If you are having sinus problems, can’t breathe through your nose, or have an awful breath condition never ask, “Should I have Sinus Surgery?” This is the wrong question to ask when you have a medical problem.
George Bernard Shaw commented, “How can I believe a surgeon? If he says to operate he gets 100 pounds; but if he says, “don’t operate” he only gets a shilling.”
Not that doctors are going to give you bad advice, but the correct question should always consist of listing your symptoms and asking about relief. For example, “I have postnasal drip that causes a bad odor and makes me cough. What can I do to get rid of it?”
Even the question “I have a bad sinus, what should I do?”
This happens to be the wrong question– might turn out to be an allergy to your cat, after all.
Every headline in the news media or the Internet proclaims, How to cure your sinus with Sinus Surgery. Public relation experts fill the news media with the fantastic cures that only this new product can give. After all, someone invested millions in the new gadget!
Depends on the day of the month which new method of sinus surgery is being written about.
If you ask, “Should I have balloon sinus surgery?” The doctor will examine you and answer “No.” And that ends your consultation as he hurries out the door.
Of course most doctors, whatever their field, will attempt to relieve your problem as simply and easily as possible.
The right question to ask your doctor is: “My nose runs heavily as soon as I get up and I feel this awful taste in my mouth all day. What should I do to clear this?”
When you ask this question, the doctor has to put on her thinking cap, run through all the possibilities, maybe take cultures or do other examinations. Usually she offers several solutions and explains the pros and cons of each method. Usually Surgery of the sinuses is not one of the recommended solutions.
Is the right question important?
Mr. Jones asked, “What should I do for my Empty Nose Syndrome? Doctor looks, examines and says, “You don’t have empty nose syndrome, ” and she exits the room.
The right question is, ” My nose hurts when I breathe, and I get infected every other month. What is best to cure me?” Now the doctor looks with a special telescope and gets cultures and offers treatment recommendations.
Why is this important? Miss Levinson came to see me. Her doctor had recommended sinus surgery. She wanted to know if she should have that surgery. She was annoyed when I took a complete history and examination, since she already had all that done before. Turns out, her main problem was a recurrent throbbing headache that a dose of one aspirin didn’t help. Her sinus X rays that she brought did show some sinus disease, but that wasn’t the cause of her headaches.
Her headaches were due to a recurrent migraine condition that she had, and responded to headache management. She had misdirected her previous doctor by concentrating on having sinus surgery.
Mr. Abernathy came in insisting on having sinus surgery, based on the latest article he had read. He had researched the Internet and was sure that surgery would cure him of his facial pains and frequent infections. I measured his nasal cilia and they were very slow. Normally, nasal cilia move rapidly to move nasal mucus blanket out of the nose down the throat into the stomach where the bacteria are disposed of. I explained to him that since his cilia were no longer moving bacteria out of the nose he was therefore prone to sinus infection.
Mr. Abernathy then said, “OK, what surgery do I need?” I explained that he didn’t need surgery. Instead he was instructed to use measures to restore his nasal cilia, such as pulsatile nasal/sinus irrigation.
“No surgery, just pulsation irrigation to restore you normal cilia speed.” I think he was disappointed that a surgery was not the answer to his problem.
Not only did Mr. Abernathy ask the wrong question, he was insisting on the wrong treatment!
My good friend is a podiatrist and specializes in certain foot surgeries. He assures me that he hears similar questions every day re foot problems. His patient saw on the Internet this fabulous surgery for foot problems and they want this miracle laser operation. Not only do you need to ask the right question of your ENT or Foot doctor, but in all fields of medicine!
Mrs. Clark went to her new internist and asked, “Do I have a heart condition?” Her doctor took a complete and thorough history and examination and explained that Mrs. Clark’s shortness of breath was due to an asthma condition. Mrs. Clark should have asked about that first.
On the other hand not all doctors are immune to answering the patient’s main concern. Sometimes you have to ask the doctor twice. Mr. Parr came to me for “postnasal drip.” I detected a significant hearing loss due to fluid behind the eardrum in both ears. I drained the fluid and I was delighted when I found I had restored his hearing. But Mr. Parr was unhappy with me, because he had come to me for postnasal drip and not for a hearing loss!
However if you ask the correct question, “I have pain in my ear when I chew hard food,” then you will get the right answer -which is, you have a TMJ problem.
In my office, the phones ring off the hook whenever a new procedure or device hits the news. “Do you have a laser machine for removing tonsils?” Turns out, that person has a tonsil infection and needs an antibiotic.
Yes, there are advances in sinus surgery, and many doctors are skilled in these procedures, but it is important to understand what these procedures are intended for.
Endoscopic sinus surgery uses telescopes to examine the inside of the nose thoroughly, without the need of making an incision on the outside of the nose. Image guided surgery allows the doctor to view a screen to see in three dimensions exactly where his instrument is. Balloon sinuplasty allows the doctor to simply place a balloon into the narrowed or closed sinus opening, inflate it and that allows infected material to exit the sinus cavity.
Today there are numerous modifications of this Balloon method that originated from the heart doctor’s methods. Coblation is a means of reducing over swollen nasal tissue by radio frequency to spare important tissue. These and other methods certainly have their place in sinus therapy. However, sometimes the enthusiastic early reports and publicity may be a bit too enthusiastic.
The patients can help, by asking the correct questions. But don’t ask, “Should I have sinus surgery.”