Author: bell

What to Do About Frequent Throat Clearing

throat clearing

We all clear our throats sometimes without giving it much thought. We may do it to get someone’s attention, to clear our throats of mucus or the feeling that something’s stuck, or it may be a nervous habit.

While there are several reasons for throat clearing, when it becomes a chronic occurrence, it can cause problems, including damage to your vocal cords. 

So what are the underlying causes of chronic throat clearing, and what can we do about it?

Why We Clear Our Throats & When It Becomes a Problem

When we clear our throats, we are transferring mucus out of our airway and into the throat. It’s normal for us to secrete up to two liters of mucus per day! Throat clearing can become excessive when mucus is too thick or copious. 

When this throat clearing process happens over and over again, it can cause redness and swelling of your vocal cords. If the clearing is very extensive, small growths called granulomas can form. If these granulomas get large, they can affect your breathing and your voice and may require surgery for removal. 

In addition, the irritation and swelling produced by chronic throat clearing can cause even more mucus production, which causes more throat clearing. As you can see, it can become a never ending cycle. Without a conscious effort to break the cycle, chronic throat clearing will likely continue. 

What Conditions Can Cause Chronic Throat Clearing?

Keep in mind that chronic throat clearing itself isn’t really a diagnosis. It’s a symptom of an underlying condition. Some of those might include:

1. Reflux

Laryngopharyngeal reflux (LPR) is a condition in which stomach acid escapes out of the stomach and goes into the esophagus and throat. The acid irritates the throat, the vocal cords, and even the nasal passages. It may result in voice problems, swallowing problems, sinus drainage, and the frequent need to clear the throat. The most effective treatment is usually a combination of medication and lifestyle changes, such as avoiding certain types of food and drink, reducing stress, and losing weight.

2.  Postnasal drainage

Another common cause of throat clearing is postnasal drainage, also called postnasal drip. Postnasal drip happens when your body starts producing extra mucus. You may feel it dripping down your throat from the back of your nose. Other symptoms may include cough, nausea, sore throat, and bad breath. Allergies are a common cause, along with viral infections, sinus infections, dry air, and changes in the weather.

Treatment for postnasal drip varies depending on the cause. If it’s related to allergies, avoiding the allergen or taking medications may stop the drip. Other treatments may include over-the-counter decongestants, antihistamines, saline nasal sprays, and staying hydrated.

3.  Allergies

Nasal allergies and food allergies can contribute to frequent throat clearing. In some cases, a food allergy or sensitivity may cause a tickling in your throat that makes you clear it. Dairy is a frequent cause, but foods such as eggs, rice, and soy may also be culprits. The treatment in such cases is avoiding the food that leads to symptoms.

Nasal allergies occur when the body’s immune system overreacts to the presence of substances, called allergens, that are usually harmless. Common allergens include pollen, dust, and animal dander. Nasal allergies can lead to excess mucus production, which can cause frequent throat clearing. Antihistamines, nasal sprays, and nasal rinsing can help with allergies, as well as avoiding the allergens when possible.

4.  Side Effect of Medication

Some blood pressure medications can cause a tickle in your throat that contributes to chronic throat clearing and chronic cough. If you’re taking blood pressure medication and are frequently clearing your throat, talk to your doctor about a potential substitute.

5.  Habit

Sometimes, there may be no underlying condition causing throat clearing. It can become a habit or something you subconsciously do when anxious or stressed. To break the habit, you can drink more fluids, ask someone to help you monitor your throat clearing, or look for an alternate activity to do when the need to clear your throat arises, such as tapping your fingers. Stress management can also be very helpful.

6.  Swallowing Problems

Swallowing problems can arise for many reasons, and there are many ways to address them, depending on the exact situation. In general, difficulty swallowing can lead to throat irritation and frequent throat clearing as well as hoarseness, coughing, and choking when eating.

7. Vocal Cord Growths

When abnormal growths, such as polyps, nodules, or cysts grow on the vocal cords, you may feel as though something unusual is in the back of the throat. If you do not know that this is a physical growth, you may try to clear your throat in an attempt to dislodge the perceived object.

Causes of these growths can include smoking; allergies; overusing or straining the vocal cords from excessive singing or shouting; and frequent or strenuous coughing.

Treatment for Chronic Throat Clearing

Long-term treatment for chronic throat clearing depends on determining the underlying condition causing it. Treatment may include lifestyle changes, medications, or, in some cases, surgery.

Here are a few general tips for the treatment and prevention of chronic throat clearing:

  • Drink plenty of water to keep the throat moist, which may relieve or lessen the feeling that something has become lodged in the throat. When you feel like you want to clear your throat, take a sip of water instead. Also, increase your water intake to help thin mucus and make it easier to swallow.
  • Eat and chew slowly if you have difficulty swallowing.
  • Use a humidifier to keep the air moist, which may help reduce throat irritation.
  • Clear your throat as few times as possible. Instead of clearing your throat, hold your breath and swallow.

Find the Cause of Chronic Throat Clearing at Excel ENT of Alabama

Our Speech-Language Pathologist, Amy Pittman, is an expert at working with patients to find the cause of chronic throat clearing and treating the underlying condition. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Lingering Loss of Smell After COVID-19? Here’s What to Do

covid-19 loss of smell

Smell is one of our five senses that we often think little about even though it’s strongly linked to emotion and memory. It can alert us to danger and works with our sense of taste to allow us to experience the flavor of food.

To lose your sense of smell (also called anosmia), and most likely your sense of taste to some extent as well, can pose several challenges, both mentally and physically. The COVID-19 pandemic has shined a light on anosmia, and doctors and scientists are still trying to figure out more about this common symptom.

Here’s information about why COVID-19 may cause us to lose these senses and some advice about how to manage it.

Loss of Smell After COVID-19 Infection

Many people wonder how common this symptom really is. A recent study collected data regarding COVID-19-related loss of smell or taste from 69,841 individuals who self-reported symptoms. The findings provide a genetic link to the biological mechanisms underlying COVID-19-related loss of smell or taste.

Of those who reported a positive test, 68% said they experienced loss of smell or taste (47,298 out of a total of 69,841 individuals). Female respondents were more likely than male respondents to report this symptom and those with this symptom were typically younger than those without it (mean age of 41 years for those with loss of smell or taste versus 45 years for those without).

While we can clearly see that a large fraction of COVID-19 patients report loss of smell or taste, the underlying mechanism is unclear. The most likely cause is that damage occurs to the cells that support and assist the olfactory neurons, called sustentacular cells. These cells can regenerate from stem cells, which may explain why smell recovers quickly in most cases.

Most often, smell dysfunction does improve soon after the infection. Approximately 90% of those affected can expect improvement within four weeks. But for others, it can take months or recovery may be incomplete. 

Tips to Help Recover Sense of Smell

Currently, there is no proven treatment for lasting smell dysfunction. Topical corticosteroid sprays are often used in the short-term for treatment, but they are unlikely to help outside of the acute illness period. 

One type of treatment that has shown promise is smell retraining therapy, or olfactory retraining. This involves exposing the patient to different strong scents for several minutes for an extended period of time. Smell retraining therapy can be effective for many different causes of smell loss, and not just from COVID.

Typically, you will smell a series of four strong scents that can be found in the home, or in the form of essential oils. Each scent is gently sniffed for 20 seconds. This process is repeated three times daily for six weeks. Long-term commitment is usually required to see improvement.

Smell training may be most effective if you work on the same four scents each day, rather than alternating. It’s also recommended that you concentrate on the scent fully, giving it your full attention, for the entire 20 seconds.

The following scents often work well:

  • ground coffee
  • rose
  • citrus
  • eucalyptus
  • vanilla
  • clove
  • mint

Another good option to consider is ginger, powdered or raw. It has a distinctive, pungent scent that makes it beneficial for use in smell training. Drinking ginger tea may also help. It can help reduce inflammation in the nasal airways and reduce excess mucus formations that block nasal passages, which may be a factor in loss of smell.

If you are unable to smell the above essences at all, try remembering what they smell like. Our brains are powerful tools and may be able to engage your senses. It does take time and commitment, but many people notice an improvement in their ability to smell within a few weeks.

Nasal irrigation can also sometimes help by flushing out allergens and mucus from the nasal cavity. This may help in COVID cases, but it can also help when other common viral upper respiratory illnesses, such as the common cold, cause dysfunction with the sense of smell.

Get More Advice About Correcting Loss of Smell from Excel ENT of Alabama

While these are methods you can try at home to help recover your sense of smell, it can be a good idea to work with an ENT, such as Dr. Davis from Excel ENT of Alabama to come up with a more specific treatment plan. We are happy to offer additional advice and options. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

 

All About Nasal Congestion

nasal congestion

There are two words we hear a lot at Excel ENT all year round, but especially during these cold winter months: “nasal congestion.” While it can be short lived, and it may resolve quickly without intervention, it often comes out of nowhere and it’s usually the first of many symptoms. 

Nasal congestion can be tricky though, because there are many causes. Our doctor, Dr. Davis, wants to help you figure out not only the cause, but also a treatment plan so that you can get back to living your life without a stuffy nose! 

Causes of Nasal Congestion

Nasal congestion, which many of us refer to as a “stuffy nose,” occurs when the blood vessels inside the nose (in addition to the adjacent tissues) become inflamed and swollen with excessive fluid. This fluid is what gives the nose the feeling of being “stuffy.”

Symptoms of nasal congestion include stuffy/runny nose, nasal pain, mucus buildup, and/or nasal swelling. There could be a number of issues causing your nasal congestion symptoms, including but not limited to:

  • Allergies
  • Benign tumors
  • Chronic sinusitis
  • Common cold
  • Deviated septum
  • Flu
  • Hay fever
  • Nasal polyps
  • Sinus infection
  • Various irritants, like tobacco smoke

With so many possible causes, it is important to seek medical attention, especially if your symptoms have lasted several days without relief, or new symptoms have appeared. 

Treatments for Nasal Congestion: Home Remedies

A good place to start may be with home remedies. Some of our patients do find that these work to alleviate symptoms. 

  • Sleep with a humidifier at night. A humidifier adds moisture to the air, which can help break up mucus and soothe inflamed nasal passages. 
  • Place a warm cloth over your face.  This can also help sooth your nasal passages. You might also want to try this method while using pillows to prop your head up during the night, which can help you breathe easier. 
  • Take a hot shower. This can assist in clearing up your nasal congestion, as the steam from the shower can improve breathing by allowing the mucus to drain through the nose. 

Nasal Rinsing

Another great option you can do at home is nasal rinsing, which is the process of flushing your sinuses with a saline (saltwater) rinse. One of your nose’s primary functions is to filter air before it enters your lungs. The mucus lining your sinuses is vital to the filtration process. However, dryness and inflammation make it hard for mucus to drain, which leads to congestion and pressure. Nasal irrigation thins mucus and cleanses your nasal passages. The saline solution used in a rinse also helps restore moisture in dry sinuses. 

Performing a nasal rinse is simple, and we recommend the pre-measured sinus rinse packets from NeilMed that you mix with eight ounces of lukewarm distilled water. NeilMed offers several types of irrigation devices including squeeze bottles, a neti pot, and a battery-operated cordless pulsating nasal washer. Read more about how to perform a nasal rinse in this article.

Treatments for Nasal Congestion: When to See A Doctor

If home remedies don’t work, it may be time to see Dr. Davis so that he can give you a more specific diagnosis and treatment plan. This might include:

  • Antibiotics
  • Nasal spray, which includes an antihistamine 
  • Nasal steroid
  • Prescription-strength decongestants
  • Surgery, if caused by nasal polyps or tumors
  • Non-surgical treatment options

Nasal Polyps

For some people, the source of long-lasting congestion is nasal polyps. These are soft, painless, benign growths inside the nasal passages. When polyps are small, you may not know they’re there. However, polyps that grow in clusters can block the nasal passages and inhibit sinus drainage causing congestion.

Nasal polyps can develop in people of all ages, but they are most common in young adults and middle-age adults. Patients with prolonged inflammation from allergies, infections, or chronic sinusitis have an increased risk of developing obstructive nasal polyps. Unfortunately, polyps are a chronic problem. It’s likely that once they occur, they will persist throughout a patient’s life.

Treatment often starts with a nasal steroid spray to reduce polyp inflammation, and we may also recommend nasal rinses, but these are temporary solutions. The next option is surgical removal of the polyps, also known as sinus surgery. 

We are excited that we have a new sinus implant called SINUVA, which is a nonsurgical treatment option if a patient’s polyps return after surgery. This innovative treatment involves a sinus implant made of bioabsorbable polymers. It delivers an anti-inflammatory corticosteroid right into the polyps. The medicine shrinks the polyps, opening a patient’s airway and allowing better sinus drainage.

Address Nasal Congestion with Excel ENT of Alabama

Nasal congestion is common, but it shouldn’t be long-lasting. If you are experiencing persistent congestion, we’d love to help you find the cause and make a treatment plan. We are always happy to answer questions about nasal congestion and any other ear, nose, and throat issues. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Causes of Chronic Cough

chronic cough

A cough that just won’t go away is one of the most common reasons for a visit to the doctor. Many people initially visit their primary care physician, but if the issue isn’t easily resolved, other doctors and specialists may become involved, such as allergists, pulmonologists, otolaryngologists (ENT), and speech-language pathologists (SLP), such as Excel ENT’s SLP, Amy Pittman.

Amy sees patients often who complain of a chronic cough. It’s annoying for the person experiencing it and others in the home, and it can disrupt sleep and cause headaches. We’re thankful that there are many ways in which Amy can help get to the bottom of the cause and find an effective solution.

Definition & Causes of Chronic Cough

According to the American Speech-Language Hearing Association, coughing helps you clear your throat and lungs and can prevent infection. But sometimes a cough can become chronic, lasting more than four weeks in children and more than eight weeks in adults. Aside from the extended duration of the cough, signs and symptoms include the frequent need to cough and having a rough-sounding voice due to that frequent coughing.

Chronic cough can be tricky because there are several possible causes. Here are the most common ones we see.

Postnasal Drip

Also called upper airway cough syndrome, postnasal drip is a common cause of a persistent cough. When a virus, allergies, dust, chemicals, or inflammation irritate your nasal membranes, they make runny mucus that drips down your throat. This makes you cough, especially at night when you lie down.

Asthma

When you have asthma, the muscles around your airways tighten, the lining of your airways swells, and cells in your airways produce thick mucus. Coughing is your body’s way of trying to get air into those restricted areas and can be triggered by infections, weather, allergies, tobacco smoke, medications, exercise, and emotions.

Infections

After you have recovered from a cold, flu, or pneumonia, you may continue to have a cough as your body completely heals and gets over the infection. COVID-19, the illness caused by SARS-CoV-2, sometimes leads to lasting lung inflammation and a lingering dry cough. The prolonged cough from COVID-19 is no different than any other virus that affects your lungs. The injured parts of your lungs are trying to clear out the infection and heal.

Laryngopharyngeal Reflux (LPR)

LPR, sometimes confused with gastroesophageal reflux disease (GERD), is a condition in which acid escapes from the stomach and goes into the esophagus and throat. This causes irritation to the throat, vocal cords, and even the nasal passages. It may result in voice problems, swallowing problems, sinus drainage, the frequent need to clear the throat, and chronic cough. 

Blood Pressure Medications

ACE inhibitors for blood pressure can cause a chronic dry cough. When a patient has a persistent cough and takes an ACE inhibitor, a slight change in medication often helps resolve the cough.

Smoking

Smoking damages your lungs, as well as the rest of your body. Smokers often experience chronic cough because chemicals and particles in tobacco smoke irritate the lungs. In response, the body makes mucus to try to get rid of it through frequent coughing. In all situations, we recommend stopping smoking to address a chronic cough and for many other reasons.

Irritable Larynx Syndrome (ILS)

ILS involves a range of conditions including chronic throat clearing, chronic cough, and others. With ILS, the larynx (voice box) becomes very sensitive to stimuli, such as strong smells, cold air, talking, and more. There are several possible causes, including viral illnesses that cause inflammation of the nerve that supplies the voice box, GERD, allergies, sinusitis, certain medications, environmental exposures, and stressful life occurrences.

Symptoms of ILS usually last longer than three weeks and have no other identifiable cause. Symptoms may include frequent non-productive throat clearing, chronic coughing attacks that bring up little or no mucus, and difficulty breathing with the sudden onset of stridor (noisy breathing).

Testing & Treatment for Chronic Cough

Our SLP, Amy Pittman, will likely work with you to get a comprehensive history regarding your chronic cough. She may perform a thorough laryngoscopic and stroboscopic examination to visualize patterns of vocal fold motion and vocal fold vibration. She may also test your voice to see if there are any changes in vocal quality that the cough might be causing.

We can work to find out more about what triggers your cough so that you can avoid those triggers. In some cases, treatment is straightforward, such as recommendations to stop smoking or making changes to medications. In other cases, you may need treatment for medical conditions, such as allergies, asthma, or LPR if those are triggers for your chronic cough. 

Many times, the goal of treatment for chronic cough is to give you the tools to better manage it, and Amy can teach you more about keeping your vocal cords healthy.

Address Chronic Cough with Excel ENT of Alabama

We are happy to answer questions about chronic cough and other ear, nose, and throat issues. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

The Driving Force Behind All Sinus Issues: Inflammation

sinus inflammation

Many patients often wonder WHY they continue to have sinus problems. What’s the root cause and the driving force behind sinus headaches, drainage, congestion, and pain? The answer is inflammation, and knowing what this means will result in a better overall understanding of your sinus issues.

More About Sinus Inflammation

Chronic sinusitis occurs when the spaces inside your nose and head (sinuses) are swollen and inflamed for three months or longer, despite treatment.

This common condition interferes with the way mucus normally drains, and makes your nose stuffy. Breathing through your nose may be difficult, and the area around your eyes might feel swollen or tender.

Chronic sinusitis can be brought on by an infection, by growths in the sinuses (nasal polyps), or by swelling of the lining of your sinuses. Also called chronic rhinosinusitis, the condition can affect both adults and children.

Common signs and symptoms of chronic sinusitis include:

  • Nasal inflammation
  • Thick, discolored discharge from the nose (runny nose)
  • Drainage down the back of the throat (postnasal drainage)
  • Blocked or stuffy (congested) nose causing difficulty breathing through your nose
  • Pain, tenderness and swelling around your eyes, cheeks, nose, or forehead
  • Reduced sense of smell and taste

Other less common signs and symptoms can include:

  • Ear pain
  • Headache
  • Aching in your upper jaw and teeth
  • Cough or throat clearing
  • Sore throat
  • Bad breath
  • Fatigue

Chronic sinusitis and acute sinusitis have similar signs and symptoms. However, acute sinusitis is a temporary infection of the sinuses often associated with a cold. The signs and symptoms of chronic sinusitis last at least 12 weeks, but you may have several episodes of acute sinusitis before developing chronic sinusitis. 

Many things can cause inflammation that leads to sinus issues, such as:

  • Deviated nasal septum — A crooked septum, the wall between the nostrils, may restrict or block sinus passages, making the symptoms of sinusitis worse.
  • Respiratory tract infections — These types of infections are most commonly colds, and they can inflame and thicken your sinus membranes and block mucus drainage. These infections can be viral, bacterial, or fungal.
  • Nasal polyps — These are painless, benign growths inside the nasal passages. Prolonged inflammation and swelling of the sinuses from infection and allergies may increase your likelihood of developing polyps.
  • Allergies — Inflammation that occurs with allergies can block your sinuses. 
  • Regular exposure to pollutants — Tobacco smoke and air contaminants can irritate and inflame your lungs and nasal passages.

How Inflammation Causes Sinus Symptoms

Pain in your sinuses — Pain is a common symptom of sinusitis. You have several different sinuses above and below your eyes as well as behind your nose. Any of these can hurt when you have a sinus infection because inflammation and swelling cause your sinuses to ache with a dull pressure. You may feel pain in your forehead, on either side of your nose, in your upper jaws and teeth, or between your eyes. This may lead to a headache.

Nasal discharge — When you have a sinus infection, you may need to blow your nose often because of nasal discharge, which can be cloudy, green, or yellow. This discharge comes from your infected sinuses and drains into your nasal passages. The discharge may also bypass your nose and drain down the back of your throat. You may feel a tickle, an itch, or even a sore throat. This is called postnasal drip, and it may cause you to cough at night when you’re lying down to sleep and in the morning after getting up. It may also cause your voice to sound hoarse.

Nasal congestion — Your inflamed sinuses may also restrict how well you can breathe through your nose. Infections cause swelling in your sinuses and nasal passages. Because of the nasal congestion, you probably won’t be able to smell or taste as well as normal. Your voice may sound “stuffy.”

Sinus headaches — The ongoing pressure, swelling, and inflammation in your sinuses can give you symptoms of a headache. Sinus pain can also give you earaches, dental pain, and pain in your jaws and cheeks. Sinus headaches are often at their worst in the morning because fluids have been collecting all night long. Your headache can also get worse when the barometric pressure of your environment changes suddenly.

Throat irritation and cough — As the discharge from your sinuses drains down the back of your throat, it can cause irritation, especially over a long period of time. This can lead to a persistent and annoying cough that can make sleeping difficult. Sleeping upright or with your head elevated can help reduce the frequency and intensity of your coughing.

Sore throat and hoarse voice — Post nasal drip can leave you with a raw and aching throat. Although it may start as an annoying tickle, it can get worse. If your infection lasts for a few weeks or more, the mucus can irritate and inflame your throat as it drips, resulting in a painful sore throat and hoarse voice.

How to Lessen Inflammation & Improve Sinus Issues

Avoiding things that irritate your nose and sinuses can help decrease sinusitis. While this is not always possible, there are several lifestyle changes and at-home strategies you can try, such as:

  • Using a cool-mist humidifier
  • Nasal rinsing several times per day
  • Wearing a pollen mask when mowing the grass or cleaning the house
  • Keeping windows closed when pollen counts are high
  • Using HEPA filters in your vacuum
  • Changing heating and air conditioning filters often
  • Avoiding nasal irritants, such as smoke, perfume, aerosol sprays, smoke, smog, and car exhaust
  • Washing bedding often; ideally weekly in hot water

Treatments for Sinus Issues at Excel ENT

If you have had sinusitis several times, and the condition doesn’t respond to treatment; if you have sinusitis symptoms that last more than 10 days; or if your symptoms don’t improve after you see your regular doctor, it’s time to see an ENT specialist, such as Dr. Davis. 

He may have new at-home remedies to suggest, and he may feel that there are other treatment options that may be beneficial. Which treatment option may be right for you will vary greatly depending on your specific situation, including what is causing your sinus problems. Here are a few of our treatment options.

Balloon Sinuplasty 

This treatment promotes sinus drainage through a minimally invasive technique for mild to moderate chronic and recurrent sinusitis. During the procedure, Dr. Davis threads a small catheter through the sinus opening and inflates a balloon with water. The balloon dilates the sinus opening and widens the outflow tract, which encourages it to drain. The procedure is a quick, non-invasive way to improve drainage, reduce the potential for bacterial infections, and improve breathing. Numerous studies have shown that 90 to 95% of balloon sinuplasty patients benefit from the procedure for at least two years.

Functional Endoscopic Sinus Surgery

This is a procedure we use to treat moderate to severe sinus problems. If you’re no longer responding to treatments like nasal irrigation, antibiotics, and decongestants, you may be a good candidate. During the procedure, Dr. Davis uses an endoscope to locate and remove bone and tissue in the sinuses that are preventing drainage. Sinus surgery creates larger drainage pathways to reduce the chances of mucus buildup after recovery. General anesthesia is often required for the procedure, which usually takes between one and three hours. Recovery is typically quick, with very little pain.

SINUVA

This is an innovative treatment for nasal polyps. For many people, nasal polyps are a chronic problem that persists throughout their lives with symptoms such as runny nose, congestion, sinus pressure, postnasal drip, snoring, headaches, and more.

SINUVA is a non-invasive nasal implant that delivers an anti-inflammatory corticosteroid (mometasone furoate) directly to the polyps. Dr. Davis can place the SINUVA implant in the office if you have had previous endoscopic sinus surgery. The implant stays in place for approximately 90 days, after which he will remove it. SINUVA successfully reduces polyp inflammation without surgical intervention.

VIVAER Nasal Airway Remodeling

The VIVAER treatment, performed in our office, is a non-invasive procedure that involves no cutting. Your nasal valve area is gently and permanently reshaped using low-temperature radiofrequency energy. Immediately after treatment, you’ll begin to experience a noticeable improvement in nasal breathing.

Septoplasty

The nasal septum is the wall between the nostrils that separates the two nasal passages, and problems in this area can make breathing difficult. Surgery to straighten the septum is called a septoplasty, or deviated septum surgery.

The procedure usually takes 60 to 90 minutes and is performed in an outpatient surgery center. Before the surgery, we look at your nasal passages and view the shape of your septum. Dr. Davis then uses surgical tools to enter the nostrils and straighten the septum.

Dupixent

Dupixent is a new biologic option to treat and manage sinus conditions for those who may have been candidates for sinus surgery in the past. It is a game-changer for managing sinus disease! 

Dupixent is a treatment used with other medicines to treat chronic rhinosinusitis with nasal polyposis in adults to reduce the size of nasal polyps, improve congestion, improve loss of smell, and reduce the need for surgery.

Discover how the team at Excel ENT of Alabama can help manage inflammation and sinus issues.

If you are experiencing sinus issues, schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Do You Have Good Vocal Hygiene?

vocal hygiene

When you think of “good hygiene” you may immediately come up with washing your hands, brushing your teeth, showering often, and keeping your nails clipped. But did you realize that there is such a thing as “vocal hygiene,” and that it’s very important for your ability to speak and communicate?

We use our voices constantly, although some jobs, professions, and roles may require more speaking. We all have the risk of developing voice problems, but people who use their voices more often may have an increased risk. An estimated 17.9 million adults in the U.S. report problems with their voice, but some of these disorders can be avoided by taking care of your voice, according to the National Institute on Deafness and Other Communication Disorders.

So what should you be on the lookout for, and how can you keep your voice healthy?

What Is Vocal Hygiene?

Your vocal cords are two tiny muscles covered with layers of tissue, and they are very delicate. When you speak, your vocal cords vibrate to produce sound. Any problems with the vocal cords significantly impact the voice. This might include growths on the vocal cords, infections, or improper use of the vocal musculature.

Good vocal hygiene encourages your vocal cords and voice are working properly with no problems. Signs that you have a voice problem might include:

  • Hoarse or raspy voice
  • Lost ability to hit some high notes when singing
  • Voice that suddenly sounds deeper
  • Throat that often feels raw, achy, or strained
  • Talking has become an effort
  • Repeatedly feeling the need to clear your throat

What Causes Voice Problems?

There are many things that can cause voice problems such as:

  • Upper respiratory infections
  • Inflammation caused by gastroesophageal reflux (sometimes called acid reflux, heartburn, or LPR)
  • Vocal misuse and overuse
  • Growths on the vocal folds, such as vocal nodules or laryngeal papillomatosis
  • Cancer of the larynx
  • Neurological diseases (such as spasmodic dysphonia or vocal fold paralysis)
  • Psychological trauma

Most voice problems can be reversed by treating the underlying cause or through a range of behavioral and surgical treatments. In some cases you have little or no control over what’s happening to your voice, but in other instances, there are several healthy habits that will help you have good vocal hygiene.

Improve Your Vocal Hygiene

  • Stay hydrated — Drink plenty of water, especially when exercising. If you drink caffeinated beverages or alcohol, balance your intake with plenty of water.
  • Take vocal breaks — Rest your voice throughout the day.
  • Use a humidifier in your home — This is especially important in winter or in dry climates.
  • Avoid or limit use of certain medications — Some medications may dry out the vocal folds, including some common cold and allergy medications. If you have voice problems, ask your doctor which medications would be safest for you to use.
  • Don’t smoke and avoid second-hand smoke — Smoke irritates the vocal folds. Also, cancer of the vocal folds is seen most often in individuals who smoke.
  • Avoid spicy foods — Spicy foods can cause stomach acid to move into the throat or esophagus, causing heartburn or laryngopharyngeal reflux (LPR).
  • Eat healthy foods — Include plenty of whole grains, fruits, and vegetables. These foods contain vitamins A, E, and C that help keep the mucus membranes that line the throat healthy.
  • Hand hygiene — Wash your hands often to prevent getting a cold or the flu.
  • Get enough rest — Physical fatigue has a negative effect on voice.
  • Exercise regularly — Exercise increases stamina and muscle tone which will help provide good posture and breathing, which are necessary for proper speaking.
  • Try not to overuse your voice — Avoid speaking or singing when your voice is hoarse or tired.
  • Avoid using the extremes of your vocal range — This includes screaming or whispering, both of which can stress your voice. Consider using a microphone when appropriate.
  • Practice good breathing techniques — When singing or talking, support your voice with deep breaths from the chest, and don’t rely on your throat alone. Talking from the throat, without supporting breath, puts a great strain on the voice.

Let Excel ENT Help You Improve Your Vocal Hygiene

No matter what voice problems you may be experiencing, our Speech-Language Pathologist, Amy Pittman, is experienced in treating voice problems, and she can teach you how to use your voice in a healthy way.

She may conduct an examination using video laryngoscopy to see your throat, larynx, and vocal cords. The short procedure involves putting a tiny camera through the lower nasal passage to reach the throat. You will be awake so that you can speak, which helps Amy see the vocal cords while they vibrate and move. The procedure isn’t painful and lasts less than one minute.

Amy will be able to see if there are any growths or signs of an infection. She also watches how you use your voice and whether there’s tension in the muscles. Then, she’s able to determine whether you would benefit from voice therapy or if other medical or surgical treatment is needed.

If you or your loved one are experiencing voice problems, we can help. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Hearing Loss & Cognitive Decline

hearing loss and cognitive decline

Hearing Loss & Cognitive Decline

 

There are many risks associated with hearing loss that can negatively affect quality of life. One such factor is that people who have hearing loss are more at risk of experiencing cognitive decline. Those with more severe degrees of hearing loss are at even greater risk.

At Excel ENT, we do not test for cognitive decline so it’s hard to say to what extent we come into contact with it on a daily basis. However, with more and more research coming out about the associations between hearing loss and cognitive decline, it is a conversation that we have with patients very often, and it’s a topic that we feel is important to cover in this article.

The Connection Between Hearing Loss & Cognitive Decline

First, let’s define cognitive decline. This is when a person experiences worsening symptoms related to memory, learning new things, concentrating, or making decisions that affect their everyday life. Dementia is often the result.

Isolation and withdrawal from social activities are known for being associated with an increased risk of dementia. If someone is having a hard time understanding their friends and family due to hearing loss, they will often choose not to participate fully, or they remove themselves from these situations altogether. This leads to more social isolation. 

Another factor that contributes to cognitive decline for those with hearing loss is the increased listening effort they deal with. They are having to work harder to hear and understand which uses more of their cognitive resources. 

Some estimates show that people with hearing loss can be up to 5x more likely to develop cognitive decline/dementia. These estimates vary across different studies. Many studies have looked more at hearing loss and its association with cognitive decline in the older adult population. However, some more recent studies have reported that those with the highest risk of dementia were adults with middle-aged onset of hearing loss.

Can We Treat Hearing Loss to Improve Cognitive Decline?

Again, we do not do any formal cognitive testing at Excel ENT, but it is something we are aware of as clinicians. We pay attention to certain aspects that could point to possible cognitive decline, such as:

  • Inappropriate reactions to the environment
  • Difficulty with word finding
  • Issues with recall/memory

A history of falls and head injury can also indicate a greater risk for cognitive changes.

We know that genetics play a strong role in the risk for developing dementia. However, different lifestyle aspects can be changed to delay its onset, such as management of smoking, hearing loss, obesity, and diabetes. 

Hearing Aids 

Some studies have shown that hearing aid use can slow the rate of cognitive decline. It has been shown that those who wear hearing aids have better cognition than those with hearing loss who do not wear hearing aids.

Overall, hearing aids can greatly improve the quality of life for all patients even those who are not experiencing cognitive decline. It allows them to hear more of the conversations that are important to them such as those with family members, friends, healthcare providers, etc. 

With hearing aids, they are able to stay connected to the world around them rather than withdrawing away from social situations. This can also prevent them from feeling like a burden to other people. The improved ease of listening is huge for many reasons. They don’t have to put in as much cognitive effort to hear and understand speech, which can help improve their overall cognitive function.

Discover how the team at Excel ENT of Alabama can help find the right hearing aids that may improve cognitive decline.

If you or your loved one are experiencing hearing issues, Dr. Miles can help. Whether hearing loss is related to cognitive decline or not, she is expertly trained in diagnosing hearing problems, and finding solutions. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

The Cause of Your Summer Sinus Issues: Inflammation

sinus inflammation

Days spent at the pool, nights around the bonfire, hours spent playing outside in the grass. While these are all wonderful things about summer, they can also cause inflammation of your sinuses, which then may lead to sinus problems.

At Excel ENT, we have many strategies to recommend and treatment options available that can provide significant relief. 

More About Sinuses & Summer

Sinusitis occurs when the spaces inside your nose and head (sinuses) become swollen and inflamed. When this inflammation continues for three months or longer, despite treatment, it’s known as chronic sinusitis. 

This common condition interferes with the way mucus normally drains, and makes your nose stuffy. Breathing through your nose may be difficult, and the area around your eyes might feel swollen or tender.

Many things can cause inflammation that leads to sinus issues in the summer, such as:

  • Respiratory tract infections — These types of infections are most commonly colds, and they can inflame and thicken your sinus membranes and block mucus drainage. These infections can be viral, bacterial, or fungal, and they do occur in the summer even though they are most commonly associated with colder weather.
  • Nasal polyps — These are painless, benign growths inside the nasal passages. Prolonged inflammation and swelling of the sinuses from infection and allergies may increase your likelihood of developing polyps.
  • Allergies — Inflammation that occurs with allergies can also block your sinuses. Many weeds and grasses bloom in the summer, releasing high amounts of pollen.
  • Temperature changes — On hot days, when the air is dry, the mucus in your nose may become thick and sticky, which blocks the sinuses and can cause stuffiness and/or headaches. Changes in barometric pressure, like when a summer thunderstorm pops up in the afternoon, can trigger sinus pain and headaches as well. 
  • Swimming — The big issue with swimming is the possibility of swimmer’s ear, which is when an infection occurs due to water staying in the ear canal for too long. This creates a perfect breeding ground for bacteria and is most common in children. Water in the nose can also cause inflammation of the sinuses.

It’s not always possible, but oftentimes the best and most effective way to deal with these summer issues that can cause sinus inflammation is to avoid the allergens or triggers. This might be accomplished through lifestyle changes and at-home strategies, such as:

  • Using a cool-mist humidifier
  • Nasal rinsing several times per day
  • Wearing a pollen mask when mowing the grass or cleaning the house
  • Keeping windows closed when pollen counts are high
  • Using HEPA filters in your vacuum
  • Changing heating and air conditioning filters often
  • Avoiding nasal irritants, such as smoke, perfume, aerosol sprays, smoke, smog, and car exhaust
  • Using a nose clip or ear plugs while swimming
  • Washing bedding often; ideally weekly in hot water

With these strategies, summer sinus issues may be avoided or improved, but sometimes sinus infections do occur, and they certainly can happen in the summer. However, there is a difference between a once in a while sinus infection and constant sinus problems that last for months. 

Treatments for Summer Sinus Issues

If you have been fighting off sinus infections for more than three months, it is time to seek medical attention to regain your quality of life. We are very happy that we have many options for treatment at Excel ENT!

Which treatment option may be right for you will vary greatly depending on your specific situation, including what is causing your sinus problems. Dr. Davis is an expert in diagnosing these problems and coming up with the best treatment options.

These include treatments such as RhinAer, SINUVA, and our new biologic option Dupixent to balloon sinuplasty and functional endoscopic sinus surgery, we are thankful to have so many options these days that can help us truly provide relief for our patients. 

Discover how the team at Excel ENT of Alabama can help manage summer sinus issues, and sinus problems all year round.

If you are experiencing sinus issues this summer, don’t put off making an appointment with Dr. Davis. Especially while kids are out of school, it’s a great time to address these problems and find the best treatment plan. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Speech and Hearing Rehabilitation: Conversations with Excel ENT Experts

speech and hearing rehabilitation excel ent birmingham al

While many ENTs offer services related to speech and hearing, at Excel ENT of Alabama, we offer something that’s a little unique, which is full speech and hearing rehabilitation. But why might someone need these services?

At the very heart of the matter is the word “rehabilitation,” which means to restore abilities through training or therapy. Rehabilitation can be used alongside or instead of other treatments, such as medication or surgery. Some disorders do well with therapy only, and others respond well to a combination of rehabilitation and medical treatment.

To learn more about what’s involved with speech and hearing rehabilitation, we sat down with Excel ENT Speech-Language Pathologist (SLP), Amy Pittman, and our audiologist, Dr. Helen Lee Miles, to ask them a few questions.

Speech Rehab at Excel ENT: A Conversation with Amy Pittman, SLP

What’s different about what you offer at Excel ENT? 

While most ENT physicians have the capability to view someone’s throat and vocal cords with a small endoscope, few partner with a speech-language pathologist to provide a holistic approach that includes both medical/surgical and rehabilitative interventions. Addressing all aspects of a voice disorder can be crucial. For this reason, we have had many patients drive here from hours away, even from other states!

What are some reasons or conditions that might cause someone to need speech rehab? 

Many conditions can cause speech problems, but I specialize in voice disorders. Voice disorders are most often caused by swelling, irritation, or growths on the vocal cords, or problems with coordinating respiratory or laryngeal musculature.

What’s typically involved in terms of evaluation, procedures, and therapy? 

A first step in evaluating a voice disorder is to take a look at the vocal cords themselves. We want to make sure the voice problem isn’t a result of something medically serious, and we also want to determine whether medication or surgery is required. We interview the patient to help us identify the problem and come up with a treatment plan. The duration of voice therapy varies, but it often only takes a few sessions to achieve significant improvement.

What is a strobe voice evaluation, and why might it be needed? 

Stroboscopy refers to a specialized method of examining the vibrating vocal cords, which are too fast for the naked eye to see. A bright flashing light lasting a fraction of a second is used to illuminate the vocal cords, allowing us to evaluate their vibration in a detailed way.

What are the results of speech therapy typically like? 

The outcome really depends on the person and the nature of their condition, but most people see great improvement.

Why would you encourage a patient to go through speech therapy, and what are the biggest benefits or advantages? 

Many people achieve excellent results through voice therapy that they could not achieve any other way. Unlike medication or surgery, there are no risks or side effects. Some people are even able to avoid having surgery for vocal cord polyps or nodules by participating in therapy! Even if surgery is required, voice therapy can help patients learn ways to prevent problems from reoccurring in the future.

Hearing Rehab at Excel ENT: A Conversation with Dr. Helen Lee Miles

What is hearing rehabilitation? 

Hearing rehabilitation, referred to as aural rehabilitation, is the process of identifying hearing loss, providing counseling, managing the hearing loss through use of technology such as hearing aids, cochlear implants, or assistive listening devices; and implementing communication strategies to improve a patient’s overall health, ability to communicate with those around them, and their quality of life.

What are some reasons or conditions that might cause someone to need hearing rehab? 

Each hearing loss is different. It can be caused by aging, exposure to recreational or occupational loud noises, genetics, medications, diseases, and syndromes. Some hearing loss can be idiopathic, which means the cause is unknown. Hearing loss can also stem from a combination of these things. It is important to identify the type and degree of each hearing loss to determine the most appropriate intervention.

What’s typically involved in terms of evaluation, procedures, and therapy? 

Typically, the first part of rehab is the identification and diagnosis of hearing loss which is done through a full audiological evaluation including a hearing test to determine the type and degree of hearing loss. Next, patients must be educated on their hearing loss and the recommendations for “next steps.” 

If their hearing loss warrants hearing aids, we would then meet to discuss their needs and wants to determine the best options for them. Then the patient can be fit with hearing aids based on their audiometric results. From there, the patient will be taught about the use, features, and care of the hearing aids. 

It is really important for people to understand that this is a process and follow-up appointments are important to ensure patient understanding and to adjust the hearing aids as needed for optimal use. It is also important for the patient and their loved ones to be taught communication strategies to be used in conjunction with their technology.

Why would you encourage a patient to go through hearing therapy, and what are the biggest benefits or advantages? 

Hearing loss can be associated with isolation and depression. Aural rehabilitation can improve a person’s quality of life and give them the ability to more effectively communicate with those around them. It can help a person by allowing them to have more ease of  listening and keeping them engaged with the world around them. 

Hearing loss can also be associated with cognitive decline. Treatment of hearing loss is not going to prevent things such as cognitive decline or dementia, but it has been shown to delay onset of symptoms. People who have participated in aural rehabilitation are more likely to report overall better health! 

Discover how the team at Excel ENT of Alabama can help with speech and hearing rehabilitation.

If you have speech or hearing issues, both Amy and Dr. Miles are the absolute best, and they will be happy to help however possible. To schedule an appointment with one of our Birmingham ENT specialists, call us at (205) 988-6858, or send us an appointment request.

Want a Solution for Nasal Polyps that Doesn’t Involve Surgery? Try Dupixent!

nasal polyps sufferer excel ent birmingham al

Nasal Polyps & Dupixent

 

Excel ENT of Alabama is very excited to introduce a new biologic option to treat and manage sinus conditions for patients that could have been candidates for sinus surgery in the past.

The sinus specialists of Excel ENT of Alabama are very passionate about how biologics can be a game-changer for managing sinus disease and are excited to offer Dupixent as an option for treatment in patients with severe/ refractory sinus polyps. 

Dupixent is a treatment used with other medicines to treat chronic rhinosinusitis with nasal polyposis in adults.

What Biologic medication Dupixent does:

  • Reduce the size of nasal polyps
  • Improve congestion
  • Improve loss of smell
  • Reduce the need for surgery

Dupixent What Are Nasal Polyps?

Polyps are painless, benign growths inside the nasal passages. If the polyps are small, a person may not know that they even have them but, polyps can grow in clusters that block the nasal passages and inhibit sinus fluid drainage and normal airflow.

Polyps also can cause secondary issues, such as sleep apnea, asthma, and sinus infections. 

Some common symptoms of nasal polyps are:

  • Congestion
  • Breathing problems
  • Recurring infections
  • Reductions in the senses of smell and taste
  • Sinus pressure
  • Pain in upper teeth or face
  • Nosebleeds

What the maker of the Biologic Medication Dupixent says:

George D. Yancopoulos, president and chief scientific officer at drug maker Regeneron, said in a statement, “Dupixent is the only approved therapy that has been shown to shrink nasal polyp size and also improve the signs and symptoms of the associated chronic rhinosinusitis. In fact, approximately three-quarters of patients treated with Dupixent no longer required either corticosteroids or surgery, the current standards of care.”

Dupixent F.A.Qs

How does Dupixent work? By blocking two critical sources of type 2 inflammation, Dupixent shrinks nasal polyps and reduces the need for surgery.

What types of results were seen in clinical studies with Dupixent? There were two clinical trials of 724 adults with uncontrolled chronic rhinosinusitis with nasal polyposis. In both studies, Dupixent helped patients breathe better by relieving nasal congestion and reducing nasal polyps size compared to the placebo group.

How is Dupixent taken? Via an injection under the skin at different injection sites. 

How do I know if Dupixent is suitable for me? Call for an appointment today with the sinus specialist professionals at Excell ENT of Alabama to determine if Dupixent is for you.

Learn More About Treatment Options for Nasal Polyps at Excel ENT of Alabama Located in Birmingham!

Are you suffering from nasal polyps? Contact the team at Excel ENT of Alabama today to schedule an appointment for a medical evaluation to receive the proper diagnosis and treatment plan.