### BLOCKED SINUS ###

Sinusitis to our knowledge is very common for most people. Even though being such a common problem it tends to cause too much trouble. There are three types of sinusitis which affects our life Acute, Subacute and Chronic. Sinusitis is an inflammation of the sinus membrane which can either be infectious or non-infectious.

Sinusitis means that sinuses get affected due to infection of sinuses. This inflammation affects the sinuses which block the air passage causing pain around your eyes and forehead. The reasons can also be viral, bacterial, fungal as well as allergic reactions.

As there is a direct connection between the nose and the sinus, it gives out signs in the form of stuffy nose and constant watering from the nose. This case of stuffy nose and pain in your forehead can get serious very easily and can complicate matters for you. Such kind of sinus infections causes breakdown in the functioning of your bodily functions.

Sinuses help in providing proper insulation of the skull which reduces its weight, letting the voice to resonate within it. To disallow any foreign bacteria sinuses has a able defense mechanism. When this mechanism fails bacteria present in nasal passage enters the sinuses causing sinus infection.

Some of the common sinuses which are affected by infection are

- Frontal Sinuses (pain in the forehead)

- Maxillary Sinuses (pain behind the cheek bones)

- Ethmoid Sinuses (pain between the eyes)

- Sphenoid Sinuses (pain behind the eyes)

Some of the common reasons which can increase your chances of sinusitis

- Smoking

- Swimming

- Diving

- Alcohol

- Pets

Some precautions to be taken

- While blowing your nose, do it gently

- Stay away from people who are already suffering from cold or other allergies

- When suffering from cold it becomes essential to have a good night’s sleep

- Keep removing the yellow mucus because, the more it stays in your body the more it causes problem

Some remedies when under a sinus attack

- Drink hot tea or soup to open the nasal passage

- Take hot compresses for your sinus area

- Good amount of rest and relaxation is very necessary

- Take hot showers

- Minimize consumption of dairy products

- Maintain a good hygiene which would avoid any formation of bacteria or fungal infection

- Be away from extreme temperatures

- Avoid polluted areas and keep your home moist by the use of humidifiers

- Check up with your doctor and get treated for the cold

- Paste of dry ginger with little water or milk when applied on the forehead may provide relief

- Make a paste of 10-15 Basil leaves with 4 cloves and 1 tsp dried ginger. Apply this paste on the forehead for relief



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Nasal Attraction

By Jullene Du Toit

South African Dr Pieter Swanepoel is one of the top five nose surgeons in the world. He has pioneered the next great step forward in nose jobs in South Africa.

A kindly aunt of mine once offered me a nose job. “Unfortunately you’ve inherited the Du Toit beak,” she said briskly. “And you know that noses only get longer the older you get. I’ve just come into a bit of money, so if you ever have the urge…”

I spared a wistful thought for my aunt while sitting under twin spotlights, every bump obvious on the computer screen showing my image from a digital camera.

Now, as you can see,” said Dr Pieter Swanepoel, wielding a pen-shaped mouse and special pad, “your nostrils are not symmetrical, and the tip is maybe too pointy. If we just smooth this part here…”

I blinked as the tip of my nose waggled on the computer screen and Dr Swanepoel started doing a virtual resculpting, shortening it, smoothing it and lifting it up ever so lightly at the end. Rather nice, I thought, gazing at the colour print-outs at the end of the session.

The Nose Clinic in Pretoria East is tucked into a sprawling property of indigenous bush, completely private and hidden from the road. It is one of the best in the world, so highly respected that Dr Swanepoel is to present a paper on his method of using local anaesthetic to the American Academy of Facial Plastic and Reconstructive Surgery in New York later this year.

He has pioneered the next step forward in rhinoplasty – painless, quick-healing, and much less stressful to the body than going under general anaesthetic.

It’s a technique known as ‘conscious sedation’ or ‘regional sensory nerve blocking’. A special computer linked to a microneedle measures and injects tiny quantities of anaesthetic under the skin – a gentle, painless procedure. You have the op in the morning, are conscious throughout, and in the afternoon someone can take your woozy self home to sleep it off. In ten days or so all the bruising and swelling is gone and you have yourself a beautiful new nose, and chin too, if that’s needed.

Dr Swanepoel is one of seven surgeons worldwide testing the procedure, and is the only one using local anaesthetic for nose and reconstructive surgery.

Then of course, there’s the specially designed American software that allowed him to tweak my nose into something of beauty. It’s only used by one other plastic surgeon in South Africa. All the rest, I’m afraid, are still sketching noses onto photographs and drawings.

Rhinoplasty, according to the good doctor, is the surgery of minutiae of millimetres. Tiny changes make big differences. You change an imperfect nose, and suddenly the face looks different.

“That’s because the human eye always focuses first on imperfections. The nose is the centre focus of the face, the fulcrum, so to speak. You cannot hide it with clothes or hair. Once a defect is rectified, the attention goes to the strongest part of the face, usually the eyes. In fact the Americans have a saying: A good rhinoplasty is seen in the eyes.”

That’s why it fascinates him so much. Dr Swanepoel has super-specialised in this niche, from qualifying as an ear, nose and throat specialist. But within this very narrow specialisation, he does a wide variety of work. Apart from the plastic surgery, he also does reconstruction for those who have had accidents or some kind of trauma, and functional surgery for people with blocked sinuses or deformities. The three can also be combined. “It’s very challenging surgery – demanding, exacting and variable.”

It’s also half art, half technique and technology, says Dr Swanepoel. Like many plastic surgeons, he’s an artist too, and sculpts in clay, sometimes working with it to figure out how he’ll operate on a particular patient.

Plastic surgery is not the cure-all though, and patient and doctor need to know the limits. Michael Jackson’s first nose job was very good, “an excellent result”, says Dr Swanepoel. But Jackson wanted it perfect. “I always say perfection is the enemy of good, and now he’s gone well over the peak of the bell curve. As my uncle used to say, the worst disease a surgeon can suffer from is itchy fingers.”

It was his uncles who inspired him to become a surgeon when Dr Swanepoel was growing up on a farm between the tiny towns of Koster and Ventersdorp. “It seemed like magic to me that they could hear people’s hearts with a stethoscope, and that they could heal people. They’d sometimes throw a white cloth over my parent’s kitchen table, and operate on emergency cases like appendix or even Caesarians. I would hide underneath and peep at what was going on.

“One day, I’ll never forget. They caught me there, and my dad was going to take me out, but his eldest brother who was very stern, looked at me and said: “No, let him stay. Who knows, maybe one day he’ll become a doctor too.”

I darted discreet looks at Dr Swanepoel’s less than beautiful schnozz. Would he ever have his done, I asked. “Well, I know it needs some work,” he mused fingering it. “But there’s no one in this country I’d lie down for. There are maybe two in the States I’d consider, but otherwise no,” he said, eyes twinkling.

Did you know?

- Nose surgery began about 3 000 years ago, in response to the lopping off of noses in battle, or in India, because of infidelity. Surgeons would graft rolld up skin from the forehead onto the gaping wound.

- Noses have 240 anatomical variations.

- Twenty years ago, a nose job would have cost the same as a small house. Now they’ll set you back about R12 000.

- Before an operation, avoid pain pills, curries, chillies and arnica. They all thin the blood and cause excessive bleeding and bruising. Arnica should only be used afterwards.

For more information on The Nose Clinic, visit www.newnose.co.za or call

(012)807-1147



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Snoring is the noise produced during sleep by vibrations of the soft tissues at the back of your nose and throat. The noise is created by turbulent flow of air through narrowed air passages.

In general and in most cases, snoring has no medical significance unless it keeps you or others from sleeping. However, a more serious problem related to snoring can occur when those same soft tissues block the air passages at the back of the throat while you are sleeping. This interferes with the ability to breathe. This condition is obstructive sleep apnea (OSA), and it can directly affect your health.

The prevalence of obstructive sleep apnea increases with age. In people aged 30 60 years, 2% of all women and 4% of all men have OSA. Up to 60% of the elderly have the condition.

Most people diagnosed with obstructive sleep apnea are obese. Increased neck fat is thought to narrow the airway, making breathing more difficult.

Men are 7-10 times more likely to have obstructive sleep apnea than women. More African Americans have OSA than do whites.

Most people with obstructive sleep apnea are older than 40 years. Weight gain and a decrease in muscle tone occur with aging, and these may play a role in increasing the incidence of OSA.

Sleep apnea is more common in postmenopausal women. Family history and genetics play a role. Polio and muscular dystrophy increase the chance of obstructive sleep apnea, as do other medical conditions such as sinus infections, allergies, colds and nasal tumors, and hypothyroidism (underactive thyroid gland).

Obstructive sleep apnea is an extreme form of snoring in which your upper airway closes while you are asleep, causing an obstruction that prevents you from breathing for a brief period.

The soft tissues of the throat, your soft palate, and the tongue collapse onto the back wall of the upper airway, forming a blockage that prevents air from entering your lungs.

The negative pressure of inhaling pulls harder on your soft tissues, sealing the airway even more tightly. To breathe and get air to your lungs, you must awaken or arouse slightly and create tension in your muscles including the tongue and throat and open the airway.

This process causes a distinctive snorting, startling, and awaking pattern. If you have sleep apnea, you begin snoring, then stop breathing for at least 10 seconds (apnea). The apnea temporarily quiets the snoring, after which you awaken with a large snort. This pattern occurs in 95% of people with sleep apnea.

Each cycle of blockage (apnea) and awakening can last from 20 seconds to 3 minutes, repeating many times throughout the night. Five episodes per hour per night are common. More than 15 episodes per hour per night are the criteria used to diagnosis the condition referred to as sleep apnea.

Some snorers can have anywhere from 100-600 episodes or cycles of sleeping and waking per night. Although people with sleep apnea may be completely unaware of this repeating sleep-snore-apnea-wake pattern, it is very disruptive to normal sleep patterns. Usually, it is the bed partner who is most aware of the condition. Relationships, along with school and job performance, often suffer because of persistent daytime fatigue that develops as a result of continuously disrupted sleep.

Characteristics of obstructive sleep apnea: Movement in the bed when you wake and change position to breathe more easily, excessive daytime sleepiness with napping that often does not fully rest you, mood changes such as anxiety and irritability, and decreased sexual drive and depression.

The repeated cycles of snoring, apnea, and waking that characterize OSA can lead to adverse physical changes and complications such as high blood pressure, coronary artery disease, heart attacks, strokes, pulmonary hypertension, confusion, loss of memory, or psychiatric disorders and impotence.

If you or someone close to you is not sleeping well because of snoring or sleep apnea, visiting your doctor may be helpful. This should be by appointment, because these are not emergency cases and sometimes extra time is scheduled for the evaluation.

A doctor’s visit may be particularly important if you are falling asleep during normal waking hours, becoming irritable, losing concentration, or becoming depressed.

Many remedies are available over-the-counter in drug stores, but most do not help correct snoring or sleep apnea.

Because you tend to snore more when sleeping on your back, one useful technique is to try to keep from sleeping in that position. One way is to wear a pocket T-shirt backward with a tennis ball in the pocket. You will be less likely to sleep on your back because it is very uncomfortable to sleep on a tennis ball.

Try losing some weight. As little as 10 pounds might make the difference. Avoid alcohol, especially in the 4 hours before going to sleep. Avoid using sedatives and narcotic medications. Alcohol, sedatives, and narcotics cause relaxation of your throat muscles and increase the tendency for airway obstruction related to snoring.



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Sinus headache can be an annoying problem that patients suffer from on an almost yearly basis. The change in seasons, often times from warm to cold, can very easily bring about a sinus headache. Sinus headache typically forms when the small cavity behind the nose becomes filled with excess mucus, putting too much pressure in that area. This can present as a feeling of pressure around the nose and eyes. This pressure can sometimes become very painful and uncomfortable. The prelude to a sinus headache is sometimes a stuffed up nose or severe congestion. If a cold or congestion extends for a prolonged period, it can very easily develop a sinus headache.

 

Prompt treatment of congestion and colds can easily prevent a sinus headache. Decongestants and nasal sprays are an effective way to prevent the attack of a sinus headache. Whenever a cold or congestion initially strikes, be sure to treat those symptoms with decongestants. A dry climate can also promote sinus headaches, so a humidifier can be a good solution as well. Sinus headaches normally develop as a result of pressure building up behind the nasal cavity that is not promptly released.

 

The problem can become painful if the mucus in the nasal cavity becomes infected by bacteria or a virus. Prolonged colds and congestion can easily lead to an infection. When bacteria infects the nasal cavity, it can prompt increased swelling. Significant pain when sneezing or blowing, in addition to a fever, are strong signs of an infection. It is important to treat such infections promptly. Sinus headache can reach painful proportions if left untreated for a significant period of time. See a doctor promptly, and they will typically prescribe both antibiotics and decongestants to rid the patient of the problem.

 

It is important to treat infections quickly. If left alone, sinus headache can become a life threatening infection. Sinus headache can be brought under control with the use of medication. The earlier the problem is caught, the more effective the treatment can be. Ignored sinus headache can develop into serious infections that are difficult to get rid of and very uncomfortable. In severe cases, it may be necessary to block off the sinus cavity to prevent a repeat of the problem.

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The word neti is and abbreviation of the sankskrit word Jala neti which means “water cleansing”. Though the technique has been unknown in the West until recently, Indian Yogi’s have been performing the procedure for thousands of years as a pert of their daily cleansing ritual.

The concept is really simple. You simply fill the neti Pot with warm salt water and poor it in one nostril until it comes out of the other one. This basically clears out all of that nasty stuff up there and prevents bacteria from having a pool party in your sinuses. Though the concept is simple, the actual technique and preparation does require a little practice. You should always use salt water for the best results. I personally opt to buy the refills, but you can make your own mixture if you run out of the refill packets. Non-iodized salt is best and the mixture should be at a ratio of approximately 1 1/2 teaspoons per liter of warm water. One advantage with the pre-mixed packets, is that they are able to have a higher saline content since special buffering agents prevent discomfort to the nasal cavity. The water should be as close to body temperature as you can get it without being too hot. If the temperature is too cold, you will fell like you are drowning in the ocean.

After stirring the mixture thoroughly, lean over a sink and tilt your head down and slightly to one side. You then place the spot of the neti pot in the nostril, establishing as tight of a seal as possible, and raise the pot slightly allowing the water to flow slowly into the nasal passage. Continue to breathe normally through your mouth. If you are positioned correctly, you should feel the water going from one side to the other until you have a steady stream flowing out of the nostril.

It took me about three attempts before I felt that I was doing it correctly, so don’t get too discouraged if it doesn’t go well the first few times. Also, if you have a lot of blockage then you may have to switch from side to side several times blowing your nose in between flushes. I recommend using just half a packet starting out, and one full pot for both nostrils. After a few weeks, you can do a full pot for each nostril for the maximum effect.

So far, I have been using the neti pot nightly for about 6 weeks and I have not had any of the usual sinus problems that have plagued me constantly for the last two years. It has also alleviated my snoring, since I am no longer struggling to breathe at night.



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