Chronic Sinus issues- the Hierarchy Perspective
- O Institute
- Jan 3
- 7 min read
If you are a clinician, this series is for you.
If you are not a clinician but just interested in learning more about health related issues from a more holistic perspective, welcome.
Either way, we hope to be of value in your endeavor to improve your knowledge and health.
Joy is not an immune compromised, sickly young woman.
She is a normal 17 year old high schooler with sinus problems.
But her sinus problems are not the seasonal allergy type like most of us.
Hers is at a different level.
However, like most people, Joys' parents just figured they could give her some Benadryl or other over-the-counter antihistamine and it would be fine. This is how we medicate our issues nowadays, after all.
When that and every other drug didn't work, it was finally time to see a specialist.
The Eyes, Ears, Nose, Throat doctor (EENT) recommended sinus surgery.
Surgery.
For a 17 year old.
For sinus congestion.
"Do you have a cold?"
"No...it's my sinuses," Joy answers sheepishly.
She is tired of always having to explain why her voice sounds stuffy, or why she is constantly blowing her nose. At 17 years old, it's exhausting and embarrassing.
This is what she shares with me about her life even after her sinus surgery.
Stuffy.
Runny nose.
Congested.
Constantly thinking about how she looks, sounds and constantly embarrassed. Not a great way to spend high school.
She has had all the tests.
Seen all the people.
And still there is little to no change.
Her parents bring her to see me in the hopes that we can somehow see something that everyone else has missed; basically a last hope.
We are the long shot.
First off, doctor, you have to have a basic understanding of the Hierarchy approach.
We are not just looking upstream at what may be contributing to a patient's symptoms, we are trying to identify which biological systems have broken down and how that explains what is happening at a physiological level.
We are not chasing symptoms.
What do we know?
First, the chief complaint is sinus drainage issues with polyps of 2+ years ongoing.
History of antibiotic therapy multiple times with temporary effectiveness.
No food allergies she knows of but dairy seems to make it worse.
Always feels bloated.
No headaches associated.
Does not seem to get better overnight- wakes up congested.
What systems of the body are affected based on what we know?
Microbiome
Microbiome
Gut lining health
Digestive systems/Microbiome
Lymphatic/Detoxification
Lymphatic/Detoxification
We actually don't know too much more than this. So from a "systems" perspective, we want to support the rebuilding of these foundational systems.
*If you are not a clinician, this may not be as relevant to you. If you want to skip to the rest of the story scroll down to What Happened?
Hierarchy Approach:
Gut microbiome foundational support:
Supplements- broad based probiotic to re-innoculate healthy bacteria to re-establish healthy microbiome balance,
Hierarchy Approach
Our specific protocol below.
You can order direct or use as a template for creating your own protocol.
We start with the microbiome because it is the keystone of all the other systems. If it is not functioning properly, it will sabotage any other treatment protocol you try.
Trust us.
The next phase of our approach is the support digestion.
Why?
Because if you cannot digest and absorb the food you are eating, you have no fuel to run the body. Without this fuel, your body will cannibalize other systems in order to maintain function.
Nowadays, everyone has some form of digestion imbalance.
Key factors that contribute to digestive imbalance:
eating too much at once
eating too late
processed foods
inadequate fruits/vegetables (fiber)
stress
inadequate stomach acid (yes, not enough!)
sedentary lifestyle-slows transit time
poor hydration
toxins
It's no wonder so many of us have digestive issues.
In future posts we will discuss and provide specific protocols to support digestion.
Detoxification is next.
Your microbiome is supported.
Your digestion and "diet" are getting on track.
Now your body needs to be able to properly dispose of the toxins it has accumulated over time.
Toxins are stored in fat.
Then the fat cells are filled with water to dilute the toxic load.
If your body's toxic load is greater than it's capacity, you have toxicity issues; it's basic math.
Some consequences of increased toxic load?
fatigue
bloating
water retention
skin issues
poor drainage/congestion
brain fog
constipation
varicose veins
bad breath
The organs responsible for detoxification:
liver
intestines (including the microbiome!)
kidney
lungs
skin
Next we support cellular replication.
Stable gut microbiome.
Digestion supported.
Detoxification pathways cleared.
Now, we must support how the body rebuilds itself.
Again, we will post the specific protocols in future posts, but the simple answer to this is phase is:
colorful foods! Eat as many colors of a rainbow daily.
exercise
stress management
WHAT HAPPENED?
After she completed the foundational supports, her sinus drainage improved.
Essentially, everything resolved.
No more sinus congestion.
No more runny nose.
No more having to explain her voice or embarrassing moments.
It was a miracle. But not really.
When the body is not draining, that means the entire system is not draining, NOT just the nose or sinuses.
Understanding that all the systems, noted above, play a role in this, helps create an entirely different perspective on how to build health and deal with symptoms. Rather than just short term symptom management, you are helping to rebuild a healthy body that can do what it was meant to do.
If you stabilize the microbiome, support digestion, detoxify, and help rebuild, the body functions "normally" and even optimally.
A sinus drainage issue is a message that something is wrong. Eliminating the messenger does not eliminate the issue.
Simply using a "natural" alternative to killing the messenger ALSO doesn't resolve the issue. And that is what we see a lot of; natural "remedies" that basically are a substitute for drug therapy.
We are not saying that it's bad. But it is not improving overall health status. And it's definitely not improving the bodies' function.
IT'S NOT ALL RAINBOWS AND BUTTERFLIES, OR MOLD.
This would have been a wonderful end the story. We would love to tell you that Joy never had an issue every again.
But then college happened.
As a freshman in college, the symptoms slowly came back.
And like a lot of patients, Joy forgot what she had learned during our time together.
What are you eating?
When are you eating?
How much?
What are your stress levels like?
Are you exposed to any toxins regularly?
We sorted some dietary stuff out, sent her some supplements to help with her stress and digestion and things improved.
But did not resolve.
And then it got worse.
Nobody could figure it out, including us.
Until one day, they discovered mold.
Mold in the college dorm.
Luckily, we didn't have to deal with a mold infection but we did need her to move out of that place and not have more exposure. It was an ordeal.
She finally got out.
Things improved again.
She was reminded of diet, exercise, stress management, and toxicity and she fell into a "healthy" routine.
THE NEXT CURVE BALL
On one of her home visits, she came in for an update and evaluation. She complained of stomach pain.
What is the difference between pain associated with bloating and "stomach" pain?
Usually, bloating is felt in the lower abdomen and stomach pain is felt in the upper abdomen, specifically on the left side.
We saw this as a good sign.
Why?
Because when you are overwhelmed with all the stuff Joy was when she first presented, it's difficult to go deeper. So many things are dysfunctional that you really don't have a ton of clarity. Having a clear message of stomach pain was a lot easier to investigate.
Where do you start?
We recommend testing.
GI Map is the most comprehensive test for gut health and microbiome composition.
What did we learn?
H. Pylori overgrowth.
If you don't know, H. Pylori is the organism that is responsible for peptic ulcers, a.k.a. stomach ulcer.
Now functionally, we understand that you don't technically have an infection of H. Pylori since it is always present, somewhere. But having it in your stomach means the stomach environment is ripe for infestation.
There are two ways to deal with an H. Pylori infection:
The traditional medicine method of broad spectrum antibiotics.
Utilization of herbs and supplements.
Both have the same results but we were not excited about having her take antibiotics, again. Especially after all the work she had done to restore a healthy microbiome.
To learn more about the two approaches, you can watch this video.
H. Pylori overgrowth
Our specific supplement approach
Order direct or use as a template to create your own protocol.
So we supported her with our protocol and she was able to resolve all her symptoms once again.
Whoohoo!
ONE LEVEL DEEPER
The big question is WHY?
H. Pylori can only establish itself in an environment of inadequate acidity because the normal acidity of the stomach is way too acidic for it to survive.
So then why did it happen?
Why does stomach acid levels reduce?
Well it reduces naturally when we age but she is 18 years old.
It can be reduced under stress since we do not produce stomach acid or any digestive enzymes under "fight or flight."
So we asked different questions...
How are you dealing with stress?
Her answer. "I have pretty bad anxiety. "
"I overthink everything."
"I have a lot of negative self talk."
A-ha!
EPILOGUE
Hopefully, this case gave you some insight and curiosity to learn more and dig deeper. Now at this point, we are not the primary person to help with her anxiety, but we know what the underlying stressor is that created this cascade in the first place.
Prolonged anxiety led to digestive issues and drainage issues.
Compounded by poor sleep.
Susceptibility to bacterial overgrowth or infection.
Immune overload.
Lymphatic and toxicity problems.
Finally manifesting in her sinus complaints.
The Hierarchy Approach
People need a HEALTH CARE system.
And healthcare is a lifetime journey of support.
It doesn't end when your symptoms go away.
It takes time.
It requires continuous updates and communication.
It requires a systems mindset to health.
When we say health, we mean building health NOT treating disease.
Traditional medicine does an okay job of treating disease.; that doesn't have to be our model or approach.
Ask yourself, do you want to be moving towards optimal health or just try to avoid disease?
Medical Wisdom Mission
Our goal with these case studies is to support the development of future clinicians with a more holistic perspective of care. This perspective, we hope, will facilitate a revolution in health care. A revolution that creates a separate discipline of care dedicated to promoting optimal health NOT an alternative to traditional medical therapy.
If you are a practicing clinician and have questions regarding this case or our model, reach out to us via info@hjieerarchymedicine.com. We are happy to connect.
If you not a clinician, please DO NOT contact us as we are not able to treat your unique case remotely.
Author
Dr. Thomas Kim, D.C.
Chiropractic physician
30 years of clinical experience utilizing chiropractic care with functional medicine.
Post doctorate focus on stress physiology
Chief Wellbeing Officer, Hierarchy Medicine
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