On the other hand its a standard procedure performed on many people. And if anxiety after surgery is common, then there is a good chance he will find enough people on the internet that they will already have formed a theory about this.

I had anxiety with panic attacks that had came with (for me) real physical (pain) experience for a few years. so I think that those people really need help, but not in the form of creating new disease-names for them. They need psychological treatment and maybe some physical 'placebo' treatment/surgery to cure them.

I got cured by telling myself over and over everything is okay, which felt like lying to myself.

Then why aren't we seeing a similar set of cases for other frequent surgeries that result in such debilitating pain as to drive people to suicide? I'm guessing we could look at appendectomies, gallbladder removals, wisdom tooth extractions, c-sections, etc - where are the similarly acute cases if it's purely anxiety unrelated to the specifics of the surgical procedure?

There are many. This is why many elective procedures associated with anxiety and depression now require psych evals before a surgeon will consent to do them, at least at more prestigious medical centers. You'll note if you go in for cosmetic surgery, lap band, gastric bypass, etc. many of these centers will ask for you to see a psych before proceeding.

Additionally, more anecdotally, have you ever visited the "alt med" internet? It's literally swarms of people with anxiety and depression obsessing over how random medical minutiae (related to their dental work, their lap-choli, etc.) explain their set-of-symptoms-that-are-typical-anxiety.

These "similar sets of cases" aren't hidden. They're ubiquitous. They just set themselves as opposed to (1) the idea that they might have a psychological illness, and (2) anything that smacks of "establishment" medical care (which they both view with anxiety and with disdain and hurt, because it was that establishment that does not take their complaints at face value.)

I read the article yes, thank you for checking.

And to be perfectly clear:

>> he didn't think he'd had that, and only then saw "turbinate reduction" in the records

So what? That's just something that was in the article. Who knows what really happened. Maybe the guy knew and he forgot about it (it's called cryptomnesia). Maybe the article misreports it. Maybe, who knows what. You can't draw firm conclusions by something someone said once.

Now can I check with you whether you read what you wrote? Because it didn't make any sense at all. How can anyone who hasn't had turbinate reduction think they have a condition that is caused by turbinate reduction? That does not compute.

> You can't draw firm conclusions by something someone said once.

The only people in this thread who are drawing firm conclusions are the ones expressing the firm conclusion that Empty Nose Syndrome is 100% attributable to anxiety.

I certainly don't claim to know what is going on. But I am not at all convinced by the people who are confidently dismissing the possibility of any other causes.

> So what? That's just something that was in the article. Who knows what really happened.

Even if I grant you that he might have unknowingly remembered that his surgery included turbinate reduction, that doesn't matter unless he knew about Empty Nose Syndrome before he experienced the symptoms.

> Now can I check with you whether you read what you wrote? Because it didn't make any sense at all. How can anyone who hasn't had turbinate reduction think they have a condition that is caused by turbinate reduction? That does not compute.

Here is why it computes. Empty Nose Syndrome, as described from various sources, has a common set of symptoms and is linked to one specific surgical procedure. Now let us suppose your theory is correct and it is caused solely by anxiety focused on the surgical intervention. If that were the case, you would expect many people to express this same set of symptoms from other nose-related surgeries. You would expect that the description of Empty Nose Syndrome would then expand to be linked to a number of different nasal surgeries. After all, if these patients are hypochondriacs whose anxiety causes physical discomfort, why would this anxiety be limited to only turbinate reduction?

Now maybe your theory is that awareness of the syndrome itself creates the power of suggestion that causes the patient to feel these symptoms. And without that and the intellectual link to turbinate reduction, they will not experience the symptoms. Now that theory is completely contrary to the story given in the article. But besides that, how under your theory did the syndrome begin? If it takes the power of suggestion to create the sensation, how did the first people experience it?

Anything that created this syndrome out of thin air for turbinate reduction should be able to create it out of thin air for other nose surgeries. And yet for 15 years it has continued to be linked specifically to turbinate reduction. Why?

First, please don't use "hypochondriac" - it's a horribly outdated term and no-one here is trying to diminish the suffering that people feel from this condition, even if they think it's somataform.

> Here is why it computes. Empty Nose Syndrome, as described from various sources, has a common set of symptoms and is linked to one specific surgical procedure. Now let us suppose your theory is correct and it is caused solely by anxiety focused on the surgical intervention. If that were the case, you would expect many people to express this same set of symptoms from other nose-related surgeries. You would expect that the description of Empty Nose Syndrome would then expand to be linked to a number of different nasal surgeries. After all, if these patients are hypochondriacs whose anxiety causes physical discomfort, why would this anxiety be limited to only turbinate reduction?

But these things tend to self limit. Ann says she has chronic fatigue. She undergoes some psychological therapy. She gets some relief from her symptoms. A bunch of people in the CFS organisation now shun Ann, and tell her that she didn't have real CFS.

I believe and trust that no one is trying to diminish the suffering. But within that I still feel there is condescension when someone describes the idea of investigating a person's symptoms as directly reported "Chasing down rabit-holes by pretending the anxiety is something /else/". There is way more certainty and dismissal in that attitude than anybody has justified in my opinion.

Don't get me wrong, I understand if investigating the direct symptoms might not be practical under some circumstances. But saying it's useless and "pretending" goes too far IMO.

> But these things tend to self limit. Ann says she has chronic fatigue. She undergoes some psychological therapy. She gets some relief from her symptoms. A bunch of people in the CFS organisation now shun Ann, and tell her that she didn't have real CFS.

I don't see how this scenario answers my question. Your story suggests that their is social pressure to resist the idea that the condition is treatable. It doesn't explain what would prevent an expanding scope for where the condition is identified.

Sorry but I can't keep up with you. You're trying to reason about things you don't even know happened, based on an account in an article you read on the internet, and on things that people report. That's no way to make sense of anything.

I'll give you an example. Where I come from, people believe in the Evil Eye: that if you stare at someone or something with a bad intention, if you're jealous etc, you can cause real, physical harm to that person, thing etc.

I've been accused of it a couple of times (I got scary eyes). Once a friend got a headache and then called her mom and asked her to say a special prayer people say that supposedly banishes the Evil Eye, then made a big todo about how a certain person always gave her the Evil Eye (it didn't take rocket science to figure out she was talking about me).

So, my friend obviously had an ailment, if you like: her head hurt. She felt bad, she blamed it on me. It helps that we were having an argument at the time it happened. We often had arguments. She often had headaches. She believed I was giving her the Evil Eye.

You can take the events themselves and try to reason about them. Did I give my friend the Evil Eye? Was the headache unrelated? Which happened first? What tells us they were cause-and-effect? What tells us they weren't?

Except, there is no such thing as the Evil Eye and you're basing your whole reasoning process on empty air- and convincing yourself that you're on firm ground.

The thing to ask is not "did I give my friend the Evil Eye?". The thing to ask is "is there such a thing as the Evil Eye?". Equally, you should be asking whether ENS is real in the first place. But you jump immediately in discussions of cause-and-effect, symptoms and accounts. If you're already convinced that ENS is real, those are not that important. But you have to ask yourself: why do you think it's real? Just because people say they have it? There doesn't seem to be anything else at the moment.

Like others say, I don't doubt for a moment that people suffer from - something. But I'm not convinced that it's what they say it is. I don't blame people for going mad about it, I do blame their doctors for not listening to them, but I don't blame ENS, because it sounds like the Evil Eye, or Morgellon's or whatever similar crazy thing people latch on to in their desperation.

And of course the worse thing is: by latching onto ENS (or whatever), people deprive themselves of the chance to have what ails them treated.

> If you're already convinced that ENS is real, those are not that important. But you have to ask yourself: why do you think it's real?

I don't know how many times I have to say it. I don't claim positively to know it is real.

I'm going to write it just once more so that hopefully you don't miss it this time: I don't claim to positively know that ENS is real.

Here is what I do know. Nobody on this thread has presented enough information to categorically deny that it exists. So if I see people who appear to be doing that, I'm going to call them on it.

>> Here is what I do know. Nobody on this thread has presented enough information to categorically deny that it exists. So if I see people who appear to be doing that, I'm going to call them on it.

That's not how it works. The side that makes a claim has to show that it's real. Everyone else has every right to doubt the veracity of the claim until that time. Otherwise we'd all be endlessly bogged down in pointless conversations.

Anyone can come up with a wild, fantastical idea. That doesn't mean everyone else has to waste their time trying to disprove it.

Btw, if you've made such a big todo just because you don't get that, I'll be a bit upset 'cause I've been wasting my time here.

> Anyone can come up with a wild, fantastical idea

The idea that a person's physical symptoms might have a physical cause is not wild or fantastical. By Occam's Razor it is (absent other information) the most likely explanation.

That's not Occam's Razor. That's an egregious misunderstanding of Occam's Razor. The simplest explanation is indeed that those people suffer from anxiety, which is a very common condition that covers all their symptoms, as others have said. You need to make too many assumptions to be convinced of the contrary.