Question about Cymetra Injections
Dr. Houser, Question about cymetra injections. I understand when I come to see you we'll do the cotton -*test*-('") to see if injections may be of benefit. If you do feel that an injection of cymetra would benefit me is there any chance that too much could be put in? Could anything be done if too much was put in? I'm assuming that with your expertise and experience this wouldn't be an issue. However, just wanted to know has that ever happened, and what if anything could be done at that point? Would the cotton -*test*-('") eliminate the chance of too much being put in? One last question. I've noticed that when I inject saline nasal gel into that left nostril that feels so empty it seems to help with the resonsance of my voice. Have you found that by using implants/injections it also helps with the resonance of the voice. Being a singer this is an important part of the process for me. Of course my main concerns with that left nostril are the dryness, empty feeling, bleeding, ect. It would be nice though if I could pick up more resonance in my voice like I used to have. Thank you, Gary

I wish I could get as much cymetra into a subject as I can cotton. Tissue will not accept that much cymetra. If too much were somehow placed it could be reduced per coblation. I would not fear too much though; too little is the main issue. Several patients have had concerns about vocal resonance. Some have felt improvement with implant or cotton -*test*-('").

Injections and resonance
Dr. Houser, As a teacher today was my last day at school so I can start concentrating on getting things set up with your office and my trip up to see you. About the resonance. Have you ever worked with singers that were having resonance problems. Being a singer it's not only the ENS type symtpoms I get that really get to me. The lack of resonance and the way it has effected my voice is almost if not as important to me. Being a semi-professional singer I still had dreams of making it professionally. What's so ironic and messed up is that I got the surgery done to help my voice by having less sinus infections and respiratory infections. I'm getting a little nervous about coming to see you because I know theres no sure guarantee that you'll be able to help me. I'm praying and hoping you can, but don't want to get my hopes up too much. This whole experience has been a nightmare since the day I walked out of that surgery. I'm just thankful theres someone like you out there helping people like me that have suffered from this problem. I never dreamed that a simple sinus surgery could cause so many problems and misery. Of course, I didn't know I was getting anything other than a deviated septum fixed at the time of surgery. Anyway, thanks for helping us and for this great website. Thank you, Gary P.S. Look foward to seeing you soon.

I have seen several singers, neither has gotten an implant yet. I have seen others with voice complaints - some have had implants and stated some improvement but not full. I think particularly of one individual that was missing alot of tissue and suffered voice fatigue - improved but not abated by implant. At this point I can do cymetra just at the sinus center (216-518-3298) and they need forewarning to purchase the product.

Few more questions about cymetra
Dr. Houser, I sang last night and sounded better than i have in a long time. I used about 3 shots of Neil Med saline gel in that left nostril before i left home. Really increased my resonance. My friend noticed after my first song that my voice sounded fuller and better. He didn't know I had used the saline. I told him what the reason was for the change in my voice. So theres definitely a problem with my left nostril when I'm not using saline gel as it relates to my voice and singing. It was good to see that someone else could notice the difference and not just me. Sometimes with an issue like this you start to question your sanity. Do you think that the cymetra will have the same effect that the saline has? That is my hope. It's too hard to constantly keep my left nostril filled with saline gel. One question about what you said about if by some chance too much cymetra is put in. You said it could be reduced per coblation. What does that mean? I guess my biggest fear about getting too much is that it'll clog my nostril up too much and I won't be able to hit my high notes. I need to still be able to get plenty of air through that nostril. I know for about 2 months after my sinus surgery I had a really hard time singing due to the swelling from the surgery. I couldn't hit my high notes at all because I couldn't get enough air through that left nostril. What's weird is that right after surgery the left nostril was too closed up and then later on it's the left nostril that's feeling too open now. I guess more work was done on that left nostril (deviated septum on that side) and thats why it had more swelling. Also, since I'm using 3-4 shots of saline gel does that give you an idea of how much cymetra to put in? My hope with the cymetra injection in left nostril is to: help add resonance, stop/reduce empty feeling, stop/reduce dryness, help reduce drainage down the back of my throat. Do those seem like resonable goals to you? Thank you, Gary

reasonable goals coblation is submucosal turbinate reduction 3-4 squirts of a gel will amount to a higher volume that I can inject you with. I do not think overfilling is a risk.

Risks involved with the injection
Dr. Houser, Think I may have asked about this before, but as this nears closer to coming to see you wanted to ask once more. There isn't any possibility of blindness just from a cymetra injection. One of the ENTs gave that reason for not wanting to inject my nose with restaylane. Said someone in Houston had gone blind after a steroid injection in the nose. Also,will I be the first person you've injected cymetra with that wasn't suffering from partial/or total turbinectomy? Will it be harder to know where to place the cymetra? Thanks , Gary Called Sinus Center today , but forgot that you're an hour ahead of us down here in Texas. I'll call again tomorrow. Right now just trying to get some last minute questions answered before i go through with this. This is way out of my comfort zone to travel off so far by myself. It'll certainly be something new for me . Kinda scary.

blindness reported in past with steroid injection, perhaps a minimal risk with cymetra; the circumstances re: the blindness issue are cloudy cymetra usually for ens-type, so no not 1st

About blindness issue
Dr. Houser, You personally haven't had or know any other doctors that have had a person go blind from a cymetra injection. Also, if there was a problem you would know it right away wouldn't you? Your last email was kinda scary. I want the cymetra injection , but not if theres any risk of losing my eyesite. I've already been battling severe depression/anxiety because of ENS type symptoms on that left side. Losing my eyesite would push me over the edge. Still confused about what to do. Wondering if I might be better off just having to use saline gel the rest of my life. This nightmare just continues. Just unbelievable all the anxiety, depression, problems a simple sinus surgery has caused me. Thanks again, Gary P.S. I have to make a decision soon about what to do. I'll have to come see you sometime in July. Plus, I need to get airline tickets ahead of time.

I have never heard of blindness from cymetra, but have heard of it with steroid injection - distant past Is it a risk? Yes, but minimal There is a risk of getting on an airplane, etc.

ABout injection
Dr. Houser, So basically, it would be a very freak/rare occurance if that were to happen. Is that correct? Also, if there was any visual problem would you know it right away? Thanks, Gary

gary i've had two restlyn injections so far and no issues.just remember you in the care of one of the best. sorry for the interuption

Gary, I can back this up as well. I have had several injections in the past. Rememeber there is a big difference between a steroid and restylane/cymetra etc. I think the steroid is what made the person go blind. JR