EP 187 WTH?!?: Clearing the Air: Dr. Kevin Smith on Nasal Health and Migraine Relief

Foreign.

Welcome back, everybody, to what the health. I'm Dr. Greg Eckel, and our topic today is the hidden link between nasal abnormalities and migraines. What's breathing got to do with it? My guest is Dr. Kevin Smith, an ear, nose and throat doctor based in Houston, Texas, whose pioneering work is transforming the lives of migraine sufferers and optimizing sports performance through innovative breathing techniques. With a mission to help individuals enhance athletic performance, reclaim their lives from the grips of debilitating migraines, Dr. Smith specializes in a revolutionary nasal procedure that offers a new lease on life. Well, welcome aboard, Dr. Smith.

Thank you very much. And I have to thank you so very much for having me on your show. A chance to talk about what I do. I know it's just going to reach other people and help other people, so I really appreciate you having me. I love it.

Yeah. Thank you. And that's why we do the show right. We like to bring it directly to our listeners and viewers. You hear it here first. It's not coming from the propaganda box down. This is how we get the message out. So, you know, let's dive into one. You know, what are you up to, this new migraine discovery. And you've got a sinus migraine institute, and you come from the ear, the eyes, ears, nose and throat realm.

And there you go.

What are you discovering here, Dr. Smith?

Well, I tell you, it's very, very fascinating and very, very exciting. I'm an ear, nose and throat doctor and facial plastic surgeon. I've been practicing 30 years. So initially in my practice, I thought what I was doing was taking care of sinus headaches because everybody has these sinus headaches. You know, I do the sinus surgery and the headaches would go away. But when I looked at my data, almost 90% of the people actually had a history of migraines. And so I was pretty perplexed because in medical school, I had learned that migraines originate in the brain. But here I am doing these nasal procedures on people with a history of migraines, and they're getting better. They're going away. In 90% of the people at that time, it was like 88% of the people. Wow. I wrote a paper on, on, on the effect of septoplasty in people with suspected migraines. And it talked about different studies that have been done in ent. In the ENT realm, we have plenty of studies that are done on contact headaches, abnormalities in the nose that cause these sinus and or contact chronic headaches. It's well known. But nobody had ever taken that information and applied it to migraine. So I happened to be on television with a woman who had had migraines for 41 years. She was four years migraine free. She was debilitated, couldn't do anything, had seen numerous neurologists, had been on numerous medications, and nothing was helping her. And so while I was on the show, I said, you know, you can have access to my expertise. Just send me your CT scan of your sinuses. Send the disc to my office. I'll let you know if you're a candidate. Lo and behold, we get hundreds of these scans, and all of them had the abnormalities that I'd been fixing. Wow. And that's when I paused and said, whoa. These people have been to the top neurologists. Mayo Clinic, Cleveland Clinic, Michigan, Vanderbilt, UCLA, Stanford. Been. Been treated for years. 30 years, 40 years.

Yeah.

And these all have these abnormalities. And I just put a stick in the ground and said, at that point, I'm actually eliminating migraine headaches with a nasal procedure. And so that's how it started, and that's how it evolved. And ever since then, I perfected this technique I call my Smith Sinus Migraine Technique. It's a nasal sinus surgery. It is covered by insurance. I use sinus and nasal codes when I submit it to the insurance company for septoplasty, turbinate reduction, or balloon sinoplasty. However, I must stress the technique that I do to correct the migraines is totally different from what one might do to help you breathe better or help you not have snoring or something like that. But the benefits of my procedure are the same. But the technique is just so highly refined and so technical, and it has to be. And the same is true for reviewing a sinus CT scan. I've had numerous patients tell me over and over, I had my doctor look at my scan. They saw something and said, oh, but that can't be causing migraines for 40 years. Or they say they didn't see something. And when I look at it, I'm like, no, it's right there. I mean, I see what I know it's right there, and that's what's causing your pain. And like, Dr. Smith, thank you so much. So it's very, very exciting. And since. Since that time, I can estimate I've probably eliminated migraines in about 5,000 patients. The only problem with that is there are 40 million patients in the United States and a billion in the world who need what I have. And so the goal is of course, for me to continue to work hard and to eventually have a training program where I can train other ents about what I do and help them know how to read the scans and do all those things necessary to help all these poor folks that are just out there just devastated from this.

You share some stories and or findings with your research and your procedure of what you've seen. I mean you, you said like fol for 30 to 40 years. Migraine sufferers.

Yes.

You read their CT scan, you do the procedure and they're immediately migraine free.

Some of them have told me I went in with a migraine. I came out and didn't have one and haven't had one since. Some people, it might take a few weeks. I had one guy take six months, I'd forgotten about him and showed up at a restaurant where he worked. And I ordered and he yelled through from the kitchen, said, oh, by the way, Dr. Smith, my migraines are gone. And it had been six months. And I was like, okay, great. So it varies, but most can tell within the first six weeks after the procedure that the migraines, the headaches are gone and, or the discomfort they're having is different, or they might have some headaches that now Tylenol can take care of, whereas before Tylenol never touched it.

Yeah, interesting. How does this work? How does this go beyond just symptomatic treatment?

Well, well, the very good question, symptomatic treatment and relief. You know, you have out there, you have Botox, you have medications, you have injections, you have all the other dietary changes. And I can tell you those things are very helpful because say, for instance, you change your diet to anti inflammatory diet. Well, the nose responds to inflammation. So when you have these abnormalities in your nose, the easiest way to explain to people is when we had those initial Covid tests that you had the swab placed deep into your nose, those things hurt. And they kept hurting until the swab was removed. Well, in essence what I'm doing is correcting somebody's nose, making it normal, removing their permanent swabs that they have in their nose that's causing the pain. And people with normal noses don't get headaches, they don't get migraines, but people that do, they have these abnormalities that must be fixed. I actually normalize the nose. I'm not doing anything abnormal. I'm taking a nose that's abnormal in the CAT scan, making it normal. And in 90% of the people, those headaches go away and those Migraines go away. Yeah. Wow.

Wow, that's awesome. Are you finding anything with sleep apnea, et cetera?

Oh, yes, absolutely. You're touching on some good stuff now. Well, let's just back up and understand who I am. I'm a root cause doctor. I look for the root cause of the problem because I believe the body is made in such a way it's very logical the way it's designed. And it could be injured and deformed from injury or trauma or hereditary or genetic components. So anytime a condition like sleep apnea is presented to me, I think it's very important that we evaluate the nose and we evaluate the throat to make sure that those structures are normal, because those are the two major airways that we breathe through. So the way I handle the sleep apnea is, of course, they get their sleep apnea test, but just knowing from their history of snoring and holding their breath and being fatigued all day and falling asleep while driving or falling asleep at work or having to take naps, I know intuitively they have sleep apnea. Sure. What I'm doing then is I'm going to look at the nose, examine the nose, examine the throat, and most often I will find again, nasal abnormalities, deviated septum, large turbinates, maybe some polyps, may have some sinus disease in addition to that, that need to be addressed. I do a lot of these procedures in my office. And so you can imagine before I would do tonsillectomy with a uvulopalidopharyngoplasty if somebody had floppy tissue in the back of the throat. But I can't do that in my office. So what I started doing was adding a uvulectomy where I just clip the uvula. The little. The little dangling worm in the back of the throat is the uvula. And those uvulas, when people snore a lot can get stretched over time, and they get really long and floppy and thick, and it makes people feel like they have a flap in the back of their throat. It. It adds to the obstruction or partial obstruction that they get at night. It also can cause chronic cough that goes undiagnosed. I've had people get CT scans of the chest and TB skin tests and all these things for a chronic dry cough. And it's simply the uvula being so long, it's tickling the back of the throat and the epiglottis and causing a cough. So what I do is I fix the nose, clip the uvula, and I've had people who have been on CPAP for as long as 18, 20 years. Not needed anymore.

Why?

Because I addressed the nose and the throat. Nowadays people get put on CPAP without knowing if the nose is normal. So you're trying to force air into a nose that may not be able to receive it. So the pressure has to be elevated, which makes it uncomfortable for the patient, which makes them not use it. And we're back to square one. Make sense?

It does. Yeah, it does. Sounds like a lot of stuff can happen up in there.

A lot of stuff can happen and usually once I take care of the problem, the benefits say if I'm doing it on a, on a migraine patient, the benefit is certainly they're going to breathe better. If they have sleep apnea and I've clipped the uvula, they're going to sleep better, they're going to wake up feeling more refreshed, they're going to have more energy during the daytime. I just had a woman today who brought in her 16 year old daughter and, and she had come to see me three years go or so and she kept saying, she said, Dr. Smith, you don't understand. What you did changed my life. I got my life back. I had chronic sinusitis, I had headaches every day and now I'm breathing better, feeling better, no more sinus infections, I sleep through the night, I have more energy. I said, you were really feeling that bad? She said, Dr. Smith, no, I'm telling you, you saved my life. And so that's the kind of thing that keeps me going and that's the kind of thing that I just love because I live my life and, and I don't have headaches and I don't have sleep apnea and I sleep well at night. I enjoy getting in my bed, I love what I do. And it hurts me to hear people say that they don't have that and haven't had it for years.

Sure, yeah. With that, you know, how about in general other connections with nasal health and general neurodegeneration or neurologic conditions out there? What do you see in there?

Well, let's talk about some of the migraines and in particular hemiplegic migraines. We'll start there. Perfect. So I had a patient who was in Belgium doing some missionary work, had a hemiplegic migraine, had to be flown back to Atlanta and somehow they found me. When this young lady who was 27 at the time and had migraines for like nine years straight, when she would have her period, that's when she would have these blackout spells. She would have weakness of her legs or paralysis of the legs where she couldn't walk. She would have slurred speech. She would stutter and have tremor and, like, these pseudo seizures. And when I first heard this, I'm, like, just blown away. I'm thinking, okay, those symptoms sound like something else, but I'll be able to take care of the headache. So I do my procedure. The headaches go away, and she doesn't have these symptoms anymore that come on with their period. And so I start reading up about what else is migraine associated with? This is interesting. And of course, it's associated with more than 75 other neurological disorders, but they don't know the connection. So what are those disorders that they're associated with? Migraines are associated with epilepsy, Parkinson's, Alzheimer's, Tourette's, autism, cerebral palsy, als, retinitis pigmentosa, Crohn's disease, chronic fatigue, irritable bowel, and the list goes on and on. Fortunately, in ms, too, I can't forget Ms. Fortunately, I had a patient in my building who worked for a neurologist. She had migraines, and she had been diagnosed with Ms. For four years earlier. So she came to me. She knew what I did. I saw her, did her surgery, and she was in the middle of a point. Her surgery was done around the time she should have had a Ms. Episode, which would be followed by some foot drops. She would describe it as. And after the surgery, the night of, she expected to have this foot drop, but she didn't have it. And it's been two years now, and she's not had a migraine, and she has not had an episode of her Ms. So now that's piquing my interest, I can tell you. I've screened some Parkinson's patients, and they all have the same abnormalities as I see in my migraine patients. And I just had a gentleman yesterday who happened to have sleep apnea, headaches, and Parkinson's with a tremor, who had his surgery done two days ago. And he has splints in his nose and all this stuff going on. But he just told me today that he noticed that he doesn't have his tremor anymore. I said, oh, well, you know, it could be the steroids I gave you for surgery. We're just going to wait and see. And we will. We just have to wait and see.

Right?

But I know his headaches are going to be gone. I know he's going to be sleeping better and breathing better, get more Oxygen. That can't hurt. That can't hurt a Parkinson's patient.

All of that helps. All of that.

So. Yes. So we'll just see. So that's in the preliminary. These are very preliminary studies and research. I'm screening people now.

Yeah.

To see one. Do they have the abnormalities? Yeah. And go from there.

Got it. And are the abnormalities, Are they from an injury or just born that way? What's. What do you think is happening?

They're, They're. Most of them are from injury. You can imagine the nose protrudes from the face. The first trauma is coming through the birth canal. As you squeeze through the mother's birth canal and the faces against the sacrum, you can get deformities of the nose there. But. But oftentimes a tricycle, bicycle, skateboard, car accident. Sure. Things like. And I think also people with traumatic brain injury, you know, we will always take care of all the serious problems which you have to the long bone fractures, the brain injury. But oftentimes they're left with these chronic headaches and migraines, and we as clinicians will pat them on the back and say, oh, you had a traumatic brain injury. I'm sorry. That kind of goes with it. I don't believe that. Yeah. Because the same mechanism of injury and trauma that caused all the long bone injuries and internal injuries, you likely hit your nose on the steering wheel or the dashboard or something.

Sure.

But it takes a back seat. And I, and I get that. But when we get those things healed, I think it's imperative for us as clinicians to do a thorough exam, get a sinus CT scan, look for the abnormalities, fix the abnormalities. Unfortunately, I mean, I'm the only one you can send it. Send it to. You should send it to, because I know what to find.

So I do have some clinicians that watch the podcast. Are there specific ways or requests that you have to do on a sinus?

No, no. Typically they come now. They're. They're axial, coronal, and sagittal views at three views. And I have a scanner in my office that does not have any millimeter cuts. You know, because you get a 2 millimeter cut, you might miss something. Sure. It's a minus continuous scanner. So I can scroll through and look for every. Every detail that I need to see. But I can tell a lot, even from a brain scan. I'll tell people now. Send me a brain scan. And if it takes, if I see something in the nose, if it happened to go low enough, I can let you know if you're a candidate, and then we'll get a sinus scan after that. But I do, I do believe a sinus scan is paramount in people with these headaches. You know, you mentioned about the neurological things and it came to me again. I called one of my professors in medical school about, he's a neurologist. And because it occurred to me, I said, you know, I'm sure that there's some people out there who've been told they had, they went to the er, they had stroke symptoms, the CT scan didn't really show anything, and they were told they had, oh, you must have had a TIA or a mini stroke.

Right?

I said, no, when you get that diagnosis, I'm going to say that it's prudent to get a sinus scan to see if they have these abnormalities because it may be a hemiplegic migraine that's resembling a stroke. So I'm sure there's a pool of patients that are out there writing on their questionnaires, their health questionnaires, that I've had a stroke or mini stroke. It's, that's far different from a hemiplegic migraine that can be eliminated. So, yeah, that's just how my mind thinks, man. I'm just, I like thinking about where is it applicable.

So you've got me then thinking maybe a little bit more meta on migraines in general for our viewers, lay public, etc. What causes migraines? Is it blood flow or structure? And what you're telling us here, it might be kind of a combination of both.

But I, I, I'm not, well, I'm not a neurologist, I'll admit. I do not know the brain. I'm not a neurologist. And likewise, neurologists don't know the nose like I know the nose. So based on what I see, y, if I have a, I've seen so many scans on so many people and I can count on one hand over the years the people who I've looked at a scan and said, I just don't see what's causing your pain. And it's rare and it's rare. And now that I'm further along, though, I, I generally would go back if I can find them and say, let's get another scan or let me look at the scan, because there may be something else that I see now that I didn't see then.

Right.

That's a process. Yeah, but it's very rare. It'd be very, if somebody says that they, I had A guy just said, I sent one of my friends to you and they said that you looked at the scan and didn't see anything. And I went, that, that doesn't sound quite right. So maybe she didn't come in because she didn't want to hurt his feelings or something. She said, I'm going to circle back around. He said, and just check to see and probe a little bit. I said, yeah, because that doesn't quite sound right. That's, that's very odd. She'd be a unicorn. So anyway, yeah, interesting. Yeah, it is, it's very interesting.

So where do you see, what's the vision for future migraine treatment? And, and how, how are you gonna get this out?

Well, I tell you, great question. I think to eliminate migraines will be an ENT condition. To control migraines will still be a neurological condition. And to diagnose migraines. I don't diagnose them. I don't diagnose them. You come to me, already diagnosed, already tried the medicines, already tried the chiropractor injections and Botox and all of that.

And there's something, if you see Botox, do you know that's the end of the line for the patient.

Exactly, exactly. And I will say, of course there's some people that just can't have surgery, they're too sick. Right. They need to have the medication. So I say that there's importance on all of these treatments. An anti inflammatory diet, very important for anybody who suffers. But to eliminate migraines, I will have to have training courses for ENT surgeons. I can envision lecturing around the world. I can see having, I have a non profit that's going to be tied into it as well. That'll help promote it because people have to know about it. A research arm that will write case reports to start to set the foundation and slowly transform the thinking. Because as you well know, it's hard to be the first out there claiming something, going against something that's been established for years. We talk about century and so it's tough, but it needs to be done. I know it works. I have the patience. But there's, there's those things that have to be done to get it into the mainstream and then marketing and branding and, and getting the word out to people. Yes, sure.

Well, as we bring this one into the station, any last parting words or insights for folks?

Well, you know, you mentioned sports performance and I want to touch on that a bit because a light bulb just went off. That's what happens to me, these light bulbs go off. So I've been out to the Super Bowl a couple, couple of years now, and I go on radio row and do my interviews and usually it's on migraines and sleep apnea. It seems that the veterans have sleep apnea more so than the younger players, but they all it at a higher rate than the normal population. Well, why is that? Well, to me, it's obvious. They play a contact sport. They likely have nasal abnormalities and it's compounding the problem, you know? Yeah, but I've had some. I have had a couple of amateur athletes that have had my procedure who've excelled. And it just hit me. I played college football and I said, nobody has ever asked nor examined thoroughly my nose to see if I breathe normally.

Right.

You have these big linemen, you know, they have sleep apnea. They've been playing contact sports all their lives too. They're falling asleep in meetings, you know, because they don't get sleep at night. They're trying to remember the plays. And I've always said if, no, if you don't know that your whole team is breathing optimally, that might be the difference between you not making it to the national championship. Yeah. Or, or winning it because somebody misses an assignment because they just tired, they're sleep deprived, they can't breathe. And I came across an article that said that when an athlete breathes optimally through their nose, they can increase their endurance by 50%.

50%.

Is that huge now? And so now I'm thinking this Edmonton.

Oilers could have used that last night.

Not only that, think about, think about the Olympic athletes who didn't make it to the Olympics at the trials this weekend because they may not breathe their very best through their nose. And who, if you fix them, they might actually be the gold medalists, but they're sitting at home because they didn't know that they're not breathing optimally. So I contend that athletes need to be screened with a sinus CT scan. If you look at pro athletes, I mean, you're putting all this money into people. Let's use some people. For example, Draymond Green.

Yeah.

Every time I see him, I said, he's a mouth breather. He can't breathe through his nose. And as good as he is, he could be better. Okay. The quarterback for the Kansas City Chiefs, Mahomes. They tease him about his voice, but when I hear his voice, I hear somebody that's nasally congested and needs to have his nose. He's a half billion dollar quarterback. You can't have as good as he is. He could be better because maybe he's not sleeping well at night. Maybe he always has a chronic runny nose. Maybe his eyes are a little fuzzy because the tears don't drain into. It's gonna be all kind of. And that might cost you somewhere down the line, it might cost you. So they just need to be optimized. I mean, we're talking about amateur athletes, college athletes and pros. They just need track, soccer. You can see the. How track and field, soccer, football, basketball would be impacted. If we could get them all breathing. Well, just the whole product is better.

Is there a way for folks at home to know, are they mouth breathers or not? Because they're. You know, there's the whole James Nestor breathe book and mouth taping and.

Right.

I mean, besides outright snoring.

Right.

Or loved one saying, hey, you're snoring. Or you get.

You could get a mirror and block one nostril and blow in the mirror. If you see some. Some condensation, you know you're breathing okay. Well, you know you're getting some air through. But if you notice a difference from one side to the other, and you need to do it over a period of days, because it's normal for the turbinates, which are the air filters of the nose, they. They cycle every four to six hours. One side swells, the other side shrinks. So you might catch it where one side's swollen and think that, oh, man, I'm really blocked on that side. When the next day, you might do it the other side. So if they're about the same after you've done it over a period of time, you probably breathe okay.

Okay.

But you never. But you never know. You still. You need an exam, a nasal endoscopy by an ent. If you hear that you've had. You have a deviated septum and you have problems like snoring, headaches, sinus infections, that's when you need to take action and have things fixed. Yeah. If you have a deviated septum and you don't have any problems, then I don't know that you need to have it fixed. However, there's a caveat to that. Because these migraines are connected to those 75 neurological disorders, and because there is a condition called silent migraines, where people don't get headaches, that they get some visual aura or something, they see spots every now and then, but they don't really get a headache. That means you still have the abnormality in your nose. And who knows if you might be one that later on in life gets diagnosed with Alzheimer's or Parkinson's or something? I just don't know yet. I don't know. But it's something to think about.

Yeah. That is super fascinating. Dr. Kevin Smith, thank you so much for coming on and sharing about your new migraine discoveries. And we're going to help get the word out here. So, folks, if you like today's show, give us a thumbs up, like subscribe if you haven't subscribed. So you get the early release to these shows and also go out, give us a five star review and let us know what you learned from this one. It could save a life. Dr. Kevin Smith, thank you so much.

Thank you very much for having me.