Posts for: September, 2017
Surgery because my nose is blocked up? Really? Yes, really. If medications aren’t capable of helping you breathe comfortably, a procedure can make all the difference. Believe it or not, this has been studied scientifically. And the word from patients who have undergone the procedure is a significant improvement in their quality of life.
Surgery is a big deal, no doubt. But, it can make a big difference for your nose and your life. Yes, it requires a general anesthetic but the procedure is short, around 45 minutes. You get to go home the same day. It hurts but typically pain medicine, if needed, is taken only for 3-4 days. The biggest complaint people have is the post-operative congestion. When the plastic splints placed during the surgery are removed in the office, 7-10 days later, life gets immediately better. Lots of smiles when people can breathe like they never have before.
One final note, if you have allergies, this surgery will not fix them. You will likely have to be on the same meds you were on pre-op. However, most people report having better success with the control of their allergies after their septum is straightened.
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We are all excited about new technologies in medicine. The press loves to create a stir over the latest chemotherapy, immune modulator, and surgical procedure. Often, though not always, these highly touted “advances” don’t pan out. It doesn’t mean they are necessarily bad ideas or the wrong approach. But, often a well-meaning journalist sees a report about something that may be groundbreaking. By the time it hits the airways, or the paper, or the Internet at preliminary report becomes the latest, greatest technique that will cure us all. But, using information from the popular press to help decide your healthcare carries risks.
It takes time, confirmation, and reconfirmation before an advance is seen as truly revolutionary. In an attempt to inform the public, the need for news 24/7/365 often bypasses this time-consuming and confirmatory process. Research is not sexy, but it is necessary to make sure we are treating you or your family with proven therapies, not just the fad of the moment.
Science is a messy business. It is long, arduous, and filled with misdirection and rediscovery. Every researcher wants to find the big truth and turn over the current thinking. They all want to make a difference and come up with new ideas and thinking to change the world. However, most of the time, one person in the lab doesn’t immediately change the world. It is the accumulated wisdom of many researchers, may labs, in collaboration that comes up with progress.
Be careful about making medical decisions from the evening new, Facebook®, or Twitter®. Inform yourself and ask your doctor about what is right for you. Use information to be healthy, but take it with a grain of salt (or not if you are on a low salt diet.)
Nasal Congestion – Why Do I Have It?
Congestion is a real problem. Not being able to breathe through your nose is very disruptive to everything you do. During the day mouth-breathing is uncomfortable; it dries out your mouth and everyone keeps asking “do you have a cold?” Not good. At night snoring is worse (your partner will confirm that for you), your sleep is disrupted, and that dreaded dry mouth is back.
Why does this happen? Could be a number of things. Allergies are common culprits. That inflammation causes swelling of the turbinates (found on the inner sides of the nose) that fills up the air space. Sometimes those turbinates just get stuck in that larger state and no matter what is in the air, you can’t breathe. The septum can block your breathing as well. It can be bent, folded, crooked, pointed, and if your nose has been broken it may be crumpled. Obviously if it is deviated you can’t move air past it.
So, what to do? Well, there really are three options:
Mark T. Brown, MD, FACS
What is Chronic Sinusitis?
It all starts with a congested nose due to a viral cold or allergy. Not much to do about the virus, it should resolve within 10 to 14 days. Chicken soup is a good idea for a cold. Antihistamines, decongestants, and nasal steroid sprays for allergy control don’t even seem to be enough. But, you just don’t seem to improve even after a couple of weeks.
Facial pressure and pain (particularly when you bend over to tie your shoes), fatigue, persistent discolored nasal mucous, cough, and even wheezing are signs that the congestion has progressed to something more: sinusitis. Now we call in the big guns – antibiotics and even oral steroids like prednisone. Most of the time that infection gets better. But, sometimes all the medicines you have taken can’t get you better.
You may end up in your friendly neighborhood ENT office. But not to worry, there is a way out. Your Otolaryngologist (medicalese for ENT) will likely take a look around, even to the point of putting a scope in your nose to see where the problem resides. And if you are both convinced that you have run out of rational medical options you have to begin to consider surgery. Yes, it comes to that sometimes.
Before you can have any type of procedure the precise nature and location of your infection needs to be found. CT scans are our best bet for this. It is an X-ray, which means radiation exposure. We know and take that into account. But don’t worry, a screening CT is fast, painless (no needles I promise), and has minimal X-rays involved. Without this critical piece of information, a sinus surgeon would just be operating blind – and you don’t want that I promise.
So, now know you know what is going on and you can make decisions based on information. Sinus surgery is surgery (duh) but it is usually VERY effective at relieving those unremitting, chronic sinus infections.
The prevalence of concha bullosa and nasal septal deviation and
their relationship to maxillary sinusitis by volumetric tomography.
Smith KD, Edwards PC, Saini TS, Norton NS - Int J Dent (2010)
Mark T. Brown, MD, FACS