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Varicose Veins

“Varicose veins” is a term you’ve most likely heard before. While people often seem to associate varicose veins with older people or as a part of the natural aging process, they can not only also affect women in their childbearing years…but men and women of all ages, too. In fact, some estimates have suggested that as many as 15 percent of Canadian men and women (adults) have varicose veins.

Varicose veins are veins (usually on the legs and/or feet) that become swollen or enlarged. They have a dark purple or blue hue, and visible to the naked eye with an appearance that is described as lumpy, twisting or bulging – though the way varicose veins appear do differ from person to person. Appearance isn’t the only concern for individuals varicose veins, however, as they can also have symptoms such as leg pain (often described as aching or feeling heavy), as well as swelling of the feet and ankles. They occur when the valves of the veins prevent blood flow. As a result of these valves failing, the blood collects inside of the veins, making it difficult for the blood to flow upward to the heart, which is what then causes the veins to appear swollen or have that purple or blue coloured hue as described.

Along with having a family history of varicose veins, they can also be caused as a result of pregnancy, standing for long periods of time, obesity, and menopause. If you are over the age of 50 you are also at a higher risk of developing varicose veins. In order to make a diagnosis, a physician will question patients on their medical history, ask about any symptoms the patient is experiencing, as well as examine the legs while the patient is in a sitting or standing position. In some cases, the patient may be referred for an ultrasound to check the blood flow. A venogram may also be recommended, in which a special dye gets injected into the legs to help give a better view of the blood flow as X-ray images are taken. A venogram can also check for any blood clots or blockages – both of which can also cause pain in the legs.

In order to prevent varicose veins, you may be required to make certain changes to your lifestyle. If you happen to work a job that has you standing for long periods of time, take breaks and sit down. Doing certain exercises, such as going for walks or doing leg stretches can also help to improve circulation and blood flow. If you’ve already been diagnosed with varicose veins, you can implement these lifestyle changes in addition to keeping your legs elevated as much as you can. Wearing compression socks, which can be found at many drug stores, can also help to alleviate swelling associated with varicose veins.

Tips to Help You Manage Diabetes

If you’ve just been diagnosed with diabetes, it can be tough to navigate – at least initially. For many, managing diabetes means having to make lifestyle changes; and while it’s certainly not a death sentence, it can still be a matter of life or death if you don’t take the appropriate measures to keep yourself healthy.

The most common form of diabetes is Type II diabetes. Type II diabetes occurs when the body doesn’t use insulin properly – also known as insulin resistance. This can lead to a number of health problems including heart disease, stroke, neuropathy, and of course high blood sugar. Below are some important steps that you can take if you’ve been diagnosed with Type II diabetes – which will not only help control your blood sugar levels, but improve your overall quality of life, too.

First and foremost, make sure you’re eating healthy. Ensuring that you have a good, well-balanced diet is important for your overall health and wellbeing, but it is especially important for managing diabetes. Certain foods such as carbohydrates (i.e. pasta, bread, grains), milk, candy, canned fruit and starchy vegetables break down into glucose and raise blood sugar levels a lot faster than other foods would. Instead, choose non-starchy vegetables like beans, broccoli, carrots, cauliflower, onions, tomatoes and peppers. You can find a full list of non-starchy vegetables by clicking here. You should also choose other healthy food options such as nuts, whole grains and seeds, and of course limit your sugar intake. When it comes to protein, make sure your choices are low in saturated fat – like turkey or fish. Avoid things like hot dogs and deli meats, as these are foods that are processed and contain little to no nutritional value, and can also increase the risk of high blood pressure. When choosing grains, make sure they’re whole grains – such as quinoa and wild rice. Whole grain bread is also a healthier alternative to white bread. Grains contain a wide variety of healthy vitamins and minerals. Avoid things like pasta and white rice. As for dairy, avoid things like chocolate milk or any dairy product that is full fat. Greek yogurt, for example, is a healthier, low-fat option.

Managing diabetes isn’t just about changing your diet, however. It is also important to have a good handle on your weight. Being overweight can lead to diabetes or make diabetes worse. Losing weight can not only decrease your blood sugar levels, but it can also decrease the risk of other health complications such as kidney failure and cardiovascular problems.

For more information on diabetes and management tips, visit www.diabetes.ca.

Emotional Eating Habits

Regardless of what it’s caused by (such as work, school, or personal relationships), stress is something that affects us all. For some, stress can be a minor and infrequent occurrence, while for others it can be a reoccurring, daily problem, resulting in serious mental health issues such as depression and anxiety.

The most important thing when it comes to dealing with stress and anxiety is not only identifying the triggers, but also being able to recognize how it affects us. For example, some individuals under stress may want to find some downtime – whether it’s keeping to themselves by finding a quiet room and reading a book, or taking a vacation. This is known as a cooling-off period. For others, dealing with stress isn’t as simple. One of the most common ways that individuals will self-treat their stress is through food – otherwise known as emotional eating. Food isn’t just something we consume to satisfy our hunger. Food can also mean comfort and can help relieve those feelings of anxiousness, sadness and/or loneliness. That being said, emotional eating doesn’t actually solve anything. Not only does the stress remain, but we also tend to feel guilty for eating – especially if we overeat, which is also easy to do when you’re under a lot of stress.

Regardless of how tempted you might be to try and relieve your stress through eating your favourite candy bar, greasy French fries, pint of ice cream or other favourite food item, it’s important that you find other, healthier alternatives to dealing with your stress. The best way to do this is to practice mindful eating; but in order to do that you first need to be aware of what’s happening around you or to you to cause the stress and therefore make you want to eat your emotions away in the first place. Start by asking yourself the following questions:

• Do you eat more when you’re feeling stressed out compared to other times?
• Do you eat even when you don’t feel hungry or are already feel full?
• Do you tell yourself that eating will make you feel better?

If the answer to any of those questions is “yes,” then there may be a problem. That being said, by answering yes to those questions, you’re also aware of the fact that the problem exists, which is an important step in being able to develop different coping mechanisms. Also remember that emotional hunger is something that tends to come on overwhelmingly suddenly, makes you crave specific comfort foods, doesn’t actually leave you feeling satisfied, and often leads to guilt and shame for overeating – all completely different feelings compared to those of someone with normal eating habits. Once you’ve identified what your triggers might be, comes the hard part: Finding those healthier alternatives. Before you eat, ask yourself why you’re eating. Are you picking up food because you’re upset or because it’s lunch and you know you need to have 3 well-balanced meals every day? Secondly, pay attention to the food choices you make. As mentioned, comfort foods are commonly associated with emotional eating, so always make sure you’re choosing foods that are healthy and nutritious. Failing to follow these steps can eventually result in serious eating disorders. If you suffer from severe stress, anxiety or other mental health issues, never hesitate to reach out for help from a trusted medical professional.

British Columbia’s Vaccine Card

For almost two years, British Columbians have had to take certain measures to keep themselves, their families, and their communities safe from COVID-19 – including testing, physical distancing, limiting or avoiding non-essential services and travel, mask-wearing, and most recently, vaccines. Now, another layer of protection will soon be coming into effect. Starting September 13th, and by order of Provincial Health Officer Dr. Bonnie Henry, British Columbians aged 12 and older will be required to show proof of at least one dose of COVID-19 vaccination (two doses by October 24th) if they want to access certain services, businesses, and events.

“Where will I be required to show proof of vaccination?”
You will need to show proof of vaccination if you want to access the following:

• Indoor ticketed sporting events, concerts, theatre, dance and symphony performances
• Indoor and outdoor dining at restaurants, bars and pubs
• Nightclubs and casinos
• Movie theatres
• Gyms (including high-intensity group exercise), recreation facilities and pools
• Indoor organized recreational classes and activities
• Indoor organized gatherings (i.e., weddings, funerals, parties, meetings, workshops)
• Post-secondary on-campus student housing

“How will I be able to access my vaccine card?”
Starting September 13th, British Columbians will be able to visit a secure website to access their vaccine card. From there, you will be able to save your vaccine to your smartphone for easy access and show it when accessing any of the aforementioned services, businesses, or events. If you do not have access to a smartphone, British Columbians will also have the option of receiving a paper copy of their vaccine card. In order to access your vaccine card, you will need to provide proof of identity – including your name, date of birth, and personal health number. To prepare and confirm your immunization records, it is recommended that you register for Health Gateway. (This secure website also provides you with information on healthcare visits and recently filled prescriptions.) If you believe any of your information on Health Gateway is incorrect, you should call 1-833-838-2323 (available 7 days a week from 7 AM to 7 PM PST.)

“Do I still need to show proof of vaccination if I’m visiting from outside of British Columbia?”
If you are visiting British Columbia from another province or territory, you will be required to show valid government identification from that province or territory in addition to an officially recognized vaccination record. If you are an international visitor, you will need to show proof of vaccination used to enter Canada, in addition to showing your passport.

“What if I cannot get (or am not yet fully) vaccinated, or do not want a vaccine?”
Because this is a temporary measure to help British Columbians get through this risky period of COVID-19 – particularly with the highly contagious and rapidly spreading Delta variant – Dr. Bonnie Henry has stated that there are no plans at this time for exemptions to be made for unvaccinated individuals who want to access discretionary services, businesses or events where the vaccine card will be required.

“If I’m not yet vaccinated but want to get a vaccine, where do I go?”
British Columbians who are not yet vaccinated (or not yet fully vaccinated) and want to be, can register for their vaccine by clicking here.

“Will I need to show proof of vaccination each and every time I want to access these things?”
For the time being, yes, you will be required to show your vaccine card when wanting to access discretionary services, business or events. The vaccine card program is set to expire on January 31st, 2022; however, it is subject to extension depending on where things are with COVID-19 in our province at that time.

COVID-19: Assessing Your Personal Risk, Setting Boundaries

When it comes to COVID-19, it is a virus that can affect individuals of all walks of life – regardless of age, gender, or where they live in the world. However, what we’ve also learned since living with this virus for the past 18 months is that there are certain individuals who may be at increased susceptibility for COVID-19 than others. While age is something that certainly plays a role (with those over the age of 60 being the most impacted by this virus with severe illness, hospitalization and death), we also know that individuals with certain pre-existing medical conditions are also more likely to contract COVID-19 and develop severe illness as a result – including the following:

• Those who have cancer or are receiving cancer treatment
• Chronic kidney disease
• Chronic lung disease (i.e., asthma, COPD)
• Diabetes (type 1 or type 2)
• Neurological conditions (i.e., dementia)
• Heart conditions (i.e., heart failure, coronary artery disease, hypertension)
• Liver disease
• HIV infection
• Pregnancy
• Those who are immunocompromised
• Blood disorders (i.e., sickle cell disease, thalassemia)
• Obesity
• Those who are smokers (current or in the past)

To mitigate the spread of the virus, measures were put in place early on in effort to help decrease the spread of COVID-19 – such as physical distancing guidelines, limiting or closing non-essential services (including limiting the number of people allowed inside a business), mask mandates, and more. However, with vaccines now in the mix, this has allowed many of these restrictions to be loosened, businesses to reopen, and life to go back to a certain degree of normalcy – and while some individuals may feel comfortable going back to living their lives the way they did prior to this pandemic, not everyone may feel comfortable doing so just yet. For example, a friend or family member might invite you out to eat at a restaurant while you might instead prefer ordering in; or, you may have been working remotely through the pandemic and are now being pressured by co-workers to return to in-office work; or people may ask why you’re still wearing a mask despite being fully vaccinated. In cases such as these, it may be surprising to some to learn you aren’t taking the exact same measures as them when re-introducing yourself to what’s known as a “post-pandemic” world (despite the pandemic still very much being a significant factor – particularly with numbers on the rise again due to the highly transmissible Delta variant.)

In any event, what’s comfortable for one person may not be comfortable for someone else, and it is both important to not only set your own personal boundaries – but, in turn, also be respectful of the personal boundaries that individuals may set for themselves due to their own personal risk profile – especially if they do not align with your own; also taking into account that someone may have certain comorbidities that you are not aware of, which may lead to some hesitancy in things like not wearing masks, etcetera.

For some, setting boundaries can be difficult, but it’s important to note that any decision you make for yourself is the right one as you’re doing what you need to do to not only protect yourself, but protect those around you, and you should not feel guilty about wanting to ensure your own optimal health as well as the health of others. While one’s risk of developing COVID-19 decreases if they are fully vaccinated, the fact remains that vaccines are not considered 100% effective – there is still the potential for breakthrough cases – and one’s personal risk factor still needs to be considered. When being invited to a social gathering, the likelihood is that your friends and family miss you; but as you turn them down, they may feel as though you’re trying to intentionally avoid them which could lead to hurt feelings. This is why it’s also important to have a conversation about why you’re setting personal boundaries, and find other ways to continue to prioritize those friendships by offering alternative ways of socializing – such as having regular group video chats, as keeping those social connections are important – particularly for our mental wellbeing.

What is a Dietitian’s Role?

When it comes to healthy eating, making the right food choices isn’t always easy. You may need to change your eating habits due to being overweight, having high cholesterol, or because of food allergies or sensitivities. While family physicians can certainly help steer patients in the right direction when it comes to making healthy food choices – such as recommending low-carb diets – you may need additional help from a dietitian. Just as any other healthcare professionals – such as doctors, pharmacists and specialists – dietitians can be just as important to your health and wellbeing. They not only work alongside patients, but also with general practitioners, in hospitals, long-term care facilities, and from time to time you may even find a dietitian in a grocery store providing customers with tips on healthy eating.

An RD (“Registered Dietitian”) is a professionally trained individual that is able to counsel patients on food and what it means to have good nutrition – and not only that, but the information in which they do provide is tailored specifically to the client whom they are helping. Meaning that the information in which a dietitian provides to you is given to you with your needs in mind and yours alone, as food that is good for one individual may not be right for another. You can learn more about dietitians and what they do by clicking here.

In addition to providing patients with counselling on nutrition, dietitians can also provide patients with information on how to combine their healthy eating with other lifestyle changes, such as fitness. Healthy eating and weight loss often go hand in hand. Following the advice of a dietitian or a nutritionist can also help to reduce the risk of diabetes as well as lower your cholesterol and blood pressure.

To find a dietitian in your area, visit the Dietitians of Canada website at dietitians.ca.

Gluten Intolerance or Sensitivity?

For anyone who suffers from gluten intolerance or gluten sensitivity, you know that finding gluten-free foods is important so as to not aggravate any symptoms. However, while the terms gluten intolerance and gluten sensitivity are often used interchangeably, there are also slight differences between the two. For example, if you are sensitive to gluten, then that means that specific parts of the immune system are involved and an immune response is triggered; whereas if you’re intolerant to gluten, the immune system does not play a role.

The best way to explain gluten intolerance is to compare it to lactose intolerance. If someone is lactose intolerant, they may experience things like diarrhea, abdominal pain, nausea and vomiting. The reason an individual may be lactose intolerant is because they lack an enzyme known as lactase. Without this enzyme, it makes it difficult for the body to breakdown and digest lactose. To avoid the aforementioned symptoms, individuals that are intolerant are unable to consume things like milk and other dairy products, and will instead have to buy products that are lactose-free. The same goes for gluten intolerance.

Because gluten sensitivity is also quite common, individuals with this condition will often say that they have a gluten allergy. However, this isn’t necessarily the case. While it’s possible to have an allergy to wheat, that doesn’t necessarily mean you have an allergy to gluten. In fact, according to allergists, gluten allergies don’t actually exist. You’re either allergic to wheat, sensitive to gluten, or have Celiac Disease – an autoimmune disease that is triggered when gluten has been ingested. The aforementioned conditions (wheat allergy, gluten sensitivity, and Celiac Disease) can also overlap. It is important to note that if you have a gluten sensitivity, you cannot go into anaphylaxis. This can only occur if you are allergic to wheat.

Symptoms of gluten intolerance and gluten sensitivity can manifest in a variety of ways. Gluten sensitivity may cause things like nausea, acid reflux, mouth ulcers and constipation, as well as feelings of fatigue, joint pain, and even headaches. Similarly, gluten sensitivity can also cause gastrointestinal-related symptoms; i.e. nausea, vomiting, diarrhea, and abdominal pain.

The best thing you can do to avoid these symptoms is to avoid gluten. Many companies often make products that are gluten-free. In fact, most grocery stores have aisles dedicated to gluten-free foods. There are also certain goods that are naturally gluten-free, and the list is extensive. Gluten-free foods include broccoli, asparagus, brussels sprouts, lettuce, mushroom, olives, potato, spinach, squash, zucchini, pineapple, coconut, beef, chicken, cod, pork, nuts quinoa and soy…just to name a few; while foods such as bread, cookies, cakes, other pastries, alcohol (beer, specifically), gravy, malt vinegar, pretzels, pizza, sausages, salami, as well as soups and sauces (as they may contain wheat as a thickener) should be avoided.

To determine whether or not gluten sensitivity or gluten intolerance are triggering your symptoms, it is recommended that you first be tested for both Celiac Disease as well as wheat allergy. If those tests come back negative, then physicians typically recommend trying a gluten elimination diet and exclude certain foods to see if that helps.

Dangers of Second-hand Smoke

It’s no secret that tobacco is one of the most harmful things for your body. If you smoke cigarettes, you’re putting yourself at risk of a multitude of health problems – including everything from changes to the skin, discolouration of the teeth and/or tooth decay, as well as severe respiratory problems such as asthma, pneumonia, emphysema, and lung cancer. In fact, smoking is directly responsible for nearly 85% of lung cancer-related deaths, and as many as 80% of deaths due to COPD (Chronic Obstructive Pulmonary Disease.) The unfortunate thing about smoking is that once you start, it’s difficult to stop. This is because tobacco contains nicotine, which is addictive. The good news is that there are many different tips, tools and other options available for individuals looking to break this bad habit – all it takes is a little bit of will power and determination.

Smokers aren’t the only people affected by tobacco use, however. It can have just as equal of a negative impact on non-smokers as it would those who smoke regularly, or even those who only smoke socially. In other words, being exposed to cigarette smoke is harmful for everyone – but unfortunately, not everyone is aware of the dangers that second-hand smoke can pose.

The first and maybe most important thing that everyone needs to know is that there is absolutely NO risk-free level of exposure to second-hand smoke – and you shouldn’t let anything, or anyone, convince you otherwise. Being exposed to second-hand smoke can lead to many of the very same health consequences as it would in someone who is a smoker – such as the previously mentioned respiratory problems and infections (COPD, asthma, pneumonia, lung cancer), to an increase in middle ear infections, nasal irritation (including sneezing and congestion), coughing, heart disease. In fact, second-hand smoke is responsible for nearly 35,000 premature deaths that are related to heart disease. In addition to this, breathing in second-hand smoke can also have immediate adverse effects on the blood and blood vessels, which can ultimately increase your risk of having a heart attack. Even the briefest exposure to second-hand smoke can be enough to do damage. It has also been known to impact the reproductive health of women, as well as is linked to sudden infant death syndrome.

As for how someone is exposed to second-hand smoke, there are many ways. For example, you might live with a friend or family member who smokes. You can also be exposed to second-hand smoke while driving in your car, simply by having your window rolled down and passing by another vehicle in which the driver happens to be smoking. Or, you could be walking past someone on the street who happens to be smoking. You may also live in an apartment building or condominium in which some of your fellow tenants are smokers, which is amongst the most common complaints when it comes to multi-dwelling living arrangements. While not all buildings are smoke-free, many have implemented (or are trying to implement) smoke-free policies. This is, in part, due to the fact that according to a survey of renters in British Columbia, the majority would rather live in smoke-free buildings. Along with living in a smoke-free property being better for your health, it can also reduce the costs of things like cleaning and repairs (such as painting, carpet cleaning and other maintenance.) If you’re unsure as to whether or not your building is smoke-free, you should check with your building manager. You can find more information on smoke-free housing here (including resources for both landlords and tenants.)

When it comes to avoiding second-hand smoke, it can be difficult, but there are certain things that both smokers and non-smokers can do to be mindful of one another. For example, if you’re visiting someone in their home and you don’t want to be exposed to second-hand smoke, ask if they would be willing to smoke outdoors instead of indoors for the duration of your stay. If you are a smoker and want to “light up” in a public area, be mindful of the fact that there are others who may not want to be exposed to second-hand smoke. Depending on where you are, many places have designated smoking zones – but you should always first check your local laws to make sure you aren’t smoking in a prohibited area. For tobacco and vapour-free locations specific to British Columbia, click here.

The Link Between Food and Anxiety

If you’re someone who suffers from anxiety, you know how debilitating it can be. Anxiety is often caused by trauma, and also co-occurs with other mental health related conditions such as depression; but what you might not realize is that certain foods you eat may also be triggering those feelings of anxiousness.

1. Coffee
This is a beverage that millions of Canadians rely on each and every day to give them that added boost of energy in the morning, as well as help them get through their days at work, as well as pull all-nighters to study for things like exam. There are both risks and benefits that come along with coffee consumption. If you’re someone who consumes several cups of coffee per day, those high levels of caffeine in your system can increase feelings of nervousness and anxiousness, and may also even decrease the production of serotonin, leaving you feeling depressed. As an alternative, try drinking herbal tea. Not only is it healthier for you, but it won’t give you any of those unwanted jitters.

2. Non-Dairy Creamers
Staying on the subject of coffee, individuals often put cream in their coffee (and even in their tea) opposed to opting for things like low-fat milk, 1% milk, 2% milk, or soy, almond or coconut milks. Creamers, especially if non-dairy, are sources of trans fats (also known as hydrogenated oils), come packed with LDL cholesterol (the “bad” cholesterol), and can lower your HDL cholesterol levels (the “good” cholesterol.) Trans fats/hydrogenated oils have been linked to depression and anxiety, as well as other types of mental illness.

3. Fermented Foods
It might sound bizarre, but certain fermented aged or cultured foods (such as certain meats and cheeses) can also contribute to anxiety. During their curing, fermenting, or culturing process, bacteria breaks down proteins into biogenic amines. One of these includes histamine, which is a neurotransmitter that can aggravate hormones, digestion, as well as the nervous and cardiovascular symptoms. If you are susceptible or sensitive and have a histamine intolerance in any way, this can also trigger anxiety. So, rather than choosing foods that are aged, fermented or cultured, always go for foods that are fresh instead.

4. Sugar
We all know that sugar isn’t good for us. In fact, sugar consumption is one of the leading contributing factors for obesity amongst Canadians – especially added sugars in certain foods. It can cause your blood sugar to spike and crash, which then causes your energy to do the same. Unfortunately, when your blood sugar crashes, so does your mood, which can then increase anxiety because the body is working extra hard to get the body feeling back to normal. If you’re craving something sweet, I recommend going for foods that are naturally sweet – such as fresh fruit.

Common Sinus Problems

Is your nose frequently congested? Do you have post-nasal drip? Are you constantly feeling sinus pain or pressure? All of these symptoms may be indicators of a sinus problem. Below, I explain what the sinuses are, the different types of sinus problems that can occur, and what you can do to find relief.

The sinuses are separated into four different categories, and they are as follows:

• Frontal Sinuses
• Sphenoid Sinuses
• Ethmoid Sinuses
• Maxillary Sinus

The frontal sinuses are located in the low-centre are of your forehead, the ethmoid sinuses are located between your eyes, the sphenoid sinuses are located in the bones just behind your nose/between the eyes, and your maxillary sinuses (which are the largest) are located in your cheekbones. The sinuses are lined with a soft, pink tissue known as mucosa; while the inside of our nose has ridges known as turbinates, which help to humidify and filter the air we breathe in through our noses. Dividing the nose is a thin wall known as the septum.

There are many types of sinus problems that one can develop, including:

• Hay Fever (Allergic Rhinitis)
• Acute Sinusitis
• Chronic Sinusitis
• Nasal Polyps
• Deviated Septum
• Turbinate Hypertophy

The most common problem associated with the sinuses is hay fever, also known as allergic rhinitis. This condition occurs most commonly during the spring season due to allergens such as pollen. However, allergic rhinitis can also develop due to pet dander and dust. Symptoms associated with allergic rhinitis include nasal congestion, sneezing, itching, and mucus. It is commonly treated with nasal sprays, such as Nasonex. People can also sometimes find relief by using over-the-counter allergy medication, such as Reactine.


Acute sinusitis is the result of a virus, bacteria, or fungi which infects the sinus cavity and causes inflammation along with other symptoms such as nasal congestion, mucus, and pain in the cheeks, forehead, and/or around the eyes. Headaches are also a common symptom with acute sinusitis. If an infection is present, patients are usually treated with a course of antibiotics. Sometimes an x-ray will be necessary to determine whether or not an infection is present. However, another telltale sign of infection is if your mucus is green in colour. Chronic sinusitis can also occur, and it is much more than just repeated sinus infections. If you have chronic sinusitis, it means that your sinuses are persistently inflamed. To help get rid of chronic sinusitis, you may need to use nasal steroids as well as saline nasal irrigation. If the aforementioned methods do not provide you any relief, your doctor will likely refer you to an ENT (Ear, Nose, Throat) specialist, and you may even be a candidate for endoscopic sinus surgery.