Creating Waves of Awareness
Mr M.A, a columnist in a regional news paper, consulted me during the initial days of my practice. He was very much troubled with a nasal discharge, with occasional sneezing, since many years. Initially, he had taken Allopathic and Ayurvedic remedies with no benefit. The discharge was watery, salty and hot. The flow used to get aggravated while straining and stooping, especially while performing Namaz. While taking that case, he said,
"doctor, I feel the discharge is coming from my brain." Immediately, I scolded him for "diagnosing" a rare condition. I told him that the discharge is from the mucus membrane of nose and para nasal sinuses. Considering his presenting totality, I prescribed Natrum mur 30. He again came with no special relief. I repeated the medicine and also suggested him to practice Pranayama. He continued my treatment for two months and stopped coming. After a long gap, he came to me with a file containing several investigation reports and a discharge summary. The report shows that the nasal discharge was Cerebro spinal fluid (CSF), leaking through the defect in the cribriform plate of the ethmoid bone. As per the discharge summary, a surgical repair was done using a graft, and the leak is now completely stopped.
I got ashamed of myself for missing the diagnosis, mainly because, he could diagnose it in-spite of being a non medical person. I had studied CSF rhinorrhea in 3rd year BHMS, but could not recollect my memory when a real patient came to me. If we are wisely attentive, we can definitely learn so many things for our patients!
Moral of the article: Do not miss the diagnosis by saying that it is very rare. Practically, there is no difference between 99% possibility and 1% possibility, because that one patient could be our patient!
Dr Muhammed Rafeeque, BHMS, PGNAHI.