Author: Excel ENT

Cutting Edge Biologic Options for Sinus Problems


Over the years, we have made many strides in improving the way we are able to treat sinus issues. One common problem that has continued to be a challenge is treating chronic rhinosinusitis with nasal polyposis (nasal polyps). 

When it comes to these conditions, it is possible that the future of better disease control may involve the use of biologics, and we’re thrilled to have these new options for our patients at Excel ENT.

The Basics of Biologics

Biologic response modifiers are a class of medications that treat conditions such as nasal polyps by targeting specific components of an individual’s immune system. They can modify the chemical responses of the immune system that are causing inflammation thought to be responsible for the growth of nasal polyps.

Biologics are made from living cells. Unlike many other pharmaceutical drugs, they are not synthesized chemically or from plants. They also don’t typically come in the form of a tablet but as a solution that has to be injected.

Biologics can be antibodies, enzymes, hormones, or other types of biologic components or cells (even viruses). Vaccines and insulin are types of biologics that have been available for many years.

Dupixent (dupilumab) is a biologic approved for the treatment of nasal polyps in the U.S., and it’s one that we’ve been offering for a while at Excel ENT. Another new biologic option we have is called Nucala.

Things to Know About Biologics for Nasal Polyps

Focusing primarily on Dupixent, as it’s the biologic option we’ve been offering the longest, here are some of the details we want our patients to know about.

Administered via injection

Biologics involve an injection. We will teach you how to do this, and you will either give yourself a shot or have a family member give you the injection. While there may be some discomfort with this, it often decreases over time. Injection site reactions, such as pain, redness, or swelling can be easily treated using cold or hot pads and over-the-counter pain relievers such as acetaminophen.

Possible side effects

As with all medications, biologics used for the treatment of nasal polyps may have side effects that inhibit their use by certain individuals. As with almost all medications, it is possible to have a life-threatening allergic reaction called anaphylaxis. Signs of this type of reaction may include swelling of the face and lips, difficulty swallowing, difficulty breathing, and wheezing.

When common side effects occur, they often improve on their own over time as you continue your treatment. These side effects might include injection site reactions, eye inflammation, increased white blood cell counts, sore throat, stomach problems, cold sores, joint pain, insomnia, and toothaches.

Not the best option for everyone

Dupixent is untested in individuals under the age of 6 for any use; it is approved only in individuals over the age of 18 for the treatment of nasal polyps. Women who are pregnant, those who wish to become pregnant, or those who are breastfeeding should not consider biologics for nasal polyps since they are also untested in these individuals. 

Your insurance might cover biologics

Your health insurance might require that you provide ample documentation if you are prescribed a biologic. We will work with you to provide any necessary documentation required by your insurance company. Even though there may be extra steps in the process, many companies ultimately cover the medications.

Additionally, many drug companies including the manufacturer of Dupixent offer assistance to people wanting to try new options. Copay cards or other programs may reduce the cost of the medication for individuals who apply.

Find Out If Biologics Are a Possibility for Treating Sinus Problems at Excel ENT of Alabama

Biologics are a cutting edge option that will only continue to grow when it comes to treating sinus problems, such as rhinosinusitis and nasal polyps. It’s a great option to consider, and Dr. Davis will work with you to determine if it’s a viable option in your case. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Dangers of Earbud & Earpod Use

dangers of earbuds

From teenagers and adolescents to working adults, everyone is using either earbuds or earpods these days. These options are like tiny speakers that fit inside the ears, and while they are convenient and useful, there are some concerns when it comes to your ears and your hearing. 

May is Better Hearing and Speech Month, and it’s the perfect time to address this topic, especially since kids are getting out of school for the summer. They will be looking for ways to keep themselves entertained, and they may be using these products more often.

Dangers of Earbuds & Earpods

The dangers with these products revolve primarily around listening to music that’s too loud and doing so for too long. 

These are the two main concerns:

Otitis Externa

This is an ear infection in the ear canal, commonly called “swimmers ear,” and the condition can be caused by repeated, frequent use of in-ear headphones. Options that seal off the ear to eliminate airflow are especially concerning as these can increase the risk of otitis externa. It can be a very painful infection that may require medical treatment.

Noise-Induced Hearing Loss

Sounds at 78 to 132 decibels (dB) have the potential to cause damage to the delicate hair cells that respond to the sounds we hear. This damage can show up as tinnitus (ringing) and/or hearing loss (difficulty hearing and understanding what is said). The louder the sound, the less time it takes to damage your hearing.

Earpods can reach levels of 102 to 112 dB. At levels that high, damage to your hearing can occur in as much as 30 minutes to as little as 2 minutes. As many as one in five teenagers already have noise induced hearing loss from exposure to loud sounds. This is 30% higher than 20 years ago.

Signs that what you’re listening to is too loud:

  • You must raise your voice to be heard
  • You can’t hear or understand someone that’s three feet away
  • Speech around you sounds muffled or dull after you leave the noisy area
  • You have pain or ringing in your ears after you hear the noise (tinnitus) that lasts for a few minutes or a few days

How to Protect Hearing When Using Earbuds or Earpods

During the month of May and throughout the summer, be sure that what you are listening to and what your children are listening to is not too loud. For kids especially, the time they spend each day using earbuds or earpods should be limited. 

Here are some specific things you can do to protect your hearing:

  • Frequently wash earbuds with rubbing alcohol and allow them to dry completely before putting them back in the ear.
  • Use bone conduction headphones that leave the ear open and do not create an environment that’s ideal for infections to grow.
  • Set a volume limit on phones or tablets to reduce your exposure to loud sounds.
  • Take a break from listening to music with earbuds or earpods.
  • Give your ears time to rest and recover from exposure to sound so you will avoid hitting that “maximum noise dose” that puts you at greater risk for hearing loss and tinnitus.
  • Wear earplugs when around loud sounds, such as when you are doing yard work, going to concerts, sporting events, and more.
  • Consider having custom earplugs made that are more comfortable than standard foam ear plugs.
  • Get an annual hearing test or a baseline test so you can track your hearing health.

Check Your Hearing or Address Hearing Problems at Excel ENT of Alabama

Remember that there is no cure for hearing loss or tinnitus, so it’s crucial that you protect your hearing starting as early as possible. You want your hearing to last a lifetime! If you’d like to schedule a hearing test or baseline test, we can help you with that at Excel ENT. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Q-Tips & Ears: Good or Bad?

q-tips in ears

Keeping cotton swabs, such as Q-tips, in the bathroom to clean out your ears is very common, and many people think this is a necessary task, but it’s one that carries significant risks. 

According to the American Academy of Otolaryngology, the use of cotton-tipped swabs or other home instruments pose a serious risk of damage to the eardrum and ear bones. When you use cotton swabs, you can accidentally damage your ears, and the most common cause of eardrum rupture is from trauma such as this. 

Instead, you should visit your doctor for an assessment if you experience uncomfortable symptoms, such as

  • Ear fullness
  • Hearing loss
  • Discomfort
  • Itching
  • The feeling of too much wax buildup

At Excel ENT, we will be able to help you with these issues in an appropriate manner. We can look inside your ear and safely remove wax, which is always the best course of action. Read on to learn more!

Q-Tips to Remove Earwax: FAQs & Dangers

We do know that earwax can be pesky. In some cases, too much earwax may cause hearing problems, itching, dizziness, and discomfort. However, you do not need to routinely clean out your ears. In most cases, earwax is actually healthy and protective for the ear. Earwax helps protect against infections, dry skin, and unwanted dirt and debris. 

What are the dangers of using a Q-tip to clean the ears?

Using cotton swabs or other instruments at home to clean your own ears can cause serious problems, such as:

  • Rupturing the eardrum – The most common cause of eardrum rupture is injury to the ear, typically occurring as a result of using cotton swabs or other instruments in the ear at home. This is painful and can lead to hearing loss and infections. 
  • Infection – Using a cotton swab in your ear can introduce bacteria, dust, and dirt into your ear and lead to ear infections. 
  • Pain – Even if you don’t fully rupture your eardrum, you can cause damage like scratches and inflammation. Cotton swabs also tend to push wax further into the ear canal, which will make the discomfort worse. 
  • Getting material stuck in the ear – Cotton material from swabs can get lodged and stuck in the ear. This can also cause hearing loss, infections, and discomfort. You will also likely need a doctor’s visit to remove it. 

How often should I clean earwax from my ears?

Most people do not need to routinely clean earwax from their ears. Our ears are normally “self-cleaning,” since earwax traps dirt and debris and slowly pushes it out. Here, it dries and falls out on its own. This helps prevent particles from getting in our ears and also prevents infection.

Why should I be so worried about my eardrum?

When using a cotton swab, you can easily reach your eardrum. But because the eardrum is so delicate, it can be easily ruptured with even gentle pressure from a swab. The pain is severe, and the ear may also leak a clear fluid. While a punctured eardrum will heal, it can take a while and can even lead to conductive hearing loss.

How should I clean my ears? 

As mentioned above, your ear typically does a great job of cleaning itself. In most cases, the ear canal does not need to be cleaned. During routine hair washing or showers, enough water enters the ear canal to loosen wax that has accumulated, and it typically loosens and falls out . on its own while you are asleep. If you’d like to clean your outer ear, also known as the pinna, occasionally you can use just a little soap, water, and a washcloth while you shower. Be very gentle. 

Let Excel ENT of Alabama Help With Issues Related to the Ears, Nose, and Throat

Whether you are dealing with earwax build-up, hearing troubles, or ear pain, our specialists at Excel ENT of Alabama can help. We have experts who can treat other issues related to the nose and throat as well. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

Major Jumps in Hearing Device Technology You Should Know About

hearing device technology

New Hearing Device Technology at Excel ENT of Alabama


The world of hearing devices can be a little confusing. There are so many different brands and so many features to consider. While hearing aids are available by mail order or from some “big box” retailers, you are missing out on so much with those options. 

Instead of going those routes, there are several reasons why you should purchase your hearing aids directly from Excel ENT of Alabama. We provide a customized fitting for your hearing aid, which is crucial to optimum hearing success. We also stay up-to-date on the latest advancements in hearing aid technology and which hearing devices are the best. 

We are big fans of all the hearing aids we offer, and we can help you find the right one. Recently, there have been some big advancements in technology with two of our favorite brands!

New Features of Phonak Hearing Devices 

The newest Phonak hearing aids in the Paradise line feature a brand new chip (the PRISM chip). In the hearing aid world, this is a big jump in technology and provides more processing power, which translates to better, faster, and smarter. 

Phonak has also recently launched a new hearing aid in the Paradise family that is called Audeo Paradise Life. It is the first fully rechargeable waterproof hearing aid. This is important not so much for the fact that it is waterproof, but more so in terms of thinking about technology being susceptible to moisture, sweat, dust, or debris.

They have also made improvements to their Bluetooth connection. We are now able to have more devices paired to the hearing aids and have two devices actively paired at the same time. In addition, Phonak hearing aids are made for all Bluetooth connectivity. This means that if you have Bluetooth on your phone, you should be able to connect to your hearing aids for streaming phone calls and audio regardless of the specific phone you have.

There is a new processing feature within these hearing aids called Motion Sensor which simply means that the hearing aids can tell when a user is moving or walking around and will automatically change its processing of the sound accordingly.

Tap Control is another feature that can be enabled in these hearing aids which allows a patient to activate voice assistant, such as Siri or Google; accept or end phone calls; and pause/resume streaming by tapping on the hearing aid instead of having to get the phone out or press the button on the hearing aid

Lastly, Phonak also recently added a new CROS-P hearing aid that is compatible with the Paradise hearing aids. CROS hearing aids are used for patients with single sided deafness where they do not have usable hearing in one ear (also called an un-aidable ear). They also work well for patients who have normal hearing in the other ear or hearing loss that can be treated with a hearing aid.

New Features of Oticon Hearing Devices

In this line, Oticon More hearing aids are their newest option, and they have provided some interesting stats. Oticon More provides 20% more speech information compared to two of their top competitors.

Conversation is difficult in complex listening environments and then hearing loss makes it even harder. Their goal is to provide as much speech information to the brain as possible. To do this, Oticon More adapts faster to provide important details to the patient as conditions within their environment change.

Oticon also has a personalization process that I can use during an initial fitting that involves me having the patient listen to different sound clips and choosing their preferences. Based on these results, the hearing aid programming will take those preferences into consideration.

Find this New Hearing Device Technology at Excel ENT of Alabama

We are happy to answer questions about these hearing aid advancements and teach you how to use all the features. Getting a custom-fitted hearing aid can truly be a life-changing decision, and we’re here to help however we can! Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

When Should You See an ENT vs. an Upper GI Doctor for Swallowing Problems?

ENT vs upper GI swalling problems Excel Ent Birmingham Al

By Amy Pittman, Excel ENT Speech-Language Pathologist

You are having trouble swallowing, and maybe you are also experiencing very bad acid reflux. What kind of doctor do you think you should see? For many, the answer is to make an appointment with a gastroenterologist who specializes in the upper gastrointestinal (GI) tract. While they may be able to help you in some instances, it may be that you also need the help of an ENT

It can be difficult to know which type of doctor best suits your needs, and sometimes you may even need both. In this article we will discuss the differences between the two most likely conditions you may have, which are laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD).

ENT vs. Upper GI — Where Is Your Problem?

First, let’s define what LPR and GERD are exactly.

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, and sinus drainage. LPR is often referred to as “silent reflux” since many people with LPR do not experience heartburn. This is because the laryngeal area is much more sensitive to stomach acid than the esophagus.

The symptoms of LPR are felt primarily in the throat and may include the following:

  • Sore throat
  • Mild hoarseness
  • The sensation of a lump in the throat
  • The need to clear the throat
  • The sensation of mucus sticking in the throat, and/or post-nasal drip
  • Chronic (long-term) cough
  • Difficulty swallowing
  • Red, swollen, or irritated larynx (voice box).

Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

Common signs and symptoms of GERD include:

  • A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
  • Chest pain
  • Difficulty swallowing
  • Regurgitation of food or sour liquid
  • The sensation of a lump in your throat

So when acid repeatedly “refluxes” from the stomach into the esophagus alone, this is GERD. When stomach acid travels up the esophagus and spills into the throat or voice box, this is LPR. People with GERD tend to experience heartburn or a feeling of acid coming up. People with LPR are more likely to have a cough, throat clearing, hoarseness, or a feeling of something stuck in their throat. Of course, some people have both!

What To Do If You Experience LPR or GERD

You should start by examining your symptoms. If your swallowing problems include food feeling stuck in your throat or you are experiencing the regurgitation of food, you may want to start by seeing a GI. You can also come straight to Excel ENT of Alabama for an ENT evaluation. Since GERD and LPR often occur together, we do sometimes collaborate with a GI doctor. The GI will focus on the esophagus and stomach, while we will focus on the throat area.

When it comes to LPR, the most effective treatment is usually a combination of medication and lifestyle changes. Lifestyle changes might include things like avoiding eating right before bed and reducing the intake of problem foods. Acidic foods and drinks are problematic, as well as caffeine, alcohol, carbonated beverages, mint, and high-fat foods.

Discover how the team at Excel ENT of Alabama can help manage swallowing problems, such as LPR.

Don’t put off making an appointment with Excel ENT’s Speech-Language Pathologist Amy Pittman if you are experiencing swallowing problems. Together with Dr. Christopher Davis, Amy can diagnose your issue and develop a treatment plan in no time. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.


Contact Us

"*" indicates required fields

Get to Know Excel ENT of Alabama’s Newest Audiologist Helen Lee Miles

Excel Ent sinus surgery

Inspired by her aunt and uncle who were both audiologists, Helen Lee Miles fell in love with this field of work at a young age. She is our newest audiologist at Excel ENT of Alabama and specializes in adult and pediatric diagnostic evaluations. She also has a special interest in hearing aids and aural rehabilitation.

From day to day, Dr. Miles diagnoses and treats hearing and balance problems for people of all ages. Once she has a full understanding of your type and degree of hearing loss, she will discuss your results, next steps, and/or treatment options using our comprehensive list of audiology services.

Dr. Miles may also fit patients with hearing devices and assistive listening devices, and she specializes in education regarding hearing loss, tinnitus, and balance system dysfunction.

Learn More About Helen Lee Miles, Excel ENT Audiologist

With more knowledge about what an audiologist is, what they do, and how they help, get to know more about Dr. Miles.

What do you love most about your job at Excel ENT?

Getting to meet and getting to know various people and having conversations helps me help them. It brings me joy to help people function better in their everyday lives.

What is the most important thing for your patients to know about you, and what’s your passion? 

That I care about what they care about. I try to listen to where they are in their journey and find out what’s important to them. This allows me to help them reach their goals and get to a place where they want to be with their hearing.

Hearing aids and hearing aid fittings are my true passion. Patients come in frustrated, and I can help them change that. I can make a difference in their lives, and I love that!

When should a patient schedule an appointment with you, and what can they expect at a consultation?

If you are experiencing difficulties hearing or understanding when someone is speaking to you. Changes in hearing or asking others to repeat things is often an indicator that you may need to see me. Also, if you find that you are intentionally avoiding situations where you need to communicate with others, that’s a big red flag. 

At a consultation, I will examine the interior of the ears and do a full hearing test to discover the amount of hearing loss. If a hearing aid is appropriate, I ask questions to get to know the patient more and determine what is essential to them in a hearing aid, such as BlueTooth technology or having a rechargeable option. We will talk about our 30-day trial period that allows them to feel confident they are getting the right hearing aid. 

Personal Notes About Dr. Miles

Dr. Miles grew up in Phenix City, Alabama, and started her education as an undergrad at the University of Alabama, where she received her B.A. in Communicative Disorders. She graduated Summa Cum Laude with Honors and continued her education at the University of Memphis, where she earned her Audiology Doctorate. 

After getting married in March of 2020, she, her husband, and their chocolate lab moved to the Birmingham area. When not at work, Dr. Miles enjoys reading and painting. While she once thought she might want to be a teacher, that passion comes into her work every day as she teaches her patients about hearing loss, improved communication, and much more.

Discover how the team at Excel ENT of Alabama can help manage hearing problems, from minor to more serious conditions.

If you have hearing issues or think it may be time for a hearing test, Dr. Miles will be happy to help however she can. To schedule an appointment with one of our Birmingham ENT specialists, call us at (205) 988-6858, or send us an appointment request.

Frequently Asked Questions about hearing and hearing aids

Being fitted for hearing aids by Excel ENT of Alabama

FAQ’s About Hearing Aids


Did you know that people who need hearing aids wait an average of seven years before actually getting their hearing checked? This is primarily because of deeply held societal issues with the stigma behind looking “old” with a hearing aid.

In this blog, we share with you some of the Frequently Asked Questions our patients have regarding hearing and hearing aids. Hopefully, one of these questions will answer yours!

How do I know if I need to get my hearing checked?

This is a top FAQ as patients try to gauge just how bad their hearing should be before they come in and see our audiologist. Three reasonably common clues are: 

  1. Having a hard time hearing in business meetings
  2. Turning the television up really loud and/or turning on closed captioning
  3. More difficulty hearing children and women than men

How can hearing aids help with tinnitus?

Some hearing aids can provide relief for the ringing and buzzing tinnitus sufferers experience with tinnitus. White noise and other sounds (such as ocean waves, for example) can be programmed into hearing aids to provide tinnitus relief.

I can purchase hearing aids at big-box retailers for less money – why should I buy hearing aids from you?

There are several reasons why you should purchase your hearing aids directly from Excel ENT. A customized fitting for your hearing aid is crucial to optimum hearing success, and you won’t get this from mail order or big-box retailers. Basically, with hearing aids, there is no such thing as “one size fits all”!  

What can I expect during a hearing test appointment?

First of all, it is not painful at all! We will first sit down with you and ask some specific questions about the different challenges you’ve experienced. We will look inside your ears, possibly with a video device. You will go into a soundproof booth, and we will administer an audiometry test so that we can identify the frequencies you cannot or have difficulty hearing. 

Hopefully, the answers to these frequently asked questions give you the boost and encouragement you need to pick up the phone and make an appointment to come see us today!

Get a 30-day reduced cost trial today on hearing aids from ExcelENT of Alabama in Birmingham, AL

If you’re looking for a new hearing aid, don’t put off making an appointment. We can conduct testing and get you fitted with a hearing aid that meets your exact desires and goals. 

Enjoy hearing the TV again and listening to simple conversations with ease. Click here to schedule an appointment online, or call one of our caring office staff to discuss coming in at a time that’s best for you: 205-988-6858. 

We are centrally located in the Birmingham market, and we treat all types of issues dealing with the ear, nose, and throat. Patients rave about our results, and our compassionate clinical staff will resolve your problems with the utmost care and professionalism. Reach out to us today! 

Chronic Nasal Obstruction: its impacts, our convenient solutions

Chronic nasal obstructions cleared with Excel ENT

If you experience chronic nasal obstruction, otherwise known as chronic nasal congestion or continually having a “stuffy nose,” you likely already know this significantly impacts your overall wellbeing and happiness. 

Chronic nasal obstruction can often make it difficult to breathe, focus on work, perform daily activities, and even fully experience the world around you, as your attention is usually centered on merely trying to get air into your nostrils. 

Not to mention, this miserable condition can lead to serious health complications if not treated properly. Below we cover the different ways chronic nasal congestion negatively affects everyday life and how it may lead to other problems. 

Additionally, keep reading to discover an in-office treatment for chronic nasal obstruction we offer at Excel ENT. It’s minimally-invasive, completely safe, exceptionally effective, and often less scary than the more popular nasal congestion treatments available today. 

5 Ways Chronic Nasal Obstruction Negatively Impacts Everyday Life

Disrupted Sleep

No doubt, sleeping can seem impossible with nasal congestion problems. A healthy nasal pathway is essential for breathing properly through the night and getting optimal sleep. 

Over time, disrupted sleeping patterns, and years of inadequate rest can lead to chronic fatigue, elevated stress levels, higher chances of depression, weight gain, and more. 

Perpetual Breathing Problems 

The severity of how difficult it is to breathe depends on the type of nasal congestion one has. However, struggling to draw breath day in and day out is never a good feeling. And since this nasal congestion forces you to breathe through your mouth over time, several problems can arise, such as dental issues, dry mouth, poor sleep, mood fluctuations, and more. 

Constant Headaches

Depending on the severity of your condition, blocked nasal passages and chronic nasal obstruction often lead to mild to intense headaches. Without a doubt, what follows is a diminished quality of life, as headaches interfere with daily routine, concentration, work abilities, and sleeping patterns. 

Loss of Taste and Smell 

Considering the sense of smell and taste are connected, it’s no surprise that loss of taste often accompanies the loss of smell due to chronic nasal congestion. While there are several reasons this may occur, loss of taste and smell is usually a side effect of nasal polyps. However, if you have lost your sense of taste and smell, we recommend visiting an experienced ENT doctor for a thorough examination. 

Dwindling Quality of Life

If you are experiencing all the things mentioned above — sleep problems, breathing difficulties, constant headaches, loss of taste and smell — your quality of life is most likely dwindling. No doubt, these symptoms of chronic nasal obstruction put a strain on your physical and mental wellbeing. 

For these reasons, it’s critical to visit a specialized ENT doctor to address and effectively treat your chronic nasal obstruction. 

Now, we understand many nasal congestion treatments available today can often be perceived as invasive, painful, and scary. Thankfully, at Excel ENT, we offer an alternative option many of our previous patients have found effective at treating their chronic nasal obstruction. 

Introducing VivAer — The Nasal Obstruction Treatment at Excel ENT

VivAer is a minimally-invasive procedure that opens the nasal passages and delivers long-lasting results — all without invasive surgery, incisions, or excessive recovery time. 

If you suffer from debilitating chronic nasal obstruction, VivAer might be right for you. It’s clinically proven to help alleviate chronic nasal obstruction symptoms to significantly improve nasal breathing, help you get a better night’s sleep, and elevate your overall quality of life. 

At Excel ENT, we’re passionate about nasal passages and sinuses! 

Treating chronic nasal obstruction can be challenging. It often requires a combination of several methods, such as nasal irrigation, decongestants, and antibiotics. But sometimes, you need the help of a professional to get rid of chronic nasal congestion and chronic sinus infections for good. 

The expert team at Excel ENT of Alabama is passionate about sinus health and helping patients breathe better. If you’re suffering from chronic nasal obstruction, get in touch with Dr. Davis. He will get you feeling better in no time! Call 205-386-6453 or schedule an appointment here.

Swallowing and throat problems: how they are found and treated?

Excel ENT patient with swallowing or voice problems

Swallowing & Throat Problems


Have you ever had the feeling of food getting stuck in your throat while eating? Do you have a habit of frequent throat-clearing? Or perhaps you even have choking spells, frequently late at night?

If you’ve experienced one of these situations, you’ve probably imagined the worst-case scenario: “Something is really wrong with me” or “I must have some horrible condition.”

Well, would you believe these types of scenarios are often related to swallowing disorders or voice problems? 

“Speech and swallowing are very complex and dynamic muscle activities that are often taken for granted,” according to Excel ENT’s Speech Pathologist Amy Schiwitz with Excel ENT, located in Vestavia Hills, Alabama. “What people imagine is a horrible problem that can be corrected by either simple repetitive treatments or minor surgeries to correct these issues.”

Swallowing problems

You will want to seek out assistance from a throat specialist if you are experiencing any of the following swallowing problems:

  • A feeling of food getting stuck
  • Coughing or choking while eating
  • Gurgling wet voice quality after swallowing food
  • Pain while swallowing
  • Inability to swallow

It is estimated that around 15 million Americans suffer from some type of swallowing problem.  

We realize that these swallowing problems can be scary, so we take your symptoms seriously. We will work hard to reassure our patients they are not alone! In most cases, swallowing problems are not serious. 

Voice issues

A voice specialist can help you when you are experiencing one of the following types of voice issues:

  • Trouble with the sound of your voice: 
    • Your voice cracks or breaks
    • Your voice cannot hit the highs and lows in your voice range anymore
    • Your vocal cords tire easily
    • Your voice sounds breathy, husky, or hoarse
  • Sensations in the throat, such as: 
    • A throat tickle, 
    • When your throat is dry, burns, aches, or is tight 
    • The feeling of a lump in the throat or a “frog in the throat”
    • Swallowing problems
    • Post-nasal dripping (nose fluids that drip down the throat)
  • Pain – dry, irritating cough; choking spells (often at night); ear or jaw pain
  • Other symptoms: difficulty breathing, frequent throat clearing, feeling of fullness in the neck muscles or glands in the throat, coughing up blood

If you are experiencing one of these types of issues, you are not alone. Approximately 7.5 million people in the United States have trouble using their voices, so it’s not as uncommon as you might think. A voice specialist knows exactly what to do to diagnose your exact problem and develop a treatment plan for you that will reduce or eliminate your voice issues.

How are swallowing problems and voice issues diagnosed?

The type of swallowing or voice issue you have is the determining factor in diagnosing the problem. Once our voice and throat specialist reaches this diagnosis, we can create a specialized treatment plan just for you.

We use some of the most state-of-the-art diagnostic procedures in the state of Alabama to determine the root cause of your issues. 

Swallowing problems and diagnostics

At Excel ENT, we use a very cool tool called the Fiberoptic Endoscopic Evaluation of Swallowing (FEES). How it works: we place a very small endoscope in your nose, and Amy Pittman slips it down to the area just above your throat and larynx/upper airway. Using this tool, she gets the chance to time the speed and coordination of foods or liquids you swallow.

You’ll actually be awake for this straightforward procedure and will be in a seated position. Amy Pittman will spray your nose and throat with an anesthetic so you won’t even feel the endoscope going down. The process of slipping the endoscope down your throat is pretty fast. The test won’t even take more than an average of 20 minutes. Some patients report a feeling of mild discomfort or a gagging sensation, but the anesthetic usually prevents this.

She will probably give you something to swallow during this procedure. She will have you slightly change positions so that she can give you visual feedback on the problem. Her diagnosis is pretty fast after this procedure. You’ll likely know within the same appointment what the problem is.

Voice issues and diagnostics

As far as diagnosing voice and vocal issues, there are a variety of approaches that Amy will use to determine the origin of the issue you face. Here are just a few of the diagnostics that could make up the plan to discern the problem and develop a treatment plan:

  • Digital Strobe Voice Analyzer – this is where you speak into a microphone, and your voice then gets measured for different types of data we gather. 
  • Video stroboscopic evaluation – this is a painless endoscopic procedure that lets Amy look at your vocal cords from the inside and take a look at their motion and vibration when you speak. First, she will spray a numbing antiseptic in your nose and throat so you will not feel the scope. Then, she will insert the flexible scope through your nose and down to your vocal cords. That way, she can use the camera’s rapidly flashing light to see your vocal cords opening and closing in slow motion while you make different sounds as she instructs. The procedure only takes about a half-hour from start to finish, and it’s done right here in our offices. Patients sometimes report that the scope feels “weird,” but you won’t experience any pain because of the numbing antiseptic we use before the procedure.

So we’ve learned that I have a swallowing problem or a voice issue. So what’s next?

So with voice issues, we usually prescribe what we call “voice treatments.” When practiced enough over time, these are exercises that teach you to become aware of your vocal production. You can then exercise different ways of speaking to help your voice issue become minimized and eventually go away.

In much the same way as an athlete works out different muscle groups to excel at their sport of choice, you’ll actually be working out your larynx in the same kind of way! The duration and types of exercises will vary by patient and also from the kind of diagnosis you receive from the diagnostic procedures by which you were evaluated. Your result will be an improved way of “voicing” that doesn’t strain or cause undue stress on the vocal cords. 

Swallowing issues are treated based upon our findings from the FEES procedure you underwent. There could be a variety of different types of treatments for swallowing issues. For example, there might just be some foods that are triggering your swallowing problems and should be avoided in the future. Or maybe you’ll need to learn to position yourself differently while eating to prevent your swallowing issues. You may even need to avoid liquids with a certain thickness. There are many other potential remedies Amy might prescribe to assist you in overcoming your swallowing issues.

So now you know. Your swallowing and vocal issues don’t have to be a big, scary deal. With some simple diagnostic tests, evaluations from Amy and Dr. Davis, and prescribed treatments and exercises, you’ll have your swallowing and vocal issues resolved in no time at all!

Schedule a swallowing or vocal evaluation at Excel ENT of Alabama

Don’t put off making an appointment with ExcelENT’s Speech-Language Pathologist Amy Pittman if you are experiencing swallowing or voice problems. Together with Dr. Christopher Davis, Amy can diagnose your issue and get you back to normal in no time. Click here to schedule an appointment online, or call one of our caring office staff to discuss coming in at a time that’s best for you: 205-988-6858. 

We are centrally located in the Birmingham market in Vestavia Hills, and we treat all types of issues dealing with the ear, nose, and throat. Patients rave about our results, and our compassionate clinical staff will resolve your problems with the utmost care and professionalism. Reach out to us today! 

Buying the perfect hearing aids: things you never thought about asking

hearing aids fitted by the audiologist at Excel ENT of Alabama

Hearing Aids


You’ve resigned yourself to the fact that it’s time to get a hearing aid. You’re tired of having to turn captions on the TV so you can “hear” what they’re saying. You’re embarrassed to keep saying “what?” every time someone asks you a question. Hearing someone through their mask is almost impossible, as is listening to a conversation when there is any background noise at all.

So, congratulations on your decision to improve the quality of your life with a hearing aid! The only regret you’re going to have is that you didn’t choose to do it sooner. 

But when purchasing a hearing aid, where in the world do you even start? There are so many different decisions to be made, so many other brands to buy, and so many various features to consider. Will people be able to notice you have a hearing aid in? Will it have Bluetooth features that allow you to answer phone calls and listen to music through it too? Or do they make hearing aids with none of those newfangled things on them – just a simple hearing device?

Of course, our team at Excel ENT, including our audiologist, Dr. Helen Lee Miles, is here to help you make the right choice when it comes to the hearing aid that best suits your lifestyle and needs. 

We understand you probably don’t know what you don’t know. That’s why we’ve created a primer for you that outlines all the things you’ll need to consider when purchasing a hearing aid. Of course, we’ll be right with you every step of the way to evaluate what’s important to you and help you make the best selection. 

Are you a technology geek? You’ll be blown away at what some hearing aids can do.

Hearing aids these days are much more than just devices that allow for better speech understanding. You can do so many more things than you ever imagined with a variety of brands.  

Look for technology options such as:

  1. Listening to music through your mobile phone. The hearing aid in this scenario becomes like wireless headphones! 
  2. Many also allow you to make hands-free phone calls right from your hearing aids.
  3. Several of our hearing aid options allow you to stream crystal-clear stereo sound from the television directly to your ears — some allow this feature from up to 23 feet away!
  4. Many hearing aids come with apps that work from your mobile devices, allowing you to get real-time hearing aid adjustment in real-life environments (like restaurants, meetings, work, and school.)

Who knew, right? There are so many options to choose from, and Dr. Miles will help you choose the hearing aid that is best for your needs.

Your Hearing Aid Fitting

To ensure a proper fit for your hearing device, Dr. Miles will take measurements of your ear to determine the correct size for the in-ear receiver. She will use your audiogram (results from your hearing test) to assist in programming your hearing aids.

Once you try on your hearing aid, Dr. Miles will check for a good acoustic and physical fit. While speaking with Dr. Miles and testing out the sound, she will fine-tune the hearing aids. Her goal is to ensure that patients hear speech appropriately based on their hearing loss and are perceiving it well at a comfortable volume.

Get a 30-day hearing aid trial today from ExcelENT of Alabama in Birmingham, AL

During each week of your 30-day trial, you’ll come back to visit with Dr. Miles for a hearing aid tuning. Throughout your trial, you can test out each device to determine which is the perfect fit for your lifestyle and hearing needs.

If you’re looking for a new hearing aid, don’t put off making an appointment. We can conduct testing and get you fitted with a hearing aid that meets your exact desires and goals. 

Click here to schedule an appointment online, or call one of our caring office staff to discuss coming in at a time that’s best for you: 205-988-6858. 

We are centrally located in the Birmingham market and we treat all types of issues dealing with the ear, nose, and throat. Patients rave about our results, and our compassionate clinical staff will resolve your problems with the utmost care and professionalism. Reach out to us today!