Those who have visited the Waterfront Botanical Gardens in Louisville, KY will tell you the various floral fragrances please one's senses as much as the vivid colors of the countless flowers and plants gathered from around the world. If you suffer from sinus trouble, however, the experience isn't nearly as pleasurable. In fact, it could be irritating. For those with chronic sinus issues, Functional Endoscopic Sinus Surgery (FESS) might be the solution to helping you breathe freely at last.

A minimally invasive procedure, FESS frees the sinus passages from infection and inflammation so that your olfactory system can function properly. The treatment is typically performed on an outpatient basis, with only minor discomfort, and presents less risk of post-operative complications than traditional sinus surgery. How is the procedure done? Why is it effective? Which patients would most benefit from undergoing treatment? What are the risks? What do sinuses actually do? Let us answer these questions and more for you.

What Are the Sinuses and What Is Their Purpose?
The sinuses are four cavities in the head, connected to the nose by narrow passages. The lower pair of sinuses are positioned, one each, to either side of the nose. The other pair is located above the eyes, in the furrow of the brow. All four sinuses produce mucus designed to clean the nose of dirt and bacteria. The mucus is delivered to the nose through the sinus passages, where it performs its function until you reach for a tissue.

What Is Acute Sinusitis?
Acute sinusitis occurs when inflammation causes the sinus passages to swell. Mucus then accumulates in the narrowed channels, making it difficult to breathe. When too much mucus accumulates in the sinus passages, the overflow drains into the throat rather than the nose. Meanwhile, the patient will experience tenderness and pressure around the cheeks, nose, eyes, and forehead, often resulting in pain and headaches. The pain tends to heighten when bending over.

Most often caused by the common cold, but also by allergies, immune disorders, cystic fibrosis, smoke inhalation, and nasal polyps or tumors, acute sinusitis is usually a temporary condition not requiring a doctor's attention. It can be treated with home and over-the-counter remedies which are usually effective within ten days. However, when acute sinusitis persists for more than twelve weeks despite self-treatment, it can be classified as chronic sinusitis, and a doctor should be consulted.

Is the Air Quality in Louisville, KY likely to Cause Acute or Chronic Sinusitis?
Actually, the air quality index in the Louisville, KY area tends to be an order of magnitude higher than the World Health Organization's recommended guidelines. The average person shouldn't be concerned about contracting sinusitis simply by going outside. Allergy sufferers are more susceptible to seasonal sinusitis, however, due to the circulation of natural pollens.

Which Patients Are Candidates for Functional Endoscopic Sinus Surgery?
Surgery is typically recommended for patients with recurrent acute sinusitis or chronic infective sinusitis. Even though FESS is minimally invasive, causes far less discomfort, and requires less intensive post-operative care, it should still be the last resort for treating recurrent or chronic forms of sinusitis, after treatments such as nasal steroid sprays, antihistamines, and antibiotics have failed to eradicate the infection. In especially severe cases where sinus infection has spread to the eyes, more conventional surgery is preferred to FESS.

What Is Functional Endoscopic Sinus Surgery?
As mentioned, the surgery is a minimally invasive procedure most often performed in a doctor's office with no need for a hospital stay. The surgeon uses fiber-optic endoscopes to both diagnose and treat the patient's condition. Using sound waves and X-ray technology, the fiber-optics transmit a Computed Tomographic (CT) image, allowing the physician to view the patient's sinus passages, determine the location(s), extent, and possible anatomical causes of the condition.

In addition, the CT scan allows the surgeon to map out the patient's sinus cavities in relation to other cranial anatomy in preparation for the actual surgery. The procedure itself widens the sinus passages, allowing for greater ventilation. If necessary, the maxillary ostium (the gateway from the sinus to the sinus passage) is also widened. When the procedure is complete, the widened passages allow mucus to pass freely, relieving pressure and pain on the surrounding areas.

What Does Post-Operative Treatment Entail?
Following FESS, the patient's greatest concern is preventing a buildup of crusty materials in the nasal and sinus passages. The simplest treatment is a nasal douche, accomplished by spraying a saline solution into the nostrils. Patients should do this several times daily, at home or work. When self-treatment isn't sufficient, two or three weekly visits to the doctor for a more thorough nasal cleaning may be necessary. In either case, the estimated recovery time is typically one to two months.

For patients who suffer from more severe inflammation, prescription medication might be in order. A short course combining antibiotics and steroids typically speeds up the recovery process. When polyps or tumors were removed, the physician may prescribe topical steroids.

What Is the Success Rate for a FESS Procedure?
Studies show Functional Endoscopic Sinus Surgery is very effective, with success rates in the 80-90% range for patients undergoing surgery for the first time. Excellent rates are also reported for patients who have had previous surgeries. A successful procedure relieves the majority of the patient's symptoms. Sinus congestion and facial pain should quickly be relieved, but post nasal drip can sometimes persist.

What Are the Risks of Complications Following Surgery?
Due to FESS' minimally invasive nature, the risks of postoperative complications are extremely low. Cerebrospinal fluid leakage is the most frequently reported complication, usually detected during surgery, and easily repaired. Such leaks have occurred in 0.2% of surgeries, or one in 500. Blocked tear ducts and orbital hematoma are also infrequent occurrences. The most severe complication, damage to the optic nerve resulting in blindness, is extremely rare.

It should be noted that all of these complications are not exclusive to endoscopic procedures for chronic sinusitis. Each is a long-standing risk inherent in conventional sinus surgery, as well, and occurs with greater frequency in more invasive surgeries.

Why Is FESS Preferable to More Conventional Sinus Surgeries?
The major advantage to endoscopic surgery is its less-invasive nature. Before FESS, the considered opinion was that chronic sinusitis was irreversible and that the affected linings in sinus passages had to be removed. These surgeries were much more painful and resulted in significant bruising and discomfort, as well as scarring. Endoscopic outpatient treatment offers a significantly lower risk of permanent damage and a much greater promise of full, pain-free functionality.

Treatment for paranasal sinus conditions was greatly enhanced with the development of fiber-optic endoscopes and Computed Tomographic (CT) scanning. As a less invasive method with a lower risk of complications and more rapid recovery times than conventional surgeries, Functional Endoscopic Sinus Surgery is a treatment that restores normal sinus ventilation and function with minimal discomfort and time lost from work or the routines of everyday life. For patients who suffer from chronic sinusitis, it is frequently the best treatment option.

Dr. Thomas Higgins is a board-certified otolaryngologist practicing in Louisville, KY. An fellow of the American Rhinologic Society and Clinical Associate Professor at the University of Louisville School of Medicine, Dr. Higgins specializes in complex sinus disease. For a consultation, contact Higgins Sinus or visit one of our three practice centers in Louisville and Jeffersonville, IN.

​Thomas S. Higgins, MD, MSPH
Dad. Husband. Sinus Nerd.
​

Happy Thanksgiving from Dr. Thomas Higgins and his dedicated staff!

We're here to tell you, "Don't get stuffing'd up!"

Nasal polyps can cause severe nasal congestion and loss of smell. Associated with asthma, having several sinus infections, or having allergies that affect your airways, anyone can suffer from this inflammatory condition. Dr. Thomas Higgins in Louisville, KY, can offer effective treatments for this condition.

But is addressing the problem really necessary or can your polyps be left untreated? Will they go away on their own? In most cases, treatment is highly recommended because larger polyps can cause many serious issues such as breathing problems, sleep disturbance, a loss of your senses of smell and taste, and recurring sinus infections. Today, let's examine what symptoms you might experience if you don't get your polyps reduced or removed.

Do Nasal Polyps Need to Be Treated? 

Polyps are small, soft growths that can occur on their own or in small groups, and they might not cause a big issue at first, especially if they are small. Fortunately, they are usually non-cancerous, so polyps are not a life-threatening issue for the vast majority of patients.

Despite this, they can cause significant issues once they grow to a certain size. For example, you might have trouble breathing during the day or at night, you might not smell and taste as well as before, and you could get more frequent sinus infections. What's more, polyps are unlikely to go away spontaneously without treatment. For this reason, you should always visit a specialist when you've been diagnosed with this condition.

Breathing Problems 
There are several reasons why patients might experience breathing problems, such as allergies, blocked sinuses, and being overweight. However, many of these issues are temporary and can be addressed holistically, while shortness of breath due to polyps is a permanent problem unless they are removed.

As the growths expand in your nasal passages, they block the airflow, thereby causing breathing trouble. When you visit your doctor because of this issue, they might recommend treatment that reduces the size of the polyp or eliminates it entirely.

Sleep Apnea
Obstructive sleep apnea happens when you temporarily stop breathing during the night because your airways are closed off by soft tissues. As a result, you might snore more, and you'll feel more tired during the day because you didn't rest properly at night. Some patients also report a morning headache, irritability, and difficulty paying attention.

In the long run, this condition shouldn't be taken lightly because it can cause significant issues such as heart trouble. Since your body doesn't get enough oxygen during the night, your blood pressure is increased and strain is put on your heart. What's more, you might no longer be eligible for certain types of surgery, since the inability to breathe can cause complications.

While nasal polyps are not usually the main cause of sleep apnea, the nasal blockage worsens sleep apnea symptoms and can make it difficult to use a CPAP. A recent treatment called Inspire Sleep is helping sleep apnea patients without the need for CPAP. (Contact us to learn more.)

Loss of Your Senses of Smell and Taste
As we grow older, it's natural that we have a reduced sense of smell and taste. If you know you have polyps and you've experienced a sudden drop in the sensitivity of your nose or taste buds, this condition might be to blame. You should visit us when this happens because, unlike many other conditions related to these senses, polyps can often still be treated and you can regain your full sense of smell and taste.

Recurring Sinus Infections 
Finally, you will also notice that you're more susceptible to sinus infections when you have large, untreated polyps in your nose. These can be very unpleasant because they include symptoms of the common cold such as fever, mucous discharge coming from the nose, and a blocked nose, but also headaches, toothache, and bad breath.

Having sinusitis on a regular basis can significantly affect your life, as you may not be able to complete all of your regular tasks well. You'll feel fatigued from the constant infection, which can affect your performance at work and your ability to participate in leisure activities.

What Are the Initial Symptoms of Polyps?

Now that you know why you shouldn't leave nasal polyps untreated for a long time, you might wonder whether there are any early signs that can indicate an issue. Although some of the symptoms that indicate polyps can be similar to those of sinusitis or the common cold, you'll know that it's a persistent problem when they don't disappear after two to three weeks.

If you suffer from a runny nose and stuffiness, postnasal drip, a loss of your senses of smell and taste, and pain in several areas of the face and teeth, you should speak to a specialist in your local Louisville, KY area, who can determine whether polyps are the cause.

A Runny Nose and Stuffiness
When your polyps start to grow and obstruct your nasal passages, they will trap some of the mucus your body produces to flush out waste products. It will be harder for you to get rid of the mucus by blowing your nose, so you will suffer from increased stuffiness. Additionally, the passages in your nose are more likely to get inflamed, and you might suffer from frequent sinus infections.

People who have polyps often feel like they have a persistent cold. If you notice that you've had a blocked nose for several weeks, it might be time to see a specialist and find out whether a polyp is causing the issue.

Postnasal Drip
A postnasal drip happens when your mucus runs down the back of your throat instead of coming out of your nose. When this occurs, you will want to clear your throat constantly, and you might cough more than usual. Many patients also develop a sore or scratchy throat over time. A postnasal drip shouldn't be ignored because it can cause an ear infection when your mucus clogs up your Eustachian tube.

Pain in the Face or Teeth
Not everyone who has polyps experiences pain, but if your nasal passages are crowded by a large number of small polyps or by one very large growth, you might start to experience pressure in the area. This can feel like a headache or a toothache, but if there are no indications of dental trouble and your symptoms don't match up with those of a migraine, a polyp could be behind the issue.

What Does Polyp Treatment in Louisville, KY Involve?

​When you come to the clinic and speak to Dr. Higgins about your polyps, he will suggest a treatment method that fits your current needs. Some polyps can be removed with the help of drugs. If this doesn't work, he can perform an endoscopic polyp removal procedure. Functional endoscopic sinus surgery, also called FESS, works almost immediately, and your symptoms should disappear as soon as the procedure is over. 

Nasal polyps should almost always be treated because they can cause significant issues such as breathing trouble, obstructive sleep apnea, a loss of your senses of smell and taste, and more frequent sinus infections. If you have been diagnosed with polyps, you should seek out a specialist who can help you to address the issue.

Schedule an appointment with us at Higgins Sinus in Louisville, KY to book an initial consultation and find out more about polyp treatment. Dr. Thomas Higgins will evaluate your situation carefully and suggest the least invasive treatment method possible. That way, you can prevent long-term issues and get back to normal as soon as possible.

What Happens During a Septoplasty?
During this procedure, your nasal septum will be trimmed if it is too wide. Then, your cartilage and bone will be repositioned. Depending on whether you were born with a deviated septum or developed one recently, we may also replace some of the cartilage and bone. If the structural damage to your septum is along your nose's bridge, we will graft extra cartilage from another part of your body and reinforce the cartilage currently supporting your septum.

Is This Procedure Painful? 
Not really, patients often comment how little pain or discomfort they experience after this procedure. The procedure is usually performed under general anesthesia. It may be administered intravenously or it may be inhaled. Depending on the scope of your procedure, your health, and your personal preference, you may only require local anesthesia. 

General anesthesia is ideal for many procedures because it numbs the entire body and puts you to sleep so you will not feel anxious during your procedure. Local anesthesia is administered into your nasal tissues via injection and numbs only the nose. If you would like to be sedated during your procedure, this will be done intravenously, but you will still be conscious. The intravenous sedation will only make you feel groggy.

How Should I Prepare for My Procedure?
There are several very important things you must do in preparation for your procedure. One of the most important things you can do pre-op is to stop smoking and drinking alcohol. It is so important to refrain from consuming alcohol and tobacco products because these products contain chemicals that elevate your blood pressure. Elevated blood pressure may affect your procedure and will slow down your recovery significantly.

Another very important thing you must do to prepare for your procedure is to ensure you are hydrated. The more hydrated you are, the smoother your procedure and recovery will go. Other important preparation steps include not taking NSAIDs, not taking fish oil supplements, and not taking garlic supplements. These drugs and supplements will thin your blood and may affect your procedure.

Will I Have to Fast Before My Procedure? 
We will advise you on whether you need to fast before your procedure during your initial consultation. If you are only receiving local anesthesia, there will be no need to fast.

However, if you have general anesthesia, you must refrain from eating or drinking during the eight hours leading up to the time you are scheduled to arrive at our office. Note, you may drink clear liquids, like water up to two hours before your scheduled arrival time.

What Happens After This Procedure? 
Once your septum is repaired, we will use absorbable sutures to close the incisions. If your septum needs a little extra support during your recovery, we will insert a soft silicone splint into each nostril. Also, a bandage may be packed into your nose temporarily. Once all of that is done, we will move you to a recovery room and observe you for a few hours to ensure that your general anesthesia wears off enough.

What Should I Expect During My Recovery Period? 
During the first 24 to 72 hours following your procedure, you should expect to feel pretty groggy. This is a natural response to sedatives regardless of whether you receive intravenous sedation or general anesthesia. Also, you will feel tired because it takes energy for your body to heal, which is what it will be concentrating on for a few days.

How Should I Care for Myself During My Recovery Period? 
There are several things you must do to care for yourself during your recovery period. For instance, you must keep your head elevated above your head while you sleep. To accomplish this, you may want to sleep with a travel pillow under your neck, sleep with an extra pillow under your head, or sleep in a recliner. It is also highly advisable to wear dresses or button-up shirts so you don't have to pull anything over your head.

Furthermore, it is very important that you avoid strenuous activities for up to two weeks post-op. If you have a strenuous job, we will meet with you when you start to feel like your old self to determine whether it is safe for you to go back to work.

Is There Anything Else I Should Avoid Post-Op? 
Yes, there are other post-operate restrictions. For instance, it is very important that you don't blow your nose for several weeks. If your nostrils feel itchy, you can spray a saline solution into your nostrils to relieve the itching. You can make your own sterile saline solution by boiling tap water and mixing salt and baking soda into it, or you can use distilled water that doesn't need to be boiled. You can also purchase nasal spray at your favorite pharmacy.

Other things you should avoid during your recovery period include steaming hot water and foods, alcohol, spicy foods, and tobacco products. It is very important to keep your blood pressure normal while you recover.

How Long Will My Recovery Period Take? 
You will only need to take a few days off from school, or you will only need to take a few days off from work if you have a sedentary job. If you have a strenuous job, you may need to take over a week off. We will bring you in for a follow-up appointment after your procedure to assess your recovery and advise you on how much of your routine you can get back to. As for complete recovery, you will only need to wait four to eight weeks.

Am I a Good Candidate for This Procedure? 
To determine whether septoplasty is right for you, it is important that you come in for an initial consultation. During this initial consultation, we will discuss your medical history, including any other procedures or treatments you have had in the area. We will also discuss your current health to ensure you are currently healthy enough to undergo this procedure.

Septoplasty is a procedure that will improve your breathing by trimming off any excess cartilage and bone, reposition your nasal septum as necessary, and replace any damaged cartilage. To find out if this procedure is right for you, visit the office of Dr. Thomas S Higgins, MD, MSPH in Louisville, KY for an initial consultation. We look forward to meeting you and helping you improve your breathing.

Imagine breathing freely, with an improved sense of smell and far less drainage at the back of your throat. Fortunately, this scenario can exist. One of the ways we do this is with a fast and relatively easy treatment known as balloon sinuplasty. This procedure improves the drainage of the sinuses while preserving normal anatomy and mucosal tissue. And it's ideal for many patients who suffer from chronic sinusitis.

Although the reasons for chronic sinusitis can be many, it's generally related to inflammation of the tissue in the sinus cavities, making it extremely difficult to remain clear.

Balloon sinuplasty (BS) aims to restore normal sinus function and provide patients with relief from chronic sinusitis. It's a minimally invasive treatment that uses a small, flexible catheter and sinus balloon. The balloon is inflated after being inserted into the nostril and gently opens the sinus passageway. This moves the surrounding tissues, and unlike medications that merely treat symptoms, BS provides a lasting solution to chronic sinusitis. Because of the complex nature of chronic sinusitis, it is difficult to know if the results will be permanent. However, many clinical trials have shown that many patients do not require any additional procedures.

BS earned FDA approval in 2005 and has since been used to restore normal sinus function, including proper drainage, in tens of thousands of patients. The treatment can often be performed in the office without general anesthesia. It boasts an excellent safety profile and, because it doesn't cut into bone or tissue, may have fewer side effects than endoscopic sinus surgery in carefully selected patients. For instance, patients tend to have:
​

• Minimal pain after the procedure 
• Little to no blood loss
• No bruising 
• No swelling

We begin by using a small camera and inserting that balloon catheter into the nostril. The balloon is gently guided into one of the sinus cavities, allows us to gain access to the blocked sinus passageway. Once the balloon is inflated, a saline solution may be sprayed into the nostril to flush out further blockages.

​After ensuring the nasal passage is cleared, we deflate and withdraw the balloon. The entire process can usually be completed in under an hour, and patients often resume their normal activities the following day. Even the recovery is straightforward with simple methods to care for your nose and nasal passageways. For instance, you'll need to give your body enough time to recover - a minimum of 12 to 24 hours.

You'll also need to resist blowing your nose for at least 24 hours. Your tissues will need a little TLC, and blowing only serves to cause irritation. We may provide a nasal spray to use at home that will help safely rinse your passageway. Doses are typically administered every four hours, but we'll tailor treatment to meet your specific needs. Last but not least, if we provide prescription medications, it's important you follow them as directed.

Sinusitis impacts 37 million Americans every year. While medications offer relief for some people, it's not a cure-all. Many patients require additional therapy to address their symptoms, and this is where balloon sinuplasty can provide much-needed help. The treatment can be especially beneficial to Louisville, KY patients who have endured years of sinus and allergy problems.

Our staff will discuss in greater detail your candidacy for BS. Generally speaking, those with the following symptoms feel much better after treatment:

• Recurrent sinus infections
• Chronic nasal problems
• Difficulty breathing through the nose
• Weakened sense of smell

​Balloon sinuplasty is a good option for many patients. Your doctor has the experience and expertise to provide recommendations from a variety of sinus procedures, including surgery involving an endoscope and balloon sinuplasty.

In endoscopic sinus surgery, a thin camera rod with a light at the end is used to magnify sinus tissues and specialized instruments can then be used to remove blockages, including scar tissue and nasal polyps.

Multiple clinical studies confirm BS provides lasting relief from the many symptoms that accompany sinusitis. We're talking about concerns like sore throat, headache, facial pain, stuffy or runny nose, and cough. And the patient success rate associated with this treatment is around 95%.
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These same studies show BS opens sinus cavities without causing unwanted side effects like facial bruising and significant discomfort. Equally important, patients do not have to pack their noses with gauze after the treatment.

​Studies further show us that patients who undergo BS have substantial improvements to their quality of living. An analysis of 45 different studies revealed that up to 97% of all patients feel relief after treatment. They experience fewer headaches, breathe better, and enjoy improved sleep. They also lead healthier lives thanks to a reduction in recurring sinus and throat infections.

​We encourage patients to get answers to their questions before moving forward with treatment. To illustrate, many people want to better understand the exact nature of sinusitis. Let's begin by describing the sinuses, which are four paired cavities in the head. They're connected by narrow channels that help drain the mucous they create. That drainage is important - it keeps the nose clean and free of harmful bacteria.

The sinuses are normally filled with air but can become blocked. When this happens, they also fill with fluid that encourages the growth of bacteria. This leads to tissue swelling that makes breathing highly difficult.

​Earlier, we said most patients resume normal activities within one day. This includes light exercise like walking. Strenuous activities, however, should be delayed at least a week. We can discuss this more during your consultation, at which time we'll assess your condition and ask about your treatment goals.

​BS dilates sinus openings by pushing aside bones that comprise the sinus ostia. These are the openings that form drainage channels for the sinuses. By physically moving that bone, we're able to remodel the ostia and create wider openings.

​Many patients have a latex allergy that might cause them to initially question BS treatment. But the balloon used is made from a high-strength plastic free of latex. This means it can be safely used even on those with common allergies.

​BS appears to be an effective and safe way to relieve chronic sinusitis symptoms in children. Many health care providers recommend BS for children to open airways and improve breathing difficulties magnified by sinusitis. Several studies have demonstrated low rates of adverse effects.

Minimally invasive functional endoscopic sinus surgery (FESS) has been a standard of care since the 1980s. The idea with FESS is to relieve sinus obstruction and recreate the natural outflow of the sinuses. BS started after biomedical engineers reasoned that just as a surgeon can dilate a blocked artery with a balloon, the same could be done with blocked sinuses. BS evolved from this theory and has become a procedure that can be quickly performed, as an in-office treatment, and doesn't require significant downtime.

BS can provide the sinusitis relief you've been searching for. It clears nasal passages, reduces headaches, and improves quality of life. And these benefits are enjoyed without a long and arduous recovery period. Schedule your consultation today by contacting Dr. Thomas S Higgins, MD, MSPH.

The Difference Between a Pandemic and an Epidemic

Outbreaks of disease have been occurring throughout history for thousands of years. In fact, the first recorded pandemic took place in Athens, Greece, during the Peloponnesian War in 430 B.C.

A ‘pandemic’ is an outbreak of disease that has spread across several countries or continents, affecting a very wide geographical area. An ‘epidemic’, on the other hand, is an outbreak of disease that occurs within one location. While many people use the term ‘plague’ when talking about a pandemic, a plague refers to the spread of an infectious disease caused by a specific bacterium, Yersinia pestis.

A pandemic follows six key phases, as outlined by the World Health Organization:

1. A disease-causing organism (pathogen) circulates among animals. It may or may not be known to infect humans.
2. A pathogen that circulates among animals is known to cause infections in humans.
3. An animal-to-human infection has occurred but has not escalated to a community outbreak.
4. A human-to-human infection has occurred, and community-level outbreaks have been verified.
5. Community-level outbreaks have occurred in two or more countries in one WHO region.
6. A community-level outbreak has been identified in a third country, in a different WHO region. It is at this phase that a pandemic is declared.

How We Have Responded to Pandemics in the Past

Viral pandemics can spread incredibly quickly, infecting millions of people around the world. Here are some examples of how we’ve navigated them in the past.

The 1918 Influenza
Caused by an H1N1 influenza virus, the 1918 influenza was a devastating pandemic that infected an estimated one-third of the world’s population, killing approximately 20–40 million people by 1920. The flu vaccine was not developed and distributed until 1930, so control efforts were limited to non-pharmaceutical interventions, such as social distancing, quarantine, personal hygiene, and limitations on public gatherings.

The 1968 Pandemic
1968 was notable for a multitude of reasons—including manned space travel, the military conflict in Vietnam, and even innovations in heart transplant surgery—but it was also the year of the H3N2 influenza pandemic in the United States. Although the infection and mortality rate was not as high as during the 1918 pandemic, it was responsible for an estimated 100K deaths in the US. Schools were closed across at least 23 states, and ‘normal’ life was significantly disrupted, including delayed package deliveries, economic slowdown, and widespread closures.

The 2009 H1N1 Pandemic
First detected in the US in April 2009, the H1N1 pandemic is perhaps our most recent memory of a viral outbreak. Before the pandemic even reached phase 6, the CDC was recommending social distancing measures and school closures to slow the spread of the disease.

Following the 2009 H1N1 pandemic, the CDC established the Pandemic Influenza Preparedness (PIP) Framework to improve the global response to mitigating the effects of a pandemic, including providing access to resources such as vaccines and supplies.

How We Are Responding to the COVID-19 Pandemic is No Different

Although the world is no stranger to pandemics and outbreaks of disease, COVID-19 took many of us by surprise. The rapid spread and severity of symptoms brought the world to a halt—businesses and schools were closed, and we were all encouraged to social distance and isolate to slow the spread. Face masks have become a fashion statement and hand sanitizer is readily available at the entrance of public buildings.

While the rush to stockpile toilet paper was perhaps a bit out of the ordinary, it’s important to note that the way we are responding to the COVID-19 pandemic is in line with how we have handled pandemics in the past. And just like we’ve seen in our history, the way back to ‘normal’ is by getting vaccinated and following the CDC’s guidelines.

There have been more than 37 million cases of COVID-19 in the United States, with over 620 thousand deaths since March of last year. The world came to a halt in 2020 as we were urged to stay home in an effort to slow the spread of the highly contagious coronavirus. Now, halfway through 2021, hope is on the horizon: major pharmaceutical companies—such as Pfizer, BioNTech, Moderna, and Johnson & Johnson—have developed and distributed vaccines to countries around the world. Here’s what you need to know.

The Benefits of Being Vaccinated

The COVID-19 vaccine will not make you immune to the coronavirus, but it can significantly reduce the severity of symptoms if you do get sick. The vaccine may also prevent you from spreading the virus to others. The virus replicates as it spreads, increasing the risk of vaccine-resistant mutations, so it’s important that we do what we can to stop the spread.
 
At the time of writing this, more than 4.74 billion doses of the vaccination have been administered worldwide, with over 350 million doses given in the United States. Approximately 51% of people in the United States have been fully vaccinated, with around 77% of the population having received at least one dose. Health officials are aiming to reach a total of 70% of Americans fully vaccinated in an effort to achieve herd immunity, which helps protect those in our community with serious medical conditions that prevent them from being able to be vaccinated.

Is the Vaccine Safe?

​Vaccine safety has been a popular topic in recent years, with many people expressing concern and spreading misinformation regarding potential side effects or risks associated with vaccinations in general. The hurried release of the COVID-19 vaccination has led many people to question whether or not it is safe, however, it has been fully approved for emergency use by the Food & Drug Administration (FDA).
 
Healthcare professionals and government officials have gone to great lengths to assure people that the vaccine is safe for use. While vaccines—and most medications, for that matter—do carry a risk of side effects, the overall risk is quite low. For example, the Johnson & Johnson Janssen vaccine carries an increased risk of blood clots (otherwise known as thrombosis with thrombocytopenia syndrome or TTS) but this occurred in only 0.0003% of cases or 42 out of the 13 million people who received the J&J vaccine. Comparatively, the average birth control pill carries a 0.3% risk of blood clots.

Get Your Vaccination Today!

Everyone 12 years of age and older is eligible to receive a COVID-19 vaccine free of charge. Visit the CDC’s website to find a vaccination provider near you, or to learn more about the benefits of being vaccinated.
 
The case rates are climbing again, with an average of 140 thousand new cases every day over the past week. I truly believe that the way back to ‘normal’ is by getting as many people vaccinated as possible. Speak to your doctor or a trusted healthcare professional to learn more about the COVID-19 vaccine, including the risks and potential side effects. 

​One of the strangest and most frustrating symptoms of COVID-19 is anosmia, or the loss of the sense of smell. Losing your sense of smell can impact many parts of your life, including your appetite. For some people, the sense of smell returns after several days or weeks - but for others, losing the sense of smell can be a persistent issue.

​Of all the symptoms related to the COVID-19 pandemic, losing the sense of smell can be a symptom you have to deal with for several weeks or months after you are no longer testing positive for the virus. Just like losing your sense of taste, losing your sense of smell can change the way you live your life, so it's understandable to want to know when you can expect your senses to return back to normal.

The good news is that time seems to be the answer to reversing anosmia. In a French study conducted on coronavirus patients, researchers concluded that most patients regained their sense of smell after nearly a year after contracting the virus. And yet for others, regaining the sense of smell is something that returns after about two weeks of other symptoms going away.

There's a huge difference between getting your sense of smell back after a few weeks or after a year. While researchers are still trying to figure out why some patients seem to recover their sense of smell more quickly than others, new research may suggest that it has to do with the way the virus affects the cells surrounding the sensory neurons in the nose. Specifically, it has to do with how quickly the cells surrounding the sensory neuron can recover.

For years, physicians have been aware that viral infections can sometimes cause patients to lose certain senses temporarily, including the sense of smell. But because this phenomenon pre-COVID was somewhat rare, there hasn't been an opportunity for much research. Now, research studies about why anosmia happens to COVID patients and how to recover your sense of smell are constantly being conducted.

What scientists have discovered about this particular viral infection is that the virus appears to target specific cells in the body - and this includes the cells that surround sensory neurons in the nasal passage called support cells. Essentially, the virus attacks and damages these support cells, which prevents them from helping the sensory neuron send information to the brain. When the support cells are infected, you lose your ability to smell; when these cells are repaired, your sense of smell returns.

​Long-haulers are the people who had COVID symptoms for several weeks or even months. In general, long-haulers dealt with more exaggerated symptoms than others while their bodies battled the viral infection. Some research suggests that the longer you have symptoms, the longer it will take for some symptoms to go away. This seems to be particularly true for the loss of taste and smell.

Compared to people who had mild or asymptomatic infections, long-haulers seem to have more challenges returning to pre-COVID health. If you battled COVID for several weeks or months, then you may want to see a specialist to do a thorough health check or even participate in post-COVID studies.

​About 80% of patients who have COVID-19 will temporarily lose their sense of smell, and for about 5 to 10% of those patients, this symptom will continue even after patients have recovered from other symptoms and are no longer infected. And while most of those patients can regain their sense of smell after several months to a year, there are still some patients who may have a longer-lasting issue.

The trouble with regaining your sense of smell is that your sensory nerves need to be surrounded by supportive cells, otherwise the nerves die or atrophy. It's incredibly difficult for sensory neurons to repair themselves, so if you are experiencing a persistent loss of sense of smell for longer than a year, then it's possible your sense of smell may never return. That said, experts suggest that maybe patients with persistent anosmia may just need additional time for their sense of smell to return.

This is a question scientists have been trying to answer. Because the virus is thought to affect the function of the sensory nerves, research for how to regain the sense of smell after COVID is focusing on a blend of neurological research and ear, nose, throat experts. One study is working on the association between visual cues and scent to try to retrain the brain.

In this study, participants are asked to smell essential oils or other scents while looking at a picture that represents the scent. In doing so, researchers are trying to figure out if the sensory nerves can re-learn scent associations. According to some, this research is long overdue since a lot still isn't known about viral-associated anosmia. The novel coronavirus has opened new demands in research that can help shed light on how to recover from certain viral infections.

For patients who have regained or partially regained their sense of smell, one of the most hopeful signs to look out for is hints of scents. While you are trying to recover your sense of smell, you may only be able to detect very faint traces of certain scents. But this is a hopeful sign that your sensory neurons and support cells are still functional and that your sense of smell is returning, however slowly.

In the grand scheme of things, if you've survived COVID-19, then regaining your sense of smell may not be one of your top priorities, especially for long-haulers. But your sense of smell, just like any other sense, is important to lead your life safely and independently. In fact, in terms of safety, not having a sense of smell can be dangerous. If you can't smell fire, gas, or something burning without looking directly at it, then you may unknowingly be in danger.

But more than that, many patients feel nostalgic about their sense of smell. Neurologists have known for years that the olfactory senses are closely linked with memory, so the loss of smell may make it difficult to have easier memory recall. Additionally, your sense of smell and your sense of taste are closely tied, and for some people, being unable to smell food makes it difficult to have an appetite, which can negatively impact your overall health over time.

Losing your sense of smell is one of the hallmarks of the novel coronavirus. For many people, losing the sense of smell is one of the first symptoms they experience after fever and fatigue - and this symptom is, unfortunately, one that can persist even after all the other symptoms associated with the viral infection have disappeared. The good news is that time seems to be the key to regaining your sense of smell. For more up-to-date information about recovery from COVID-19, contact Dr. Thomas S Higgins, MD, MSPH at Higgins Sinus in Louisville, KY today.

Some ear conditions are ultimately related to the nose.  Once you think about the intertwined anatomy and physiology of these two body parts, it makes complete sense. The nose is connected to the ear via a functional tube called the Eustachian tube. This tube helps ventilate, drain, and maintain an equilibrium of air pressure in the middle ear. It opens in the back of the nose called the nasopharynx. If something were to block that opening, the system gets backed up, causing increased ear pressure and ear fluid.

We have known that one of the causes of ear infections or persistent middle ear fluid in kids is obstruction of the Eustachian tube from the adenoids, which are in the nasopharynx. Thus, performing an adenoidectomy is one of the treatments for chronic ear fluid in kids.

Our research group set out to see if chronic rhinosinusitis affected ear symptoms in adults and our findings were significant. We found that, in patients with chronic rhinosinusitis, ear symptoms and nose/sinus symptoms were strongly correlated.  So, those with worse sinus symptoms seemed to have worse ear symptoms.

We also looked at how sinus surgery affected ear symptoms. In this study, 80% of the patients had improvement in ear symptoms with sinus surgery alone and 60% had complete resolution (or normalization) of their ear symptoms!

So, we have found it important to ask questions about both nose and ear symptoms because treating the nose is often the answer to solving certain ear problems.