Help! I cannot breathe through my nose and it's driving me crazy
Nasal congestion is a real pain! It leads to embarrassing noisy breathing, discomfort, crusting, mouth breathing and poor sleep. Additionally, it can contribute to medical issues such as sleep apnea, bad breath and poor dental health.Understanding your nasal anatomy may be helpful to understand why you struggle to breath through your nose. Discussing your symptoms with a qualified ENT who is familiar with both medical and surgical treatment options may provide you with a substantial improvement in your quality of life. In fact, I would suggest that my nasal surgery patients are among my most satisfied patients!
I have been told i snore, should I be concerned?
A: Aside from being embarrassing and very bothersome to anyone sleeping in the same room as you, snoring can be an indicator of a more serious problem... OBSTRUCTIVE SLEEP APNEA (OSA). This is a disease process that affects up to 30% of the adult population in the US! Symptoms include low energy, sleepiness, frequent headaches, nasal congestion, weight gain, and concentration difficulties. Click on this link (Epworth Sleepiness Scale) to complete a questionnaire to help assess your risk for OSA. A score of greater than 8 warrants discussion with your ENT or Otolaryngologist. The links below will take you to other videos that can provide you with more information on the disease process, its risks, and some treatment options. Johns Hopkins OSAJohns Hopkins OSA (Spanish)
I have a scar on my face that I am not happy with. Is there anything I can do to improve the appearance?
Absolutely! There are many things we can do for you at El Paso Head and Neck Surgery to help improve the appearance of disfiguring scars of the head and neck. The skin is actually the largest organ of the body and is quite complex in its makeup. An ENT surgeon with experience in facial cosmetics is a very good option for the evaluation and treatment of conditions of the skin of the head and neck. Additionally, I work closely with dermatologists in town to make sure I can advise you and guide you to the optimal care for your specific problem.
I have a lump in my neck. Do I need to get it checked?
The short answer is, "Yes!". A neck mass, especially in adults, should be evaluated by a qualified and board-certified ENT doctor. This is especially true if it has been present for more than a month, if it is growing, or if it is painful. The list of possible diagnoses is long. It could be an infection. It could be a lymph node (image) that is swollen because you were recently ill. It could be a benign growth. It could be a skin cyst. But the time-sensitive reason this needs to be checked by an otolaryngologist is that it could also be an early sign of CANCER! Don't worry. Dr. Westbrook is ready to help you figure out how to best treat this condition.
Do you offer any treatment options for sleep apnea?
It is hard to overstate how significant the impact sleep apnea can have on a person's quality of life. In adults, sleep apnea is associated with increased risk for stroke, heart attack, high blood pressure, weight gain and early death. In children it can be associated with significant cognitive developmental delay and behavioral issues and many other complications.I can help you determine whether or not this is something you're experiencing or at risk of experiencing. I can help you understand your surgical and non-surgical treatment options. I am uniquely qualified to help with your surgical options that may require the capabilities offered by robotic-assisted surgery. As of the writing of this post I am the only ENT surgeon in El Paso offering this level of surgical care. Please see the videos below for additional information on this condition.
What can I do about my sinus problem?
Sinonasal pathology is very common in this part of the country. Our windy and dusty environment contributes to chronic rhinitis which is frequently the underlying cause of sinusitis. At El Paso Head and Neck Surgery clinic we have the expertise, experience and diagnostic technology to manage these complaints. You will be pleased with the honest and thorough care you receive with us for your sinonasal complaints. We have a CT scanner in the clinic to help us determine if you need medical or surgical management. If we determine that your complaints require surgical management I perform balloon sinuplasty in the office. I also perform functional endoscopic sinus surgery in the operating room. Please reference the links below to help you understand sinusitis in more detail.● Rinitis y sinusitis--Hospital Angeles ● Sinusitis: Causas, Sintomas y Tratamiento--Dr. Planas● Balloon Sinuplasty and Endoscopic Sinus Surgery--Falquier ENT● Sinuses, Sinusitis, Sinus Surgery Overview--Dr. Liu● Sinusitis animation--Alila Medical Media
Do you do aesthetic surgery?
A: I am highly trained in the anatomy of the head and neck and feel very comfortable with the surgical modification of the face, neck, eyes, brows and nose. I have a lot of experience in rhinoplasty surgery. I feel comfortable performing most surgeries to address facial aging. In my opinion, the most important aspect of patient decision making on whether or not to have aesthetic surgery or “plastic” surgery is the relationship and communication between the patient and the surgeon. I would be happy to counsel you on your surgical and medical treatment options and we can decide together whether or not you are a good candidate for aesthetic surgery.
Should I get my tonsils removed?
This question can only be confidently answered through a consultation with your ENT surgeon. There are two main indications for removing someone’s tonsils: infection and obstruction. If you or your child frequently requires visits to the doctor for tonsillitis or throat pain you should be evaluated for this procedure. If you snore, have sleep apnea or are concerned about your sleep quality, then getting the opinion of your ENT doctor is a good idea.
ENT, otolaryngology, head and neck surgeon? What is the difference between these things?
ENT stands for Ear, Nose and Throat. Otolaryngology is the Latin term for study of ears and throat. Head and neck surgery is a basic description of the type of surgery that we perform. Most people use these terms interchangeably.
Do i need to be worried about HPV? Should I get vaccinated?
HPV stands for Human Papilloma Virus. It is considered to be a sexually transmitted disease though sexual contact is not the only path of spread. It is very common amongst sexually-active young adults. It is responsible for almost all cervical cancer in females. It is responsible for much of the squamous cell cancer in people's throat. It can happen in patients as young as in their 20s! There are now very effective vaccines available to patients of all ages. The vaccine can be administered to children as young as 9 years of age.If you have a growth or sore in your mouth or throat that has not healed in over a month you need to seek care from an ENT doctor who is comfortable diagnosing and treating this disease.
What is swimmer's ears?
"Swimmer's ear" is the layman's term for otitis externa or an outer ear infection. It is referred to as "swimmer's ear" because it can occur after swimming in pools or lakes if water gets trapped in the ear canal. This is usually very easily treated by an ENT surgeon or even your primary care. Typically one would only require antibiotic ear drops and NOT oral antibiotics.
Why do I feel pressure and pain in my ear when I fly on planes of change elevation?
I see so many patients in my ENT clinic with complaints of ear pain, muffled hearing, dizziness and pressure. A very common reason for these symptoms is the dysfunction of your Eustachian tube. The Eustachian tube helps regulate the pressure in the middle ear space. Pressure in the air around us changes all the time based on weather, temperature, elevation, etc. Most people experience a sensation of pressure when they go up several flights on an elevator or during the off and landing of an airplane ride. While Eustachian tube dysfunction is very common, in some people it can require surgery or medical management. If this is a problem you experience you should consider scheduling an appointment with your Ear, Nose, and Throat physician to discuss what implications this may have on the health of your ears.
Should I be concerned if my child snores?
Mild, intermittent snoring is not necessarily a bid deal. A child who snores every night or who snores loudly or snores enough that it seems to be disrupting sleep quality should be seen by an ENT surgeon. This may be an sign of pediatric obstructive sleep apnea. Sleep apnea poses different risks for children than it does for adults. Specifically, pediatric sleep apnea can impact a child's cognitive development. The good news is that the problem is typically easily fixed with a small surgical procedure, tonsillectomy and adenoidectomy. If your child snores I would be happy to see them to discuss with you whether or not intervention is necessary.
These nose bleeds are driving me crazy! What can I do?
One of the joys of living in a dry, warm climate is a high frequency of nose bleeds. Our nasal cavities have a lot of blood flow and the lining is kept moist by our bodies. In climates with low humidity or with high amounts of dust, nose bleeds become common. It is uncommon for them to be dangerous but they can be very inconvenient and embarrassing. If you have a history of bleeding disorders or if you take blood thinners you should absolutely seek consultation with an ENT surgeon.
For everyone else, use nasal saline spray or gel frequently to moisturize the inside of your nose. Use of a saline lavage is even better (netipot, NeilMed, Navage, etc). Additionally, application of Vaseline on the inside of each nostril once to twice a day can really be effective at reducing the frequency of nose bleeds.
If you do experience a nose bleed, firmly squeeze the entire soft part of your nose for 10-20 minutes. If it doesn't stop, go to the emergency room.
What can I do about my bothersome allergy symptoms?
Allergy symptoms such as runny nose, post nasal drip, watery/itchy eyes, sneezing and nasal congestion plague millions of Americans. Allergies tend to be seasonal and regional. New allergies can be developed even in older adults.
Over the counter oral antihistamines and nasal steroid sprays are both quite effective at reducing these symptoms. Nasal saline irrigations (Neil Med, NetiPot, Navage, etc) are safe and highly effective as well.
When these routine solutions fail to improve your symptoms you should seek consultation with your ENT provider. At EPHNS we have an array of medical and surgical treatment options to offer our patients.
What are those things that I cough up that smell bad?
From time to time we will all cough up little stone-looking things from the back of our throat. The medical term for this is tonsillith. The layman's term is "throat rock" or "tonsil stone". The good news is these things, while bothersome, are NOT indicative of anything bad going on in your throat. You can try mouth washes, gargles, increased brushing to reduce their frequency. But unfortunately, increased oral hygiene rarely makes any significant impact on this process. Tonsilliths can be a source of bad breathe and when people start to become bothered by this condition, the most reliable treatment is a tonsillectomy. Contact your ENT surgeon if you think this is something for which you need to be evaluated.
I am concerned because I just found out I have a nodule on my thyroid gland
Don't lose sleep over this! Thyroid nodules are very common. They are found in females more often than in males but anyone can develop these. More often than not nodules do NOT affect the function of the gland which is to produce a hormone that controls your body's metabolism.This issue does need to be evaluted by an ENT surgeon who feels comfortable managing this surgically should the clinical situation require it. The reason it needs to be evaluated by an ENT surgeon is to help determine whether or not the nodule is cancerous or malignant. Depending on the characteristics, size, location of the nodule, it may be something that is simply observed overtime with ultrasounds or it may require biopsy and/or surgery. I can provide all of these services comfortably and expertly. I perform more than 30 thyroid surgeries annually. I have the ability to do ultrasound and biopsies from the convenience of my office. Below are links to two additional resources I recommend to help further educate you on thyroid nodules.www.thyroidcancer.com
Can I see you if I am having symptoms of illness?
Our COVID-19 screening questions and COVID-19 spread prevention policy can be seen by clicking on these links or by visiting the COVID-19 page of our website.
You may already be aware that the highest area of detectable viral load in a patient in the back of the nose (nasopharynx). Most of the patients an ENT doctor sees require evaluation in this area. Additionally, our physical exam techniques can stimulate coughing and sneezing which aerosolizes viral particles in sick patients. For these reasons, we are very stringent in our adherence to our prevention policies. Our patients have been gracious in understanding the mild inconveniences and limitations the creates in our scheduling and availability.
Is it safe to go back to normal?
The COVID-19 pandemic has altered our lives in so many ways. New variants, changing rules and regulations on local, national and even global levels make it difficult to feel comfortable about what used to be normal daily activities. We are all now being forced to be thoughtful about risk/benefit analysis of what used to be mundane tasks such as going to the grocery store or gathering for social events.
We must continue to be aware that what constitutes a safe or acceptable practice for you may be much different for other people you come into contact with. It seems to be a delicate balance between personal freedoms (wearing a mask or not, traveling or staying home) vs. consideration for the fears and safety of others. This is not new to us. We make similar decisions every time we drive a vehicle or engage in ANY activity that has the potential to impact those around us.
Patience and courtesy must be the driving forces in our civic engagement. Opinions and concerns should not be politicized unnecessarily as this only complicates our efforts to navigate difficult situations.
What can I do to prevent Covid-19?
It has been clearly established through sound medical studies that COVID-19 is spread through the air. You are at the highest risk if you are in enclosed spaces for extended periods of time with individuals that are infected.
There is very little risk to transmission in the outdoor environment so get outside, get active and loose the mask when outdoors!N-95 masks are now widely available. These masks offer the best protection for yourself and those you are around. All other masks are helpful but the level of efficacy is hotly debated and not clearly established through scientific study.
Frequent nasal saline irrigations (Neti pot, Navage, Neil Med, etc). Adding a few drops of iodine or betadine cleanser until it is the color of watered-down tea can be very effective if you think you may have been in contact with a person who has active COVID-19 infection.