Self-Diagnosing

Our gas furnace wasn’t working. The air coming out of the vents was cool. But it was intermittent. Sometimes I turned the unit on and it would work. Other times, it wouldn’t.

I set up a service call with an AC/Heat company.

The technician was here forever. Checking all kinds of things but couldn’t find the problem. The heater worked.

That afternoon, after the technician left, the heater didn’t work.

This continued over several weeks with four different AC/Heat companies.

Each time a technician finished his assessment, I asked, “So, what’s the problem?” and each time, the answer was a mishmash of maybe this, maybe that. And each time, the heater would sometimes work, sometimes not but worked every time the technician showed up.

Finally, with the last technician, I pressed him on his analysis. I said, “I don’t know anything about heating systems but here’s what I’ve noticed. When I turn the unit on at the thermostat, it often doesn’t work. When you guys go up in the attic and jump-start the unit, it works. Every time. So, it seems to me the problem is not in the attic.”

The technician said, “Well, I suppose your thermostat could be faulty. How old is it?”

“About two years,” I replied.

“Huh. Well, that’s pretty new so probably not but let’s swap it out and see if it helps,” he said.

And bingo, that was the problem.

This hit or miss, try this, try that approach can be an expensive, time-wasting way to fix just about anything and that’s especially true for the human body. Sometimes, yes, that’s the best you can do because symptoms and problems are a many-to-many relationship. You can have more than one symptom from more than one source or you can have one symptom from more than one source.

And diagnosing something you’ve never seen or worked with is difficult. That’s why it’s called a practice.

Diagnosing the problem is often a function of how you see the problem. If you see, for example, hip or knee pain, as a result of muscle tightness or inflexibility, then your solution is stretching. If you think of it as muscle weakness, then strengthening is your go-to intervention. If you believe the fascia is too tight, then you’ll turn to myofascial release. And that’s just a few of the models out there.

Or, for example with knee joint pain, some practitioners believe the best you can do is strengthen the thigh muscles which works, sometimes, until you get up on your feet and try to push yourself. Then, your knee pain typically comes right back.

The Internet has been a phenomenal resource except when it comes to self-diagnosing some ache or pain. Trying to self-diagnose is mostly a waste of time. And in some cases, can run you down a long, confusing, frustrating road.

I’ve worked with clients who had unusual symptoms and have stumped me. Of course, it’s only unusual because I’d not seen it before. Sometimes, I figured it out, sometimes with help from others and sometimes, I didn’t figure it out. It almost always takes longer than you think it should.

I was teaching a class on shoulder pain to clinicians once and one of the students asked about her own shoulder. She had been diagnosed with instability (shoulder joint is too loose) and rotator cuff tendinosis. She had been through the usual shoulder rehab yet continued to have problems with the shoulder mainly when she tried to lift, push or pull.

So, I brought her to the front of the class and gave her a 5lb dumbbell and asked her to lift and lower it with the painful arm. She looked at me, with a horrified expression, and said, “There’s no way I can do that! It’ll hurt too much!”

I placed my hands on her hips and told her to keep still as I tried to twist her body. And then, when I told her to, lift the arm up and down.

Guess what? No shoulder pain. She completed 10 reps with the 5lb dumbbell easily.

What was that about? Pattern recognition. Often times people with shoulder joint instability fail to activate the main stabilizers of the shoulder. The hip twisting trick increases the recruitment of the muscles and confirms that notion. Because I had seen this scenario a lot, I recognized the story. Now the students in the room have seen it too.

So, what do you do? The Internet is a great resource for information but not so much for knowledge. 

Information + Experience = Knowledge. And diagnostics require knowledge. I had information about my gas furnace but didn’t have any knowledge about gas furnaces. I suppose I could have removed the thermostat and installed another one but I’m not much of a handyman. I could easily make things worse – again, a lack of knowledge.

Diagnosis leads to a better outcome but it’s harder to do, takes more commitment, more time.

Thanks for reading.

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