Ref ID 453646 Per my previous question this is a

Patient : Ref ID 453646. Per my previous question this is a followup Doctor: my symptoms are unchanged. I have a second ENT opinion scheduled now but a month away. I have two questions: 1) will continued stopping smoking help my nose and throat to heal. If so how does it help? 2) I am assuming the new ENT will do a history and endoscopy. What questions should I ask him specific to my situation?
Symptoms:  Symptoms unchanged. Still have loss of smell for mild odors such as grass, trees, flowers and anything to do with water (lake air, dew on grass). Still have no sensation of moisture in nose. Still have resistance to breathing through nose without mucous. Voice still raspy and dry and at times painful.
Doctor :   Hi. Thanks for your follow up questions. There is no change in the situation you were in. To answer your queries: 1) will continued stopping smoking help my nose and throat to heal. If so how does it help? > Yes, stopping smoking altogether helps a lot to heal the respiratory system mucosa. This is done by the following ways: - The mucocilliary function starts to regain. This means the ciliary action of the top most layer of the cells start functioning. This helps in clearing the allergens out of the respiratory system, the nose and sinuses being a part of the respiratory system. - There is regeneration of the normal mucus membrane to give its the wetness and the luster and functions too. - The changes start reverting back as the irritation and the chemical reactions that the smoke caused are not present. 2) I am assuming the new ENT will do a history and endoscopy. What questions should I ask him specific to my situation? > You should ask the following questions: - To conduct the actual smell tests with the help of the actual smells. - Get the actual photographs of the endoscopy, post to me so that I can actually see the condition to have on the spot diagnosis. - To get necessary investigations. - To ask for the exact diagnosis and the probable treatment. - To ask for the blood tests of vitamin D, methylcobalamin and others. - To give your therapeutic dosages of the deficiency of the vitamins as these help as anti-oxidants and also help faster recovery. - Review MRI or get a fresh one particularly for the olfactory nerves area. And obviously the ones that you must have thought about. I hope this answer helsp you, lease feel free to ask for further relevant queries if you feel that there is a gap of communication.

Comments / Follow Ups

Patient: Wow this is very helpful. Thank you. Should I ask him if he believes that the sensory (moisture sensation) and olfactory nerves have been either damaged or destroyed and why? I just had a fresh CT scan last night. Is doing and MRI preferable to CT and why?
Doctor: Please give him the time to explain first, listen carefully and without any intervening/interrupting question as you may get most of the answers. Ask the question only when he says so, as you want to ask as you have just mentioned.
MRI study can help to get the mucosal architecture better than the CT scan or for that matter of the area of the olfactory nerves. It is the best for soft tissues.

I hope these answers give you the correct diagnosis .
Patient: Doctor I had my visit with ENT. Entire visit was 3-5 minutes. He said CT scan ok other than two small cysts in floor of sinuses that were ok and we should just leave them. He then said we were done for the day. I asked him to scope my throat which he did but would say only still no lesions. I asked him if we could do something that might enable me to breathe through my nose and he said - no kidding - you can breathe through your mouth can't you? On the way out I asked about the "normal" mucosa on his clinical report and he said only "i never said that". It is typed on his report. In our country doctors get paid on volume and looks like he is just churning the people through. I have a second ENT opinion visit scheduled in a large city in about a month. I will wait for that and hope for more help. in the meantime will continue to abstain from smoking. My throat and mouth continue to be very very dry as well as nose. Part of this is my meds. Can I consider asking family doctor her opinion on whether or not Salagen might help me?
Doctor: Thanks for your feedback and additional query.
Salagen: It needs a prescription and should have real dry mouth and throat. Please discuss this with your Doctor on your visit to another ENT Surgeon which is on the anvil.
Please request your ENT to be specific about the diagnosis.
Get the snaps/photographs of the endoscopy and send me all so that I too can have a possible on-the-spot diagnosis.
- I was wondering: if there would have been nasal blockage, it would have been seen even on CT scan.
Oh, no smoking at all and avoid the dust, fumes, molds and mildew or any other allergens.
Use masks whenever require.
Try plain water steam inhalation or breathing through wet cotton cloth to humidify the nasal passages.
Warm water showers help
Respiratory exercises under an Yoga expert may help you.
Try naturopathy, go for vacation far away from your city and enjoy the hobbies, change the routine, may help.
...
Please get these done and give me the feedback. I am hopeful that all the things I just mentioned will help you.
...
Please ask a fresh query and give ref : 453646 and 459965

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