Stopping to Smell the Roses

Sharing Mayo Clinic

Stopping to Smell the Roses

By
Joel Streed

August 4, 2011

For more than a decade, Debra Testa suffered from nasal congestion and severe headaches first thing in the morning. “Even before my head came off the pillow, I would have an excruciating headache, and it was happening quite often — at least once a week if not several times a week,” says the Connecticut native.

Testa, now 52 and living in Jacksonville, Fla., visited various doctors over the years. Allergies were ruled out. She was eventually diagnosed with mild sleep apnea — doctors thought this was the cause of her headaches — and given migraine medication.

The pills seemed to help after the fact, but Testa says her quality of life was affected. She was constantly tired. The medicine caused debilitating nausea — so severe it began to impact her job. “I felt so sick that I couldn’t get into work on time. When I did come in, my productivity was affected because the medicine made me groggy, too.” On weekends, she was often unable to join her husband of 33 years on bike rides or walks they enjoyed.

Over the years, her symptoms grew worse. Her left nostril was almost completely blocked and the pain radiated through her left cheekbone and temple. “I couldn’t get any air in or out. And it was worse if I slept on the left side. I thought maybe my sinuses were triggering the headaches,” Testa says. She avoided the migraine medication as much as possible and instead took over-the-counter decongestants and other pain relievers, but the headaches prevailed.

Normal sinuses but no relief

A CT scan of her head in December 2009 showed normal sinuses. But her pain continued, so in early 2010, she saw William Bolger, M.D., an otorhinolaryngologist (ear, nose, throat specialist) at Mayo Clinic in Florida.

“Many people complain of trouble breathing through nose, nasal obstruction or post nasal drip — vague symptoms that are often equated with sinus issues,” Dr. Bolger says. “But when a person’s quality of life becomes affected, it’s important to confirm whether it’s a sinus problem or something else.”

In Testa’s case, it was something else.

Dr. Bolger confirmed Testa had a deviated septum, where the thin wall (nasal septum) inside her nose was displaced to one side. She also had enlarged turbinates, the spongy bones in the nasal passages that serve to warm inhaled air before it enters the lungs. In Testa’s case, one turbinate was so large it blocked the nasal passage and affected her breathing.

Surgery opens airway

In February 2011, Testa underwent minimally invasive surgery to resize the turbinate and open her airway.

“In the past, sinus and nasal surgery often required incisions in the scalp, face or under the gums,” Dr. Bolger says. “But now, newer techniques and advances in endoscopy allow us to go through the nostril and have more precision and control.”

This is part of a growing trend for surgeons in all areas of medicine to use minimally invasive techniques. “These advances make it so much easier on patients,” Dr. Bolgersays. “The recovery is faster and there is less pain.” Testa’s procedure was done under a brief, general anesthesia, but she was home that afternoon. “I thought it was great that he could go through my nose and do it all,” Testa says. “There was nothing invasive. It was amazing to me. He opened all my passageways so I could breathe easier.”

Today, Testa says her headaches are gone. She wakes up rested, breathing easy and enjoys early morning walks or bike trips with her husband — perhaps stopping occasionally to smell the roses.