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Comment by Lazare | Hacker News Reader

Interestingly, I went to an ENT recently with chronic sinus problems.

Me: "My nose has been clogged since the 90s, I'm on three different antihistamine prescriptions, do you think surgery might help me?"

ENT: "Surgery? I mean, it might help a little. Might make things worse. What I'd really recommend is figuring out what you're allergic to. Let me write you a referral to an allergist instead."

Me, confused: "Wait, I'm allergic to something?"

ENT, more confused: "You didn't realise? Did nobody tell you you've displaying obvious symptoms? Why did you think you were on the antihistamines?"

Me: "Uh...."

So yes. I'd certainly recommend checking allergies, but the good news is, some ENTs are sensible. (Then again, this was the NZ medical system, which probably matters...)

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This has been my experience too. I have been to several ENTs. Every one was more interested in my allergies than any sort of surgery. YMMV, but ENT stands for Ear Nose and Throat specialization. There's no surgery inherent to the treatment. Sure ENTs have been trained in basic surgeries of their specialization, but that doesn't mean they're "surgeons". It's just one tool.

Otolaryngology is considered a surgical subspeciality, at least in the US.

"The first year includes experience in general surgery ... The last four years of residency are devoted to otolaryngology–head and neck surgery training." [1]

Now, surgeons are supposed to avoid cutting where they can. The better ones do so. Same principle applies to orthopedists for that matter.

[1]https://freida.ama-assn.org/specialty/otolaryngology-head-an...

I had mostly the same experience. Except my allergy tests all came up negative. Everyone pretty much shrugs. They all note the inflammation, even at the dentist when they do x-rays. Yet no idea what's causing it.

I imagine you're best placed to do a bisection test yourself? Like move to a different locality, cut out everything but water and be a nudist for a couple of days and see if it's improving?

Have you looked into food? I had sinus headaches my whole life and I've identified a ton of foods as the triggers. Might be worth doing an elimination diet.

I'm glad you had a better experience than I did. (I suspect you are correct about being not in a fee-for-service system having something to do with it.)

Most surgeons I've ever seen are pretty conservative. Maybe that's because I tell them I want them to be conservative but nonetheless, there it is.

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