Episode Summary: Ep. 70 | It Comes Back

Introduction

In episode 70 of MrBallen’s Medical Mysteries, titled "It Comes Back," host Mr. Ballin presents the harrowing journey of Roger Donovan, a man plagued by mysterious and debilitating digestive and respiratory symptoms for over two decades. This episode meticulously chronicles Roger's relentless struggle for a correct diagnosis, highlighting the complexities and frustrations often encountered within the healthcare system.

Early Symptoms and Initial Events [00:00 - 12:40]

The story begins on a warm afternoon in Rhode Island during the summer of 2003. Roger Donovan, a 50-year-old corporate sales director, attends a barbecue at his new job. While grilling, he experiences an unexpected and severe episode:

"As he bent over, he felt a sudden surge from his gut. He lurched to the edge of the lawn, fell to his knees and heaved as stomach acid and half-digested food flowed up into his throat and spilled out of his mouth." [02:15]

This alarming incident occurs without any prior signs of nausea or typical vomiting sensations, leaving Roger both embarrassed and deeply confused.

Seeking Medical Help and Early Misdiagnoses [12:41 - 30:13]

Disturbed by the episode, Roger decides to consult medical professionals. His initial visit to a pulmonologist leads to a diagnosis of late-onset asthma:

"Roger was surprised because he'd always lived a very active life and never had any breathing issues before... late onset asthma, which is actually very common in adults." [05:30]

Simultaneously, a gastroenterologist attributes his digestive problems to acid reflux. However, these diagnoses do little to alleviate his symptoms, and Roger remains skeptical:

"Roger took his advice and a few days later visited with a recommended local gastroenterologist... he found it especially odd that it would set in at the same time as his late onset asthma." [08:45]

Despite adhering to prescribed treatments, Roger's condition worsens over the years. Frequent coughing fits, persistent nausea, and severe acid reflux significantly impact his quality of life, leading to isolation and depression.

The Struggle and Decline Over Two Decades [13:57 - 30:13]

Roger relocates multiple times in search of relief, moving from Rhode Island to Georgia, and later to Cleveland, each time hoping a change in environment or job will mitigate his symptoms. However, the harsh climates and exposure to industrial chemicals exacerbate his respiratory issues:

"The harsh chemicals used to clean the knitting machinery wreaked havoc on his lungs... his coughing fits only continued to get worse." [20:50]

By 2023, at the age of 70, Roger's health has deteriorated severely. Sleep deprivation from incessant coughing and vomiting attacks leaves him debilitated. A critical moment arrives when a CT scan reveals ominous dark spots in his lungs, raising fears of cancer:

"Roger's heart sank. A part of him had always dreaded that his condition might be something truly terrible." [25:20]

The Turning Point: Accurate Diagnosis [25:50 - 29:30]

Referred to Dr. Gregory Crane, a seasoned pulmonologist in Cleveland, Roger undergoes a comprehensive 24-hour pH impedance test. The results are groundbreaking:

"Roger's esophagus was defective. He was missing a sphincter at the bottom of it. That meant there was no barrier between his esophagus and stomach like most people have." [28:10]

Further examination by Dr. Amanda Davenport, a gastric surgeon, uncovers that Roger's stomach has ruptured through his diaphragm, exerting constant pressure on his lungs. This rare condition, known as non-erosive reflux disease, explains the relentless acid reflux and respiratory problems Roger has endured.

Successful Treatment and Resolution [29:31 - End]

Roger undergoes surgery to repair his diaphragm and reconstruct the esophageal sphincter using tissue from his stomach lining. The operation proves successful, bringing an end to his chronic symptoms:

"After the operation was successful, Roger's cough vanished and he could now bend and stoop and sleep in any position he wants without worrying." [29:55]

With his health restored, Roger's quality of life improves dramatically. He can finally lead a normal, symptom-free life, a stark contrast to the two decades of suffering he previously endured.

Conclusion

"It Comes Back" is a poignant testament to the challenges faced by individuals with rare and elusive medical conditions. Roger Donovan's story underscores the importance of persistent medical advocacy and the critical role of specialized diagnostic tests in uncovering hidden health issues. This episode serves as a powerful reminder of the resilience required to navigate the often frustrating path to accurate medical diagnosis and effective treatment.

Notable Quotes

• "As he bent over, he felt a sudden surge from his gut. He lurched to the edge of the lawn, fell to his knees and heaved as stomach acid and half-digested food flowed up into his throat and spilled out of his mouth." [02:15]

• "Roger was surprised because he'd always lived a very active life and never had any breathing issues before... late onset asthma, which is actually very common in adults." [05:30]

• "Roger's esophagus was defective. He was missing a sphincter at the bottom of it. That meant there was no barrier between his esophagus and stomach like most people have." [28:10]

• "After the operation was successful, Roger's cough vanished and he could now bend and stoop and sleep in any position he wants without worrying." [29:55]

This comprehensive summary captures the essence of "It Comes Back," providing listeners with a clear and engaging overview of Roger Donovan's medical mystery, from the onset of symptoms to the ultimate resolution of his condition.