Former schoolteacher finds relief from sinus infections with technology called Balloon Sinuplasty at Winneshiek Medical Center.

Verla Stegge
Verla Stegge could count on her seasonal sinus infections like clockwork, and they hindered her job teaching reading to elementary students and, after retirement, upset her travel plans. “Larry and I love to travel – we have been to Alaska, Hawaii, England, Europe and the Panama Canal – I was tired of planning things around sinus infections; I was tired of them disrupting my life.”

Breathing Easy Again

Most of us take breathing for granted. Like heart beats or digestion, it happens whether or not we are paying attention to it. Breathing allows our bodies to take in life-giving oxygen and release poisonous carbon dioxide. Our breaths tell us when we are out of shape, excited or scared. We can breathe through our mouths or noses, and many savvy children claim they can hold their breath until they die – a common ploy to avoid mashed potatoes or bath time.

But for some people, breathing is not as easy as it should be. For Verla Steege, a retired rural Fredericksburg school-teacher, breathing becomes difficult during a particular season. She says, “Every winter, since I don’t know when, I’ve gotten sinus infections.” Otherwise known as sinusitis, these infections generally happen in response to the common cold, an allergy attack, or irritation by environmental pollutants such as smoke or dust.

The sinuses are air chambers that extend outward from the inside of the nose into the bones of the face and skull. Sinuses have a very important job in keeping us healthy; they produce the mucus that helps our body rid itself of dust particles, bacteria and other air pollutants before the unwelcome particles make us sick.

“One of the hardest parts of a sinus infection is sleeping,” says Verla. She recalls lying in bed with her nose completely blocked. “The only way I could breathe was through my mouth. My lips would dry out and crack; my throat would feel like sandpaper; it was hard to swallow because my throat was so sore…and I would have to work the next day.” She endured this for months at a time, through multiple rounds of antibiotics, every winter.

Verla could count on her seasonal sinus infections like clockwork, and they hindered her job teaching reading to elementary students and, after retirement, upset her travel plans. “Larry and I love to travel – we have been to Alaska, Hawaii, England, Europe and the Panama Canal – I was tired of planning things around sinus infections; I was tired of them disrupting my life.”

Verla’s primary care provider in Fredericksburg referred her to William Remington, M.D., Mayo Clinic Health System ear, nose, throat, head and neck Surgeon with at Winneshiek Medical Center.  After a thorough review of Verla’s medical history and evaluating a Computed Tomography (CT) scan, Dr. Remington diagnosed isolated right sphenoid sinusitis. He explains, “There are sinuses that exist deep in the skull right in front of the brain, called the sphenoid sinus. Sometimes, there is a wall that develops in them, resulting in a right and left sphenoid sinus.” Verla’s right sphenoid sinus was blocked, and surgery was the best option.

Dr. Remington suggested using new technology called Balloon Sinuplasty for the surgery. He says, “Balloon Sinuplasty is a new, minimally invasive tool to open blocked sinuses. A small balloon passes over a wire inserted into the sinus, and the balloon is inflated. This opens the passage and allows the surgeon to clear away the blockage or infection.” The surgeon removes the balloon at the end of the procedure, and the patient goes home the same day.

Verla’s surgery took place at Winneshiek Medical Center in Decorah.  “Larry and I left home very early – it was still dark – to get to the medical center for the surgery, but the actual procedure, I’m told, took less than twenty minutes!” says Verla.

Dr. Remington found something besides the expected blockage while clearing Verla’s right sphenoid sinus. “He told me that I had a fungal ball in my sinus, probably the cause of all my infections,” says Verla. A fungal ball is a rare complication and changed the direction of Verla’s treatment. Dr. Remington says, “Fungi are around us in the air all the time. Unfortunately for Verla, the fungi collected in her sphenoid sinus, producing a ball about an inch in diameter.” He describes the fungal ball like a clump of thick mud smashed into a compact ball. “Once the swelling from the surgery went down, I could see that there was a significant amount of matter in her sphenoid sinus. The only way to get rid of it was through the tedious process of extracting it by a vacuum instrument, a little at a time.”

Dr. Remington performed the vacuum procedures during Verla’s follow-up appointments at his Decorah office. “I trust Dr. Remington’s judgment and skill and I was very glad that Larry and I didn’t have to drive to Rochester every week. Dr. Remington had everything he needed for this complicated procedure right in Decorah. He even called a colleague at the Mayo Clinic to discuss using different instruments on me, but was told Decorah had everything Mayo would use in my situation,” says Verla.

Another surgery later, followed by continuous saline flushes and vacuum procedures, the fungal ball gave way. “I couldn’t be happier – it is gone,” says Verla, “and finally, so are the sinus infections. I could never feel the ball, but we determined it had been there for more than seven years – an old CT scan showed a blockage in my right sphenoid sinus even then.”

Verla is looking forward to her first winter of easy breathing. She will continue to flush her sinuses and will most likely have regular visits with Dr. Remington, but only for check-ups. Verla says, “I trusted Dr. Remington the entire time, and would go through everything again if I had too. It is worth it to be able to breathe…all year long.”

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