Dr. Seth Evans

Ear, Nose, Throat, & Allergy Specialist in Central Texas

  • Conditions
  • Contact
  • About Me

Why I think Bikram yoga is good for you and how to get started

February 27, 2014 by Dr. Evans Leave a Comment

Well, today’s post is a bit off the usual ENT related topics, but it’s good to mix things up from time to time, right? I’d like to talk about Bikram yoga, which is something that I’ve been doing regularly for about the past year.

Bikram yoga is a standardized 90 minute long series of 26 postures and 2 breathing exercises that is done in a hot room (105 degrees, 40% humidity) with an instructor leading the class. The first half of the Bikram series is done standing up, and the second half lying or sitting on the floor. Throughout the class, the instructor is talking the large majority of the time giving you a somewhat standardized monologue of instructions on the postures. (Each instructor adds their own twist, but you’ll hear a lot of the same lines every class).

A guide to the postures is HERE.

The workout is intense, and you’ll sweat a ton and burn a lot of calories. Although it’s claimed to be a “full body workout,” I find that the main strength benefit is to my legs, back, and abdominal muscles. Physically, my flexibility and balance have also improved substantially since starting Bikram.

Perhaps an even greater benefit is mental health. The most important part of Bikram yoga is keeping your mind clear and focused on your body and the instructor’s words. In class, my mind does wander sometimes, but most of the time it is relaxed and focused on the present moment. Afterwards, I feel a tremendous calm and clarity of mind, and I can easily say that Bikram yoga is the only exercise I’ve ever done where I feel more energized afterward.

Proponents of Bikram yoga make a lot of claims about it being able to reverse injuries and other health benefits. I cannot make any claims other than what I’ve noticed in myself. Fortunately, I have avoided any major injuries in my life and I’ve generally been in very good health. I do feel that my health is better since starting Bikram yoga, though. I have more energy and core strength, and I just feel good!

The studio where I practice, Pure Bikram Austin has created a nonprofit organization (Pure Action) that funds medical and scientific research of the benefits of Bikram yoga so we may find out more proven benefits in the future.

So, what should you do to start? First, before starting any exercise program, it is safest to consult with your primary care doctor. The staff at your local Bikram studio can also be helpful- if you have it, they’ve probably seen it before.  I’ve seen people of all ages (age about 10 to at least 70), shapes, and sizes in Bikram class.  No one is going to judge you- the instructors and other students are some of the nicest and most supportive people I’ve met anywhere.

Before class, it is important to optimize your hydration and avoid eating for at least 3 hours before entering the hot room. Optimizing hydration means more than just drinking a lot of water, it also means getting enough electrolytes in your system. So, drink a Gatorade, coconut water, or another high-electrolyte drink in addition to water before class. I personally drink 1 liter of water mixed with a packet of Electromix 2-3 hours before class and I’ve never had any problems with cramping or other signs of depleted electrolytes. I drink water with all my meals as well. Also, try to eat healthy the day of Bikram class. I’ve gone a couple times after eating a greasy lunch and it was not pleasant…

During class, you’ll need a yoga mat, a towel to put over it, and a bottle of water. My studio offers mat and towel rentals, and I would guess most others do as well. For your first few classes, your only goal should be to stay in the room for the whole 90 minutes. If you find yourself getting out of breath or lightheaded, stop and rest for as long as you need to. It is fine to sit and watch! After a couple of classes, you’ll get used to the heat and things will come a lot easier.

After class, congratulate yourself on coming out and doing your best. I would suggest taking a quick rinse-off shower and changing clothes before getting in your car. Otherwise your car will start smelling very bad very quickly. You can take a longer shower once you get home.  Make sure to drink more water and electrolytes after class to minimize muscle cramping.

Give it a month of going regularly to decide if Bikram is for you. I’ve found that 2-3 classes a week is the best schedule for me. Some hardcore folks go every day, but that is too much of a time commitment for me and I also would get bored of the class if I went that much.

For more information:

Pure Bikram Yoga (4 Metro Austin locations)

Hill Country Hot Yoga (Wimberley and San Marcos locations)

Pure Action (researching the medical benefits of hot yoga)

How do I diagnose a sinus infection?

February 24, 2014 by Dr. Evans Leave a Comment

Sinus infections are called sinusitis or even more accurately rhinosinusitis by ENT doctors such as myself.  Rhinosinusitis means “inflammation (“-itis”) of the inside of the nose (“rhino”) and sinuses.  For the rest of this article, I will use “sinusitis” to mean the same thing as sinus infection or rhinosinusitis.

Sinusitis can be divided into several different subtypes based on the duration of symptoms.

Acute sinusitis is defined as symptoms lasting less than 4 weeks.  Acute sinusitis can be further split into acute viral and acute bacterial sinusitis.  Subacute sinusitis is defined as symptoms lasting more than 4 but less than 12 weeks.  Chronic sinusitis refers to symptoms lasting longer than 12 weeks.  And finally, there is recurrent acute sinusitis which I define as 3 or more episodes of acute sinusitis in a year with resolution of symptoms in between.

Types of sinusitis

Acute viral sinusitis

Symptoms lasting less than 10 days and not getting worse

Acute bacterial sinusitis

Symptoms lasting longer than 7-10 days, or getting worse after initial improvement

Subacute sinusitis

Symptoms lasting between 4 and 12 weeks

Chronic sinusitis

Symptoms lasting longer than 12 weeks

Recurrent acute sinusitis

At least 3 episodes of acute sinusitis in 1 year with no symptoms in between

So, what are the symptoms?  You need at least 2 of the following to diagnose sinusitis:

  • Thick, green drainage from the nose (can be out the front, down the back, or both)
  • Facial pain or pressure
  • Nasal congestion/obstruction
  • Lessened sense of smell

 

There are other associated symptoms that are less common including cough, tooth pain, ear pain, sore throat, nosebleed, fever, and headache in the top or back of the head.  But without at least 2 of the top 4 symptoms, it is less likely that you have sinusitis.

After talking with you to find out what symptoms you are having and how long you’ve had them, I will examine your nose and face to further support the diagnosis.  The nose is generally congested inside and frequently there is pain when I press on the areas of your face over the sinuses.  I will examine the inside of your nose using nasal endoscopy and look at the middle meatus (the area where the maxillary, frontal, and anterior ethmoid sinuses drain out), and the back of the nose (where the posterior ethmoids and the sphenoid sinuses drain).  In patients with sinusitis, I will generally see swelling of the tissues in these areas, sometimes with thick green mucus or polyps present as well.

Radiographic imaging such as CT scans of the sinuses can be useful in some patients, especially those who might benefit from procedures such as balloon sinuplasty or endoscopic sinus surgery.

Once your sinus infection has been diagnosed, I’ll recommend treatment for you.  As a general rule, I try medicines first and reserve procedures or surgery for patients with chronic sinusitis or recurrent acute sinusitis who continue to have problems despite taking the proper medications.

Acute viral sinusitis does not require antibiotics and usually gets better with time and treatment of the symptoms with decongestants, saline rinses, and medicines to thin the mucus.  For acute bacterial sinusitis, I will add antibiotics and sometimes steroid pills as well.

Chronic sinusitis requires a longer course of antibiotics (usually 3-4 weeks) and steroids, and may require balloon sinuplasty or surgery.  For patients with recurrent acute sinusitis, I’ve found that balloon sinuplasty is really helpful at reducing symptoms and frequency of infections.

I love seeing patients with sinus problems and helping them out.  If you are struggling with lots of sinus infections, come and see me!

Why is your ear hurting?

February 20, 2014 by Dr. Evans Leave a Comment

Pain in the ears can be caused by a number of different problems, both inside the ear and out. I see a lot of patients with ear pain who are convinced that they are having ear infections because their ear hurts. Sometimes they have received several rounds of antibiotics with no help.

Ear infections and problems inside the ear can certainly cause earache, but there are many other problems away from the ear that can cause referred pain to the ear.

Causes of earache:

  1. Problems inside the ear:  
  • Middle ear infection (otitis media). Caused by fluid buildup behind the eardrum which becomes infected. Will ALWAYS have associated hearing loss because the fluid limits the normal transmission of sound to the inner ear
  • Outer ear infection (otitis externa, a.k.a. “swimmers ear”). An infection outside the eardrum within the ear canal.  Can be triggered by water that gets in the ear from swimming or bathing. Usually patients will notice drainage from the ear but not always. There is usually pain with manipulation of the ear.
  • Ear wax impaction can sometimes cause pain.
  • Eustachian tube dysfunction.  Caused by blockage of the Eustachian tube between the middle ear  and the back of the nasal cavity (usually due to allergy or upper respiratory infection). This causes the pressure behind the eardrum to become different from the atmosphere around you. This sometimes can lead to otitis media if fluid builds up behind the ear drum.
  • Tumors or other growths in the ear (fortunately, these are rare).

2. Problems in areas next to the ear

  • TMJ pain (temporomandibular joint pain). Caused by arthritis or stress in the jaw joint which sits directly in front of the ear. This is very common.
  •  Muscle pain: usually in the chewing muscles, the sternocleidomastoid muscle     (below the ear), or the temporalis muscle (above the ear).
  • Fibromyalgia: this is a whole-body pain disorder that can affect the ears and muscles around the ears.

3. Problems in areas remote from the ear. All of these are due to referred nerve pain from other areas:

  • Tonsillitis/throat infection/sore throat
  • Sinus infection
  • Acid reflux
  • Tooth pain or infection
  • Teething in infants
  • Cervical spine problems in the neck
  • Cancers in the back of the nose or throat

4. Nerve pain (pain produced by the brain or from abnormal nerve signals)

  • Migraines.  A newer concept of migraines is that they are not only headaches but are a “global disorder of sensation.”  Many unpleasant symptoms can be caused by migraines including pain in the ears and throughout the body, nausea/vomiting, dizziness, ringing in the ears, and allergic symptoms in the nose.
  • Neuropathic pain: This is pain produced by the nerves themselves.  It can be caused by diabetes or other underlying disorders.

When any patient comes to see me for ear pain, the first step is to take a careful history and perform a head and neck physical exam.  A good clue that the ear pain is not caused by an ear infection is the absence of hearing loss.  In certain patients, further testing such as an audiogram (formal hearing test) or tympanograms (a test to check the pressure behind the eardrum) might be helpful.

Where are the sinuses inside your nose?

February 17, 2014 by Dr. Evans Leave a Comment

We all have 4 sinuses in each side of our noses. The sinuses are normally air-filled spaces inside of the head that drain into the inside of the nose.

The purpose of the sinuses is not known for certain.  There are a number of reasons that people have theorized including: 1. The air-filled spaces make our heads less heavy and easier to hold upright and 2. The sinuses help to add resonance and strength to our voices.
The four sinuses are:
1. Maxillary sinuses: below the eyes behind your cheek bones
2. Frontal sinuses: above the eyes behind your forehead bones
3. Sphenoid sinuses: in the very back of the nose close to the center of your head
4. Ethmoid sinuses: inside the nose between the eyes

sinuses

The maxillary, frontal, and sphenoid sinuses are similar to each other in an important way. They are all one big open space with one opening into the nose.  This fact is important because it allows me to perform procedures to widen the natural openings into those sinuses to allow for better drainage and less risk of infection.  I perform in-office balloon sinuplasty on all of these sinuses in my Kyle, TX office.
On the other hand, the ethmoid sinus is more like a honeycomb. It’s a collection of small airspaces which are divided by thin pieces of bone. There is not one opening into the ethmoid sinus.  So, for significant ethmoid disease, I need to clean out all of the honeycomb, not just open one small area.

 

 

 

« Previous Page
Next Page »

Contact Info

Email: drevans@texanent.com

Phone: 512-550-0321

Practice Website: texanent.com

Categories of Posts

Ear General Health Miscellaneous Neck Nose/Sinus Personal Updates/About Me Surgery/Procedure Throat/Mouth Uncategorized

Recent Posts

  • Wolf Procedure Surgery
  • Trying out the Slow Carb Diet
  • Book Review: The Chronic Cough Enigma by Dr. Jamie Koufman
  • A brief greeting from Hawaii!
  • The business side of running a solo ENT practice

Copyright © 2025 · Beautiful Pro Theme on Genesis Framework · WordPress · Log in