“I know it doesn’t really describe what’s happening to me, but I just feel ‘off’.” I listened intently as Susan continued to tell me her story. “I don’t know if it’s a difficult to-
treat condition I have, but it sure has been difficult to get diagnosed. You’re the 5th doctor I’ve seen in the last four months.”
“Even though I’m board-certified in family medicine, my practice has morphed into one that handles cases that other physicians have difficulty with. Tell me more about what’s been going on.”
“Well, I’m not sure where to start because there wasn’t any one thing that I can blame for how I’m feeling.” Susan continued, “I just noticed that I’m tired all the time. I can’t stay up late. When I come home, I’m spent. I know exercise is supposed to help, but I just can’t keep up with my spinning class anymore.”
“Fatigue has lots of causes, sometimes more than one at a time. After hearing your history I’ll use some of this 80+ minute consultation to do a complete physical exam
so I don’t miss anything.”
“But there’s more. I’m bloated whenever I eat. My tongue has been coated so white, my kids sometimes ask if I brought home any vanilla ice cream. Do you know what causes that?”
“Open up; let me see.” Sure enough, Susan’s tongue was heavily coated white. “That’s classic candida! You’ve got yeast.”
“You mean like a yeast infection? I get those from time to time, but I don’t feel anything now.”
“Yes, a classic candida infection is what you’re thinking about, but I’m speaking of CANDIDA ENTERITIS, a systemic yeast infection in your gut. It can cause lots of
symptoms including the fatigue and bloating you mentioned, but also chronic sinusitis, heartburn, diarrhea, anal itching, and ‘brain fog’, where your concentration and
memory are impaired.”
“That sounds just like me. I can’t tell you how many times I walk into the kitchen not knowing why, and then I say to myself, ‘Oh yeah, to get my keys! Why didn’t my
other doctors diagnose this?”
“Unfortunately, many doctors just write off these symptoms as stuff that happens with normal aging. The problem is that medical schools don’t do much teaching about the various problems that occur with yeast.” I motioned her to the exam table, “Let’s finish our physical exam.”
“See these white spots on your arms and legs?” Susan nodded. “It’s called IDIOPATHIC GUTTATE HYPOMELANOSIS and it’s caused by yeast that prevents your body from making melanin, or skin pigment.”
“But my dermatologist said it’s caused by too much sun!”
“Unfortunately, dermatologists and other doctors double or triple book 15 minute appointment slots and don’t have time to give a proper explanation. Because
I’m out-of-network I’m not forced by insurance companies to run patients through as fast as possible. I take the time to diagnose things better and find solutions that treat
the cause of your condition, not just cover up symptoms.”
“So, do I just take a Diflucan pill, the way my GYN has prescribed before?”
“There’s a lot of drug-resistant bacteria and yeast out there so I need to do a culture and sensitivity test to figure out how to best treat you, and then we’ll have to be aggressive
in our treatment. It’s not just one pill, it’s a good 3 months to kill all the spores inside your gut.”
Susan’s testing did show yeast, and perhaps due to all the Diflucan she’s had in the past, it was resistant to that drug. Luckily, it was killed by another safe medication, and
after 3 months of treatment (along with probiotics and a yeast-free diet), Susan returned full of energy.
“Dr. Woliner, I convinced my spinning class to do an outdoor ride for charity. Can I sign you up as a sponsor?”