Men's Journal

For millions of Americans, a stuffed-up nose and constant headaches are a way of life. But a new surgery is changing that.

By Paul Solotaroff

It’s a dark day in august and I’m playing roughhouse hoops on a Brooklyn court. I’ve got the ball at the arc, and I’m driving right, ready to launch myself six feet from the tin. Halfway in the air, though, something happens — either the rim recedes or I stop gliding. No finger-roll lay-in, just a plop-plop air ball that hangs there like a bag of bruised tomatoes. The shame is fierce, but I’ve got bigger problems: I can’t breathe. Terrified and heaving for air, I grab for my pocket inhaler. It’s useless. This clearly isn’t asthma. Asthma I know, having had it since boyhood. This feels more like trying to breathe through glue. After a while, I’m steady enough to call my doctor. His diagnosis: a sinus infection. But by the end of October, I’ve been through four different drugs and nothing is working. Finally, I’m sent to a sinus surgeon, Dr. Clark Huang in Manhattan. He eases a wire lens up my nose, then screens the feed on his laptop. “Amazing,” he says. “A total disaster. Not one of your sinuses works.”

THE  SCIENCE
Sinuses are humidifiers for the lungs. Located in the forehead, behind the cheekbones, and between and behind the eyes, they’re carpeted with mucus membranes to warm and moisten incoming air. According to the Centers for Disease Control, more than 30 million Americans have chronic sinusitis, caused by infections or structural deformities that arise from genetic abnormality or trauma (like a busted nose).

About half of sinusitis cases stem from structural problems that a new operation called sinus revision surgery can repair. (It’s harder to fix problems related to immune-system woes, such as chronic inflammation caused by allergies or chronic fungal infection.)

Some symptoms of blocked sinuses are obvious —headaches, discharge, congestion — but others you may not connect to your sinuses at all. “Many of my patients have chronic fatigue, and post surgery, people say they can’t believe how depressed they were,” says Huang. “The body’s resources are used up fighting sinus infections, and they have no energy at work or in the gym.”

Luckily for me, I have structural issues, having shattered my nose twice. Ten years ago, there wouldn’t have been a doctor anywhere who could have helped me. But now a technical breakthrough of the ’80s — the endoscope, a meandering rod with a light, lens, and magnifier — has evolved into a tool of such precision that surgery is performed exclusively through the nostrils, with minimal sawing and blood loss. Through the endoscope’s cam, surgeons see previously obscure regions and can cut back to the rearmost sinuses, which butt up against the brain. The second coming of magic was computer-guided navigation, an imaging device that maps the head in 3-D and tells the surgeon his location at all times. This proved to be a major boon for me: My sinuses were so mangled that Huang couldn’t tell which was which.

THE  TREATMENT
Five weeks after my first meeting with Huang, I show up at a Manhattan hospital for a revision of all four pairs of sinuses. During the two-hour surgery, Huang finds walls where there should have been sinus openings and slices wafer-thin bone with a floppy, weed whacker–like blade to open things up. When I awake, I’m stunned to find there’s next to no pain from the cutting. There is, however, bleeding — a slo-mo seep from my splinted, gauze-packed nose.

In his office the following week, Huang removes the splints. In goes the clearest breath of air I’ve ever taken in my dammed-up life, a blast so pure and unconstrained that I break into a madman’s giggles. Huang is pleased but urges me to take it easy for a while. Sorry, can’t oblige: I feel reborn. That night I hit the gym, where I’d slogged along, listless, for months. In a fortnight, I’m benching 245, a weight I haven’t lifted since grad school. But the best gift by far is my mood: I feel literally lifted by air.

“I hear it all the time from post-op patients: They’re on the treadmill breaking their own records,” says Huang.

In just a week, I’m back playing half-court ball. I still don’t have much ups, but that finger roll’s as soft as the breeze.

—-

This article originally appeared in the September 2009 issue of Men’s Journal.

Print this article