# Final-Exam-Tier Medical Problem With Handwavy Reasons We Can't Just Call A Licensed M.D. 

General notes: This is a hard problem. You will not be able to give a useful answer by skimming. I couldn't include all relevant information because there's just too much; I'm happy to answer any questions in the comments. 

Biomedical context: I'm 25 and otherwise healthy, nonsmoker, active, good cardio endurance, normal weight, no STDs or potential exposure, etc.

\[ Edit: As of 26 October 2025, an acquaintance has suggested the original problem might have been related to some injury from a Covid test. I've become suspicious that they're right, and some piece of detritus was left in my right nasopharynx when I was swabbed in 2020, and may still be there. It would explain where the bacteria \[which started causing symptoms in 2021\] came from, and the occasional scratchy feeling in that area, like the one I keep getting now that I've rinsed my sinuses 5x over the past 3 days with NeilMed/\[distilled vinegar\] solution. Not sure though. \]

![](https://39669.cdn.cke-cs.com/rQvD3VnunXZu34m86e5f/images/71df9faec1c1f4f9a813a91fecc1ee449f4721575c433fb1.jpeg)

The nasopharyngeal area is at the Eustachian tube opening.

My [staph](https://en.wikipedia.org/wiki/Staphylococcus_aureus?wprov=sfla1) [nasopharyngeal](https://drive.google.com/drive/folders/1QDDhFlR5Rug5jriIBKtDR7E6lprETOqh) [biofilm](https://academic.oup.com/femsre/article/41/3/276/3089981) has become aggressively clonal, repeatedly and, for the last two months, perpetually, infecting my skin, ears, and eyes, as well as [giving me Eustachian tube dysfunction and vertigo](https://www.lesswrong.com/posts/Xt5JPjeTdpPEZhu77/galaxy-brain-hobo-antibiotics) by perceptibly inflaming the nasopharynx itself \[ an unusual symptom, but one I've been experiencing with more or less monotonic increase since March of 2021 \]. It is also antibiotic-tolerant, which for staph means it [has a barely-alive low-ATP quiescient phase](https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://pubmed.ncbi.nlm.nih.gov/27398229/&ved=2ahUKEwiG2LyytLGQAxVUFFkFHW7IOYYQFnoECFcQAQ&usg=AOvVaw0a-weUUX3q2t5psak-AGG4) that reactivates and recolonizes my tissues after every antibiotic dose wipes out the currently-metabolic-phase cells and temporarily alleviates my symptoms. Tried: neomycin, garlic, ofloxacin, doxycycline, azithromycin, sulfamethoxazole/trimethoprim, augmentin, mupirocin. Now been on the latter three antibiotics and washing skin with chlorhexidine for 6 weeks and counting, to partially suppress skin pustule formation and middle ear blockage. \[ This is not good for me. \]

I am already \[re\]trying gargling sterile saline and diluted vinegar. I will probably finagle nasal washes with those as well, but I instinctively doubt that repeated mechanical clearage with such weak solvents/bactericides will be enough, and I'm concerned I'd eventually wash lots of staph somewhere it shouldn't go, especially since moisture easily disperses my skin colony. If this was Japan, I'd get nasopharyngeal\[/"epipharyngeal"\] abrasion \[ EAT \]; 

![](https://39669.cdn.cke-cs.com/rQvD3VnunXZu34m86e5f/images/45f0382c230ca460405efdb2d3dd3e4549a5ec9b6973cc3a.jpg)

I've already submitted a consultation request with the one clinic in the U.S. that does this. The other obvious option is "biofilm-busting antibiotics"; I haven't been able to find them on the grey-market sites and I'm on a several-weeks-long waiting list to see an infectious disease specialist who, after the last 20 doctors, will likely dismiss my claims without testing me anyway, if I don't have grape-sized pustules all over my arms and legs. \[ CW unpleasant skin lesions: [images of Lorec's leg pustules](https://drive.google.com/drive/folders/1gPRhLAoYBDg53H0Lh3wlZkmLUmskTIrX). \]

\[ My alarmed but overworked GP, who saw the grape phase, maintains my stabilizing antibiotic dose and says anything else is above her pay grade. A previous GP had tried to claim it was fungal; I'd had to source the antibiotics myself. Then the next could prescribe enough doxycycline to clear up my obvious middle ear infection . . . but no more. He said the nasopharynx stuff was beyond his pay grade, and sent me to an ENT who assured me the nasopharynx couldn't affect balance and all ETD was because of allergies and refused my request to follow up. And on and on . . . x 20. Just saw another one of these ENT chuckleheads a couple weeks ago. Totally different city, totally different state. At first he said the nasopharynx didn't communicate with the middle ear. I pointed out that it does. He had this model on his table.

![](https://39669.cdn.cke-cs.com/rQvD3VnunXZu34m86e5f/images/fa30866b8ea053e707addbca7e2ea5c515404a4b707bc448.jpg)

The Eustachian or auditory tube is the beige cylinder on the right. The chamber it opens into, underneath the blue-colored cochlea/labyrinth, is the middle ear. Its more medial, wider end \[ on the right \] opens into the throat and is called the nasopharynx.

![](https://39669.cdn.cke-cs.com/rQvD3VnunXZu34m86e5f/images/a26838cc707b6166ac4d4234cbbd90868b54d2b447eb6396.jpg)

Note: since drawing this, I've learned that the Eustachian tube obstruction is likely more medial than I thought, toward the wide end of the tube.

"Admittedly the nasopharynx is above my pay grade", he said. There have been like 6 of these guys at this point. \]

![](https://39669.cdn.cke-cs.com/rQvD3VnunXZu34m86e5f/images/822a6204390b4e0cba52ff4fdcf24cceb653f3626c54a2b9.jpg)

My latest [VNG and cVEMP](https://www.lesswrong.com/posts/Xt5JPjeTdpPEZhu77/galaxy-brain-hobo-antibiotics) results, from October 2, 2025, both showing nominally subclinical \[?\] but dramatic right-side weakness. Sorry about cryptic notes. I failed to figure out how they're calculating the putatively diagnostic "Interaural Amplitude Asymmetry Ratio".

![](https://39669.cdn.cke-cs.com/rQvD3VnunXZu34m86e5f/images/6380e83b7c677538bac1008fc7415a5a18403d03c26e044e.jpg)

Kumazawa et al. depict Eustachian tube dysfunction \[ I'm Type B. \] \[ Acta-Otolaryngologica, Supplement 478, 1990 \]

The thing that's worked the best?

Fresh garlic purée as a nasal spray. Totally cured me for several hours. None of the oral antibiotics have come close. \[ But months of [Flonase](https://commons.wikimedia.org/wiki/Category:Fluticasone_propionate#/media/File%3A227Poblacion%2C_Baliuag%2C_Bulacan_24.jpg) and then months of Nasacort just prior hadn't done anything, so I know the effect was chemical rather than mechanical. \]

Am I going to try that again given, you know, agar delivery direct to CNS?

Maybe. I'm getting desperate.

How remove clonal persister staph biofilm from nasopharynx before sepsis? I need to physically get the biofilm out, and then either find some way to kill the persisters \[ there are a few experimental chemicals that do this in vitro \], or stamp out the living drainage so rapidly that the persisters fail to repopulate.

Self-EAT? Some antibiotic nasal spray I've never heard of? Throat spray? How high should I prioritize trying nasal hypochlorous \[ as getting it will be a nontrivial effort for me and most studies don't find an advantage over saline \]? Self-myringotomy \[ risk of CNS infection is way too high, right? \]? Is there something I don't know about rifampin & co. that means I should expect them not to be as useless as every other oral antibiotic against the nasopharyngeal fortress?