MrBallen’s Medical Mysteries - Ep. 70 | It Comes Back

Episode Date: February 4, 2025

For his entire adult life, a successful businessman deals with a bizarre problem: whenever he bends over, he throws up. On top of that, he struggles with asthma-like symptoms. But no matter w...hat techniques he tries or medicine he takes, the man can’t shake his symptoms, sometimes with embarrassing results.Follow MrBallen's Medical Mysteries on Amazon Music or wherever you get your podcasts. New episodes publish for free every Tuesday. Prime members can binge episodes 65-72 early and ad-free on Amazon Music. Wondery+ subscribers can listen ad-free--join Wondery+ in the Wondery App or on Apple Podcasts. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Starting point is 00:00:00 Hey Prime members, you can binge episodes 65 through 72 right now and ad free on Amazon Music. Download the app today. On a warm afternoon in Rhode Island in the summer of 2003, a 50-year-old man flipped burgers on the grill while sipping a beer. He had moved to the area for a job a few years ago, but he still felt like the new guy at work. And so a midsummer barbecue was a perfect excuse to get the whole team together for some extracurricular bonding. As the sun set and the backyard full of people turned dark, he crouched down to plug in some light strung along the deck. But as he bent over, he felt a sudden surge from his gut.
Starting point is 00:00:45 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. The man's co-workers rushed over with napkins and water and helped prop him up against the railing. Once he was upright, his stomach gradually settled and, after the man got over his embarrassment, the party returned to normal. But the experience confused and disturbed him. He wasn't drunk.
Starting point is 00:01:10 He hadn't been nauseous. It hadn't really even felt like he was vomiting exactly. It was like the contents of his stomach had just decided to exit his body, and he was powerless to stop it. forever changed. Binge all episodes of We Came to the Forest ad-free on Wondery+. From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape – our own bodies. So if you liked today's story, please invite the follow button to a quiet study session
Starting point is 00:02:07 in the library and just as they begin to focus, start rhythmically tapping your pencil on the desk non-stop, humming off key versions of popular songs. This episode is called It Comes Back. In the summer of 1982, a corporate sales director named Roger Donovan walked up the steps of a suburban house in Detroit, Michigan and knocked on the door. It was his 29th birthday and one of his co-workers had insisted on throwing him a party. When the door swung open, nearly half his office was clustered inside, and they all shouted happy birthday and blue noisemakers. Roger had only been at the job for about a year, so he really appreciated the warm welcome.
Starting point is 00:02:58 Especially since lately, he'd been feeling strange and kind of lousy. He'd developed a nasty wet cough, despite not being congested or sick. Some nights it got so bad he couldn't get to sleep, which left him feeling wrecked in the morning. He hoped it was just some weird seasonal allergy thing, and so he was just trying to tough it out. So, for now, this party was a pleasant distraction. Roger had some drinks and snacks and caught up with a few co-workers he rarely got a chance
Starting point is 00:03:24 to chat with, but towards the end he found himself on the back patio near a group of people who were smoking. Although Roger himself had never been a smoker, being around smokers didn't usually bother him. But tonight the smoke triggered his cough and once it started, Roger couldn't stop. It got so intense that he felt embarrassed and decided to leave. But on the drive home, the cough stirred up this churning in his stomach. He could feel liquids sloshing around inside of him and it made him feel queasy.
Starting point is 00:03:55 Roger thought back to what he had eaten at the party, but there was nothing out of the ordinary, except for maybe a slice of birthday cake which he didn't eat very often. And so he couldn't figure out why he was having so much gastric distress. Back at his house where Roger lived alone, he turned on the TV and laid on the couch. He hoped being sedentary would help calm his stomach down. But only minutes after laying down, Roger began coughing heavily again and then felt the surge of nausea that immediately forced him to sit up straight. And as he was sitting there he began sipping some water and eventually he sort of calmed
Starting point is 00:04:30 down and caught his breath, but he still felt rattled by what his body was doing. Crawling into his bed later that night, Roger wondered if maybe he had developed some new allergy to something or if the coughing indicated a respiratory problem, like bronchitis. Either way, it worried him. Because it was new, and because he had no idea what could be causing it. Clutching a pillow to his still-churning stomach, he realized it was probably time to see a doctor. A few days later, Roger sat on the examination table in the office of a local pulmonologist,
Starting point is 00:05:06 which is a doctor who specializes in the respiratory system. The doctor held a stethoscope to Roger's chest and asked him to take in a few deep breaths. After a minute of doing this, the doctor nodded, removed the stethoscope from his ears, and told Roger that his breathing sounded like he had asthma. Roger was surprised because he'd always lived a very active life and never had any breathing issues before. The doctor shrugged and explained that asthma can start at any age and can range from very
Starting point is 00:05:34 mild to severe. He thought Roger most likely had what's called late-onset asthma, which is actually very common in adults. He prescribed Roger an inhaler and told him that using it frequently would make a big difference in his cough and breathing. He also advised Roger to see a gastroenterologist for any of his digestion issues. Roger took his advice and a few days later, visited with a recommended local gastroenterologist named Dr. Ostrander. And after listening to Roger's organs and asking some questions about Roger's medical
Starting point is 00:06:05 history, Dr. Ostrander concluded that Roger probably had acid reflux. This would explain Roger's nausea, his digestive pain, and his coughing. At first, Roger was skeptical of this diagnosis. He had never had digestion issues before, and he found it especially odd that it would set in at the same time as his late onset asthma. Why would all of this just start now out of the blue? Dr. Ostrander wasn't a lung specialist, so he wasn't really sure about if and how the asthma played a role in the acid reflux, but he said it's not usually connected to
Starting point is 00:06:39 something like acid reflux. He explained that for most people, acid reflux is not something a person has their whole life. It comes and goes, depending on a variety of factors. Sometimes it's triggered by eating unusually rich foods or lying down too soon after a big meal, or stress, or smoking cigarettes, or even certain medications can cause it. Dr. Ostrander explained that when food travels down the esophagus to the stomach, sometimes the sphincter muscle at the bottom of the esophagus relaxes at the wrong time, or it
Starting point is 00:07:09 relaxes too much. That allows stomach acid to flow back up into the esophagus, which can cause heartburn, nausea, or stomach pain. And if the stomach acid sloshes high enough, it spills into the lungs, and that can block the airway. And so the doctor speculated that this could be the source of Roger's cough. Dr. Ostrander prescribed Roger some medication to help reduce his stomach acid production. But otherwise, he told Roger not to worry too much and just be aware of his diet
Starting point is 00:07:37 in case there might be a particular food triggering all of his symptoms. A few months later, on a rainy autumn evening, Roger sat inside on his couch symptoms. A few months later, on a rainy autumn evening, Roger sat inside on his couch feeling defeated. He had been using his inhaler diligently for months, but he hadn't noticed a difference. His cough was the same. And the meds had done nothing for his acid reflux. Even on nights when Roger went out of his way to eat an extra bland simple dinner to avoid irritating his stomach He'd still feel a surge of nausea as soon as he laid down
Starting point is 00:08:09 The Michigan weather didn't help either once summer ended and the temperature started to plummet the chill of the air would sting Roger's lungs Particularly on early mornings before work by the time full on winter, Roger knew he'd basically have to stay indoors, because outside, he'd struggle to breathe. Being cooped up inside so much only darkened Roger's already dark mood. But, he hoped that, eventually, somehow, his body would acclimate to whatever was going on, and he'd come out on the other side. In the meantime, he took another puff on his inhaler and laid back down on the couch. About ten years later, Roger walked alone down a dark and silent suburban street late at night.
Starting point is 00:08:54 The only sound was his footsteps echoing on the concrete and the occasional huff of his inhaler. Walks like these had become routine for Roger. Over the past decade, his cough and digestion problems had steadily worsened. Roger relocated to Augusta, Georgia for a new job last year, but that hadn't helped. It was a welcome change from breathing the frigid air of midwestern winters, but even in the warmer southern climate, he often woke up with liquid in his lungs, causing him to cough until he vomited.
Starting point is 00:09:23 These fits left him feeling delirious and nauseous, so he began taking late-night walks around the neighborhood just to settle his stomach. As Roger slowly shuffled along the empty streets, he felt depressed and disoriented. He'd recently turned 40, which he worried might be a health tipping point. What if his stomach issues and coughing only got worse with age? Roger took another puff on his inhaler and sighed. He didn't understand why all the doctors he had visited over the years had accomplished so little. At this point, Roger had been taking acid reflux medication and using his inhaler for a decade straight, yet his symptoms really had not
Starting point is 00:09:58 improved in the slightest. And the lack of sleep as a result of these symptoms that were just not being curbed was really taking a toll on him and beginning to affect his performance at work. As Roger looped back towards home, letting his thoughts wander, he suddenly noticed an odd sensation in his chest, an unfamiliar pressure he'd never felt before. He stopped under a streetlight and ran a finger over his chest, trying to sense where this pressure was located. Roger took a slow, deep breath and abruptly stopped. There it was again. The moment air filled his lungs, he could sense it. There was the soft pressure at the base of his lungs. It was almost like there was an invisible hand inside of his abdomen,
Starting point is 00:10:39 literally holding his lungs up. Roger shook his head, totally confused. I mean, who could actually feel their lungs? That's not a sensation you get. And so now, in addition to all these terrible symptoms he had had for years, Roger wondered if he was also starting to lose his mind. I'm Sarah Trelevin, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies.
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Starting point is 00:12:22 Search for Haunted Canada on Apple Podcasts, Spotify, Amazon Music, or wherever you find your favorite podcasts. Another decade later, on a cold morning in the fall of 2003, Roger sat at the edge of an indoor swimming pool in suburban Rhode Island. His brain still felt blurry from yet another bad night's sleep, but he hoped a good swim would set him straight.
Starting point is 00:12:50 After eight years in Georgia and countless doctor's visits that led nowhere, Roger decided he needed a major change. He was approaching 50 years old and felt like he was in a bit of a rut, so he applied for and landed a job near Providence, Rhode Island as the vice president of a technology company. Roger was coming up on three years at this new job and had grown to love the team there, but unfortunately, his health problems had come with him. His cough had steadily worsened over the years, lasting longer and cutting deeper.
Starting point is 00:13:21 The acid in his stomach sloshed around and went up into his esophagus anytime he wasn't actively standing upright. As a result, he had taken to sleeping on a mound of pillows to try to keep his body somewhat propped upright. It was not comfortable, but otherwise he'd be woken up by a sudden surge of vomit. In an effort to strengthen his breathing, Roger had found a local health club with an indoor pool and started swimming most mornings before work. It was the only activity Roger had discovered where his body could be horizontal and not
Starting point is 00:13:50 trigger his symptoms. He didn't understand why, but he embraced it. Swimming had become, by far, the best part of his day. Once he was ready, Roger took a deep breath, dove into the water, then swam all the way to the other side. After a couple of warm-up laps, he tried testing how far he could swim while holding his breath underwater, surprising himself by making it two whole lengths of the pool. As he climbed out and toweled off, Roger felt energized.
Starting point is 00:14:18 He also felt confident that, whatever his health issues were, he did not have asthma. There is no way he'd be able to hold his breath so long and swim so vigorously if he did. It would also explain why the inhaler had never made a difference in 20 years. Roger was tempted to just throw the inhaler away. A couple weeks later, Roger hosted a barbecue party and suffered the worst flare-up of symptoms he'd ever had in over 20 years. While he was grilling burgers for his co-workers, Roger at some point had casually bent over to plug something in, and a torrent of half-digested food surged out of his mouth.
Starting point is 00:14:57 There was so much stomach acid leaving his body that Roger fell to his knees unable to breathe and feeling this terrible burning sensation all along his esophagus. The experience was a wake-up call. Roger had to face the truth. His condition was not something he could just keep ignoring. It was only intensifying over time, and his body was starting to lose the fight against it. A week after the barbecue, Roger's colleagues stopped him in the hallways to ask how he
Starting point is 00:15:25 was feeling. By now word had spread, everyone knew something was seriously wrong with Roger's health. But as much as he tried to act like it was no big deal, privately Roger was starting to panic. He knew his life could not go on like this forever. He had been battered by the same digestive and respiratory symptoms for decades, and clearly they were not going anywhere. The thought of fighting this battle for decades more to come felt unbearable.
Starting point is 00:15:54 But Roger did bear it, without relief, for 20 more years. And he did that by distracting himself by focusing on his career. After leaving Rhode Island in 2008, Roger had hopped around to a few different places before finally landing the biggest opportunity of his life in 2014. He was named the Chief Marketing Officer for a fabric manufacturer in Cleveland. On a spring morning in 2023, Roger strolled through the company's massive industrial warehouse to inspect a new delivery of fabrics all neatly stacked on pallets. Although he'd recently turned 70, Roger had no intentions of retiring anytime soon.
Starting point is 00:16:33 However, the harsh chemicals used to clean the knitting machinery wreaked havoc on his lungs. Even before COVID hit, Roger had taken to wearing a mask in the warehouse to avoid exposing others to his coughing. Even so, his coughing fits only continued to get worse. Many days, Roger would be forced to make an excuse in order to hurry to his office, lock the door, and hack until he vomited into a trash can. Then he would wait until the entire office emptied out to dispose of the vomit in a toilet. And the night's after work were very
Starting point is 00:17:04 lonely, because his condition made it impossible to socialize. Roger's digestive system was too fragile. He dreaded going to bed, knowing that his cough would inevitably wake him in a fit. The lack of sleep continued to add up. And he was older now and really felt his age, and so it wasn't as easy to bounce back in the mornings. Then came the breaking point. Later that week, in the middle of the night, Roger woke with his usual cough and stumbled to the refrigerator to fill a glass of cold water. But he couldn't make it. A sharp pang in his chest made his knees wobble and he slumped onto the couch. Roger tried to take slow, deep breaths, but his lungs felt shrunken. The shortness of breath made him so dizzy,
Starting point is 00:17:45 he worried he was about to pass out. Lying there motionless, waiting for his body to stabilize, it hit Roger with total clarity. It could not go on like this. It was no longer bearable. When his alarm went off later that morning, Roger called his primary care physician and booked the next available appointment.
Starting point is 00:18:02 that morning, Roger called his primary care physician and booked the next available appointment. A couple days later, in the middle of the weekly staff meeting, Roger's cell phone vibrated with a voicemail from his doctor. Roger had been on edge, waiting to hear back about the results of a CT scan. At his appointment a few days ago, Roger's doctor had theorized that Roger might have chronic bronchitis.
Starting point is 00:18:26 That would explain the wet, nagging cough. He proposed a CT scan to look for inflammation in the tubes connecting the windpipe to the lungs, which Roger agreed to. But the last 48 hours after the scan had dragged by as Roger's head swirled with worries. He hoped whatever news he got would finally put the years of uncertainty to rest. Apologizing for the interruption, Roger stepped into the hallway to return the call. And as soon as he heard his doctor's voice, he could tell something was very serious. The doctor spoke calmly and urged Roger not to worry until they knew more, but his CT
Starting point is 00:19:01 scan had come back showing dark spots across his lungs. These could be one of many things, but among the possibilities, unfortunately, was cancer. Roger's heart sank. A part of him had always dreaded that his condition might be something truly terrible. Slipping the phone back into his pocket, Roger returned to the meeting. His co-workers carried on with business as usual, but Roger's mind was elsewhere, reeling at how everything in his life could have led to this. Dr. Gregory Crane had heard plenty of unusual medical histories over his many years as a
Starting point is 00:19:37 pulmonologist in Cleveland, but the 70-year-old man sitting in his office was a rare case. Roger's story spanned so many different jobs and cities and major life changes, yet throughout them all, his symptoms had never improved. And then when Roger explained how he could actually feel his lungs like there was a phantom hand inside of his body, Dr. Crane was riveted.
Starting point is 00:20:02 Roger had been referred to Dr. Crane after receiving his CT scan results. Although it took multiple tests to prove it, Roger's doctor eventually determined that those dark spots on his scan were not cancerous. But despite this good news, Dr. Crane could plainly see that Roger was not a healthy man. His eyes were sunken and his skin looked gray from fatigue and the exhaustion of constant coughing. Ruling out cancer was a relief, but it didn't solve the much bigger question of what was
Starting point is 00:20:32 causing Roger's condition. Dr. Crane's first thought was that Roger must have some unusual type of asthma, but Roger was quick to explain how previous doctors had diagnosed him similarly, yet four decades of using an inhaler had not helped at all. And so after running some additional tests, Dr. Crane told Roger something that no doctor had told him in 40 years. Roger's hunch was right. He definitely was not asthmatic. All those huffs on the inhaler had been for nothing.
Starting point is 00:21:03 Roger sighed, shook his head, and then pulled out his inhaler and chucked it at the small trash can in the corner of the room. But he missed, and it hit the floor. When Roger stood up to pick up the inhaler, he suddenly began coughing violently. He quickly stood back upright, and the cough died down. But the sight of Roger bent over gave Dr. Crane an idea. He told Roger there was one more test he wanted to run. One morning the following week, Roger dragged himself out of bed after another ragged sleepless night.
Starting point is 00:21:36 His head felt tingly and hollow from being awoken every couple of hours in a fit of coughing. No matter how simply he streamlined his diet or what angle he propped himself at to go to bed, his stomach still churned and his lungs still felt blocked. No matter how simply he streamlined his diet, or what angle he propped himself at to go to bed, his stomach still churned and his lungs still felt blocked. As an increasingly elderly man, Roger worried he would not be able to keep fighting this off much longer. Today however, he felt more optimistic than usual. He had a special procedure planned with Dr. Crane that he actually had high hopes for.
Starting point is 00:22:03 Roger showered but then skipped coffee and breakfast because he was told not to eat or drink anything for four hours before this operation. At the hospital, Roger was led to a room where a technician was preparing a computer monitoring system. Roger felt a bit nervous, but more than that, he felt desperate. His body was beaten down by fatigue.
Starting point is 00:22:23 This procedure seemed like his last chance. There was a knock at the door, and Dr. Crane entered, followed by a nurse carrying a kit of medical equipment. Dr. Crane told Roger to land the hospital bed and try to relax. Roger did his best, but flinched when Dr. Crane moved close, holding a thin, flexible catheter. Dr. Crane had warned Roger that this procedure would be uncomfortable, but even though Roger knew that, now that it was happening, it was hard not to be anxious.
Starting point is 00:22:51 The first thing Dr. Crane did was he sprayed a numbing medication up Roger's nostrils and into the back of his throat. After that, he guided the tube up Roger's nose while the nurse handed Roger a cup of water to drink. With each swallow, Dr. Crane slid the catheter further and further down Roger's esophagus until it reached the entrance of his stomach. Roger almost gagged many times, but managed not to break into a coughing fit. Once the catheter was secure, Dr. Crane looped it over Roger's ear and connected it to a
Starting point is 00:23:22 small computer about the size of a smartphone. Then he attached the computer to a belt, which Roger was to wear for the next 24 hours. Roger could eat and drink like normal, but he would need to keep a diary of his meals, activities, and symptoms. Meanwhile, the tip of the catheter inside of Roger would be recording the levels of acid in Roger's esophagus and transmitting them to the computer. The rest of Roger's day was bizarre. Doing anything with a catheter up your nose and down your throat was awkward. He had told his boss he was taking that day off for medical
Starting point is 00:23:54 reasons so he had plenty of time to kill. Roger went for a long walk in a nearby park, then bought some groceries and made dinner for himself while watching TV. Nighttime felt long, strange, and uncomfortable. Roger's stomach was irritated by the tubing and his breathing was as bad as ever. Lying in bed, staring up at the ceiling with a bulky belt around his waist strapped to a computer, Roger felt a little ridiculous. But he had run out of options in his life, and so at this point, even the smallest sliver of a chance that this procedure could help him was worth taking.
Starting point is 00:24:26 And the next day, he found out it was definitely worth the risk. Dr. Crane had downloaded and studied the data from the computer, and the results were conclusive and shocking. The test that Dr. Crane had administered was called a 24-hour pH impedance test. By tracking the fluctuations in acid levels in Roger's esophagus across an entire day and night, he discovered something that no other doctor in 40 years ever had. 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. So there was nothing to stop the contents of his stomach from coming back up if his
Starting point is 00:25:11 body was positioned at the wrong angle. And so night after night in bed, Roger's stomach fluids flowed up into his lungs. That's why he coughed so much at night and why walking around upright helped settle his stomach. Dr. Crane could not determine whether Roger was simply born without a sphincter in his esophagus or whether his sphincter had been damaged or destroyed over the years somehow. But regardless, the effect was the same. Roger's rare condition actually had a name. It was called non-erosive reflux disease.
Starting point is 00:25:43 Roger was shocked as Dr. Crane explained his findings. All these years he had imagined so many different outcomes, but this was never one of them. Dr. Crane referred Roger to a gastric surgeon colleague of his named Dr. Amanda Davenport to confirm his findings. But she soon discovered that a missing sphincter was not Roger's only medical curiosity. discovered that a missing sphincter was not Roger's only medical curiosity. It would turn out the reason Roger could feel his lungs as if there was a phantom hand putting pressure at the bottom of his lungs was because his stomach had broken through the layer of muscle at the bottom of his lungs, called the diaphragm, and was actually pushed up against them.
Starting point is 00:26:20 That meant the fluid in his stomach was directly next to his lungs. That pressure, Roger felt, came from the stomach fluids sloshing around because there was no sphincter to contain them. And so that was what he was feeling. Dr. Davenport was able to move Roger's stomach down, mend his diaphragm, and create a sphincter in his esophagus by using extra tissue from his stomach lining. And the operation was successful. And ever since, Roger's cough has vanished and he can now bend and stoop and sleep in any position he wants without worrying. Hey Prime members, you can listen to new episodes of Mr. Bollin's Medical Mysteries early and ad free on Amazon Music.
Starting point is 00:27:08 Download the app today. And also, Wondry Plus subscribers can listen to Mr. Bollin's Medical Mysteries ad free. Join Wondry Plus today. Before you go, tell us about yourself by completing a short survey at ListenersSurvey.com. From Ballen Studios and Wondry, this is Mr. Ballen's Medical Mysteries, hosted by me, Mr. Ballen. A quick note about our stories. They are all inspired by true events, but we do sometimes use pseudonyms to protect
Starting point is 00:27:38 the people involved, and also some details are fictionalized for dramatic purposes. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This episode was written by Britt Brown. Our editor is Heather Dundas. Sound design is by Matthew Cilelli. Our senior managing producer is Nick Ryan. And our coordinating producer is Taylor Sniffin.
Starting point is 00:28:04 Our senior producer is Alex Benedon, our associate producers and researchers are Sarah Bytak and Tasia Palaconda. Fact-checking was done by Sheila Patterson. For Ballin Studios, our head of production is Zach Levitt, script editing by Scott Allen and Evan Allen, our coordinating producer is Samantha Collins, production support by Avery Siegel, executiveers are myself, Mr. Ballin, and also Nick Witters. For Wondry, our Head of Sound is Marcelino Villapondo. Senior Producers are Laura Donna Palavota and Dave Schilling.
Starting point is 00:28:35 Senior Managing Producer is Ryan Lohr. Our Executive Producers are Aaron O'Flaherty and Marshall Louis for Wondry. Harvard is the oldest and richest university in America. But when a social media fueled fight over Harvard and its new president broke out last fall, that was no protection. Claudian Gay is now gone. We've exposed the DEI regime and there's much more to come.
Starting point is 00:29:09 This is The Harvard Plan, a special series from the Boston Globe and WNYC's On the Media. To listen, subscribe to On the Media wherever you get your podcasts.

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