neurologist and a Traditional and Complementary Medical (T&CM) Sinseh when I was mysteriously affected with “dizziness” and poor vision when walking in the open, particularly after spending sometime reading or working on my computer.

MY UNPLEASANT ENCOUNTERS

(a) With my family GP for over thirty years

At the end of my diving expedition in Pulau Weh in early February this year, my right ear was infected as there was some discharge coming out from the ear canal and my hearing was affected. It was a day or two before the Chinese New Year when I came back, and the clinic of my family GP in Petaling Jaya was closed for a week and so I did not seek any medical treatment for my ear as I felt it was slowly getting better. However during this period, the discharge had finally stopped but there was still a ringing in my affected ear and I also felt a bit of dizziness with my distant vision. So when my family GP’s clinic was opened after the Chinese New Year I went to consult him. After a quick examination of my right ear, he told me, “There is some infection in your ear and also there is earwax in it.” He prescribed some medication like Clarinase which I believe only relieves symptoms associated with allergies, such as sneezing, running and itchy nose. He also prescribed ear-drops and some medication to fight bacterial infection (not antibiotics as he knew that I’ve not taken these for over twenty years). As for my dizziness, he was silent and prescribed nothing. After a couple of days of taking the prescribed medications, I stopped as I felt I was on a wrong track.

(b) With a ENT Specialist in KL

As the ringing in my left ear still persisted and my distant vision did not improve, I decided to see an ENT specialist. I remembered seeing one in Jalan Pudu about 15 years ago when I first learnt to scuba dive and had my right eardrum perforated. From the Yellow Pages, I located one ENT Specialist Clinic in Jalan Pudu and made an appointment to see the Specialist on 18th February in mid morning.

As I was aware that it would not be easy to park my car in that busy area, I took a taxi from the Lake Club to this Clinic. When my turn came to see the Specialist I noticed that he was relatively young, in his early forties, and was not the ENT Specialist I saw more than 15 years ago. I told him about my diving in Pulau Weh and the problem with my right ear after I returned home. After he had used an otoscope to examine my right ear he curtly told me, “Your ear problem was due to sinusitis.”

I was very surprised by his abrupt statement and retorted, “No, I could not remember the last time I had sinus; it could be a long long time ago. And if I had sinus lately, I would not be able to scuba dive!” I further added, “I did not have block or running nose before, during and after the dives in Pulau Weh.” (I know that sinusitis is commonly referred to as “sinus” here and is due to inflammation of membrane lining the nose resulting in blocked or running nose with mucous discharge from the nose.)

The Specialist still insisted that my ear problem was caused by sinusitis and proceeded to show me in a monitor screen, using a special instrument inserted into my ear and nose, life images of the ear infection in the ear canal and accumulation of earwax in my outer and middle ear near the eardrum. He then started to educate me, as if I was a stupid old man, and told me that the nose, mouth and ears are interconnected. He also insisted that I had been breathing through my mouth. I told him bluntly to stop all the jazz and that I had to breathe through my mouth only when I was diving under water!

(Obviously he was not a diver and knew nothing about it. This reminds me of my visit to my family GP when my ear was having some infection after undergoing my scuba diving course in Redang Island more than fifteen years ago. After examining my affected ear, my GP discovered there was a minor perforation in my eardrum. He advised me to use an earplug the next time I went diving!)

He proceeded to use a suction catheter to remove the pus and earwax from my outer ear. When that was done he told me that he had to puncture the ear drum to remove the earwax from the middle ear. I objected and told him to leave that alone.

As he proceeded to write the prescription, I told him that I did not want to take any antibiotics as I had refused to take them for over twenty years. He nonchalantly said,

“As a doctor, I have to prescribe the necessary medication necessary to treat your illness. It is up to you whether you want to take it or not!”

I immediately walked out of his office without taking a second look at him. I waited outside for the receptionist to hand me the bill. What I got was not only a bill for over three hundred Ringgit but also a pack of medications which consisted of antibiotics, a nasal spray and Aerius tablets for the relief of nasal symptoms like nasal discharge and itching. Of course I did not use any of the medications as I believed I was wrongly diagnosed.

That was not the end of my unpleasant episode with this ENT Specialist. As I walked out of the clinic after paying the bill and collected the medication, I was feeling hot and was absolutely disgusted and angry with the haughty treatment I received from the uncouth Specialist. My immediate task was to get a taxi to take me back to the Lake Club to have a cold beer to cool me down. There were a number of cabs parked on both sides of the road, some with the drivers inside and some with no driver insight. I approached a few cabs with drivers seated inside by knocking the doors to alert them. A couple just completely ignored me; a couple wound down the window and when I told them that I wanted to go to the Lake Club they said nothing and ignored me totally. I also try to hail a few empty cabs moving along the road, but none bothered to stop. I went across the road and was similarly treated by the cab drivers. Though feeling totally disgusted by what happened the whole morning, I still had the presence of mind not to lose my temper and decided to walk all the way back to the Lake Club.

It took me half an hour walking in the hot sun to reach my destination. When I arrived, it was just past noon and I headed straight to the Batek Bar and had two cold beers to cool me down! What a day!

(c) With An Eye Specialist in PJ

Feeling restless after the unpleasant episode with the ENT Specialist and not being able to take my usual afternoon nap, I decided to see an Eye Specialist in Megah Medical Centre to examine my two eyes which were fitted with plastic lens implants more than twenty years ago.

I decided to see this Specialist because two of my golf kakis were quite pleased to have their cataracts surgeries done recently by her. In mid afternoon of 18th February, I went to this Specialist to have my two eyes examined. After I told her my problem, she started to check my eyes. In about ten to fifteen minutes, she completed the examination and said, “Your eyes are in very good condition.”

“But what about my poor and dizzy vision?” I asked.

“It’s due to your brain!” She replied without any hesitation.

I was shell-shocked and speechless for a few moments. After I recovered my composure I asked her whether she could recommend a good brain specialist whom I could consult. She wrote the details in a piece of paper and gave to me. I left the Medical Centre after paying the bill and felt miserable for the rest of the day.

I just could not comprehend why for a simple ear infection, the ENT Specialist would attribute it to my nose; and for a simple problem of poor dizzy vision the Eye Specialist would attribute it to my brain. I only hoped that my brain was sound and I wasn’t going crazy

!

(d) With a Neurologist in SJMC

The recommended Neurologist was in SJMC and without much hesitation I called to make an appointment on 20th February. When I met the Neurologist I explained to him my problem and my recent encounter with the two other medical practitioners. He made a quick an examination and recommended that a brain scan or Magnetic Resonance Imaging (MRI) was to be carried out first followed by other diagnostics tests like Electrocardiogram (ECG), Audiological and Eye Vision tests. All tests were carried out in SJMC and were programmed so that all the reports would be ready for the Neurologist’s attention in the afternoon of 26th February.

I collected all the test reports on 26th February and handed over to the Neurologist. After studying them all, he commented that everything seemed to be alright except that from the MRI of my brain, there was fluid in the mastoid bones. (The mastoid bone is located behind the ear. It is porous, with a lot of air cells and looks like a honeycomb.) He further commented that this could not be the cause of my problem.

I was relieved to hear that but was stunned by his next statement when he said as a matter-of-factly, “I think it is an old man’s disease!”

Though stunned, I retorted, “No, I don’t agree! How did I suddenly become old? Are you implying that a month ago I was not old?”

The Neurologist was silent to my outburst but told me to wait outside for his staff to give me the prescription for the medicines to be taken by me.

But why do I need any medication if it is an old man’s disease?

(e) With ENT, Sinus & Dizziness Centre in Singapore

Having reached the dead end in my search for the cause/cure of my vision problem, I had completely lost my confidence in the local medical practitioners. It was entirely left to me now whether to live for the rest of my life with the “old man’s disease” or proceed further to search for the cause/cure of my problem. Without much thought I decided the latter.

Having lost confidence in our local medical practitioners, I shifted my attention to our neighboring country, Singapore to find a reputable medical specialist to look at my problem. From the Internet, I located a medical specialist centre in Mt. Elizabeth Hospital, called Ear, Nose, Throat, Sinus & Dizziness Centre, which I considered to be an ideal centre to deal with my problem. In the first place, I am more familiar with the location because I had my cataract operations done there more than twenty years ago. Secondly, I perceived that my problem (dizziness) could be due to imbalance caused by my right ear’s mastoid bone which was filled with liquid.

To go to this Medical Centre in Singapore, I decided to do it during my fortnightly visit to our oil palm plantation in Pagoh, Johor. It takes me about two hours to drive to Pagoh and another two hours to reach Johor Bahru. Killing two birds with one stone, I would spend a night in my cabin in the plantation and drive to JB the next morning. From there I could take a cab to Singapore. Having decided on my travel plan, I made my first appointment to see the Specialist in Singapore on 12th March.

Going through the records I brought along from the SJMC Neurologist and after carrying out the necessary tests, the Specialist asked me to go for an ear CT scan. The scan was done in the hospital’s Department of Diagnostic Radiology in the afternoon. The report of the Radiologist indicated that both my ears were normal and confirmed that there was fluid seen in the right air cells of the Mastoid bone.

The Specialist further recommended that a dizziness test to be conducted for both my ears and an appointment was made with a Consultant Audiologist to carry out the test on the following day. After the tests were carried out, the Audiologist Reports shows only the following:

(R) Ear – suggestive of Vestibular dsyfunctions.

i) unilateral weakness,

ii) mild positional nystagmus.

After reviewing the results of all the tests carried out, the Specialist told me that the root cause of my problem could not be identified. However, he said it could be due to four causes, namely infection of the Mastoid bone, poor blood circulation to the head and two other ailments relating to the inner ear which could only be known from surgery.

Nevertheless I was pleased that he did not tell me it was an old man’s disease!

Two types of medications were prescribed, antibiotics and blood-thinning tablets. As I don’t take antibiotics but have taken Ginkgo for a number of years, I refrained from consuming these prescribed medications.

Again my attempt to find a solution to my problem came to another dead end!

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