As an ENT physician, I often see patients with many different problems that affect the head and neck. Often times the primary complaint is pain, which can vary from a dull constant ache to sharp repetitive pain. Often the pain has been present for a long time. It may increase with certain positions, eating, swallowing, chewing, temperature or barometric pressure changes. It may be accompanied be signs of infection like a temperature or swelling of the face. It may be recent in onset or may have been present for a longer period of time. So you decide to see an ENT – Now what?
At the initial evaluation for facial pain, I always start by taking the patient’s history. A rule of thumb in my practice is to listen to the patient tell their story uninterrupted for several minutes to try and learn what is bothering them the most. When a patient comes in to see me, it’s helpful if they’ve already thought about what bothers them the most. It’s a good idea to write your symptoms down ahead of time.
Questions to prepare for:
- What is the primary reason for your visit?
- Where is the pain located?
- How long has it been present?
- Is it constant, sharp or dull?
- Does anything make it worse or better?
- Does a weather change make it worse?
- Have you tried any medications to see if they help?
Knowing what medicines you have tried and what did not help is very important in identifying the underlying problem. Be sure to let us know if you’re taking:
- OTC pain meds like Tylenol, ibuprofen (Advil) or Aleve
- Nasal medicines: antihistamines (Zyrtec, Allegra, Claritin, Benadryl)
- Decongestants (Sudafed), mucolytic (guaifenesin)
- Nasal sprays, like steroids, decongestants (afrin)
- Topical antihistamines
- Nasal rinses like a saline product or a netti pot. Antacids like Pepcid, Nexium, omeprazole, Protonix, or Dexilent.
- Antibiotics – you’ll want to know the name and long you’ve taken it. Snap a pic of the bottle!
If you suspect the pain may be allergic or seasonal think ahead what allergens have been present when your symptoms started. In Central Texas we have very predictable allergy seasons: Cedar, Oak, Ragweed, fall tree pollens, grasses and the constant molds. If you have been to an allergist try and remember the doctor’s name and when were you tested. If you were tested for allergies what were the results of the test? Did you take allergy shots; were they recommended?
With 25 years of clinical experience, I give every patient a thorough examination of their ear, nose, mouth and throat regions and will examine the muscles, structures and glands of the neck. Then I’ll examine your nervous system as it relates to the head and neck. Often times a thorough examination will require the use of a microscope for the ears, or a nasopharyngeal endoscope.
The head and face is a complex organ with many different types of tissue in a small space. Muscles, bone, cartilage, sinuses, nerves, teeth, tendons, blood vessels, and sensory end organs are just some of the tissues that make up the face and head. The head is supported by the neck, which also has its own group of tissues that can contribute to pain, but I’ll address that in a future blog.
Tests performed on the ear, nose and throat region are billed as separate procedures. Your insurance will often cover these procedures.
An ENT physician is a subspecialist, highly trained in examination and treatment of the complex regions of the head and neck, but occasionally further testing may be recommended; this might include routine x-rays or blood tests, or more extensive tests like a CT scans or MRI.
I will work to the best of my ability to identify and treat your ailment and get you back to enjoying life!