Can Balloon Sinuplasty Help Relieve Chronic Rhinosinusitis?

Jan 27, 2021 | Ear Nose Throat, Your Health

Approximately 15 percent of adults in the United States experience debilitating symptoms of chronic rhinosinusitis (CRS), which include congestion, runny nose, and headache. Far fewer, however, seek the advice of a physician. Satish Govindaraj, MD, Chief of Rhinology and Sinus Surgery, at the Mount Sinai Health System, discusses a variety of innovative treatments that have significantly improved the quality of life for tens of thousands of patients each year.

Satish Govindaraj, MD, Chief of Rhinology and Skull Base Surgery at the Mount Sinai Health System

What is chronic rhinosinusitis?

Most of us have had a runny or stuffy nose at some point in our lifetime. When these symptoms last for a few days or even weeks you may be diagnosed with a condition known as acute sinusitis. Chronic rhinosinusitis (CRS), however, occurs when the sinuses passages—four pairs of hollow cavities in the nose and head—swell and are unable to properly drain for a period of three months or longer.

What are the symptoms?

Patients with CRS typically experience persistent nasal drainage, congestion that impacts their ability to breathe, headache, facial pain or pressure, fatigue, and difficulty smelling or tasting. These symptoms can have a tremendous impact on your ability to work and enjoy leisure time.

What treatments are available?

When the sinus passages swell and are unable to drain, mucus gets stuck and can become infected. The key to treating CRS is to reduce this inflammation. The first line of defense is always medical management, including nasal saline irrigations that flush out the nasal passageways, topical steroids sprayed into the nose to reduce swelling, and oral antibiotics which treat infection. If medical management fails, numerous surgical options are also available. Mount Sinai’s ear, nose, and throat specialists (otolaryngologists) are highly trained in a variety of minimally invasive procedures that can be performed in the office setting without making an incision.

Am I a candidate for balloon sinuplasty?

We partner with patients to develop an individualized treatment plan based on their unique anatomy, symptoms, procedure tolerance, and medical history. Patients with CRS are typically eligible for balloon sinuplasty if their symptoms have not improved with medical management and they have had four or more sinus infections in one year.

How does balloon sinuplasty work?

Balloon sinuplasty opens up the nasal passageways. During this in-office procedure, a thin wire or probe with an attached balloon is guided through the nose into the swollen sinus cavity. When the balloon is in the correct spot, it is inflated and dilates the blocked passageway—similar to the way a stent is used to open up a clogged artery. The sinus cavity is then irrigated or flushed with salt water to allow the trapped mucus to drain out.

What distinguishes Mount Sinai with balloon sinuplasty treatment?

Many of our ear, nose, and throat physicians are fellowship trained in sinus surgery and receive additional education in performing the balloon sinuplasty procedure. Mount Sinai surgeons also specialize in using image-guided CT scans to precisely navigate tiny instruments through the nasal passageways. As a large, tertiary medical center reputable for managing complex cases, patients can feel safe knowing there is a multidisciplinary team at every surgeon’s fingertips. We have multiple locations throughout New York City, making it easy to find care close to home.

What are the benefits of balloon sinuplasty?

Research shows numerous advantages to having a balloon sinuplasty, compared to traditional sinus surgery. These include:

  • Faster recovery time — patients report fewer missed days of work or school
  • Use of local sedation rather than general anesthesia — the procedure is performed in a doctor’s office rather than an operating room using numbing agents and IV sedation when necessary
  • Shorter operating time — depending on how many sinus cavities are affected, the procedure typically takes one hour
  • Comparable outcomes to more invasive sinus surgeries in patients with mild to moderate chronic sinusitis
  • Fewer side effects, including pain, soreness, and congestion — the surgery does not require an incision or any tissue or bone to be removed
  • Minimal follow-up care — there is no nasal packing after the operation

What is the follow-up treatment? Will my CRS return?

A balloon sinuplasty procedure causes minimal disruption to daily life—most patients return to work the next day. In an abundance of caution, individuals who have sinus surgery should not exert themselves physically for a few days. Follow-up appointments are typically made in one to two weeks. The overwhelming majority of patients who have balloon sinuplasty notice a significant improvement in their symptoms. The length of time individuals experience benefit depends on the severity of their disease and whether or not they have other compromising disorders such as allergies or immune system conditions. To ensure success, it is important that patients continue to take their medication regularly after surgery and properly irrigate their sinuses with nasal rinses.

Learn more about ENT services at Mount Sinai
Make an appointment with Dr. Govindaraj

Thyroid Cancer: Total Thyroidectomy or Hemithyroidectomy – Which is Right for You?

Updated on Jun 30, 2022 | Ear Nose Throat, Your Health

Physicians are taught to make recommendations based on research and experience. But Marita Teng, MD, Professor of Otolaryngology – Head and Neck Surgery at Mount Sinai, often finds herself telling patients that decisions in thyroid cancer surgery are becoming as much personal as medical. The ‘right’ decision regarding whether to biopsy a thyroid nodule, or how much surgery to have, she explains, is different for every patient.

Marita Teng, MD, Professor of Otolaryngology – Head and Neck Surgery at Mount Sinai

This is particularly true in the field of thyroid cancer, where so much of the thinking and approach has changed in the last five years. The American Thyroid Association (ATA) published more than 100 new recommendations for the treatment of thyroid cancer in 2015. One of the most remarkable changes, and difficult decisions for patients, is determining what type of surgery to have.

“We are living in an age of information being at people’s fingertips and a culture where shared decision-making is more prevalent,” explains Dr. Teng. “Many times, there is not simply one right treatment path. Clinical outcomes are important, but decisions also depend on what feels right to the patient.”

Choosing between Total Thyroidectomy and Hemithyroidectomy

For decades, total thyroidectomy—a surgical procedure which removes the entire thyroid gland—was considered the gold standard treatment for most thyroid cancers. However, the latest ATA guidelines advocate that removing half of the thyroid gland, a procedure known as hemithyroidectomy, is as beneficial as having a total thyroidectomy in patients with well-differentiated cancerous growths measuring up to four centimeters.

“Some individuals who have thyroid cancer want the entire organ out of their body, so they do not have to worry about having problems with the other side. Other patients want to have as little surgery as possible. After I give these options to my patients, they frequently know exactly which one resonates with them,” explains Dr. Teng.

The Consideration of Thyroid-Stimulating Hormone Post Surgery

There are pros and cons to both hemi- and total thyroidectomy. One of the most important differences is the need for thyroid-stimulating hormone after surgery. The thyroid produces hormones that help regulate important body functions such as the heart rate and metabolism. When the entire thyroid is surgically removed, patients must take synthetic thyroid hormone for the rest of their lives. When half of the thyroid remains intact, close to 90 percent of patients can maintain normal thyroid function without medication.

“Some people shrug it off when I tell them they have to take medicine every day; others absolutely do not want to take a pill,” Dr. Teng says. “I also explain that some patients can be more difficult to regulate with medication than others. It really depends on how much that inconvenience strikes them.”

What Are the Risks of Thyroid Surgery?

The surgical risks of any thyroid procedure are small. But the likelihood of the rare complication, such as injury to the nerve that controls the voice, is cut in half with hemithyroidectomy because the procedure involves only one side as opposed to both. The recovery for both operations is about the same.

One potential downside to hemithyroidectomy, however, is that the remaining side will require monitoring and may potentially need to be removed later. In a small number of patients, a later biopsy finds cancer in the side that was thought to be unaffected.

“We can predict a fair amount before we operate. When I counsel patients, I try not to give them a recommendation that could bring them back to the operating room again,” explains Dr. Teng. “But by taking out the entire gland you never have to worry about that small chance you may need another thyroid operation.”

Dr. Teng says it is important that patients are informed, because implementing new guidelines into widespread practice can be a challenge. In fact, it takes an average of 17 years for an established medical guideline to become common practice. That means it could be be 2032 by the time these 2015 ATA guidelines are consistently followed throughout the country. Patients who were told total thyroidectomy was their only option often see her for a second opinion.

Mount Sinai Provides Patients with a Personalized Approach

“At Mount Sinai, we provide a personalized approach to every case and are up to date on current practice guidelines. We have a multidisciplinary team; for complex cases, our recommendations are evaluated carefully as a group of surgeons, endocrinologists, nuclear medicine specialists, and sometimes even medical and radiation oncologists.  We are thankful to be able to engage our patients in this collaborative decision-making process,” says Dr. Teng.

Learn more about ENT services at Mount Sinai
Make an appointment with Dr. Teng

How Will We Know Any New COVID-19 Vaccine Is Safe?

Nov 20, 2020 | COVID-19, Featured, Vaccines, Your Health

Vaccines for COVID-19 are in the news these days. For many pediatricians and preventive medicine specialists, vaccines have always been one of their most important tools and one of their most trusted measures for keeping patients healthy. In this Q&A, Kristin Oliver, MD, MHS, a pediatrician and preventive medicine physician at the Mount Sinai Health System and an Assistant Professor of Pediatrics, and Environmental Medicine and Public Health, at the Icahn School of Medicine at Mount Sinai, explains why.

Why are vaccines so important?

Vaccines are one of the best tools we have to prevent disease and death in both children and adults. Getting vaccinated is one of the easiest things that we can do to keep ourselves and our children healthy. When I think about all the things I do to stay healthy—eat well, exercise, manage stress—that’s a lot of work. But it’s easy for me to go and get my flu shot, or bring my kids in to get their vaccines. And when I do that, I’m preventing disease, not just in myself and my family, but also in the communities where I live and work.

How do you measure the effectiveness of a vaccine?

There are two measures of how well a vaccine works. One is called “efficacy,” and that’s how well a vaccine works in a clinical trial. That’s a perfect situation where everybody in the trial who is getting the vaccine doses is getting them exactly when they’re supposed to, and they’re being watched really carefully. Later on, we look at “effectiveness.” That’s in the real world—what happens when people get that second dose a little bit late, or things aren’t in such a controlled setting? For both measures, we compare a group of people who got the vaccine to a group of people who did not get the vaccine, and see how many cases of the disease are in one group compared to the other. You hope that there’s a lot less disease in the group of patients who got the vaccine.

In general, how effective are vaccines?

When you get a disease, how long you have protection from getting it again can vary from person to person and from disease to disease. In the same way, how well a vaccine works also varies depending on the disease and the vaccine. Some vaccines have a really high efficacy rate.  For instance the MMR vaccine that protects against measles has 98 to 99 percent efficacy. Other vaccines are not quite as high. The pertussis (whooping cough) vaccine is closer to 80 to 90 percent. The flu vaccine effectiveness varies from year to year, and is closer to 50 percent. Obviously higher is better. We’re hoping that for COVID-19, vaccine efficacy and effectiveness are closer to 90 percent. But we know that’s not always realistic for every vaccine.

Do we know if the COVID-19 vaccine will be effective for the general population, including children and the elderly?

Right now, we still don’t have a complete answer. Early data from some of the clinical trials looks good. As far as children are concerned, the youngest who have started to receive the trial vaccines are 12. We don’t have enough data yet to know how well the vaccine is going to work in these groups.

If I received the COVID-19 vaccine, can I stop wearing a face mask and social distancing?

Not yet. We don’t know how effective the vaccine is going to be, or how many people are going to receive it.  The recommendation is continue to practice social distancing, wear a face mask, and really good hand-washing. We’re going to have to do this for a little while longer.

How long does a vaccine protect you from a disease?

The protection that you get from a disease, either by having the disease itself and recovering, or by getting the protection from the vaccine, is what we call immunity. This protection depends a lot on the type of disease, and the type of vaccine. Unfortunately, right now, we don’t know how long immunity lasts when you get the disease or when you get the vaccine.

Will a vaccine for COVID-19 get us closer to herd immunity for the virus?

It will definitely get us closer. Immunity is the protection you get either from having the disease, or from getting vaccinated against the disease. With herd immunity, enough people in the community have this protection so that even if someone gets the disease, it is not likely to spread widely. At that point even people who aren’t immune won’t catch it. Right now, we still don’t know what percentage of immunity we need to reach herd immunity.

Can we reach herd immunity by letting everyone get infected?

For diseases where we have safe and effective vaccines, it is much better to reach herd immunity by getting everyone vaccinated than it is by waiting to have everyone get infected. We know the severe, terrible consequences of COVID-19, and so we’re looking for a safe vaccine that can prevent the infection.

Once a vaccine is available to the general public, how do we continue to make sure it is safe?

In the United States, we have incredible systems to track vaccine safety. One system allows everybody to report if they’ve had an adverse event—a bad side effect—after they get a vaccine. That’s not just doctors and nurses; it’s anybody in the public who may have received the vaccine. A group of scientists, working through the U.S. Centers for Disease Control and Prevention (CDC), investigate all of those cases to see if there’s a potential problem. Other systems look at big databases and compare people who have gotten the vaccine to people who didn’t get the vaccine, and look for potential side effects or adverse events, really rare things. They compare the rate in the group who get the vaccine to the group who did not get the vaccine to see if there is a cause between the vaccine and that rare side effect. With all these systems in place, I’m comfortable giving vaccines to my patients, and to my children, because I know that these systems work.

Read more about Mount Sinai and COVID-19
Get more COVID-19 vaccination information from Mount Sinai

What You Need to Know About COVID-19 Vaccines

Nov 12, 2020 | COVID-19, Featured, Vaccines, Your Health

There are new headlines every day about the rapid development of vaccines to prevent COVID-19.In this Q&A, Gopi Patel, MD, Hospital Epidemiologist at The Mount Sinai Hospital, Medical Director for Antimicrobial Stewardship for the Mount Sinai Health System, and Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, addresses some of the most pressing COVID-19 vaccine questions.

New Guidance on COVID-19 Vaccines: In April 2023, the Food and Drug Administration and the Centers for Disease Control and Prevention announced some major changes for COVID-19 vaccines. Click here to read more about what you need to know.

In general, how do vaccines work?

Vaccines expose us to pieces of either a bacterium or a virus, and our body mounts an immune response by making antibodies against those pieces. Antibodies are proteins that fight germs like viruses and bacteria by latching onto and disabling them. The goal is that our body will then recognize those pieces and use the antibodies to fight off any future exposure to the real bacteria or virus.

Can a COVID-19 vaccine give me COVID-19?

No.  None of the vaccines in advanced clinical trials can give you COVID-19.

Gopi Patel, MD

Should I get a COVID-19 vaccine if I already have antibodies?

We are learning a lot more about the human response to COVID-19. A lot of people who have had COVID-19 did mount an antibody response, but we don’t know yet how long that response might last. So right now, if you have a history of COVID-19 it is still worthwhile to get a COVID-19 vaccine when they become available.

How will we know if a COVID-19 vaccine is safe?

The Food and Drug Administration (FDA), pharmaceutical companies, and scientists who are involved in vaccine development are all very committed to developing a safe and effective vaccine. There is rigorous testing for all vaccines to ensure safety. During any vaccine clinical trial, side effects or adverse events—health problems that happen after the vaccine is given, which may or may not have been caused by the vaccine—are recorded and monitored by safety monitoring boards before the vaccine becomes publicly available through either an Emergency Use Authorization or through FDA approval. All that data is made available and will be quite transparent. The goal is a safe and effective COVID-19 vaccine.

What if many people do not get a COVID-19 vaccine?

It is hard to say. Currently, the recommendation from the FDA is that if a COVID-19 vaccine is made available, it has to be at least 50 percent effective. That means when you test the vaccine in clinical trials, the group of people who got the vaccine has at least 50 percent fewer cases of COVID-19 than the “placebo” group who didn’t get the vaccine. I think there are lots of questions about how many individuals need to be vaccinated to reach what we call herd immunity, where the rate of immunity throughout a community makes the spread of a particular disease between individuals less likely.

What is herd immunity?

Herd immunity is the idea that you can protect vulnerable people if most of the population gets vaccinated and develops an immune response. We talked about this with something that hit New York hard in 2019, which was the measles. In the case of measles, when most people are vaccinated, that protects those individuals who cannot get vaccinated—the very young or those who have immune systems that can’t respond to the vaccine. So that’s the idea of herd immunity. It is very unclear at this point what herd immunity means for COVID-19. It may be that a lot of people may make antibodies, but we also have to make sure people don’t transmit infection. So practices like wearing masks, washing hands, and watching your distance are still really important, even in the setting of a vaccine.

How is Mount Sinai involved in the testing of a COVID-19 vaccine?

We’re very lucky at the Mount Sinai Health System in that we are actually involved in trials of COVID-19 vaccines. We’ve been involved in the trial of the Pfizer vaccine, one of the candidates that is furthest along in the process, and we’re starting enrollment in other trials soon. So we are prepared in terms of looking at the safety and efficacy of the four vaccines that are most advanced in Phase 3 clinical trials.

How is Mount Sinai planning for administering a vaccine once it becomes available?

Mount Sinai is already looking at how we would distribute and allocate a vaccine. It is important to remember that this vaccine would be administered under an Emergency Use Authorization from the FDA. So what would that look like? Who would we offer vaccination to, and how would we monitor those individuals? How would we make sure that we offer the vaccine to those who are most vulnerable to COVID-19 infection, whether it be in the community or in the health care setting? We know our health care workers are at risk. But we also know there are essential workers outside of health care who may be at risk. We’re working with our public health authorities—including the New York State Department of Health and our New York City Department of Health and Mental Hygiene—and watching the safety and efficacy data closely. Members of our Icahn School of Medicine at Mount Sinai faculty are working with New York State on the safety, efficacy, and evaluation of any vaccine candidate that becomes available in the next few months.

Read more about Mount Sinai and COVID-19
Get more COVID-19 vaccination information from Mount Sinai

How to Safely Celebrate With Family This Holiday Season

Nov 9, 2020 | COVID-19, Your Health

Cozy family gatherings are a staple of the winter holiday season. But this year, with COVID-19 continuing to circulate throughout the country, getting together with family will look decidedly different.

In this Q & A, Krystina Woods, MD, Hospital Epidemiologist and Medical Director of Infection Prevention at Mount Sinai West, answers questions about how families can celebrate the holiday season while preventing the spread of COVID-19. 

Read the latest recommendations from the CDC urging Americans to stay home this holiday season

How can families in the tristate area safely celebrate together this holiday season?

This year, in particular, everyone is really looking forward to holiday festivities because this has been a year in which we have had to keep our distance from friends and family. However, like with the rest of the year, the safest thing to do this holiday season is to gather virtually. Throughout the COVID-19 pandemic, we have learned that gathering outdoors presents a lower transmission risk than gathering indoors. But in the northeast, most of the holidays that we look forward to are going to be in colder weather which makes meeting outdoors impossible or, at the very least, uncomfortable.

I know that there are many people who are not looking forward to celebrating virtually, but in terms of safety, the best thing to do is to not meet in person.

I am hosting a small holiday dinner. Are there health-related questions I should ask guests before arriving?

If you are going to take the risk of gathering indoors, the most important thing to do is to make sure that everyone in attendance is taking precautions outside of the gathering. If you—the host—are very careful about masking, washing your hands, limiting outside activities, and you are working from home, then your risk for contracting COVID-19 is going to be low. So, you want to think about the people coming into your home. They should have a similar risk profile to yours.

It defeats the purpose for you to be super careful, and then invite someone to your home who is taking risks, like going out to a lot of events or parties. So, it is a good idea to get a sense of a guest’s risk profile if you don’t already know.

In a blog post on how to safely date during a pandemic, Mount Sinai pulmonologist Lina Miyakawa, MD, advised asking potential partners the following risk profile questions. They provide a great start in assessing anyone who enters your home for a holiday get-together.

To assess your guest’s risk profile, you can ask them these questions:
  • How many contacts do you have on a daily basis?
  • Who do you live with?
  • Do you leave the house? If so, where do you go?
  • Do you follow the recommendations to mitigate the risk of exposure, like wearing a mask and practicing social distancing?
  • Do you work in situations with high exposure risk?

If families choose to gather, what precautions should they take to minimize the risk of spreading COVID-19?

Here are five suggestions:

Head outdoors. If families insist on meeting in person, the most important thing would be to try to gather outside. But again, with the weather being what it is in the tristate area for the winter holidays, that will be tough.

Keep it brief. Although it goes against what we all think about holiday celebrations and how to enjoy them, keep any gatherings relatively brief. The longer you are with a group of people, the more chance you have of possibly getting sick.

Keep the numbers small. This isn’t the time for large extended family gatherings. This is the time to think about keeping the group smaller.

Increase the air flow. If you have to be indoors, make sure that the space is well ventilated. While it is not environmentally friendly to have windows open while the heat is on, it is essential to have fresh air coming in.

Mask up and keep your distance. If you are going to gather indoors, wear face coverings for as much of the gathering as possible. That may feel strange since you are inviting a sister or a parent to your home, but given the pandemic, it would make an indoor gathering safer for everyone. It is also important to keep six feet of distance from others, even if you’re wearing masks inside, and especially when you’re eating.

Should changes be made in how food is served?

Buffet-style meals are not ideal because you don’t want a whole lot of people handling utensils.

There are two different ways to serve food in a safer way. The first is that everybody brings their own dish which, would not work for a holiday like Thanksgiving because you will have a ton of food leftover. The second is that you have one person serve everyone, preventing each family members from touching the tongs, the spoons, the forks, etc., when filling their plate. This person should be masked and should clean their hands before touching any dishes or utensils. 

Also, when sitting to eat, you should try to distance people by six feet. More space is better, but those who live in and around the New York metropolitan area don’t always have the luxury of ample space. However, if you will be gathering, try spacing out with six feet being the minimum.

Is it safer to gather indoors if all family members get tested for COVID-19 prior to gathering?

There are a lot of questions about using testing as a sort of permission slip to meet up with others.

If you test before you have a get-together, it is helpful if someone comes back with a positive test result. At that point, you know for sure that this person should be excluded from the gathering. However, it is not so helpful when someone receives a negative test because it does not give you an idea of their potential to turn positive within the next day or the next few days.

For example, if I receive a negative test on Monday, this result does not tell me what my status will be on Tuesday or Wednesday. So, if I attend a family gathering on Wednesday and I start experiencing COVID-19 symptoms on Thursday, everyone who I met at that family gathering will have been exposed to the virus.

Unfortunately, I think testing is giving people a false sense of security. You should continue to take all precautionary steps, specifically if your test result is negative. And, if it is positive, you know that you should be isolating at home and taking care of yourself.

How can families maintain safety in the 14-day window following an indoor gathering?

After any gathering, especially one that is indoors, keep your distance from other people in the two weeks following. This limits the potential that you unwittingly expose anyone to COVID-19. Also, if you go to a party and two days afterward an attendee tests positive, you will have to quarantine. So, if you kept to yourself for those two days after the party, you will not need to worry that you exposed a friend, colleague, or loved one to the virus.

See this flyer for more tips from Mount Sinai for how to have a safe holiday season

Read more from Mount Sinai about COVID-19
Watch more of Mount Sinai's COVID-19 video series

How to Manage Migraines During Stressful Situations

Nov 2, 2020 | Neurology, Your Health

Migraine headaches can be debilitating, and undue stress can exacerbate the condition, creating new problems. Lauren R. Natbony, MD, a headache specialist at the Mount Sinai Center for Headache and Facial Pain and an Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai, provides some suggestions for how to manage your headaches when life gets stressful.

What’s the difference between a migraine and a regular headache?

Headache is a catchall term for any type of pain in the head. Almost everyone has experienced a headache in his or her life. Migraine, however, is more than just a headache. It is a chronic and disabling neurologic disease that affects the way the brain processes pain. Headache is only one symptom of migraine and typically presents with moderate to severe pain on one side of the head. The pain tends to have a pounding or throbbing quality and it often gets worse with movement. Other symptoms include sensitivity to light, sound or smells, nausea and vomiting. Some people may also see spots or flashing lights in their vision. We think that migraine is likely genetic, meaning that it runs in families and is inherited.

How does stress affect migraine sufferers?

Stress can cause migraine and migraine can cause stress. Since they both feed each other, it can turn into an endless cycle. Stress causes various chemical and hormonal changes in the body. In some people, these changes can trigger a migraine. And, if your body is accustomed to daily stress, a day without stress—like a weekend or special event—can result in a letdown migraine. This can be a real bummer and can ruin any attempt to unwind.

How should migraine patients cope with unexpected stressors?

The COVID-19 pandemic is a great example of an abrupt, unexpected stressor and a change from normalcy. First, it is important to recognize that the migraine brain is very sensitive to change. Thus, keeping a consistent schedule every day to minimize change is crucial for migraine sufferers. Multiple lifestyle modifications can also help the brain cope better with stress.

What can patients do to help manage their migraines?

First, establish a sleep routine, as sleep is essential for brain health. Try to go to bed at the same time every night and wake up at the same time every morning. While it can be difficult to get good quality sleep during stressful times, it’s something that should be prioritized for everyone—especially migraine sufferers. It is also important to have a morning routine, whether it’s going outside for some fresh air after waking, talking on the phone to a loved one, or drinking a hot beverage while reading the newspaper.

You should also eat something rich in protein within 30 to 60 minutes of waking up. Throughout the day, eat healthy, nutritious meals with plenty of fruits, vegetables, and protein. Try to eat something with protein every three to four hours. Protein helps to stabilize blood sugar levels, and abrupt changes in these levels can trigger migraine. Also, be sure to stay hydrated by drinking at least 64 ounces of water a day.

Another thing that can be helpful is exercise, which is a great stress reliever. Engaging in regular physical activity—ideally at least 30 minutes, five days a week—will help reduce stress not only in the moment but also over time. Relaxation techniques like yoga and meditation are also helpful and have evidence for benefit in migraine

Do I need to schedule an office visit with a headache specialist or are video visits just as worthwhile?

Video visits are a great option for those with migraine and headaches. The fact is, patients with migraine do not love coming into the office. Travel to the office itself can be a stressor. Likewise, the office can seem bright and noisy and trigger a migraine for some.

Seeing patients in their own space is extremely helpful. For example, I have patients who do not know all the medications they are taking. During video visits, I have them walk over to their medicine cabinets and show me the bottles. We review the medications—and their doses—and I can give them much better advice. I also have patients who will tell me they do not have space to exercise. During video visits, I can see their home and together we can carve out a space for exercise. I can also suggest different lifestyle techniques based on their living environment to improve headaches.

Why see a specialist?

It’s important that migraine sufferers work with doctors who understand the condition. There are many treatments available, but treatments should be tailored to each patient’s lifestyle and health concerns. I aim to help my patients control their headaches, especially during stressful life events.

At the Mount Sinai Center for Headache and Facial Pain, we understand what you are going through and are committed to working with you to get you the relief you need.

Learn more about the Center for Headache and Facial Pain at Mount Sinai
Read more from Mount Sinai about Your Health

Pin It on Pinterest