For those of you who aren’t aware of it already, “Don’t bet against Occam” is Dr Afrin’s book, published last year. Occam (Okham) was a friar and philosopher in the 14th century. (Here is Brittanica’s blurb if you want to know more). There’s some debate of he was the first one to write about it, or if he even said that…but that’s not relevant today.
The ‘Occam’s razor’ principle basically says that simpler explanations are ‘better’ than complex ones. (They’re easier to study, and the more complex a proof, the easier it is to make an argument against it. Strong theories get stronger with more evidence, bad ones get weaker). It is not to say that a simple explanation is always right, but it’s a better bet. In math terms, it’s about finding the common denominators, and simplifying the equation.
The diagnoses in my life (I’m skipping anything from any trauma, such as a car crash) are many. One diagnosis keeps coming back-depending on the decade, psychosomatic, somatoform disorder, somatic symptom disorder… It has never been a positive diagnosis, always a default for ‘I don’t know.’. At one point or another, I have had doctors diagnose me with a HUGE number of things. In most cases, I didn’t disagree. They ‘fit’ rather like clothes- no one piece is going to cover me, or work in all situations, but I can’t wear them all at once, either. No one diagnosis covered everything, and the pile of others didn’t make complete outfits- they always left awkward uncovered bits.
So here is my ‘Occam’s List’ (in no particular order):
- Ehler’s Danlos Syndrome
- Heart/BP dysrhythmia
- Heart murmur
- Idiopathic Anaphylaxis
- Chronic Urticaria
- CFS (Chronic Fatigue Syndrome/ ME).
- MCS (multiple chemical sensitivity)
- Chronic Urticaria
- Migraine (extremely atypical aura)
- Sensitive, delicate skin (I have the ‘velvet’ skin of many people with EDS- lovely and soft, bit hard to keep happy)
- Weather headaches
- Systemic reactions to insect bites
- Edema and/or third spacing
- IBS (Irritable Bowel Syndrome)
- Liver/biliary issues (a ‘sludgy gall bladder, severe pain, enlarged liver, elevated enzymes)
- Frequent dislocations and sprains
- CSS (Central Sensitization Syndrome)
- Foot pain, back pain, knee pain, bone pain
- Idiopathic Inflammatory Arthritis
- Environmental allergies
- Oral allergy Syndrome
- IgE mediated type hypersensitivity reactions to some foods, and many environmental allergens
- IgG mediated type hypersensitivity reactions to a lot more foods
- Weak teeth
- Hyposensitive to ‘caines’ such as lidocaine (I start with 4X the dose at the dentist.)
- Ovarian cysts
- Repeated miscarriages
- Reactive Arthritis
- Unexplained fevers
- Temperature Dysautonomia
- Hypertensive anaphylaxis, hypotensive anaphylaxis, just plain f-ed up BP anaphylaxis (135/50 anyone….😳)
- Abdominal pain
- Restless leg syndrome
- Sensory integration difficulties (the ‘volume’ of various senses is off)
- Synesthesia (what do you mean that red doesn’t have a smell?
- Morbid obesity
- Mild depression
- Severe malnutrition
- Bone/Joint/connective tissue ‘malleability’
- Raynaud’s Syndrome (called ‘asthma of the hands’ by some)
I either have ALL of those, or, I have :
- Complicated by allergies (as in ‘typical IgE mediated allergies, many people with MCAS do not have ‘typical’ allergies)
- Um….yup. That about covers it.
Do the math, guys. Is it more likely that I have 20 separate things going on, or that I have one thing (possibly complicated by an additional factor)? Hmmmm, nope, you don’t need to have studied philosophy or know who Occam was to know the answer to that one. There’s a common denominator- messed up mast cells.
It’s a common problem for people with MCAS. Every time I see a new doctor, I have to ‘pick’ the diagnoses that will fit with what I’m seeing them for. Inevitably I will have to add to the list- and poof, it looks like I’m making stuff up as I go along. “You didn’t say you had that before…” I carry a medication list and a symptom list, maybe I should start carrying around my ‘Occam’s List’ too. Maybe, one day, when I say “I have MCAS.” the doctor will know what that means.