Clearing the Airways - #1: Best in Class Treatment

Intro: Welcome to Clearing the Airways. Where award-winning board-certified otolaryngologist Dr. Kandula and his guests unpack the secrets of your airway and arm you with the tools to conquer breathing challenges. Each episode will dive headfirst into enlightening discussions, explore the latest advancements in airway breathing solutions, and empower you with the knowledge to reclaim control over your breathing health. Say hello to a future filled with clearer, healthier airways. 

Jason: Doc, it's been 12 years since I met you, and when we first met was right before you performed surgery on me. That I can absolutely attest to. That changed my life in terms of being able to breathe freely. It does have a profound effect. And so, what we're telling people out there on the airwaves absolutely is 100% genuine. It did change my life. It's going to change a lot more people's lives as we go forward. 

Dr. Kandula: It's a goal. So how did you end up, coming in to see me? 

Jason: Well, I caught you, on a television ad. and I had said to Art, my partner Art and I, who you know pretty well as well. So, this is going to be ours. This is our next doctor. 

Dr. Kandula: Why did you. I guess so I've. I seem to recall a couple things. One is you thought we could do better than what you saw. Well, I happen to be. 

Jason: That's right. 

Dr. Kandula: Yeah. There was something about it that got you to come. And maybe it was just the issue that it was. 

Jason: That was the issue that I had. But it was the word balloon. I guess. What got me excited? Well, you know, because most people I think are afraid to have this procedure done. And so balloon said to me, okay, well, maybe this is the easy way out. You know, this is maybe this isn't so invasive. My nose happened to be kind of much more messed up that a balloon wasn't able to fix. 

However, what you did, you personally did do to me, was a really life-changing decision. And it was probably one of the best decisions I made for my quality of life. Yeah. 

Dr. Kandula: Which is awesome. I mean, I guess that's where. So even our old crappy, ads, in your opinion, still gained traction because basically you had an issue that, without, knowledge and education you were just going to sit on. Why would you do something you don't want? I mean, you didn't. I mean, I don't even know what was in your head prior to, you know, coming in. 

But I think for us, when we just go a different direction, when we are putting our messages out, we're doing that with an intention to educate people who have issues that they are sick and tired of dealing with. And the good news nowadays, you know, 12 years, 12 years later, things have actually gotten, you know, easier and easier as far as delivering solutions for folks. You don't have to say you don't have to suffer. And, that's a great thing. But I think, you know, and I do think let me just kind of go in a weird direction is, you know, you, have been assisting me and us and our messaging and getting the word out. And, you know, a lot of what we do is radio messaging. And the reason that we do radio, you know, one, that's your forte. Number two, it allows us to have a minute to tell a story. And the patients that we take care of at ADVENT are individual stories of individual people who have their own stories, their own sort of preconceived notions, their own, you know, physical issues and, you know, other issues. And, you know, for me, it's just taking those folks, making sure that they know, you know, how do you say there's a place you can go that, that might be able to help you. And then being able to kind of take those individuals through a process that works and deliver results. I mean, that's what we do. I mean, that's why we exist. 

And I guess where I'm going is that I believe our medical care starts at the very second that somebody, you know, hears or sees our messaging. There's a reason our brand is, in my opinion, best-in-class. When you see our visuals, when you hear anything coming from ADVENT, there should be a market quality, around it, because that is the first. That's our first point of contact. First time I'm going to say, here we are. We can help you. Because what we're trying to do is, get the message out, make sure people understand there's things you can do. There are places you can go and actually deliver results. 

Jason: I think it's sincerity and believability. Another big factor is convenience. I mean, that's something that we've been playing on a lot of talk about the convenience of it, talk about the differences between what the conventional health care is talking about versus how ADVENT actually performs. 

Dr. Kandula: Yeah, I mean, I've got this visual in my head. I've been, you know, rummaging around in there over the last 48 hours, which is this concept that, and people don't I don't think they understand this or think about this, is that in this day and age, in this country that we live in, most physicians are employed by big systems. And, and even if they're not employed by big systems, they are sort of, their goal is to serve the system. And when I say that, I mean, it could be hospital, it could be, you know, so forth and so on. But it's almost like if you think about, a thousand people, a million people sitting there, the back of our providers is turn to those people. It's turned towards a system. So, it's a system that we're really trying to serve. They're trying to serve. And the problem is the system is broken. The system doesn't work. I mean, let me just kind of go with that very, I think obvious direction. The health care system, as we know it, conventional status quo doesn't work. And I'm not here to fix the entirety of the system, but I'm here to fix the most important part of the system, which is the nose in the throat. You know, that's the most important area in the human body. And in that area, I found myself no longer willing to sit and stare at a system that was broken. And so all that we've really done is we've turned away from that system, turn towards people like you. I mean, literally, it's taking our attention and focus and putting it on the place that it's supposed to be. Which are the who are the people were serving? It's all of those people out there, the thousands, the millions of people out there who are suffering needlessly and, you know, for me personally, I got tired standing behind a system that was no longer was it, I don't know, maybe I think it did work back in the day. 

My parents were docs, and you know, when I was growing up, I feel like and this is old now, 70s, 80s. I feel like the system kind of worked. I don't know if you remember back in those days, but I feel like things worked better. And then what happened between then and now is that the system, you know, started caring about itself more. More than it cared about the patients that it was trying to serve. And it shows. It shows in everything that you see about health care that exists in this country it is fundamentally broken. And again, I'm not here to fix the whole system. I'm not even here to really, you know, shout at the wall anymore. I'm here to serve the patients that are out there. They're suffering from the conditions that we can treat. And in order to do that, it's simply, you know, doing things like this as a specific example, getting the word out, getting the message out that, you know, if you're suffering, with conditions. And again, we at ADVENT focus on the nose and throat. That's our area of expertise. That's all that we do. And we're best in class at that. And so, if you have a condition in those areas, there's a place that you can go where we can deliver results and we can do that in a simple manner, because I don't have an operating room, I don't have a hospital, I don't have an imaging center, I don't have any of those things. I have offices, and I have the best-in-class clinicians. And, you know, for people who are suffering from conditions that we can deal with, if there's an option to deal with those things in a simple manner in an office setting, who wouldn't want to do that? Unfortunately, most people don't have access to that, those simple solutions. 

Jason: So that's why we're getting the word out with so many people as we possibly can. Because making them aware that there is a difference and that there are solutions that are simpler, I think is really paramount. 

Dr. Kandula: Well, it's, again, it seems odd and let me go this way too, is I think, some people might find it odd that there's a medical practice like ADVENT that they hear about so often they're hearing your message and you're seeing messaging, you know, why is that you don't see too many other folks doing it in the way that we do it. And the reason is because it is important that we get the word out as if not us, then who? Like if we don't let people know  that these solutions exist, who's going to do it? I'm not. I mean, the answer is nobody. You know, so we have a system and a process that works, works consistently. It delivers outstanding results. It's user friendly. And so, you know, we have to get the word out. If we don't get the word out, nobody knows we exist. And if nobody knows we exist, then we're just sort of sitting on these solutions that could have a more useful purpose. 

Jason: Let's talk about user friendly. I think that's a really big key in many of their testimonials, people. One of the guys I remember saying the girl answered the attendant answered the phone and said, how can I change the model? How can I change your life today? So that that turned him on? You wanted to get you to have his life changed and that made him move in your direction. Let's just talk about. 

Dr. Kandula: Yeah. I mean, I mean, I think, I mean, you personally have your own story about you, and you probably forget it's been 12 years. You probably don't remember what life was like 13 years ago. I'll tell you what. 

Jason: You know what I mean. I can tell you when before bed, I can tell you exactly what life was like. A stuffed-up nose and worried about, being able to sleep well because of that nose. Started getting stuffed every night, right? And, I think people, that kind of suffer in that same way, without them knowing that these solutions exist, they continue to suffer. It just makes life worse for them. And knowing that we have opportunities to change people's life, tell them more people about that. That helps. Sure. 

Dr. Kandula: So, I mean, I mean, it's stating the obvious, but you'd rather be on this side of the fence than that side of the fence. And I think the reality for the conditions that we treat, again, just to be clear, we treat nose and throat issues. And most people, I think, sort of when I say nose and throat, most people kind of think about it a little bit like a downbeat, like, oh, that's kind of cute. Like people think about noses being kind of cute things. There's no more important area in the world than what we call The Breathing Triangle®. So those two nostrils in the back of your throat, that is the most powerful area in the world. So your Breathing Triangle, if it is working properly, your potential is fully unlocked. If it is caged or diminished or blocked, your potential is caged and diminished. So, you, prior to coming in and, you know, really having those areas open properly, you are living a diminished life. 

Jason: And living my best life. 

Dr. Kandula: It was that's all you knew. I mean, that was what I seem to remember, I think you had some trauma to your nose. And so, you know, there's a reason why things got shut down for you, but so from whenever that incident happened until we got those areas open, you were living, you know, basically in many ways, like you're breathing through a straw. And that's not a fun place to be. And it's not a, you know, good way to live, but, you know, you got by, you know, it was sort of you got it. You kind of do what you do. So, I think, I guess back to kind of where we're coming from before. Yeah. The nose, well, my nose is certainly not diminutive, but the nose is a concept. It's not a diminutive subject, meaning that, it's a powerful area, and I think, and maybe I'm a little, you know, sort of odd this way, but I think the part of the reason for the drive and passion that I have, and the drive and the passion that we have at ADVENT, is that I saw very clearly the power of opening these areas up for people who were formerly caged. And, then I connected that. I, you know, you could think like in your situation specifically, you could say, well, you know, it's been 12 years, but I seem to recall you had a deviated septum. Your turbinates which of the humidifiers are big and the sinus passages were shut down. So we straighten your septum, reduce the size of those humidifiers and open the sinus passages. So we had anatomy issues kind of throughout the nose and the sinuses. We got those areas more open. And by doing that we opened up that most important area, you know, in the human body and unlock the potential you should have had before, you know, before that stuff was happening. I guess where I was going is that some people might say, well, it's, you know, it's okay, a septoplasty. That's a technical name for straightening the septum. Okay. Septoplasty. So, my ENT colleagues, we go there, my colleagues, you know, and I'm proud to be an otolaryngologist or otherwise known as an ENT. it's a very small medical specialty. It is a very, most people don't have the access that they deserve to my specialty. And so I love being part of that specialty. I love, you know, kind of everything that we do. I just feel like more people need to have access to that. But my colleagues haven't necessarily made that connection that I made. It wasn't just 12 years ago, but let's say somewhere in that ballpark to say, geez, when I do these things that are relatively simple for me, it makes a profound difference on people like Jason and then really and then you take the next leap of logic. It's like, well, what's more important than breathing? And there isn't anything more important than breathing, other than, let's say, what's more important, breathing. Nothing. Well, there's one thing that's more important than breathing itself, which is your airway. And most people don't think about it in this way. So in order to breathe properly, you have to have an airway that is built properly. And if it's restricted like yours was, you can't breathe. And so there is something that's actually more important than breathing. It's actually the health of your airway. And there's really there is just kind of coming back full circle. There's only one medical specialty that's able to open those areas up, and that's ENT. Otolaryngology is a fancy name for practices like mine. Now at ADVENT, we've taken the next, sort of step up the ladder, which is, I'd rather if I could avoid it, I rather get you breathing well and get your airway corrected without having to take you to surgery. So, you know what? If we could do what we did for you, but we didn't have to go to surgery? And that's the move that we've been making. You know, really over the last 12 years or so. And then, so, I mean, you know, for you, you know, for you, you had some additional issues that said, hey, surgery may be the best fit for you. But for most folks, it's, we can do this in the office. And so then it's almost even, the bar becomes even lower to say, just why would we why would we not want to get these areas open, help people? 

Jason: I think that is the biggest, I don't want to say, selling point. Okay. For people to make that step is to say this can be actually easy for me. There's no downtime. It's not real. It's not a surgery. It's a procedure. It's 20 minutes. You know, I've watched you, I've watched a physician perform balloon on you. I mean, it was a very simple process. and I think that the gain versus the loss in that situation is, I mean, should I take a chance and see if this actually works? It's let's just talk about. How many of these other treatments that are out there, this one in particular talks about 80% effectiveness. I mean, I'm thinking we're close to 100 out of 100. 

Dr. Kandula: Nothing in life is 100. So other than here's the only 100% guarantee is, you're going to die someday, and I'm going to die that we know. But short of. 

Jason: That, close to where we are, we're. 

Dr. Kandula: Well. Yeah. Yes. Yeah. I mean, yeah. So, if the question is like how successful our treatments are? They're extraordinarily successful. Is it close are we are we closer to 80% successful or pushing, you know, closer 100. We're pushing close to 100. Are we 100? We're not 100, just to be clear. But what I will say is, for us at ADVENT and for how I like to think about things and how I like to put things together is I, it isn't it's not about one procedure. So, we talk a lot about balloon sinuplasty, and we've talked about turbinate reduction. We talk about oral appliance therapy. Sometimes we talk about allergy drops. Sometimes there's a lot of things we'll talk about. And in isolation, each of those specific, solutions have a likelihood for success in combination. You know, I'll just speak humbly for ADVENT. In combination, we have a process that will give every individual who suffers from nose and throat issues, their best chance for success. So that's all I can say. Is it 100%? No. But I will say, when we fail, we never fail. So, for lack of trying, meaning, like when I say that I know it kind of. I don't know what that comes off to sound like, but just say it's true. and what I mean by like that, if you have a nose problem very, very simply, you either have an anatomy problem so the passageways are not open enough through your nose or your throat through your sinuses. That's an anatomy problem. Or you have a lining problem. The lining is to irritated. Or sometimes some people have both of those issues. And so if you have anatomy issues in your nose, anatomy issues in your sinuses, and a lining issue, we have very specific treatment options to address anatomy issues with the nose, anatomy issues in the sinuses and lining issues that you can't get at the pharmacy and you're not actually going to find them, in the kind of status quo health care system, they just don't exist. And so, what that means is we can listen to you. Let's hear what's going on. We can look at you. Let's figure out, do you have that nasal anatomy problem? Do you have that sinus anatomy problem? Do you have the lining problem? And then we could set up. We can and we will. And we do set up a specific treatment plan that brings to you the best-in-class treatments that are available. And we do that and thinking, you know, when I think about best-in-class to me is what's the highest yield for what we're putting you through. So talking about like something like balloon sinuplasty we can get you. I can open up. Sorry. I was trained to open sinuses up by taking you to the operating room and removing bone and soft tissue to open the sinus passages up. So that's the standard of care. You know, we've been doing that as a specialty for 50 years. You know, using little cameras in the nose. Now, I could do that. I could take you to surgery and I can do that. But nowadays, for the last 20 years, almost, we've been able to do the exact same, or get the same results, meaning get the passageways open without removing anything by simply using a balloon in those passageways and dilating and open those, opening those up. And so, you know, if you came in and we said we had a conversation and we saw that, hey, you got the narrowing in those sinus passageways, you have really three choices. One, do you leave alone? I'm not gonna do anything with it. Two, we can open those up, in the office using a balloon. Number three, we can take you to the operating room, open those passages up by removing tissue. And it depends on the situation. And sometimes it makes sense to go to the operating room. Sometimes it makes sense to just leave it alone. But that wide expanse of what if we. What would life be like if we had those areas open, those sinuses, airways open? So a lot of folks are candidates for these less invasive options. And, and that's a wonderful thing. 

Jason: Would you say most folks are candidates? 

Dr. Kandula: Yeah. I mean, most can. Most folks who are, dealing with nose and throat issues. So when I say that, I mean the anatomy issues in the nose or the sinuses, the lining issues or the throat shutting down when they're sleeping at night, most of those individuals, the individuals really, I'd say almost all of those individuals, could be benefited by some, you know, one or more of our office based treatments, whether it's the nose treatments, the sinus treatments, the allergy or the lining treatments, or the sleep  treatments, which is the throat part of things. And it's just and so I know I'm kind of throwing a lot at you. You don't have to figure this out. I mean, like I said, so like a lot of most of our patients who come in, how do you say this? They'll come in with a specific issue. So. Yeah, you came in with snoring. We're going to evaluate. Your snoring is coming from your throat. I don't even need to look at you to know that's the case, because that's the case. So, we're going to look at your throat. But we're not going to we're not going to not look at your nose, and we're not going to not think about the sinuses. So, we're going to look at you holistically as it relates to The Breathing Triangle® and we will understand exactly what's going on. We'll make sure you understand exactly what's going on. We'll make sure we together are putting together a treatment plan that works for you. Not for me. For you, not for the hospital. Because I don't care about the hospital. It's you and, you know, let's put that in play and then let's see where that takes us. And the other thing we’ll always do is when we're putting that treatment plan together, there's sort of, you know, contingency planning. If we do that, what if we zone you. Let me go, you two. You specifically you had a deviated septum. Your turbinates which are the humidifiers are too big. The sinus openings were, were tight or and you had inflammation up in the sinuses. So, to really straighten the septum out, it tends to be something we have to go to surgery to do so. And I do recall in your case that was the pivot thing to like, okay, we're going to, if we're going to straighten the septum out we're going to go to surgery. But same. No same situation. An alternative approach could have been let's go down this in office. Right. We're only the septum alone, but we'll gain space around it by reducing the turbinate. It opens up room around the septum. We'll get the sinuses open using the balloon. Let's see where that lands you. If that gets you where you want to be. You’re breathing like you want to be breathing during the day and during the night. Cool. We'll keep an eye on it. Go from there. If it doesn't get you where you need to be, we can always go up the ladder to surgery to take care of that septum. And, that tends to be more of our thought process. 

Jason: More palatable to a potential patient as well, to know that they might not have to take that extra step. That and that's what that's the step that scares people. And keeps people away. 

Dr. Kandula: And I get it. I mean, and that's the step that I mean, that is so for me because I'm a surgeon, like, septoplasty, I mean, it's a high yield, low key kind of a thing. But so as a surgeon, how it registers is, that's a pretty straightforward surgery. I'm very confident in my skill set. We're going to be able to get you where you need to be. How it registers to you? Is that surgery? I got to go to sleep. Scared where you're going to cut where you are. You know, I mean for just to be clear, for a septum, we don't have to make anything, any incisions outside of anybody's space. So it's all on the inside. But still, if I were you or I were anybody, and I had a, choice, in the matter, I would say I want to do something because this is pretty annoying. And generally speaking, most of our patients choose the office option, and we and not all patients have the deviated septum issue. But, we always have more aggressive options if necessary. But the times we ever need to do that is almost never. I mean, so just like as what does that mean? I mean, for the patients who come in to see us when we're doing procedures, what are the odds of us doing a surgical in the operating procedure versus an office procedure? You know, roughly about 95, 96% of our patients we’re doing office procedures. That other small handful of folks we would have taken to surgery. Sometimes those folks are folks that we've tried office and then we moved to surgery. Other times is simply, you know, the septum is so bad. We just need to really kind of go there. So, yeah. 

Jason: Well, I think that's probably the most important thing that people need to know is that there are options that don't include surgery. It's conventional health care. They're not doing this, in-office stuff. Why? 

Dr. Kandula: You know, I'm not them. I'm me, you know? So, I mean, I'll tell you what I think you know, but, because it's about the system, honestly, you know, it's about the system. The system is broken. And so, everybody who's working for those, in my opinion, failed systems, it's not really about taking care of it. I mean, there it is. I don't know if that. Maybe I'll get more to the point. Those big systems have operating rooms. Those operating rooms, they cost a lot of money. There's a lot of people who work in those operating rooms. It pays the bills, those operating rooms. So to take you who has a condition that I could either take you to the operating room or take care of you in the office for a big system. It makes no sense at all for them to keep you in the office. Just and I'm not. I don't even need to go there. You're a smart person. Figure it out. You know what that means. That's what I'm saying. So, you know, for me and for us, we're an independent medical practice. We always have been. We always will be. What does that mean? We're independent. Well, so what's so good about that? We don't exist unless we deliver results for our patients. That's a beautiful world. If we aren't doing what we need to do, we shouldn't exist. That's not true for. 

Jason: The opposite direction, that's for sure. 

Dr. Kandula: Well, I mean, it's not true for the status quo, you know, sort of health care system. It's too big to fail, you know, fails every day, but it's too big to fail. You know what I'm saying? You know, it's not going to go anywhere. So, you know, and I don't I guess I don't I try not to put my time, effort, energy and attention on things from the past, like this sort of failed system. And I try to put them on, you know, sort of the present and the near future, which are the patients that we're serving. And so, yeah, I mean, what I've seen from I mean, when you saw is, I mean, really and so when you saw us, we had one office in Wauwatosa, Wisconsin, and it was me. We had one doc, and you're looking at him and we probably had a staff of maybe six people. And, we delivered results. We wouldn't be sitting here talking if I didn't deliver a result for you. Bottom line. And, you know, now, you know, not that it. I mean, I guess our growth, I think, is part and parcel with the fact that we deliver results. So, you know, I forget the numbers. I think we're in the 40,000 range of people like you. Stories that can now be told the way they ought to be told, which is, I had this problem and now I don't, because these guys helped me, you know, so we've grown, you know, we had 20 offices currently, I think 21 coming next week. But anyway, that and the reason for the growth is that, we serve our patients and we serve them well, and, we deliver results, and we get the word out so that other people who are suffering don't have to continue to do that. And, and it's a bit rinse and repeat. On the flip side, it never gets old, meaning that every single person in the world like you and like me, I dealt with these issues myself. Prior to getting on the other side of the fence, was living, a diminished life. And to me, that's what drives me, is thinking about all the people out there right now who are, in my opinion, needlessly suffering with conditions that can be easily treated. And this year, you know what I'm saying, and the access to the services that are required for them to do so is really hard. And I'm doing something about it. That's why we're growing. That's where we're trying to get out into the communities where people, live and exist. Because, if we get there, we can help. If we get the word out, we can help. If we're not there and we don't get the word out, people are just going to keep suffering. 

Jason: Yeah. And the needless suffering, I think, is what drives you. Obviously, you can see that there's a passion behind it. It's producing results and that's the growth that, you know, we continue to see. It's pretty amazing. What you've done, I guess being that there's an independent practice out there, why aren't more people trying to, like, follow your lead? 

Dr. Kandula: It's really hard. It's really. It's not for the faint of heart. It, I mean, I always in my, I always think about sort of the David and Goliath story, as it relates to the independent practice of medicine. You know, it's not easy to be David, when you are, yeah. If you think about this, when I'm talking about physicians in particular, who are basically in an army, on an army, in an army with Goliath, and they're standing behind Goliath, and they see little David out there, you know, swinging his little rock around my little rock around. And they say, I'm just going to stick by my. And that's the place to be, you know, why would you ever want to leave the safety of Goliath to go out on your own? You'd have to almost be, a bit, I wouldn't say crazy, but you got to be. You have to have something that's driving you, 

Jason: Extremely confident with that passion and drive. 

Dr. Kandula: Confident. Maybe foolish, you know, I mean, because I. Yeah, I always think about that David and Goliath story, and I always think about the fact that David should not have won, you know, I mean, normal, you know, some sort of mere human doesn't beat, giants, you know what I'm saying? And so, I guess back to independent medicine, I'd say. Let me just say that same thing. In this day and age, as normal mere mortals like me, we don't. We shouldn't be on the playing field with the Goliath. It's like, what are you doing out there, Woody? Who do you think you are? 

Jason: You got a pretty good rock. How about that? 

Dr. Kandula: Well, I got a pretty good rock, and I'm not afraid to use it. And I'm not afraid to use it on behalf of, you know, the people out there who are not being served by Goliath. And that's the thing. I mean, I don't, honestly, I don't I mean, I know in the story, David took down Goliath and you know, that that's how that story ended. I don't need to take Goliath down. Hey, Goliath, you be Goliath. You do your thing like you. You sort of be big and stand up in the clouds. And I'll be down here on earth with the people that we can serve. I'll be on their level, and, I'll serve them on their level. So, I'm not swinging rocks around, at Goliath, necessarily. 

Jason: Being the service you and the service you provide, the people that need it, the conduit to, better quality of life. I think it's one of the most powerful things that we can provide people is that change. 

‍