Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Sinuses

Episode Date: February 18, 2017

Hey, but what ARE sinuses. It's OK if you don't know, Justin didn't either. Join him in a brief education from doctor Sydnee and hear about DaVinci's near miss with sinus history. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two, three, four. I'm not a sense the escalant my cop for the mouth. Hello everybody and welcome to Sobhones,

a mayoral tour of Miskite, Admedicine. I'm your co-host, Justin McRoy. And I'm Sydney McRoy. How you doing, Sydney? I'm pretty good, Justin. We've been doing a lot of pretty topical shows lately. You know, current trendy, like, really in them. Hot button.

Yeah. Now, so now. And I wanted to continue that trend. Okay. That's my whole intro. What's, well, what do we, me put me in charge of it. So, what's the trend?

What's the hot trend we're talking about? It's the sinus headache I've had for days. Okay. Everybody, I mean, and by everybody everybody I mean me, has been talking about is that I've had a headache for, I mean it's been actually five days now, five days to be fair. You've had a headache. I don't get headaches. This is very rare.

But I've had a headache every day for five days. So we're covering the breaking news story of you having had a headache. That's right. I've had a headache every day for five days. So we're covering the breaking news story of you having had a headache. That's right. I've had a headache There's been a lot of other actual news, but it makes it harder to cope with it when you have a headache is all I'm saying so Sydney has a headache. Oh, That's not gonna stop. Oh my I hooked my headphone wire on my ear. I just got stuck in my headphones in other tragic news Yeah, so yeah, it's really rough rough weekend head phone wire on my ear. I just got stuck in my head phone. In other tragic news, Justin Hook is head phone wire. Yeah, it's been really rough weekend for that family. Things are hard in the Macrioy household right now.

Okay, so you mentioned you had a sinus headache and I'm gonna ask a dumb question. It's because I know, I vaguely know, but specifically, correctly, medically, what are sinuses? Like what are your sinuses? Now, wait, Justin, because my, okay, first of all, we're going to be talking about sinuses and sinus infections and sinusitis, which are slightly different things. But before I do that, I want to thank Sarah and Alondra and Elizabeth for recommending

this topic, as well as, I guess, my own head. Right. My own sciences. My question to you to start this episode was going to be what are sinuses because I am very excited to hear what you think they are. Okay. I bet you've read ahead and you can already answer this question. I have not read ahead.

This is just cold from the gut. Right. I feel like. I'm very excited. I feel like sentences are the tubes that connect your nose to your eyes and your ears. Everything in that area, all the tubes in that area are your sinuses. The eye tubes connected to the nose tube,

the nose tubes, and do the ear tube. The eye does, you can get air from your eye. You can't shoot air out of your eyeball, eye your tear ducts. That's true, don't make fun of me. It's true, that's true. Don't make fun of me. It's true. That's true. Uh-huh.

And so what? What? Okay. You can shoot, like, you can make air come out your eyeballs. I have never made air come out of my eyeballs. You've never made air come out your eyeball. Have you ever seen somebody shoot milk out their tear ducts? No.

Well, that can happen. You can do that. And you can shoot water or air out of your two dots. I mean, out of your nose. No, not your nose, and I'm not talking about a gag from like every kid's comedy movie ever. I'm talking about milk out of your tear ducts. I'm going to show you some anatomical drawings later.

Okay, I'm going to show you a YouTube video of somebody shooting milk out of their eyeball and readers at home just, if you want this experience, search for milk out of the eye and then you can experience what Sydney is experiencing with someone shooting milk out of their eye. I can't with this, okay.

Can I get an apology from you, doctor? That's okay, that's fine. I'm sorry. I'm sorry. And I'm sorry to everybody else that right now, you're listening to a podcast where two people are watching the YouTube video of someone shooting milk out of their eye.

Can I tell you about sinuses? Yeah, it's the tubes. Well, I feel we've got a general overview of what those are. Sinuses are like holes in your head sort of. Okay. There are cavities holes in your head sort of. Okay. There are cavities inside the bones of your skull. There are open areas inside some of your skull bones, and we call them sinuses.

So they're like pockets of air. There's four paired air pockets within the maxillary frontal, ethmoid, and sphenoid bones in your skull. And then those air pockets within them are named for the bone they're in. So you're maxillary sinus, you're frontal sinus. You got it.

So it's just an open area of the body. You know that I don't know what maxillary or frontal or effinate. They're different bones in your skull. Okay. And there are pockets of air in these bones. And those are called sinuses. Okay. Got it.

Yes. They connect to your nose through little teeny passageways, to little teeny holes. Okay. Okay. Got it. Yes. They connect to your nose through little teeny passageways, little teeny holes. Okay. The word sinus, by the way, comes from a curve or a hollow in land. We've also in historically called them antroms before, which you could kind of make, you know, the antrom, like, think of an open hollowed out area. Okay. Same idea Kind of makes sense The the maxillary and etymoid sinuses that you have formed while you're still in utero so you're born with those Two of your other two sinuses your sphenoid you don't get to your about five years old and your frontal sinuses

You actually don't get to your seven or eight years old Which is where you'll hear like somebody will say well kids can't get sinusitis because they don't even have sinuses will they do they have some of them they just don't have all of them yet, okay, so But by by about seven or eight you have all of them you really can't do like the frontal one isn't completely developed You're an adolescent typically though They get bigger as your skull gets bigger. What's when you have them, like tubes in their holes? Like, why is there holes? You know, that's a great question. And we have, that's one of the things I'm going to talk about is it's taken us a really long time to get kind of a grasp on that. We had a lot

of crazy ideas. And even now we have some, some fairly good, like we, we think we have it figured out, but that's been a subject of hot debate for a long time. So they're lined with... We're a hot. Well, as hot as anatomical debate gets. They're lined with a muco-periosteum. So basically like a mucus, it's a creaks mucus. Your scientists that's a creak mucus is what I'm trying to say.

They make mucus. They're filled with air, but they secrete this mucus, and this mucus is really important. That's one of the main functions of the sinuses, is that they secrete all this mucus that is really important for all the reasons that mucus is important, which I think we've talked about before. It helps to moisturize the inside of your nasal passageways and I think it catches germs. It catches germs and particles that are floating around in the air, you know, all kinds of allergens and environmental urotents and all that kind of stuff.

So the mucus is really important and that's from the sinuses. They also help to form the shape of your face just practically. Part of the reason our faces look like they do is because of the bones growing bigger around these big air pockets. It also allows for your skull to be lighter. Because it doesn't. Because it has those openings. If that was all like a big solid chunk of bone,

our skull would be way heavier. Okay, that makes sense. I don't know, we'd all walk around like dragging our heads on the ground behind us or something. We would probably have evolved stronger legs. Well, maybe that too. You know what I'm a person of science, Sydney. I can't turn it off.

It's just the way I see the world. They also help to provide some of the resonance for our voice. I don't know if that's important, but I guess we do a podcast. So that's important for us. Well, and that is that why it sounds different when you got a cold partially. Yeah, in part. Yeah. The big thing that they do that people hate the most

is get inflamed or infected. Yeah, people will talk about that a lot. It seems like, or especially when they have had a headache, it seems like maybe it's all you hear about pretty much. The understanding of the existence of sinuses dates back to ancient times. When we look back to ancient Egypt and the Edwin Smith Papyrus, which is from 1600 BCE, there's a description of the maxillary bone and everything about it,

including the fact that there's a big hole in it, the maxillary sinus. They talk about treatment for different facial fractures, so you kind of have to understand the anatomical structure if you're going to put it back together. In addition, they used to remove the brain during the embalming process. Sure, they put a little hook up there, scrambled around, yank it out. Yeah, through the Esamoid sinus. I think we had probably, um,

mummy's episode. Yes, yeah, I think we did. So you had to know there were sinuses, there were big holes there, because that's where you stuck the thing, the hook, the brain hook, you know. You know. The brain hook.

The brain hook. Sort of like a crochet hook. But for brains. So for brains. So obviously they knew they were there. Hypocrates talked about them. He described some nasal surgeries that could involve the sinuses like removing nasal polyps and he talked about how important it was that air passes through these openings in our skull so that our voices sound like they do, which was kind of right. Yeah, I'm impressed by all the time people knowing about bones because it's like, yeah,

I know. You do have those. Like you could just check after somebody kicks it. Right, but you've got to remember that the practice, and we've talked about this on the show before, the practice of dissecting human bodies after someone has passed away has been taboo. Sure, but no, at some point. On and off throughout history, depending on what culture and what time you're in, you may not have ever had that opportunity.

Similarly, Celsius described the sinuses in part, so that far back. But it was just in reference to different nerves that pass through different sinuses and that kind of thing. So basically, everybody just kind of knew they were there. Like, yeah, there happened to be some holes in your skull. We don't know why. That's all we got. Thanks, ancient Greece out. Peace.

The ancient concept of disease of the sinuses were all kind of lumped together. So basically, like, if anything was wrong with your nose or anything in that region, sinus disease, they call it ozina, which is from the Greek for stench. And initially, it kind of referenced any really bad breath, but it eventually came to mean specifically, like a bad smell coming from your nose. Mm. Ugh. So give your nose smells really bad.

No, yeah, I got the image, thank you. And initially it was just like, don't go near those people. Like they're kind of social outcast because they smell so bad. Then I was just smell bad. We would advise you to stay far away from them because they smell bad. We don't have any treatment for you.

And well, for quite a while. We don't know what's happening here. Let me say that. I think you're gonna miss out on it. I would not wait or hold it, Rob. Plenty, one of our favorites on the show, Plenty the Elder, who had advice for everything, has advice if you have a stinky nose.

He has a treatment plan for you. What a cruel fate that it, what a cruel irony have a stinky nose. He has a treatment plan for you. What a cruel fate that it. What a cruel irony never stinky nose. Is I don't like it. I think it's a little, it's very gendered. He says that if you're a man and your nose stinks, you should kiss the nostrils of a he mule. And if you're a woman who's no stinks, you kiss the nostrils of a Sheep mule sure. Yeah, I mean and then you're no still stinks But now you're known as the person who kissed the mules knows as opposed to being known as the person who's no Stinks your nose still stinks with the rest of you smells like mule. So all of these things now. I don't know All of these things. All of these things now, I don't know.

Plenty never has, well, not one thing to say to this stuff. Plenty rarely has great advice. Herodotus also had his own recipe for success if you have this nasal stench, which is nasal douching. I mean, I guess you could also consider like a rinse, because we do. In any pot. Rinse is today, right. I guess you could also consider like a rinse, because we do. And any pot. Rinse is today, right?

But nasal dosing specifically had to do with like perfumeing what you were going to squirt up there. Because it smelled bad, right? So why not? So just like really douche your nose with white wine that has been perfumed with cypress and roses and m mer and just like squirt that up there a lot. A lot. And then stick swabs up there that have been soaked in like silver

and honey. And then nothing will happen. And then just do shit. And then just do shit. Honey, honey, honey, do shit, do shit, do shit, do shit. And then your nose smells better. Do you want to say do shit a few more times? Or do you want to move on?

That's okay, right? Like douche? Yeah, I think douche is okay. Especially when you're using it clinically. A clinical douche is always for me. That's a clinical douche. On an educational show. Hey, here's my little sidebar of real medical advice.

Don't douche, there, anybody? Don't douche. You got that? Take that big douche. If you can't, you're gonna try to buy it. It's on our show, keep it. No, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no's like 1600 douching, 1700s, more douching. Like, I don't know why you brought it to the right, it's down.

Doesn't is line, this is not true. No, they hot things were thought to be good for the sinuses. So hot air, hot food, hot douches. Don't drink, get exercise, stick a hot poker up your nose. No. Yeah, especially if you have, if you have like a really severe infection and you're starting to develop like, ulcers inside your nose,

it was very common to just stick, you know, something hot up there and cauterize it. Yeah, sure, yeah. Yeah. That was a common treatment for a lot of all sort of, like things that were open, oozing, wound, wound, wound, you put a shot.

Open, oozy, woundy things, you know. You know. I'm sure there's a medical term for them, but hey, who's got the time to get that degree and everything? A bit of hey, I have a sign that said hey. In medieval times, my favorite times to talk about on the show. The one of the rare times in history were things got dumber for a little while. Well, unless you count now, but before now.

It's funny because as I was reading about it in the medieval times, there were two specific theories that, because doctors were still debating not just what to do when your sinuses go berserk on you, but what, therefore, like, why do we have these sinuses? We still don't know all this stuff that I told you about mucus yet. So people were debating and there were two main theories that emerged. And it's interesting because I was reading about it. A lot of authors point out that you got to understand. It's almost like apologetic.

You got to understand, though, at the time, one, if anything was difficult to understand, like we don't know why the sinuses exist. This is a difficult question. It was thought that it was probably something, you know, spiritual or magical or it's unknowable and divine. Exactly. If it's hard, we can't know it anyway. That's probably what it is.

I'm going to show you something magical in magical. You're going to start doing that? It's just what's unknowable. In my school, I guess. It's unclear right now. The other thing is that instead of allowing fact to guide you, instead of using evidence to reach conclusions, a lot of people would reach a conclusion based on their own belief or faith and then try to make their scientific theory fit their belief. So you see a lot of that happening where it's like, well, I really feel like this is

what this does. And so I'm going to create a scientific theory that matches this firmly held, maybe spiritual belief. It was always really dangerous. There's always really dangerous. This had to be big for that because we didn't have, I mean, we didn't know there are four let alone how to fix stuff. Exactly. So we had two kind of competing theories. One was that the sinuses held the grease that like our eyeballs kind of floated and moved around

and that's why our eyeballs are able to move so well is cause they're just like. You know, your sinus grease is keeping them all looped up. Exactly, it's keeping them all looped up so that you've just got all that, you can just roll your eyes all the way around. Thank you, sinus grease. So that was one and the other was that maybe

the mucus and the stuff that was in the sinuses was coming from the brain and it was like all of the like malignant spirits and evil thoughts and bad spirits and you could just let it flow from your brain to your sinuses to your nose and out into the world and out of your body. So it's one of those two. They knew it was one of those two. They didn't know which one, but they knew it was one of the two. Tough to narrow down. You know, Da Vinci was one of the first to actually produce really well done anatomical drawings of the sinuses. Oh, wow.

It's sad. He's not credited with that because we didn't find them until like the 1900s. I don't know about sad. I feel like Da Vininci probably gets a few pets on the metaphorical back what with the code and the betruvian man and the Mona Lisa. Yeah. The way I said Mona Lisa there was when you were questioning if you were

in my head. I was like, is that the venti? Which Ninja Turtle was it? Well, but he could have had a sinus named after him. And he didn't. No, I guess it is, kind of, son. But he theorized that since the teeth were so closely connected to the floor of the maxillary sinus, which I didn't clarify where sinuses are. So your maxillary sinuses are kind of in your cheeks. They're on either side of your nose and your cheek areas.

Your frontal sinuses are up in your forehead of your eyebrows. In your ephamoid sinuses are kind of in the middle between your eyes and your nose, like the bridge and your nose, and then your sphenoid sinuses are kind of back behind that. All right. Just kind of where everything is, by the way. He theorized that since a teeth were so closely connected to the floor of the maxler, sinusoidal and your cheeks, that maybe its job was to hold a humor that did something for the teeth.

So that was kind of... Leonardo Vinci, good at drawing, bad at guessing. Vassalia also drew them not very well, but he did contribute the idea that maybe they were helping to form the voice and light in the skull. So we see this idea all the way back then. Great question. But you know who did get a sinus named after him was a doctor high more. And that's who I want to tell you about next. All right, let's hear it.

Well, first let's head to the billing department. Let's go. Let's head to the Billing Department. Let's go. The medicines, the medicines, that ask you lift my car before the mouth. My name is Patrick. My name is Parker. Max Hong Kong has been a huge inspiration in my life.

Now I have this network of friends that I've made that span literally across the entire globe and they're some of my favorite people in the world. I truly cannot believe the amount of wonderful and lasting friendships that have come out of this. If you feel like you might not fit in, as long as you're a good person, you will fit in because everyone there is good

and amazing and kind and wonderful. And you should absolutely go, it will be the best decision of your life. Make a ton of new friends like Parker and Patrick and Max Funcon. Tickets for Max Funcon and Max Funcon East are on sale now at maxfuncon.com. Said before the break,

you were going to tell me about high more. What's his or her story? Well, I I was I was been mounting the fact that eventually never got a sinus named after him Because doctor high more did and the 1600s in English English physician high more Described in great detail the maxillary sinus and of course he was credited with with depicting the maxillary sinus in a way that we really didn't think had Previously even though technically it probably had Nathaniel high more with depicting the macular sinus in a way that we really didn't think had previously, even the technically it probably had. Nathaniel Heimor was a...

What a fancy name, I'm gonna say. He was supposed to go into the clergy. That was his position in the family. That was what was expected of him. But he was a huge disappointment. Instead, he became a doctor. It's noted that instead he went to Trinity College and he spent 10 years there studying science and philosophy and classics and eventually medicine and he became a physician.

And I only mentioned this because as I read that sentence, I thought, I am so jealous. Doesn't that sound amazing? 10 years, Trinity College, just to study. Science, philosophy, classics, medicine., just to study, science, philosophy, classics, medicine. I just got jealous. I got halfway there because I felt Spanish. So I got jealous.

Five years. Five years. I wish I had done that. He knew. Filled Spanish? No, I don't wish I had failed Spanish. No, I actually got an A in Spanish. I have a minor in Spanish.

You don't have to. We don't have to do this. It doesn't matter. Do you want to know any more of my grades? It isn't how to be like this. I can share an A in Spanish. I have a minor in Spanish. You don't have to, we don't have to do this. It doesn't matter. Do you want to know any more of my grades? It doesn't have to be like that. I can share them with you later. Yeah, we'll see you later. It won't take very long.

Off air. Yeah, just say A or whatever. Just say A a lot. He knew the anatomy of dogs and sheep very well. This was noted. He also once famously dissected an ostrich. I don't know what this has to do with humans. I mean, he probably knew them too though

because he wrote a very thorough, famous treatise on the anatomy of humans. And so I'm guessing he also knew about us. He also did, but he couldn't help but compare them to ostriches. In every autopsy, it's, oh, kind of a stubby neck. Well, no, nothing. I mean, we've been out for this. They're usually, oh, it seems to, kind of a stubby neck. Well, no, nothing. I mean, we've been over this there usually.

Oh, it seems to come up stubby neck. I don't know. Seems like a good good girl. I'm compared to an ostrich. If you compare it to an ostrich, no one's comparing it to an ostrich. I'm comparing it to an ostrich. We've been over this.

There's no connection. Too much, it's all I'm saying. This included a very detailed. More than wings and a f wings Nathaniel so help me God I'll throw you out of this med school yeah I've been here for eight years you wouldn't I would I would destiny this included a very thorough description of the maxillary sinus and it was known forever after as the antrim hym, the maxillary sinus. But now, I don't remember being taught the name

Antrim Himori in med school, but from the way it was used in a lot of the papers and studies that I was reading to research this topic, I get the impression that maybe in other parts of the world it's still called the Antrim Himori. Even though all I ever knew it as was the maxillary sinus. Anyway, the name stuck instead of the antrim, the antrim, the antrim, is the antrim hemorrhag.

Now, the other thing that's interesting about Dr. Heimor is that in addition to his description of the sinuses, he also talks a little bit about the function of the sinuses and throws this clever little anecdote in there. So he's still wrong. He kind of thinks along with a lot of his predecessors that the function of the sinuses is to drain the humor from the brain.

No. Right, right, that's not true. But he also includes the story of one of his patients who said, and the story goes like this. So this woman has a tooth extracted. And after one of her top teeth, her canine is to be exact. After it is extracted,

Puss starts to ooze from the hole in her head. Okay, yeah, Carino. She's very disturbed because she doesn't know where it's coming from. And I mean, there's Puss coming out of her head like that too. Yeah, she was cracked case. But she's curious. And so she starts to experiment.

She starts by taking a slate pencil. Just top. And inserting it into the hole. Not now, please know. From whence the pus came. She's able to push it about two inches inside her head. Mm-mm-mm. So she pulls that out because that's getting,

that's like a little like, I don't know what, I'm gonna hit something eventually and a pencil seems like the wrong instrument for this delicate probing. She pulls that out because she had to write a check. So the, what's the right instrument? Why not try a feather? Because at least that will bend

if it hits something that I don't know is essential to human functioning. So she takes a feather and she's able to insert that even farther. It's a rough tickle though. It's a deep down tickle. Into her head. Now at this point, at this point she gets freaked out.

Okay. Now she's concerned. So she goes to Highmore, who is her doctor, and she tells him this story because she thinks maybe she stuck a feather into her brain. And he just says, not a worry, you just that you discovered your sinus.

Congratulations. You found your sinus. Also please stop sticking things in your head, lady. We have no way of correcting this, man. Please, you have to think carefully. Do you know what happens when infections happen right now? We have, I don't even know what infection is. I'm just telling you, I know it's bad.

In the 1700, a Dr. William Calper described some different approaches for draining the sinuses. So this idea that the sinuses could get filled with pus and could get kind of filled with and what would have been infection. We begin to get this idea, but the only thought is like,

well, we don't know how to treat this. Maybe we just need to drain it. So once we figure out that there's this connection between what's right above the teeth and the sinuses, we think, well, maybe that's a pathway for draining the sinuses. So we start, William Kaeper describes these approaches of removing a tooth and then kind of just like

digging up that way. Great. Up through that hole. Yeah, it's much more pleasant and humane. He describes three different cases of this. One, he notes, went really well. Everything seemed to turn out okay for that patient. Another one, he talks about how important

and like upper class and rich the patient was, but I don't really know what happened to them. There's no documented result. The third one did not go well after he drained the sinuses. It resulted in death from meningitis and carries. And I only mention this because, I mean, I think you probably know a meningitis is.

Yeah. Carries, he means like cavity. Wow. Like a cad, a dental carry is a cavity. Okay. So the somebody died from meningitis and like cavity. Wow. Like a dental carry is a cavity. Okay. So somebody died from meningitis and a cavity. I was probably the meningitis, it's going to be my guess. That's pretty grody still.

Yeah. This was also the beginning, in this period, where we began to understand the difference between infections of the sinuses and inflammation of the sinuses and nose problems. And you see that the term ozina actually begins to move away and we start to have like sinusitis. It's a little bit more specific. Yeah, something a little bit more specific because ozina is a whole other thing actually

that I'll mention at the end here. But we also begin to understand that the mucus in the sinuses is actually coming from the sinuses and not from the brain. That's when we finally get a hold of that idea. And as we move through the 18 and 1900s, we just get better. We do smarter things. We get better at visualizing the sinuses and doing surgery on the sinuses to relieve infection

and inflammation. We develop the disciplines of ear, nose, and throat, otolaryngology and maxillofacial surgery and dentistry and we have more options for treatment and diagnosis. We have a CAT scanner so we can visualize the sinuses a lot easier and antibiotics and all other sorts of meds and procedures. Ozena, by the way, now, references something that's called either atrophic rhinitis or empty nose syndrome, which is actually when the nasal mucosa becomes like the lining of your nose becomes really infected.

It dries up. It kind of dies off, so to speak. And you can actually involve the underlying bone as well. So like that's a whole other condition from like your run of the middle sinusitis that we're talking about. Because when we talk about sinusitis now, we're really just referring to inflammation of the lining of your sinuses.

Your sinuses are supposed to be filled with air, not fluid. So if they are filled with fluid for some reason, that can cause problems. They can be filled with fluid and inflamed for a variety of reasons. They could be blocked by inflammation from a cold. You know, you got sick.

It could be because of allergies. It could be because you got polyps inside that are just mechanically obstructing the flow of mucus. You could have other structural issues just from birth or from maybe a broken nose or something, a broken bone that healed the wrong way, a deviated septum, things like that. So you could have structural issues that result in a sinus not draining properly.

Okay. But infection is the thing that everybody worries about, right? Because you've got the sinus pain and pressure and you think, I need to go to the doctor, I probably got a sinus infection. Also by the way, in kids, second hand smoke is a risk factor for sinusitis. Please stop smoking, my kids. Yes, please. The symptoms, if you have sinusitis, we all know them and hate them.

Facial pain, pressure, stuffy, runny nose, maybe you lose your sense of smell, maybe you got cough, maybe you got fever, bad breath, your teeth can hurt, you might get the thick greens not as well. It can last a really long time. How long is long? Two to four weeks for an acute, meaning like brief, sinusitis. Tag, I gotta listen to the headache chat

for another week. Wolf. Thank you. I'm just kidding. I really don't mind babe. I really, something to do. Up to 12 weeks for chronic. I was just kidding.

I don't want you to get mad at me. Up to 12? I don't want you to get mad at me later. I was just teasing. So jump for the show to get mad at me. I don't want you to get mad at me later. I was just teasing. So, jump for this show. I wouldn't have said it in real life. Sure. There are all kinds of medicines.

Yeah, much of a joke. And things that we recommend for sinusitis, stuff that you can do at home, vaporizers, saline washes. There are all kinds of nasal sprays and decongestants and allergy meds that your doctor may recommend to you. I'm not saying go take them to the doctor. There's a lot of that helps with congestion.

Right, there are, and I didn't get into, there are some like osteopathic maneuvers that can help relieve sinus pressure and that kind of thing too. Nettie pots, a lot of people like to ask about nettie pots. Yeah, I was thinking of that. It's a very old form of nasal irrigation, just a way of flushing out.

A douche. Sort out. A douche. Sort of like a douche. Okay. Only without perfume, you know. Listen, if you don't prepare an air pot, you're on water. But it's actually part of an Ayurvedic medicine tradition. It, netty meaning from the Sanskrit for nasal cleansing. And it was really popularized in the US by Dr. Oz in 2007.

Oh, great. On Oprah. But it is supported by evidence. By the way, nasal irrigation in general though, it doesn't have to be a netty pot. Anything that flushes out, you know, is if you're if you're flushing it up one nostril almost coming out the other, that's what we're talking about. It doesn't have to be anything fancy. Winning.

That's Charlie Schoenman's side. Um, it, but only for short term use, by the way. Mm-hmm. So you use it for a few days while you've got the sinusitis and then stop. Please do not use it daily to try to keep your sinuses clean. That can actually lead to more sinusitis in the long run. Don't get addicted to your nitty-pot. No.

One specific question I got was about oregano oil. Somebody asked in reference to sinusitis about oregano oil, because it's advised on a lot of different naturopathic websites that oregano oil will help you with sinusitis if you inhale it as a vapor or you've squirted under your tongue or you mix it with apple cider vinegar, all that stuff. A lot of spices in labs, not just oregano, a lot of different spices show some ability

to inhibit bacterial or fungal growth. That's not like a rarity to say, like, well, when we put oregano on a petri dish, bacteria wouldn't grow there. A lot of spices, that's true for. There are no studies that say that it works in humans or that it doesn't work. I have no idea. I usually mean scientifically speaking, it probably does work. No. I think it's important to remember that just because something works in a lab does

not necessarily mean it's going to work inside the human body. Human body is incredibly complex. Right. So, I don't think that oregano oil would hurt you But I also have no evidence to say that it would help The big point I want to make about sinusitis Infection if it is an infection that you have in your sinuses Infections can be due to viruses bacteria or fungi

Generally speaking, okay? Bacteria are the ones that respond to antibiotics. And to be fair, if it is a fungal infection, we have medicines for that too. But if it's a virus, nothing's gonna help. You just, the stuff I mentioned, vaporizers and sometimes antihistamines are de-conjustants

or saline washes, all those things, but not antibiotics. And in adults, nine out of 10 infections in your sinuses are caused by viruses. In kids, somewhere between five and seven out of 10 infections in your sinuses are caused by viruses. So...

Chances are, you don't need an antibiotic because it won't help. If it's a virus, it won't help. You're gonna get better, and I understand it sucks. I got a sinus headache right now, it sucks. But I also know it's gonna get better and I don't need an antibiotic. Tell you what else sucks, is antibiotic resistance?

Superbugs. That's exactly right, Justin. That sucks too. So if you're sick, if you're concerned, please go get checked out. Please talk to your doctor. Please get examined. Yes, absolutely.

Because even if it's not a bacterial infection, and they don't think you need antibiotics, there are other medicines that can help relieve the symptoms that they can recommend based on your medical history. So it's always important to go get checked out and make sure, but if your doctor doesn't think you need an antibiotic, I'd trust him on this one. Folks, that's gonna do it for us.

Thank you so much for listening. We hope you have enjoyed yourself. Thanks to the experienced for letting us use their song Medicines is the intro natural bar program. And thank you to the maximum fun that we're for having us on. We really appreciate you all for everything you do. And until next week, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head. Alright! Maximumfund.org

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