ADVENTing: Cold Season & Sinus Infections

A cold is just the tip of the iceberg when a sinus infection is lingering underneath. We tackle the season of sinus suffering on this episode of ADVENTing.

Colds, that turn into sinus infections are just misery. I have experience with that. You have experience with that. I think the world around us, it's a pretty common theme. Meaning that like, this time of year where school has just started is-

Brutal.

Brutal for many folks, and they don't even necessarily, so there is a truth there, meaning that you absolutely are exposed to more cold viruses and those things when everybody's together and you know, in close contact.

In the herd?

In the herd, when the herd's together you're gonna pass things around, to the herd.

Right.

And so, and kids, whether it's daycare or schools and the teachers in the schools, it's fertile grounds to get things passed through. So I, personally, I don't currently, I still have three children, and they're older now than they used to be but now I'm not scared of my children's colds versus about, boy, when my kids first started in school, it was like, you know, stay away from me with your cold, because every cold back before I had, you know, my procedures done, every single cold would turn into a sinus infection and then it, I remember, trying to think, late 2000s, like 2006, 7, 8, 9 kind of a thing, it was like from start of school all the way to the next summer, constant, stuffy, headachy, plugged up, dealing with it, dealing with it, and it's just like, ugh. And that didn't happen, back before I had kids that wasn't the case, I mean, I was annoyed with the congestion but it wasn't the sinus infection thing, that had added a whole new reality to, insult to injury.

Yeah, it's like summertime's just enough time to forget what that feels like, and then within that first week of school and then your kids come home and it's runny noses and you're like uh-oh-

Uh-oh, here it comes.

This is gonna be a problem you know and so, yeah, my experience wasn't as bad as yours from a you know, time standpoint, like for me really it was like, once my kids got in school I was able to understand what was going on and attack it by pulling you in that room and having you do procedures in my nose but, you know for me, 'cause people ask like, why'd I have that done and what's the tipping point. Everybody wants to know, why like why did things change two years ago and everybody's got some tipping point that makes their nose worse than it had been prior and for me it was kids in school and then, it's awful, like it's awful just feeling crummy and facial pressure and pain and just drainage and you can feel it going back and it's about being able to blow your nose, get stuff out, clear that cold efficiently so that it doesn't turn in to the sinus infection. You know, I mean I feel like for us, if our patients come in and they're like, 'Hey I can blow my nose "and I'm getting a bunch of crap out.' great, good sign, right?

Yeah, although, and I don't think a lot of people understand this, the concept is as far as, you know what even a sinus infection is, because a sinus infection, basically, sinuses are the air pockets of your skull, they all drain in the nose. If things are working properly, all good, if the sinus openings shut down on you, then all of a sudden, everything backs up and then you can get sinus infection. So if, for me personally it was, my anatomy was challenged, you know I've had, I've broken my nose a few times and that sort of thing and so I didn't deal with sinus infections but my anatomy was tight and so all of a sudden onto that tight anatomy you throw frequent, frequent colds of all sorts of different varieties and that inflammation takes what was tight, and shuts it down. Once that shuts down, then you're stuck. And, now you're treading water just trying to get out of trouble and so if things are moving, you know not always, but basically if you have a choice, well, certainly always, if you have a choice between open anatomy and closed anatomy in your nose and your sinuses, open is better than closed every day of the week.

100%.

Most people don't understand they have a choice. The reality with what we do here is that there is a choice and because there's a choice it doesn't mean you need to choose to do something, but by not doing something, if you know that there's a choice and you choose not to do something then you're making an active choice.

Yep.

And so, for those that kind of follow the ball there, that, if you're running into frequent trouble or constant trouble then there's something wrong with your anatomy in this situation and you know, the nice thing nowadays is there's a spectrum of options from, do nothing, keep dealing with it, meds, if you've got an anatomy issue, medications aren't gonna help you, really, it's just that's the deal.

People have been through the pharmacy aisle dealing with that and like it's-

Right, and it's sort of, you know, because meds can't open the anatomy, meds can help to treat the lining, maybe, at their best, and so, then it's like well, you can do nothing, you could play around with some medications and have fun with that, now and then it used to be well, or you could go to surgery and surgery's still absolutely appropriate but now we've got that in between step or you know, sort of alternate pathway of office space procedures which, conceptually, is just taking those areas that are shut and opening them up with you know, simple things we could do here in the office, and so for a lot of folks that's opened the door, like literally opened the doors for the sinuses, open the door to say, 'Yeah, this current existence is not what it needs to be, maybe I'm not too keen on surgery but doing a you know, an office procedure if it's gonna help me, worth a shot.' And it often almost, you know, nothing's 100% but it's pretty remarkable and helpful, how helpful that stuff can be.

And we live in this whole quality of life kind of realm in the sense that like, hey, if somebody had 10 sinus infections in one year, and we got it to five, or two or three, for them that might be a massive win for them, you know?

True.

And it is, you know, I mean we can't get rid of sinus infections forever and ever for every patient, always, like that's just not reality but I think the point is is that people have decisions that they can make and, hey, if we step things up the ladder and they come in for an office space procedure and to them it feels like it's dramatically better and they're happy, that's a win.

Yeah, absolutely.

You know, and so, and in not necessarily have to go into the operating room and it's still something we can always do when we feel comfortable doing it, it's just, you're right, most people, 'Hey, I wanna make some improvement, I don't wanna be down for a week.' And so that's where it's a nice, middle ground.

Yeah, and it can take, I mean, again, everybody's different, everybody's anatomy's different, everybody's situation is different, but it's a, you know for those that are fighting that fight, I mean, some folks it just never ends and other folks it's certain times of the year but if you're fighting those fights that yeah, there's not the, there are some possible solutions to that. I guess that's the bottom line.

And it makes treating the lining easier right? So that's where it's, hey, can we get people off this combination of, you know there's Sudafed, there's Claritin, maybe the Benadryl at night like, combo pill which you know, from my standpoint it's always like well, what are the systemic side effects you're getting from all those pills right? So, can we get you off that, get your nose open? Use sprays directly where it matters right here, keep things local and mellow things out that way, because now you're more open, sprays can get in, they'll work better for you and then maybe it's just a seasonal thing that you need to be on those sprays.

No, and I think that's another topic another topic that I thinks is worth talking about is, this difference in opinion as far as medications versus procedures, like you know, what's better, what's not better, and the reality that every person, every individual, every physician has a different viewpoint on that and I don't think people understand that reality, that when you're seeing a physician, as you said, we're ENT docs, otolaryngologists, wonderful, you know wonderful for us which is great but our viewpoint is distinct, and different, just like everybody has a different political opinion, whatever you wanna call it but, pick a subject, everyone will have a different opinion. It's sort of assumed in the outside world that, 'Oh, I'm gonna go see an ENT.' and, therefore you're gonna get the exact same thing off the menu that you're gonna get at every other. You know, it's like if you're at McDonald's, you can get a Big Mac and a Big Mac's a Big Mac, it's a commodity. Wonderful, and a Big Mac's fine, if that's what you're looking for, but the truth is, is that when you're seeking out medical care, and you're seeking out an individual, you're seeking out an individual's opinion and my personal opinion, which weighs heavy around here is, my personal opinion is, if I have a choice between doing something active to make me feel better and minimize my use of medications, versus, you know, don't do that thing and use medications, for me, in my body, I want to use the minimal amount of medication as possible, like I want to be, I take nothing, I don't take any medications. Now if I have to do that, like if I had no choice and that's what I've gotta do, fine, but, if I have a choice between something procedurally that may alleviate my need for medications versus bandaid after bandaid, medication after medication, every day of the week I'm gonna do that and I don't know how you feel, I know how you feel about it but it's a, and maybe we're, maybe we're anomalies, like maybe, maybe we're the weirdos here but I'd say I don't think so, I think we have a lot of people come to see us because they're weird just like us, you know what I mean?

Well, I wouldn't even say it's that, it's because people are sick and tired of taking all those pills and medications, right?

Right.

Because people, and that's why they-

Well especially, and they don't work and I guess that the other thing is-

Right.

And they don't work. I think if you're taking something that's working and you have a choice to not take it, okay, maybe you might mull that over, you've taken something that's not helping you, and you have a choice to do something that might actually help you, then, that's all-

Well, or their sense of what's helping them you know, they feel like maybe they're a little better or not but it's not like this profound change for them, and I think that that's what's frustrating for people that come here is they've seen a lot of times all these other physicians and like you said, we all have opinions based on science, hopefully, but there's different ways you can interpret what that means and there's, no direct way, you don't have to go from doing nothing, to medication management, to procedures to the next although a lot of people say that that's the route you have to take but a lot of people who've tried these medications aren't feeling like it's helping them find us because hey, trying something that's gonna help them is better than doing nothing.

Sure.

You know, and it's not inexpensive to keep buying all of these pills.

Right, correct.

Like it's just not.

Yeah, absolutely.

You know and so if insurance can help them feel better dramatically and then they don't have to take all those pills, that's a win for everybody.

Yeah, which is, and I think, again, people, I don't, unfortunately that's, so the reality with what we do, in the nose in the throat and in those areas, the science is not settled, there's not, there is not, I mean for science, if anybody ever says, 'Oh, the science is settled, that this is what it is.' They're obviously not scientists-

Run the other way.

Well I mean that's like, there is no, and it's a challenge because, you tend to hear, sort of this group think mentality which is, sort of, was forged in a different era. Nose and sinus issues in particular, the typical treatment pattern that most ENTs follow, and the medical community follows was, that was adopted prior, you know that's adopted decades ago.

That was adopted when it was more dangerous and scary to do these procedures. It was more invasive and so yes-

Absolutely.

You would use that as a last resort because the risks and complications were higher. And so, and that's just-

And that's still the mentality. I mean, and medicine's slow to change and it's, if something new pops on the playing field, it doesn't make it great. But if something new pops up on the playing field that allows us to do something we couldn't previously do, that, to me, and generally our opinion is, well then we then, forget everything. Forget old world, let's think about how this might impact our new reality. And let's see where that goes. It's not a, it's not for everybody you know, I'd say, obviously it's not for everybody because what we do here is distinct than what is done elsewhere because we have that mentality. And I think part of it, sometimes I think people wonder like, what are these guys doing? Ya know, what is that? What is this versus what's happening you know, elsewhere? Maybe they wonder that. I do. Sometimes, I don't concern myself with so much what's happening elsewhere. It's more a matter of, you know, what's in our control and absolutely. If there's things that make sense that can help somebody that we can offer and do then it's our job to let folks know that those things are out there. I think that's pretty simple.

Yeah, I think coming back to kind of like the, okay, so cold, flu season, so you know flu shots. Okay so, parainfluenza, that's the flu. It is an upper respiratory tract issue. Fortunately, like if you get the flu shot, it does decrease your chances of getting that and that can be pretty dangerous, you know and, for kids and adults even. And so worthwhile getting. That being said, probably more likely what you get throughout the year is like a common cold. Right?

Sure.

Which is a virus also but where we play a role in that is, again helping people, get through those periods, more easily.

Sure.

Where it's not as debilitating. They can still take their kids to school, they can still go to work, feel productive, maybe deal with it but it'd be a lot less of an issue for them and maybe people who are sick won't have to be on as many rounds of antibiotics and things like that. Right throughout that season.

Correct.

Which, honestly runs all through winter and then like, the summer. And then you get hit by allergies.

Right, right. It's a similar thing. Meaning that like all, what we're doing mostly, most of our procedures are taking things that are tight and making them more open.

Right.

Anatomy that's more open is both, easier to roll with the punches. You have more wiggle room, so if you're more open, you can deal with a little bit of swelling that a cold's gonna give you or allergies gonna give you and it may not shut you down. That's a good thing. In addition, the more that things are open, the easier it is for us to deliver, you to deliver medications if necessary into the nose. This isn't like, this is very, this is second grade logic. But second grade logic for some reason escapes the medical community often. It's that simple and so if you could do something to, if you can be more open in those areas, you will be more bulletproof when you're out in the world and the more shut down you are in those areas, the more fragile you are and it's like well, ya know, same thing. It's not necessarily a stark choice but often times it is. You can choose to be sort of solid bulletproof or you can choose to remain fragile. And um, that's a choice. I mean, it's not to me to decide what's the right thing for you but it's, for us to decide, to let people know that those choices are, ya know, deserve to be known and deserve to be made. So, yeah, pretty straight forward so, yeah."

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