Episode Transcript
[00:00:01] Speaker A: You're listening to the Doc Lounge podcast. This is a place for candid conversations with the healthcare industry's top physicians, executives and thought leaders.
This podcast is made possible by Pacific companies, your trusted advisor in physician recruitment.
[00:00:20] Speaker B: Welcome to the Doc Lounge podcast, your go to destination for insightful conversation with leading healthcare professionals. I'm your host, Stacey Doyle, senior director of marketing at Pacific Companies. In today's episode, we're delving into the fascinating world of migraine treatment with Dr. Kevin Smith, an ear, nose and throat specialist, or ENT, and facial plastic surgeon whose pioneering work is transforming the lives of migraine sufferers worldwide. Dr. Smith is the author of the Migraine Impostor, a book that explores the often overlooked link between nasal abnormalities and chronic migraines. With over 4000 successful procedures and a remarkable 90% success rate, Dr. Smith brings a wealth of knowledge and practical experience to our discussion today. In this episode, we're going to uncover the hidden link between these nasal irregularities and migraines and learn about how Dr. Smith's innovative surgical approach is offering really profound relief for migraine sufferers and explore the future of migraine treatment. So sit back and relax and enjoy amazing episode as we unlock these secrets with Dr. Kevin Smith. So I want to go ahead and welcome you, Dr. Smith, to the podcast and would love to just learn a little bit more about you and what got you into the world, know everything you're doing today.
[00:01:46] Speaker C: Well, thank you so much for having me. I'm very excited to be on the podcast and to share what I know and to help people who are out there suffering needlessly.
I am, like you said, an ear, nose and throat facial plastic surgeon, double board certified. I've been practicing about 30 years.
Went to University of Michigan. Go blue. We won the national championship in football. And I had a football scholarship there and actually went there because I knew I wanted to be a doctor. So whoever was top ten football, top ten premed, that's where I decided to go and then decided to come back home to Texas. Went to medical school at the University of Texas, McGovern medical school, and did my residency in ear, nose and throat there. And then a facial plastic surgery fellowship in Birmingham, Alabama. Came back to Houston, set up my practice in the medical center, the largest in the world, and stayed there for about 17 years until I moved to my current location, which is north of Houston in the Woodlands, Texas.
[00:02:44] Speaker D: Nice.
[00:02:46] Speaker B: So what originally thought, okay, hey, I want to be an ent or I want to be a facial plastic surgeon. What made you do?
[00:02:57] Speaker C: You know, it goes back to being in tune with your personality. In high school, I was in drafting class and entered into some home design competitions in place. And then I was a junior draftsman at this company during the summers, redrawing these old yellow drawings. But it required me to be very exact and detailed and accurate, and so that's just part of who I am. And I've always liked these fine, dainty, intricate things, whether it's my toy cars I used to put together or my little football men on those little electric football machines we used to get, I'd have them painted exactly like they should have been. So that's just being in tune with the artistic side of me. Once I got to medical school, though.
[00:03:39] Speaker D: I really enjoy the head and neck anatomy.
[00:03:42] Speaker C: It's very confined to just the head and neck. There are bones, there's muscle, there's fat, there's tissue, there's nerves. It houses all the senses. And I really enjoyed that. And at the time, I'm going to.
[00:03:55] Speaker D: Be honest, I didn't know there was a specialty called ear, nose, and throat at that time as a first year.
[00:04:00] Speaker C: So as I got to my third year, I recall one of my classmates saying how they just enjoyed this rotation on ENT.
The residents were nice, and the attending seemed to be cool. And I was like, what is ent? And they told me, and I was like, you mean there's a specialty in this area only? So I immediately went and asked the chief resident if I could scrub in on cases, because I was doing psychiatry.
[00:04:24] Speaker D: Getting out at noon every day, and.
[00:04:26] Speaker C: So I would go. Get out at noon, go scrub with them, and the rest was history. I loved it. Got to know the folks there at ut really well, applied, got in, and then decided after my residency in ENT that I really should know how to.
[00:04:41] Speaker D: Do a good rhinoplasty. And so that sent me on the course of getting a fellowship in facial plastic surgery.
[00:04:49] Speaker C: So now I mainly do rhinoplasties, eyelid surgery, and facelifts. Those are the three main things that.
[00:04:55] Speaker D: I do, so it fulfills my personality.
[00:04:57] Speaker C: I mean, I love the intricacies of both the creativity of the facial plastic.
[00:05:02] Speaker D: Surgery, because you have to be an artist.
[00:05:04] Speaker C: You really have to be an artist to put incisions on people's faces and make them look better.
[00:05:12] Speaker B: Oh, that's so cool. That's really neat. Now tell us, I've heard that there's now something called a headache fellowship. Do you have any advice for thinking of residents that are becoming, they want to be you? What would any advice you'd give to them.
[00:05:28] Speaker C: Well, the fellowship, that would have to be. It had to come from me, because the procedure I do was developed by me. And if somebody else tried to do.
[00:05:35] Speaker D: It without the proper training, you won't.
[00:05:38] Speaker C: Get the results that I get.
And people would then think that, oh, I guess my migraines are caused by something else. But there are fellowships. You have to go back to medical school. Let's go back there and talk about how migraines are taught, even currently, that.
[00:05:54] Speaker D: They originate in the brain.
[00:05:57] Speaker C: A vascular dilation of vessels in the brain causes the pain.
[00:06:00] Speaker D: And I was with that mindset for.
[00:06:03] Speaker C: A long time until I got into.
[00:06:05] Speaker D: Ent and noticed early on that I.
[00:06:08] Speaker C: Was doing surgeries on people with these.
[00:06:10] Speaker D: Really bad headaches, and they would go away.
So initially, I thought, wow, okay, these.
[00:06:17] Speaker C: Headaches are acting like migraines.
[00:06:19] Speaker D: And I call them migraine imposters, because.
[00:06:23] Speaker C: I looked at the data and they were coming in with these histories of migraine, but they were getting better. And so I said, well, no, these can't be migraines, because migraines are in.
[00:06:31] Speaker D: The brain and I'm doing something in the nose.
[00:06:33] Speaker C: And so let's try to get some of these migraine patients in here to.
[00:06:37] Speaker D: See if they have what I'm looking for.
[00:06:40] Speaker C: So I do this, and one day, I was on television, national television, and I said, if you have migraines and.
[00:06:48] Speaker D: They aren't getting better, you can have.
[00:06:50] Speaker C: Access to my expertise by just getting a sinus CT scan. Send it to me. I will see if you have the abnormalities that I know cause these migraine imposters.
[00:06:59] Speaker D: Well, I got scans from all over.
[00:07:01] Speaker C: The country, and you can look at this as a randomized trial, right. These are people across the country who have migraines. They've seen all the expert neurologists.
[00:07:10] Speaker D: I don't diagnose migraines. Okay.
[00:07:13] Speaker C: People come to me already diagnosed, and I started getting these scans in my.
[00:07:18] Speaker D: Office, and I had an idea what percentage might have the abnormalities. But as I looked at all these.
[00:07:26] Speaker C: Scans, nearly 100% of the scans had the abnormalities that I know caused the pain.
And they come in, get their procedures.
Like you mentioned earlier, the success rate is about 90%. And it gets better because you can understand the things I do now are a little different from the things I used to do, and I refine it every time I go. I learn something about what it takes to really get a high percentage of.
[00:07:53] Speaker D: Success when you do what I call.
[00:07:55] Speaker C: The Smith sinus migraine technique. And it's very intricate, very detailed. You have to be very exact. You have to know what to look for, first of all, on the scan.
[00:08:05] Speaker D: And then how to correct it properly.
[00:08:08] Speaker C: Without causing a problem, because you can go in there and just be cavalier, end up with some scar tissue, and.
[00:08:13] Speaker D: Then now you're back to square one.
[00:08:16] Speaker B: Wow.
This sounds obviously like really a big discovery and something that can really impact and change a lot of people's lives and a lot of people that are suffering with migraines.
Were you a little bit hesitant and skeptical? It sounded like you kind of went in it the right way where you said, hey, if you have this semi ear scan, and then let's see if this approach works.
[00:08:42] Speaker D: Right.
[00:08:43] Speaker B: How did you kind of navigate that when you first started?
[00:08:47] Speaker C: Well, that's a very good question, and it's one that is a very thoughtful question and needs a thoughtful answer.
[00:08:58] Speaker D: I am a puzzle solver.
[00:09:02] Speaker C: I've always been very curious. And in medicine, you know, they call it the practice of medicine, I was actually doing that.
[00:09:09] Speaker D: I was doing a procedure and looking at the results, looking at the data, do the procedure and look at the results. And the more I did it, the more I learned and the more I.
[00:09:22] Speaker C: Just had to be honest. And at first, I was using terms like, if you have migraine, like headaches, it was all a transition. If you have migraine impostor headaches, because I had to get the term migraine in there to get the migraine people in here, because migraine people think differently.
[00:09:40] Speaker D: About, do you have a headache or.
[00:09:43] Speaker C: Do you have a migraine? So if you don't mention migraine, you just say, oh, I help people with headaches or get rid of people with really bad headaches, the migraine folks are.
[00:09:51] Speaker D: Like, no, that's not me.
[00:09:53] Speaker C: So I had to use the term somehow.
[00:09:57] Speaker D: And then finally, after that stint on.
[00:10:00] Speaker C: Television where I started getting all these scans and they had what I was looking for, and they'd all been to all these top neurologists everywhere, and these are all type of migraine. Even though my title of my business.
[00:10:10] Speaker D: Is the sinus Migraine Institute.
[00:10:15] Speaker C: The procedure.
[00:10:15] Speaker D: That I do, it eliminates all type of migraines.
[00:10:20] Speaker C: Tension, ocular, hormonal, hereditary, some people with Arnold Chiari disorders, hemiplegic migraines that resemble a stroke. I mean, these people come in and they get blindness in an eye, slurred speech, weakness in their arms and legs, can't walk, tremors. And all that goes away after I do my Smith sinus migraine technique.
[00:10:43] Speaker D: So it's just being mindful.
[00:10:45] Speaker C: And I just had to be honest.
[00:10:47] Speaker D: With myself and say, look, you really.
[00:10:51] Speaker C: Are doing a procedure that is eliminating migraines in people who have been diagnosed by neurologists all over the country.
[00:11:00] Speaker D: And it just is what it is. And so it's pretty fascinating, to be honest with you.
[00:11:07] Speaker B: That's really fascinating. And it sounds like you also have a marketing brain bringing in, okay, the migraine imposter or migraine like, or a migraine light, however you're going to say it, to still get people to want to, okay, this could be me, or this is me, right? Love that.
Okay, so tell me a little bit more. So there seems to be a connection here between nasal irregularities, maybe. Is it deviating septums? What is it that you're kind of seeing that you say, aha, I can help you?
[00:11:42] Speaker C: It's a mixture of things and it's individualized depending on what I see on the CT scan, the procedure that I do. Although it's called the Smith sinus migraine.
[00:11:50] Speaker D: Technique, it is really customized based on.
[00:11:53] Speaker C: What I see on the CAT scan. One of the most common abnormalities is the deviated septum, and that's acquired generally.
[00:12:01] Speaker D: By injury to the nose.
[00:12:03] Speaker C: But there could be other problems with the turbinates, which are the very sensitive structures in the nose. They're like the filters of the nose. There can be abnormalities with them. There can be people, even with normal.
[00:12:14] Speaker D: Septums, can have problems with the turbinates.
[00:12:17] Speaker C: Or even have sinus disease within the sinuses tooth. So there's kind of like three parts, the septum, the turbinates, and the sinus. And you have to look at all those and know critically what you're looking at to know. I've gotten to the point now where if people tell me where they feel their pain, I sort of know where in the nose of sinuses I need.
[00:12:35] Speaker D: To look what's probably causing the problem.
[00:12:39] Speaker B: Now, you've done over 4000 procedures. You have a 90% success rate.
I'm assuming there are some misconceptions that you want to dispel about migraines since you've been doing this work.
[00:12:57] Speaker D: Yeah.
[00:12:58] Speaker C: And the biggest one is that it's.
[00:12:59] Speaker D: Not in the brain, it's in the nose.
[00:13:02] Speaker C: Now, when you look at it, though, anatomically, the nose is very close to the brain. These abnormalities are right next to the under the brain. And when you look at the nose.
[00:13:11] Speaker D: The nose is a very sensitive structure. Think about it.
[00:13:14] Speaker C: I don't know if you've ever had a COVID test, but those first COVID tests, they put that swab all the way back in your nose, and it hurts.
[00:13:21] Speaker D: And it hurts until you remove the swab.
Right.
[00:13:26] Speaker C: So in a sense, what I'm doing is these people with these migraines have.
[00:13:31] Speaker D: Abnormal noses, and I'm making their nose normal.
[00:13:35] Speaker C: I'm normalizing their nose.
[00:13:37] Speaker D: So it acts like someone who doesn't have migraine.
[00:13:40] Speaker C: So it's not an artificial procedure that I'm doing. I'm not cutting nerves, which would be abnormal. I'm not putting in an implant of some kind, some electrodes with a battery pack. I'm not doing that. I'm not repeatedly injecting you with some toxins to help block the nerves.
It's just a procedure that normalizes the.
[00:14:07] Speaker D: Nose so that the nose works normally.
[00:14:10] Speaker C: And does not respond to the outside.
[00:14:12] Speaker D: Stimuli, which are known as triggers.
[00:14:15] Speaker C: And when you look at migraines, migraines are basically named after their symptoms or their triggers.
[00:14:21] Speaker D: Oh, I see things in my eyes. Oh, you have an ocular migraine. Oh, I get stomach cramps. Oh, you have an abdominal migraine.
[00:14:29] Speaker C: Oh, people in my family all have migraines. Oh, you have hereditary migraines or I get migraines when I have my period.
[00:14:36] Speaker D: That's a hormonal migraine. The label is good in a sense.
[00:14:41] Speaker C: But really.
[00:14:44] Speaker D: It doesn't help as far.
[00:14:46] Speaker C: As you're trying to get rid of them. What I believe in, everything that I do is you have to get down.
[00:14:51] Speaker D: To the root cause of a problem.
[00:14:53] Speaker C: And the body is made in a very logical way. So when you stumble upon something like.
[00:14:59] Speaker D: I did, you really have to look at it and understand it.
[00:15:04] Speaker C: And I'm so happy that this is.
[00:15:06] Speaker D: Going out to physician and executives, because a lot of times doctors will get.
[00:15:13] Speaker C: In the mindset of just staying with.
[00:15:15] Speaker D: What they learn and not opening up.
[00:15:19] Speaker C: Their minds to new and different things.
[00:15:23] Speaker D: And being the first can be very difficult and challenging.
But with respect to eliminating migraines, I'm the expert because I don't know of anybody else that's doing it.
[00:15:38] Speaker C: So it's a matter of me getting out and sharing the word. I have some patents and things in the works, but it's a matter of me. I've got a lot of work to do because there are 40 million people in the United States with a migraine and a billion people in the world. So I've got to train other surgeons in my technique. That way, we keep the standards high, we keep the success rate high, because I used to tell people, yeah, go see your ent let them do it.
[00:16:03] Speaker D: And it just didn't work because, as.
[00:16:06] Speaker C: You can imagine, there are different levels of expertise as far as surgical skill amongst ents and approaches to things, I.
[00:16:16] Speaker D: Have to be the one to train the person to go out and do the procedure.
[00:16:22] Speaker B: So tell us, because I'm curious, obviously, you said you have patents and you're looking at that and training. Is there a way that right now, if an ENT wanted to learn this, they could be taught by you?
[00:16:39] Speaker C: Not right now. I'm writing the training manual as we speak, and I'm thinking there's a couple of approaches.
[00:16:48] Speaker D: One would be to have, like, I.
[00:16:51] Speaker C: Think it would be. It's kind of tough. It just depends on how long it takes people to grasp it. And the problem is going to be training. But there's things I'm looking at as far as training tools to help doctors, whether it be videos or a course or courses or probably all of it is what's going to happen and where I have to go through and go.
[00:17:14] Speaker D: Step by step on.
[00:17:15] Speaker C: You start with the CT scan review. Then how do you formulate the surgical plan? Take care of the patients postoperatively, too. And some people that are in that 10%, they'll do well for a few.
[00:17:26] Speaker D: Months, but then they'll start having headaches.
[00:17:29] Speaker C: And you have to know what to look for in that regard. It's like, you know, it's in the.
[00:17:33] Speaker D: Nose sinuses because that's the location of where the origin is.
[00:17:41] Speaker C: Training will be very important because I'm.
[00:17:43] Speaker D: One that just doesn't want to go.
[00:17:45] Speaker C: Willy nilly out there and have people.
[00:17:47] Speaker D: Doing things and have the poor patients.
[00:17:51] Speaker C: Not getting it done properly so that they leave going.
[00:17:55] Speaker D: Well, I guess my migraines weren't caused.
[00:17:57] Speaker C: By the problem in the nose. It must be a true migraine they fall back on. It must be my hormones, or it must be the wine that I'm drinking.
[00:18:06] Speaker D: Or the cheese that I'm eating.
[00:18:08] Speaker C: And it's just your nose responding to.
[00:18:10] Speaker D: Those triggers and causing the pain because your nose is abnormal. That's the simplest way to think about it.
[00:18:18] Speaker B: So fascinating. And I love that you're looking at ways to really kind of broaden this innovative way of helping people with migraines. Now tell me, if somebody is suffering right now and they wanted you to help them, what can they do? What are the next steps there?
[00:18:40] Speaker D: Well, if you enter around Houston, you.
[00:18:42] Speaker C: Just make an appointment by calling the office. It's 713-795-0600 but we get a lot of people from out of town as.
[00:18:50] Speaker D: Well, and we have them all the time.
[00:18:53] Speaker C: And for out of town patients, it's very easy.
You go to your doctor and you.
[00:18:58] Speaker D: Ask for a sinus CT scan.
[00:19:01] Speaker C: And if you have trouble getting the code or need the code, you can always call my office and my receptionist can give you the code to give you your doctor so they know exactly what to order. Once you get the scan, you can.
[00:19:12] Speaker D: Ask the facility to mail the disc to me.
[00:19:15] Speaker C: I don't want to see the report because the report doesn't hold everything on it that I know to look for.
[00:19:21] Speaker D: And that I need.
[00:19:23] Speaker C: Send me the disc. I review the disc personally and I give the patients a call and say, you're a candidate.
It's funny, I used to say, send.
[00:19:32] Speaker D: Me a disc to see if you are a candidate.
[00:19:34] Speaker C: Now it's to the point where if you say you have migraines or chronic.
[00:19:38] Speaker D: Headaches of any kind, I just need.
[00:19:41] Speaker C: To see the scan to see what I need to do, because you are.
[00:19:43] Speaker D: A candidate and these are chronic headaches.
[00:19:46] Speaker C: Just to make sure. Chronic migraines.
Let me say this. If it's your very first severe headache.
[00:19:52] Speaker D: You definitely need to see a neurologist.
[00:19:55] Speaker C: And you need to make sure that you don't have an aneurysm or a brain abscess or a tumor or something that might be causing that. That's the first thing I want to say.
[00:20:02] Speaker D: So you certainly want to see a neurologist for that.
[00:20:07] Speaker C: But I think also what's going to.
[00:20:09] Speaker D: Come and become standard is in addition.
[00:20:12] Speaker C: To a brain scan will be a sinus CT scan.
[00:20:15] Speaker D: Because when you look at people with.
[00:20:17] Speaker C: Chronic migraines, those who get brain scans, 95% of those scans are normal.
[00:20:26] Speaker D: Interesting.
[00:20:26] Speaker B: I didn't know that.
[00:20:27] Speaker D: Yeah. Okay.
[00:20:28] Speaker C: And I have patients that have had.
[00:20:29] Speaker D: Ten scans in a lifetime.
[00:20:33] Speaker C: The opposite is true. When you add the sinus CT scan, nearly 100% of those people who are not that 5% that had the initial.
[00:20:42] Speaker D: Scan that was positive, they have the.
[00:20:45] Speaker C: Nasal abnormalities that I know that caused the problem.
[00:20:48] Speaker B: That's fascinating. I think that's a really good advice for anyone that's listening. If you want to get a sinus.
[00:20:55] Speaker C: CT scan, tell your doctor.
[00:20:57] Speaker D: Don't say you have migraines.
[00:21:01] Speaker C: Say, I'm having facial pain and headaches really severe, which is what it is, because a lot of people, when you think about, they'll say, oh, my head hurts here. It's in my temples, it's in my cheeks, it's behind my eyes.
[00:21:13] Speaker D: Those are the nose and sinus areas.
They just are.
[00:21:17] Speaker C: So tell your doctor I'm having facial pain and headaches.
[00:21:20] Speaker D: I need a sinus CT scan.
[00:21:23] Speaker C: Get the scan, send me the disc. I call you, tell you you're a candidate. Here's what needs to be done. You come down to Houston, you stay for a week. The surgery is covered by insurance. It takes me about an hour to perform.
Usually by the second day, people are taking Tylenol. And I tell people who are from out of town, I want you to go for walks, go to the mall, people in town, go to the grocery.
[00:21:45] Speaker D: Store, run your errands.
[00:21:47] Speaker C: You're taking Tylenol. You're not going to be knocked down for one week. A lot of patients, those who have.
[00:21:53] Speaker D: Them every day, will go into surgery.
[00:21:56] Speaker C: With the migraine, come out without the migraine and say, that was the last.
[00:22:01] Speaker D: Day I had a migraine. Wow. Yeah.
[00:22:05] Speaker B: That is incredible. Okay, well, I'm sure you're giving hope to a lot of people that are listening right now. They're like, wow, okay.
[00:22:12] Speaker C: They need that. They need their lives back. People are living their lives. And it's just incredible.
[00:22:18] Speaker D: The stories I hear about folks who.
[00:22:20] Speaker C: They might take a bucket from home to working in their car because they're.
[00:22:24] Speaker D: So nauseated, they throw up so much.
[00:22:26] Speaker C: These are actual stories I've heard.
They get a hemiplegic migraine and they.
[00:22:31] Speaker D: Black out and they can't walk, and.
[00:22:35] Speaker C: They have numbness and slurred speech, and they go to the ER and they.
[00:22:39] Speaker D: Always get worked up for a stroke.
[00:22:44] Speaker C: And there's nothing on the brain scan. So they're left with like, dang, I.
[00:22:51] Speaker D: Must have had a mini stroke.
[00:22:53] Speaker C: And here's how I'm thinking.
[00:22:54] Speaker D: Now, think about this.
[00:22:55] Speaker C: There are people who have been told they've had a mini stroke or a TIA. You might have heard of a transient ischemic attack, and those are real things.
[00:23:04] Speaker D: However, I have to believe that within that category, there are people who actually.
[00:23:11] Speaker C: Have hemiplegic migraines or complex migraine, both.
[00:23:15] Speaker D: Of which resemble a stroke.
And it's important that we figure out which do they have.
[00:23:22] Speaker C: So in those people, I think, that.
[00:23:24] Speaker D: Have had a TIA or a mini stroke, as they say, they need to get a sinus CT scan and send.
[00:23:32] Speaker C: It to me and have me review.
[00:23:34] Speaker D: It, because there's a big difference between.
[00:23:37] Speaker C: Walking around and putting on your health questionnaire every time, oh, I had a.
[00:23:39] Speaker D: Mini stroke and saying, oh, I had a hemiplegic migraine.
[00:23:43] Speaker C: But Dr. Smith took care of it.
[00:23:44] Speaker D: I don't have it anymore. That's a big difference.
[00:23:48] Speaker C: This is how my mind works, you see. I'm tying it into all these little things that are like. And this just came to me about two months ago.
[00:23:55] Speaker D: I was like, Tia.
[00:23:56] Speaker C: Because I kept asking people, well, what did they see on your scan, your brain scan? And as soon as I hear well.
[00:24:03] Speaker D: Or well, that means there's no commitment.
[00:24:07] Speaker C: There wasn't a bleed.
[00:24:08] Speaker D: There wasn't a clot. There could have been a small little fleck of something from the carotid that might have blocked some vessel transiently. There could have been.
But I say, what does it hurt to get a scan of the sinuses.
[00:24:22] Speaker C: And make sure they didn't have a.
[00:24:23] Speaker D: Hemiplegic migraine that resembles a stroke?
[00:24:25] Speaker C: We all know it resembles a stroke. So, I mean, some people are going.
[00:24:28] Speaker D: To get mixed up in that category.
[00:24:30] Speaker B: Love that. How are you thinking, Dr. Smith, of how you're going to know innovating in the field of migraine mean? I think you just kind of said a little bit about how you're always staying on the forefront of things by really listening to your patients.
[00:24:48] Speaker D: But let's hear more, right.
Well, what's really fascinating to me are.
[00:24:57] Speaker C: The people who have these associated symptoms that go along with their migraines.
They might be pseudo seizures, blindness, tremors, stuttering, the paralysis, the weakness, the tingling, the irritable bowel.
[00:25:16] Speaker D: And I have people who have, for.
[00:25:20] Speaker C: Instance, one lady told me, Dr. Smith.
[00:25:22] Speaker D: My headaches are gone, but I've been.
[00:25:24] Speaker C: Constipated since I was 19 years old.
[00:25:26] Speaker D: And that's gone, too.
So I just have to make a note.
[00:25:30] Speaker C: I'm making notes. Like what?
[00:25:32] Speaker D: Why would she tell me that? Because it's a big deal to her.
[00:25:35] Speaker C: Had a 17 year old who has irritable bowel and said, Dr. Smith, I can't eat pasta and breads.
[00:25:41] Speaker D: I'm thin as a rail. But my stomach's always a little bloated and uncomfortable.
[00:25:46] Speaker C: She comes in at her third or fourth visit after surgery, she goes, my headaches are gone. Oh, and by the way, Dr. Smith, I can eat whatever I want. My stomach's flat, and I feel so good.
[00:25:56] Speaker D: And I just have to make the mental notes on know or people.
[00:26:00] Speaker C: I have several people who stutter during.
[00:26:02] Speaker D: Their migraines, and their stuttering goes away, or their tremor goes away.
[00:26:07] Speaker C: And so those are things I'm making notes on to figure out what is all this about?
[00:26:11] Speaker D: Do people with a sitral tremor and.
[00:26:14] Speaker C: That'S all they have?
[00:26:14] Speaker D: Do they have the same abnormalities that I'm talking about.
Do people who have irritable bowel. Is that some way connected to it?
[00:26:29] Speaker B: So fascinating, but it really sounds like. Yeah, it's once you really listen to your patients and really kind of give them a holistic way of approach, how they can live a better life.
Wanted to ask you for our listeners out there, both a physician audience, healthcare executives, and then just a regular laypeople that are listening that may be suffering from this. You do have the book. You wrote the book, the migraine imposter. Tell us how we can get a hold of that and give us a little bit more information. What's in that book?
[00:27:07] Speaker C: Well, the book is called the migraine imposter, and I'm going to have to tell you it's on hold right now. I have 1000 copies ready to order. But I really feel, and my office.
[00:27:15] Speaker D: Manager feels we need to write like.
[00:27:16] Speaker C: A little forward or something, explaining that this is old information, which it is.
[00:27:21] Speaker D: It's a great book, though, and it.
[00:27:23] Speaker C: Has a lot of great science in there. It's written on an 8th grade level, easy to read. And it takes you through this discovery.
[00:27:30] Speaker D: Of finding out that these abnormalities in.
[00:27:34] Speaker C: The nose can cause these migraine impostor.
[00:27:37] Speaker D: Like symptoms, and in that it has.
[00:27:42] Speaker C: A lot of ear, nose and throat.
[00:27:44] Speaker D: Studies on what are called contact headaches.
[00:27:47] Speaker C: And the studies there show that the success rate anywhere from 77% up to nearly 100% success when you address these.
[00:27:58] Speaker D: Abnormalities in the nose.
And then I did a study where.
[00:28:03] Speaker C: It looked at septoplasty, and people with suspected migraine is what I called it. And my success rate at that time was like 88%.
[00:28:12] Speaker D: Their scores went up as far as.
[00:28:15] Speaker C: How they felt and after the surgery. And so it's coming time now where I need to do some more research, of course, but I'm private practice. I'm out here hustling and working.
[00:28:25] Speaker D: But it's going to take that to start writing some journal articles.
[00:28:31] Speaker C: But I can tell you, when I.
[00:28:32] Speaker D: First I did submit an article of.
[00:28:35] Speaker C: That suspected migraine study I did, it didn't get accepted.
I'm not going to fight people, but I thought it was a pretty novel approach to suspected migraines to talk about the effect of septoplasty. But it's coming.
I got a lot to do, and I'll be doing a lot for the rest of my days.
[00:28:55] Speaker D: I tell you. I love that.
[00:28:58] Speaker B: I love that. What advice would you give the fellow physicians to? Kind of. It sounds like you have the confidence, you keep following your instinct and your intuition, what would you want to impart on your.
[00:29:15] Speaker C: That's a very good question, and I.
[00:29:17] Speaker D: Thank you for asking it to the physicians out there who are listening.
[00:29:22] Speaker C: If you have someone with chronic headaches or chronic migraines who've seen you over years, you've tried all the meds, they've had a hysterectomy, they've done the implantable device, they try the botox, and they're.
[00:29:36] Speaker D: Still coming to you, even if it's a first time, not even over years.
[00:29:42] Speaker C: I think it's incumbent upon you to explore other options.
[00:29:47] Speaker D: Meaning, get a sinus CT scan of the head and neck area.
Have that sent to me.
[00:29:56] Speaker C: Let me take a look at it. And let me tell the patient if they have the abnormalities that I know that cause the problems. I mean, the days of just seeing.
[00:30:04] Speaker D: These people over and over, they get frustrated.
[00:30:08] Speaker C: You're frustrated. And like I like to say, don't.
[00:30:10] Speaker D: Let a headache patient be your headache. Send them to me because I love them, because I can fix them.
[00:30:18] Speaker C: In addition to getting the brain scans.
[00:30:20] Speaker D: I think it's incumbent upon all doctors.
[00:30:23] Speaker C: With these chronic migraine patients, chronic headache patients, cluster headache patients, to get a sinus CT scan and have the disc, have them get a copy of it.
[00:30:34] Speaker D: And send it to me, and let's get these people well.
[00:30:37] Speaker C: And you'll be surprised that once patients find out that these doctors have a.
[00:30:42] Speaker D: Connection to me and can get them well.
[00:30:44] Speaker C: Oh, my God. It spreads through the community like wildfire. So now you get these patients flooding.
[00:30:50] Speaker D: To you because you helped this patient.
[00:30:54] Speaker C: And it just makes the world a better place.
[00:30:56] Speaker D: Everybody gets healthy and happy, and there's.
[00:30:59] Speaker C: Nothing like having patients. I call it removing the migraine mask.
[00:31:03] Speaker D: Patients come to my office like this, and then they come back and it's.
[00:31:08] Speaker C: Like, hi, Dr. Smith. I'm doing so good.
[00:31:12] Speaker D: So it's amazing.
[00:31:14] Speaker C: It feeds me. It really is. I'm actually very fortunate that I'm doing what I was designed and put on this earth to do. It's my passion, it's my purpose.
[00:31:23] Speaker D: I love it. It never gets old.
[00:31:26] Speaker C: It's like Christmas to me, because one, I have to get the scan, and I'm always like, okay, are they going.
[00:31:31] Speaker D: To have it or not?
[00:31:33] Speaker C: I'll read over the questionnaire. Okay. 40 years of migraines. They have all this tingling and blindness and this and that. They're forgetful.
And then I have to see, do they have it okay? Yes, they do.
[00:31:43] Speaker D: Okay.
[00:31:44] Speaker C: Then I call them and tell them. They come down. Then I do the procedure. I'm like, okay, does the procedure work? I've got to wait several weeks.
[00:31:52] Speaker D: And.
[00:31:52] Speaker C: 90% of them will tell me, Dr. Smith, thank you so much.
[00:31:56] Speaker D: I mean, it's really incredible that these.
[00:31:59] Speaker C: People have been to see so many.
[00:32:01] Speaker D: Doctors, and they've been so disappointed, and they're at their wits end. And unfortunately, they're depressed. They're disabled, they can't work. They're losing their marriages over it.
And then, unfortunately, there's some of them.
[00:32:17] Speaker C: That want to end their lives, and.
[00:32:18] Speaker D: Some of them that do, because they just can't take the pain every day. So we owe it to all of them to give them a chance, to give them hope that they can get better, that they can get well and.
[00:32:33] Speaker C: Not have to live in the fear.
[00:32:35] Speaker D: Of having a migraine.
[00:32:38] Speaker C: And so what I do, I start my visit off like this. I'll read the questionnaire.
[00:32:43] Speaker D: I look at the scan first, then.
[00:32:45] Speaker C: I go see the patient, and the first thing I say is, I'm Dr. Smith.
[00:32:49] Speaker D: Thanks for coming to see me. I just want to let you know.
[00:32:53] Speaker C: I looked at your scan, and I'll.
[00:32:54] Speaker D: Be able to help you.
[00:32:55] Speaker C: And there have been numerous times when.
[00:32:57] Speaker D: I say that, they go, oh, thank goodness. I was hoping you would find something.
[00:33:03] Speaker C: These people want me to find something.
There are others, though, that will break down and just start crying. Just get real solemn and just look at the ground and just start weeping. Because they know, oh, my God. I finally have a doctor that's giving.
[00:33:16] Speaker D: Me hope instead of, well, let's try.
[00:33:19] Speaker C: You on the newest med.
[00:33:20] Speaker D: Is this. Let's go with that. Have you tried that? Yeah, I've already tried that. Okay.
[00:33:24] Speaker C: I can't afford that. It costs $1,000 a month. I can't afford it.
[00:33:29] Speaker D: So they're feeling boxed in.
[00:33:31] Speaker C: It's like, I can't afford the medicine.
[00:33:33] Speaker D: Even if the medicine helps.
But then the medicine has side effects.
[00:33:39] Speaker C: They don't feel like themselves. They have brain fog with that.
[00:33:42] Speaker D: They're forgetful.
[00:33:44] Speaker C: But it beats the alternative. Having the severe pain.
That's what I do. So to all the doctors out there, there is an answer. There is hope. You can give these people a migraine free life by getting a sinus CT.
[00:34:00] Speaker D: Scan, which gets this part of the face, the brain scan. Think about this headache, this head pain.
[00:34:08] Speaker C: In its basic form, they're having head pain. Some of it's the ear, the temples, the forehead, the top of the head, the cheeks, behind the nose, between the eye.
[00:34:17] Speaker D: That's right through here.
Okay, so let's not shortchange them by.
[00:34:22] Speaker C: Just getting a scan of the brain.
[00:34:24] Speaker D: When people have head pain, we need.
[00:34:28] Speaker C: To be looking at the sinuses, and then if those are normal, we need.
[00:34:31] Speaker D: To look at the teeth and the jawbone and figure out what's causing it.
[00:34:36] Speaker B: It makes a lot of sense when you say it that way.
[00:34:40] Speaker D: Well, I just like being very logical in my thinking and breaking it down.
[00:34:47] Speaker C: Into just basic, fundamental thought processes and explanations.
[00:34:53] Speaker D: Headache is head pain in its simplest form, and this is your head.
It does not make sense to only look here in the brain when my head hurts.
People hit their noses all the time.
So you're going to have nasal abnormalities.
[00:35:14] Speaker C: Either coming through the birth canal, that's.
[00:35:16] Speaker D: The first trauma, or they can inherit it.
[00:35:19] Speaker C: It could be genetic through a whole line of people. I'm sure there's families that just, they have abnormalities that show up in their.
[00:35:24] Speaker D: Noses like they have anything else that shows up on their body.
And when you think about it, the.
[00:35:32] Speaker C: Many times that kids that we fall in tricycle accidents, swinging accidents, elbows, mothers getting hit with the baby's head while they're on the lap, I've heard all, you know, kids are playing soccer on.
[00:35:48] Speaker D: All these sports at an earlier age, so they're set up to have nasal abnormalities.
[00:35:55] Speaker C: I was just at the Super bowl activities.
[00:35:57] Speaker D: Why?
Because NFL players have headaches and migraines.
[00:36:03] Speaker C: At a much higher percentage than the general population.
They also suffer from sleep apnea at a much higher percentage than the general population.
[00:36:11] Speaker D: Why is that? So? You think about it, professional athletes have played a contact sport all their lives, right?
But not only just football, they played.
[00:36:22] Speaker C: Basketball, baseball, soccer, all these things.
[00:36:26] Speaker D: So they have a higher likelihood of having been hit in the nose and sustaining an injury.
[00:36:33] Speaker C: And that makes the simplest answer as.
[00:36:36] Speaker D: To why they likely suffer from all.
[00:36:39] Speaker C: These conditions at a higher rate than the general population.
[00:36:42] Speaker D: It's that simple and easy.
[00:36:46] Speaker B: Well, I want to thank you, Dr. Kevin Smith, for being a part of this.
I just to what really why you're doing what you're doing, I think, is so moving and touching, and I hope that our audience, that it's listening, that it resonates with them as well. Just how to be an advocate for patients and be always looking for what might be the cause of things and being open minded and like you're saying, having a logical approach, an approach that can bring relief and really so much joy to people that have been living with pain. And I know of several people that suffer from migraines. And it is, it's like what you're saying it's a daily thing that can really be life altering.
[00:37:34] Speaker D: It is.
[00:37:35] Speaker B: To have a potential way to have something that can help remedy that is huge.
I think your work is quite impressive. We will definitely put all your information available to anyone listening if they want to get in touch with you, learn more or send you their scan.
[00:37:56] Speaker D: Right, good.
[00:37:58] Speaker B: But thank you so much for being a part of this.
[00:38:00] Speaker C: Well, thank you so very much for having me. I really appreciate it and I appreciate all that you do by having a podcast that allows us to talk and.
[00:38:07] Speaker D: Tell people what we do.
[00:38:09] Speaker B: Thank you so much.
[00:38:11] Speaker D: You're very welcome.
[00:38:12] Speaker A: Thank you to all of our listeners. If you would like to be notified when new episodes air, make sure to hit that subscribe button and a big thank you to Pacific companies. Without you guys, this podcast would not be possible. If you would like to be a guest, please go to www.pacificcompanies.com. Thank you.
