When Amanda Gillespie of Rock Hill wakes up Monday, she hopes to be almost pain free.
The 33-year-old Gillespie is one of an estimated 37 million people in the United States who suffer from chronic sinusitis, defined as an inflammation of the sinuses that lasts for more than 12 weeks and happens several times a year. The swelling blocks the sinuses, trapping mucus and air inside, which can cause pressure and pain.
Sometimes the result is a bacterial infection, often treated with antibiotics. Because there can be multiple infections over a year or longer, doctors are careful not to overprescribe a particular antibiotic, which can lessen its effectiveness. Steroids also can be prescribed to treat the inflamed sinus tissue.
Gillespie said she typically gets at least two infections a year, but the pain is daily. Her routine is to take three or four ibuprofen pills, hoping that in about 30 to 45 minutes the pain goes away.
It often works, but sometimes it doesn’t. The result is a “bad mood, but you just have to keep going.” Gillespie said.
To keep going for Gillespie means teaching first grade or kindergarten students. She taught in Charlotte-Mecklenburg Schools for several years before moving to Pennsylvania. Recently she moved south, this time to Rock Hill. A long-term assignment as a substitute with a York school starts Monday.
On Thursday, Gillespie was in the Rock Hill office of Dr. Andrea Williams, an ear, nose and throat specialist.
In a darkened room, a slightly sedated but awake Gillespie reclined in a chair. Much like being in a dentist’s office, Gillespie waited for the medication to numb her. But instead of a tooth, the medication numbed her sinuses.
With a gentle touch, Williams inserted a probe into one of the six sinus cavities reachable with a probe. Williams watched her work on a television monitor. When Williams came to a sinus opening, her assistant inflated a 1-millimeter balloon attached to the probe. The balloon expanded, breaking the bones around the sinus and making the opening six times bigger.
With a larger opening, the hope is the sinuses would drain better, relieving Gillespie of the pressure that has made for many a miserable morning.
Sinus balloon surgery has been around since 1995. But until recently it was done in hospital operating rooms. After several clinical studies, the decision was made to allow the surgery outside a hospital setting.
The venue change to doctors’ offices or surgery centers is good for the patient, the doctor and even the insurance companies, Williams said.
It’s good for the patients because they are awake and the recovery time is shorter than traditional sinus surgery, she said. Traditional sinus surgery requires the cutting of tissue and breaking of bones. The operation was done with a fully sedated, asleep patient. The result was “more bleeding, more scarring,” and a recovery time that would require several visits to the doctor to debride or clean the sinus of scar material, Williams said.
“The surgery is technically easier because the patient isn’t sedated,” Williams said. Balloon surgery is “so much more relaxed,” she added. The surgery on Gillespie took about an hour.
Because the surgery is done at a doctor’s office, the cost is usually less, Williams said. Patients pay their co-pay for the office visit. There is a charge for the surgery, with the cost determined by a patient’s insurance policy and deductible levels.
Williams and other doctors stress that balloon surgery is not for every chronic sinusitis patient. The condition can be caused by allergies, growths in the nasal passages called polyps or even migraines, Williams said. A combination of several different approaches, such as medication and nasal irrigation, can be effective.
For Gillespie, balloon surgery was an option after Williams did a CAT scan and nasal exam.
Gillespie said she was up and about a day after the surgery. Her sinuses were still slightly stuffy, something she was told would initially happen. But the pain, even from the surgery, was going away, Gillespie said Sunday.