Dr. Houser couple of questions about an office visit withyou
Dr. Houser, I'm going to try and come see you this summer. I have some questions. My problem is confined to my left nostril. I'm the one that had uncinate process removed and deviated septum corrected. The deviated septum was also on left side. Since I'm coming from Texas this is going to be quite a expensive journey. I understand you'll perform the cotton test first. If I benefit from the cotton test what will be our options? I'm concerned whether or not I'll be able to afford alloderm implants and whether my insurance will pay anything. Is there anything else that could be done other than implants that would benefit me? I guess I'm lucky in that my problem is contained to the left side only. A MD that I saw last week said he can certainly see why I'm complaining about the left side. He said my right side is producing normal mucus/moisture. He said my left side is completely dry and doesn't seem to be producing any mucus at all. His take was that my mucus membranes were damaged on that side during surgery. I asked him why the ENT's I saw keep claiming that my nose is fine on the left side. He said because they don't have a surgical answer as to how to fix it. I assume I'll need to call your office to get specific details. Right now I'm looking at airline prices/hotel prices, ect. I'm a teacher and on a limited budget so I want to make sure if I come see you I have a game plan as to what to do. If alloderm does need to be implanted would that have to be scheduled on a return visit? I benefit from shooting saline up my left nostril. As I've said before that is only a temporary solution , and I'm looking for a permanent solution. I'm convinced now that coming to see you is my only option. I've been to 5 ENTs here in Texas without any answers. I'm just trying to prepare myself financially for the possible solution to this problem. Any answers you can give me would be greatly appreciated. I plan on calling your office sometime this week. Thanks agian, Gary

prior email: I received and reviewed your CT sinus x2. Your septum was straightened. You still have some residual ethmoid and sphenoid thickening - mild. Your max sinuses were opened in the appropriate location. Your turbinates appear to be of proper size - little reduction if any. If you have an ENS issue, looking at the scans and reading your symptoms, then perhaps you could have ENS-type. Your turbinates were not over resected. I do not have anyone to direct you to. Have you found that blocking the nose is beneficial? This can predict if a turbinate expansion is of possible benefit. sh Your situation is less clear than many, given the apparent normal anatomy on the scan. An implant may be useful, or may not help. It is difficult to plan ahead given your anatomy. I hesitate in the thought of reserving OR time with such an unclear issue.

Dr. Houser little confused by your reply
Dr. Houser, If I understand you clearly you're not telling me to not to come see you. You're simply stating that since I'd be out of the norm (having my turbs/normal anatomy) you're not sure how much benefit if any you can give me. Is that correct? If I do come to see you and the cotton test proves to be helpful are there any other options other than alloderm implants for me? I was wondering about possible injections on left side. If alloderm implants were the solution however, would that have to be done on a return trip. ( I assume that's probably something I'llhave to talk to your office/nurse about). I think what I got from your last reply is that I shouldn't get my hopes up that you may have a solution, and that I should give it careful consideration about the time and expense involved coming from Texas when theres a good chance that you might not have any procedure to relieve the symptoms I'm complaining of. As you know I've been to 5 ENT's here in Houston (including the one that performed the surgery) and have gotten no where. They just tell me to use saline on my left nostril and live with it. Thank you, Gary

Yes, you are a candidate for injection if the cotton test proves you would benefit. That can be done in the initial visit, although you would end up covering it yourself and then mess with insurance after the fact. You could set up with the office for monetary questions.

About possible injection
Dr.Houser, If indeed an injection was the solution would the intial injection be permanent, or would it be temporary? Would a return visit be needed to put a permanent injection in? As you can tell I'm a planner and just trying to figure out how many visits might be necessary. I'll get with your office about the monetary issues. Being a teacher I'm trying to get up to see you within the next two months while I'm out for Summer break. Thank you, Gary

There is a limit as to how much injection the tissue will accept, so it may be that 1 injection is not enough I believe the cymetra stays, but in the face/lips/etc. it tends to dissipate There is just no way to fully plan these issues