Hey everyone.
I'm here at ADVENT today and I'm going to take us through a new patient
appointment. Come with me.
Molly, you're a physician assistant here at ADVENT and I'm so excited to meet with you today
because I want to show everyone what it's like to have a first appointment here
because people, I feel,
deal with issues with sleep and snoring their entire life before they come to
see someone like you. So what will someone expect when they first come in?
Yeah, here in our clinic, we do new patient visits.
They're usually about 30 minutes long and we really focus on listening to the
patients. A lot of our patients have had symptoms five, 10, sometimes lifetime.
And they feel like in the past, when they brought it up,
they might not have gotten any answers or felt validated with their concerns.
So we always listen to our patients,
hear what's kinda going on and we do an evaluation as well.
And one of the things you do an evaluation of is this thing called The Breathing
Triangle®, right?
Yes, The Breathing Triangle®. So you only have three ways for air to get in.
You got two nostrils and you got your mouth and it makes a triangle.
So if two of them don't work, like your nostrils,
that's affecting how you're breathing.
So we always evaluate your Breathing Triangle®.
We talk about that because it's huge.
Absolutely.
I feel like you guys are different than regular ENTs because you have this
specialty with sleep and with snoring and actually getting to the root of the
problem.
Yes. So we're not a general ENT practice. We do focus on sinus.
We focused on snoring and sleep apnea. We also take a nasal approach.
So we focus on the nose first, what's going on with the nose.
Cause that affects other things like sleeping and people don't always realize
how it can affect your sleep quality.
Do you think it's usually the person coming in for themselves or their partner
suggesting they come in? Because I feel like this is a marriage issue too.
Oh yeah. Sleep divorce-real thing. I have quite a few patients who are like,
I just want to sleep in my bed. Like I don't want to sleep on the couch.
I keep getting elbowed all night long and sometimes they bring their spouse with
them and they're sitting in a corner and are like, "uh huh,
uh huh," and you didn't talk about that!
So true. Well, that's why I love what you do,
because you ask the goal goals of the patient.
That I think is something so different than a lot of ENTs do.
They're just kind of like, you follow their route.
Yeah. We always ask in that the first patient visit,
"what is your goal?" Is it that you just want to sleep in your bed with your
wife,
or is it that you have sinus infections multiple times throughout the year and
it's really affecting the quality of your life,
where you're sick a lot of the time. Things like that.
So we get that goal and we always focus on that goal as we create our treatment
plan.
Well, I love that you can do that. Even if it's allergies,
you can still work on things that help.
So the evaluation of The Breathing Triangle®, how does that work?
Cause I know you've got a little tool that you can use.
Yes. So do you mind if I do an evaluation on you?
Sure!
All right. So I'm going to look at your throat first.
Okay. This can all happen on the first appointment.
It does. Yes. We all evaluate everybody on that first appointment. So,
we'll have you open up wide say, "ah." Alright,
good job. And then this is called nasal endoscopy. And so what this is,
is it helps us get a better look at your nose. Okay. So we can see, you know,
do you have nasal polyps? What is your septum look like? Yeah,
are your turbinates okay? So I'm going to spray your nose with some spray.
It's lidocaine and Afrin,
so it doesn't taste the best, but it's safe to swallow.
Good. Cause I swallowed a little.
You're fine. You're fine.
This whole thing is not going in your nose.
Okay, good.
It's just a bit of it going in.
And I'll just kind of talk you through what I'm looking at, okay?
So you can see things in my nose and throat when you do this?
Yes.
Things that I wouldn't be able to see if I just took a speculum and looked in
your nose.
So what I'm looking at right here is I look at your septum just to make sure,
is it deviated to one side. I'm looking at your turbinates,
which are tissues that moisten and humidify the air.
And then looking further back, looking for any polyps in the back.
I look all the way to the back of the throat and then down to your vocal chords.
All right. And then after do that on the other side.
That was it?
Yeah.
Do you see anything?
You know, you don't have polyps. Very glad about that.
But I'm looking at everything, your turbinates,
all that stuff and how it contributes.
So that's kind of The Breathing Triangle®. So we're looking at that nose,
looking at that mouth.
That's not bad at all. Well, especially since it's numbed,
there's really no sensation beside, you know,
just someone being close to you and seeing that. So,
once you see something like that, then what can you determine from that?
Would you do another appointment or would you be able to tell me right then and
there maybe some issues,
because I think a lot of people don't expect to get answers in a first
appointment.
Yeah, we do tell you, you know, what's going on? What is your nose look like?
Why do you think you have this drainage or snoring?
Is the nose connected to that or what's going on.
So depending on what your goal is, is kind of how we create a treatment plan.
And you know, if you're dealing with snoring,
we always evaluate you for sleep apnea by doing an in-home sleep study.
If we're thinking there's sinus stuff or, you know, your nasal complaints,
things like that, then we may head towards a CT scan. We do those in-office.
We may try some different medications to see if that can help the symptoms.
So we always do a follow-up appointment based on where,
what you need and what your treatment plan is.
Seems like a super simple process. And I think that's what people want, right?
Because they probably come at a point where they feel like they've tried
everything else. They've tried the nasal sprays,
they've done everything and they just can't get relief.
Yeah. And it is. It's a simple process. It's simple to be evaluated,
30 minute appointment.
And then a lot of patients have been standing in that aisle in pharmacy,
and they're like, "Tried that, tried that. I've sprayed that stuff.
I've tried this stuff, like I've taken these pills. What else is there?".
Absolutely.
And we offer that what else is there?
Was there simple options to make your quality of life better?
What do you hear patients say after they've done even this evaluation,
because I feel like even just doing that,
I feel like I have more information about my own situation.
So I'm sure you hear a lot of great responses.
I really do. I really hear a lot of like, oh, that's it? Or like, oh,
that's why that spray didn't work? I'm like, yeah,
that spray didn't work because of this, this or your septum is so deviated,
that's what's obstructing that side of the nose.
Super simple. So, Molly, thank you so much. If people want to come see you,
they can do a quick evaluation or sign up for a consultation online. Right?
It's so simple.
60 Seconds. It takes you 60 seconds to go online.
We have multiple different clinics throughout Wisconsin, even into Illinois.
So you can go online, sign up for a new patient visit and come see us.
Do you have to have a referral?
No, you don't. Nope. Nope. Just come see us.
That means there's no excuses.
No, there really isn't it. There's really not.
Thanks so much, Molly.
You're welcome. Nice to see you here today.