Chris Martin's book is excellent and I recommend it to patients. ENS is so little understood or appreciated by the ENT profession. I am attending the national ENT convention and for the first time there is discussion of care to spare the mucosa and prevent ENS, this has come about from patient advocacy. I think patients benefit when they can discuss with the doctor, "will this procedure cause ENS and are there alternatives?"

Because of my connection with the Hydro Pulse I probably hear from more persons with ENS than the average doctor so I can appreciate what the patient feels.

The important point is that ENS is preventable and this book will go a long way to that prevention. Yes, if you are having ENT surgery read this book.

-Murray Grossan, M.D., Author of The Sinus Cure and inventor of the Grossan HydroPulse Nasal-Sinus Irrigation System.  This was stated in a letter posted at www.postnasaldrip.net on 9/18/2007.

Chris has written a compelling and comprehensive account of his own personal experience with a relatively unknown affliction known as Empty Nose Syndrome (ENS). ENS is basically a surgically ruined nose that does not properly humidify and sense air flow, preventing it from performing its basic functions of smell and controlled, natural breathing. I can attest to the reality of this condition, as I have experienced many of the symptoms outlined in this book, as a result of nasal surgery involving my turbinates. If you are experiencing undefined, or hard to explain nasal dryness and crusting, loss of sense of smell, and uncontrolled breathing through your nose, this is a valuable and singular resource for gaining important insight that may not be provided from your local ENT. The complications and potential side effects of nasal surgery are not completely understood by many in the medical community (otolaryngology included), and as a patient that contends with sinus difficulties or is contemplating surgery, this book will serve as an enlightening introduction into the complexities of the nose. I know that I took for granted this amazingly complex organ and Chris's book will make sure that you don't repeat other's mistakes or suffer the potentially devastating effects of nasal surgery.

-Paul (New York, USA)

Chris has done an amazing job putting together this book for himself and others considering or have had nasal surgery. Please take the time to read this if you’re considering nasal surgery or if you've already had it. I truly believe this book can be a guide to helping those who had nasal surgery gone bad and to those who are considering nasal surgery.

-Tony Ponte (Alberta, Canada)

I have read through the book and have found it really helpful. Chris' story is inspiring...how he has suffered with ENS for so long and manages to still have a positive outlook. I think it covers a lot of important information, both technical and emotional. It is a book that many people could read - sufferers of ENS, friends and family, people thinking about getting surgery. It has helped me to gain a better understanding of what to expect, what turbinates are, their functions in the body, and how to better live with this serious condition. Oh! I wish I was informed like this before the surgery. I would definitely suggest this book to my friends and family so that they have a better understanding of what ENS is and what it entails. There are so many people every year who get butchered by doctors who for one reason or another do not inform their patients properly of the procedure and possible side effects. This is a problem in many areas of medicine. Chris' book is a reminder not to go blindly into surgery but also to live bravely with things one cannot change.

-S. Kramer (New York)

This is a comprehensive book about sinus surgery and empty nose syndrome for the general public. ens is a poorly understood real complication of sinus surgery. this book provides a good explanation of ens and its treatments

-Peggy (Cleveland, Ohio)

Your book is very well written and informative. I almost get sick to my stomach reading some of your experiences with ENTs and trying to get them to understand your symptoms. Great job on the book and you are truly an inspiration! Thank you very much for your excellent book!

-Tom

I have to say that I am impressed. The book is an easy read and Chris does an exceptional job at putting some rather complex concepts into layperson's terms. If you have ever wondered "what the heck is this person talking about?" when reading posts on the ENS forum then this is the book for you. For example, I found the glossary particularly useful as I was never quite sure what "Rhinitis" was or how you spell it.

The story of his journey through the world of ENTs rings all too familiar, and he does a very good job at examining various nasal surgery techniques and ENS medical treatments.

Chris, I would like nothing more than for your book to sweep the country and for you to appear on Dr. Phil or Oprah spreading the word. For all of you coming to this forum, this is $12.95 (U.S currency for you canadians) well spent. 

-Anonymous Source

You have written a valuable book for ENS sufferers and the medical community. In later correspondence, she wrote: I have said this before, but I am really impressed with your book and hope Cold Tree can give it great distribution. As you know audiences for the book will include both lay people who are considering surgery or treatment and the medical community hence the index must be accessible to both. Given these considerations, I will include a peer review to be certain I give this fine, informative book the index it deserves!

-Margy Olmstead, indexer for Having Nasal Surgery?

Chris Martin's book is very helpful to anyone considering having nasal surgery, or anyone whom has undergone it and is experiencing troubling symptoms.

The book is easily read by the layperson (me). Furthermore, Chris taps into the personal feelings and struggles that coincide with having an empty nose.
Unfortunately, this condition is not understood by many ENTs. I can personally attest to how damaging it is, not only physically, but psychologically too. Especially when this is misdiagnosed and leads to a 2nd or 3rd procedure. Chris provides a fine resource of information to the reader.

Finally, he concludes the book with a ray of hope; How progress is being made by a select number of doctors who are willing to take the time to further understand this devastating condition.

-Matt (Indiana)

Anyone considering sinus surgery or having sinus problems needs to read this book first!!!

ENS is real and you don’t want to get it!

-Jeeves

Chris Martin put a lot of time and energy into writing this book, to raise awareness on this highly debilitating condition that is widely unknown to many, and in some cases even ignored. As someone who is currently suffering ENS symptoms, his personal story really hits close to home and provides me with inspiration, hope and treatment suggestions from a 10-year ENS veteran.

Turbinates are a common source of nasal obstruction and therefore reducing them is a common surgical procedure to reduce congestion. They are also highly complex and their importance is largely misunderstood, even in the medical community. Reducing them too much, or by using a method that damages too much healthy tissue, results in irreversible consequences. This book explains the turbinates, their role in nasal function and also all the different methods used to reduce them. By reading this book, you will be well prepared to understand their importance and the safest surgical options in reducing them. Or you can find out just how important these vital nose organs are, the hard way. You can have your nasal surgery, unaware of any negative consequences as I did, and once you have ENS you will truly understand how important your nose and the turbinates are for your overall well-being. I think you know what to do... just read the book!

For those of you that already have ENS, or suspect you might because you still experience difficult breathing among other things after your nasal surgery, this book provides information on the most important ways to treat ENS. If you have recently had surgery, or if you are considering it, buy this book so that you can be well prepared to practice all the treatments mentioned within. Some ENS symptoms have a chance of resolving within a year after surgery, but those chances rely heavily on the actions you take to promote optimal healing. Even if you don't experience any ENS symptoms, most of the suggestions in the book would be helpful to a healing nose after the trauma of surgery.

The amount of references cited in each individual chapter is very impressive and will earn your respect and trust. ENS is real, and it is honestly the worst medical problem I have ever experienced, and unless it resolves within a year, it doesn't go away. This book should be read by anyone considering nasal surgery, those who have already had surgery, and anyone who practices nasal surgery. ENS is a truly distressing and uncomfortable condition, both physically and mentally that is with you 24 hours a day, 7 days a week. It's impossible to fully understand it until you've had your turbinates amputated and you see the difference, much like having your hand amputated after enjoying full use for your entire life. There is no going back, and at this time there are no doctors in Canada with any significant ENS experience or practice with ENS specific implant surgery which improves symptoms. There are a small few in the United States that acknowledge ENS and even less that have experience in treating it, but Canadian health insurance is very unlikely to cover this treatment outside of the country. I would assume that for most people, traveling to the United States and paying thousands of dollars from your pockets to gain some relief (but in most cases not 100%) to be difficult to manage. Being a young student myself, with little income it certainly doesn't seem very feasible that I will be able to afford proper care anytime soon. My only choice right now is to live with a condition that for many, constantly begs for relief every minute of every day. We all know the saying, "An ounce of prevention is worth a pound of cure". In consideration of ENS and its symptoms, it might be more appropriate to say that an ounce of prevention is worth a ton of cure. Well this book certainly weighs more than an ounce and it could be the difference between preventing or living with an action that you may regret for the rest of your life.

If you have any choice in the matter, you do not want ENS. There has even been documented cases of suicide because of ENS. Do yourself, all ENS sufferers out there, and Chris a great favor right now: stop reading this review, and start reading this book! It could save your life.

-Ryan Webb (Ontario, Canada)

How would you feel if you went into a surgical procedure to help alleviate a physical problem, only to learn after the surgery is completed that the surgeon created a much more devastating problem than the one you went into surgery to cure, even though the surgeon followed accepted medical practices? In fact you also later find out that over 50% of the people who come down with this artificially created illness meet the definition of clinically depressed, and this is on top of and because of the awful physical anguish which was the result of the initial surgery. And the icing on the cake is that the problems caused in surgery cannot be reversed. The above scenario sounds almost unreal, but this is what happens to victims of ENS, or Empty Nose Syndrome.

Anyone who is contemplating sinus surgery should read this book. Also, anyone who has a friend, colleague, or family member who is facing sinus surgery should urge those people to read this book as well.

Christopher Martin has written an important book about ENS. In layman's terms what happens is this: during sinus surgery all or a portion of the turbinates in the nose are extracted. It has been fairly common practice in the past for turbinates to be cut out because they sometimes can block nasal passages. Not much was known about the functions of the turbinates, and it was felt that extracting them wouldn't cause much harm. In fact the term ENS did not even appear until 1994 when Dr. Kern, formerly of the Mayo Clinic, coined the term when he was treating patients complaining about sinus infections and congestion, which was puzzling because their nasal passages were wide open. In fact they appeared to have an empty nose, and thus the term was coined for this condition. These people felt so miserable that, according to Dr. Kern, two of the patients he was treating committed suicide.

Martin discusses the basics about how the nose works. He talks about mucous tissue, cilia, and how mucus in the nose is normally disposed of. Of course he discusses the turbinates and the functions they perform, such as directing air flow, providing air flow resistance, warming and humidifying air before it reaches the lungs, etc. He discusses the symptoms of ENS, traces the history of various nasal surgical procedures, even discusses the politics of ENS and why many ENT specialists are not very aware of it or don't consider it seriously. He also talks about various surgery options and gives an opinion about which procedures are the safest and most risky in terms of ENS.

And of course he tells his own story. Here is a young man of only 27 years of age with a young family. He has had to deal with this condition virtually all of his adult life. Here is an excerpt: "While there are times I have felt confident and strong, I will concede there are times when I cried. I cried because of the severity of this problem and the constant management of it. I cried because I want to have more energy for my wife and children, for people other than myself, but I find myself preoccupied with my nose and depleted of such energy. It seemed selfish to be so consumed with my nose, but I could not avoid it. I wish I could say that I never complained, but I cannot. It is ENS with which I have been dealing and ENS is a difficult condition to endure." Martin offers extensive commentary about how he personally deals with his condition and gives suggestions and encouragement for other ENS sufferers.

In the Introduction of the book, Dr. Wellington S. Tichenor, a medical specialist in sinusitis in New York City who often treats patients who have had surgeries that did not work, says the following: "I have been overwhelmed by the devastation that ENS patients experience. As a result of an iatrogenic (caused by medical treatment) origin, the lives of these productive individuals have been profoundly affected. Before their surgery they could go about the lives with varying degrees of difficulty, but after it they were completely disabled." He adds, "Too many surgeons today believe they can indiscriminately remove large amounts of turbinate tissue and, indeed, there remains controversy in the field whether this surgery can be done with minimal complications. I am a strong proponent of conservative turbinate surgery that consists of removing the smallest amount of tissue possible."

If I were to criticize the book I would offer the opinion that Martin is sometimes too technical. I understand why he is doing this, as he wants to fully explain the condition and what to do about it. However, he often sounds like an ENT, which he is not. He clearly explains in his disclaimer at the outset of the book that he is not a medical professional, and I expect he had several ENTs review the book, and they apparently didn't ask him to change what has been published. For all I know everything he says and every medical term he uses are correct, and I would not be surprised if that were the case. It just seems to me that he sounds at times like an ENT, and I would respectfully question his credentials to do so.

What is clear, however, is that he certainly has sufficient credentials to speak about ENS, and his message is powerful and important and clearly overrides the comments in the previous paragraph. I personally have had two sinus surgeries and consider myself lucky and thankful that Empty Nose Syndrome hasn't happened to me. For a few dollars to buy the book and a couple of hours to read it, sinus sufferers who are considering surgery can learn a great deal about their condition and can possibly prevent themselves very serious problems in the future. It is certainly worth the time and money.

-Walter Ballenberger, founder of www.postnasaldrip.net, a website for sinusitis sufferers such as himself (Monument, CO)

Chris Martin has written the ultimate "Bible" for anyone considering nasal surgery in general, and more specifically for those who have breathing problems related to swollen turbinates and are considering turbinate reduction surgery. This book will also serve as the ultimate guide for how to improve the lives of those who have already had the misfortune of overzealous resections of their turbinates and are now struggling with ENS. "Having Nasal Surgery?" is the first ever book on ENS. The coping strategies and tips detailed in this book can benefit not only ENS sufferers, but also all those who suffer from chronic nasal problems and discomfort, such as chronic sinusitis, allergic rhinitis, vasomotor rhinitis, and every otherwise healthy individual who simply wants to learn how to better deal with the most common medical problems affecting humanity: the common cold and nasal obstruction.

"Having Nasal Surgery?" is addressed to the layman and medical professionals alike. It is written as an easy and well-flowing read, but at the same time is backed and packed with scientific references from the latest medical literature published in leading medical journals. True, Chris Martin is not a doctor himself, but the fact that his book is endorsed by well-known and acclaimed doctors - such as Drs. Grossan, Tichenor and Houser - with a foreword by Dr. Houser himself (a leading authority on ENS) adds greatly to the scientific and medical credibility of this book.

Chris tells of his personal misfortune of suffering from ENS due to an over aggressive surgery he had in his late teens. As a fellow sufferer, I can testify firsthand that his descriptions are honest and accurate. Sadly, ENS is a devastating medical condition which has a very negative impact on the sufferer's well-being and quality of life.

I hope that ENT and facial reconstructive specialists and plastic surgeons will embrace this book just as much as I know their ENS patients will. I hope that through this book they will better understand the depth of suffering from ENS and realize their responsibility to 1) not only avoid destroying the mucosal structures of the nose when they perform nasal and sinus surgeries of all sorts, but also 2) that they will recognize the fact that for many decades now patients have been over "turbinectomized" and as a result there are potentially millions of patients in the world today suffering from ENS symptoms and are misdiagnosed because of overmasking other pre-existing conditions and not enough awareness to ENS.

I hope that one of the accomplishments of this book will be that these doctors begin to more aggressively search for those misdiagnosed ENS patients and that they will maximize their efforts to help improve their symptoms and utilize their knowledge and skills to come up with viable medical solutions (surgical and others) to rebuild or regenerate amputated turbinates.

-ENS Member T.E.

I truly wish that this book had been available prior to my nasal surgeries. I did research, but nothing that would have prepared and informed me like Chris Martin's book. It is very detailed and heartfelt. For those who have already rolled the dice and lost with a nasal surgery, this book offers hope, support and many helpful suggestions. ENS is real! Even with a "conservative" surgery, it is still possible to experience a myriad of debilitating symptoms. Doctors are often dismissive and unhelpful. Hopefully this book will begin to turn that tide.

-ENS Member R.E.

The nose is an organ of the human body that can be afflicted with a number of serious ailments to health. These problems include such conditions as rhinosinusitis, allergic rhinitis, and empty nose syndrome (ENS). It has only been in recent years that physicians have come to understand and treat ENS. But there are still a great many doctors unfamiliar with this syndrome and the treatment options that sufferers have to choose from. An ENS sufferer himself, Christopher Martin has written a comprehensive and thoroughly 'reader friendly' introduction to what ENS is, what can be done about it, and what to be aware of in various treatment options in "Having Nasal Surgery? Don't You Become An Empty Nose Victim!” Christopher relates his own personal account of coping with ENS, offers an informed and informative evaluation of turbinate surgeries with respect to nasal conditions, provides an 'insider' look at the politics surrounding ENS within the medical community, and identifies the best treatments for ENS, many of which are also efficaciously applicable to sinusitis, allergic rhinitis, postnasal drip, GERD, and asthma. Invaluable reading for medical students, physicians, and non-specialist general readers, "Having Nasal Surgery" is especially recommended for personal, professional, and community library Health & Medicine reference collections and reading lists.

-Jim Cox, Editor-in-Chief, Midwest Book Review

School psychologist Martin explores a little-known condition that has lifelong detrimental effects.

In direct, instructive language, Martin examines the devastation of Empty Nose Syndrome (ENS), a term coined by a Mayo Clinic physician in 1994. ENS is characterized by a “cluster of symptoms” that occur after too much of the airflow-regulating bony structures in the nasal cavity called turbinates are surgically removed, usually from efforts to assuage sinus pressure, headaches or nasal stuffiness (“turbinate reduction” surgery). The author believes that post-surgery, people with ENS go on to experience a wide array of harrowing symptoms including nasal dryness, sleep disturbances, excessive mucus, nosebleeds, diminished sense of smell and fatigue. Martin became an ENS sufferer after an overly aggressive partial turbinectomy performed in his late teens to improve a chronic nasal inflammatory condition. But before his ENS diagnosis, Martin endured numerous allergy injections, CAT scans, bacterial infections and the possibility of additional surgery. Determined to find answers, the author channeled his disillusionment, anger and psychological distress into increasing awareness about the condition and by positively dedicating (and educating) himself on the possibly devastating side-effects of nasal surgery. His comprehensive research has produced illustrations, tips, charts, glossaries and case studies about ENS, all presented in a straightforward manner, making the information more accessible to average readers with limited medical knowledge or experience. Martin smartly counterbalances the negative experiences (and clinical politics) of ENS with a host of beneficial natural remedies (chicken soup, humidifier, etc.), non-surgical options, as well as a chapter on the author’s own approach after suffering the debilitating effects of ENS. He had enlisted an ear, nose and throat physician to attach two restorative implants inside his nasal cavities, a procedure he advocates as beneficial in improving his own quality of life.

This slim but potent book is tremendously important and informative not only for those considering nasal surgeries, but for the specialists who perform them.

-Kirkus Discoveries

In July 1997, shortly before going away to college, Chris Martin underwent surgery to remove turbinate tissue from both sides of his nose. An ENT doctor had recommended the procedure, called a bilateral turbinectomy, to relieve the chronic stuffiness the young man had been experiencing as a result of allergies and sinus infections. In the weeks and months that followed, Martin realized that the surgery had not helped him. The cycle of sinus infections had not only continued, but had intensified. His nose was perpetually dry, his throat sore, his mucous membranes inflamed. Before long, he was also experiencing panic-inducing shortness of breath, disturbed sleep, and intolerance to cold air. He became anxious and concerned. His discomfort led him back to ENT specialists and almost into another surgery, until, by accident in 2003, he discovered a Web site that defined “empty nose syndrome.” He now knew that his problem has a name: ENS. Its cause is summed up by Dr. W.S. Tichenor, a New York City sinusitis specialist: “Too many surgeons today believe they can indiscriminately remove large amounts of turbinate tissue.” Martin and his fellow ENS sufferers are the unhappy victims of these surgeries.

For the past four years, Chris Martin has been learning how to live with ENS. With this book he has fulfilled a major step in his mission to help educate sinus, allergy, and post-nasal drip victims who are considering surgery, as well as ENS sufferers and ENT professionals and plastic surgeons, many of whom have not been exposed to the scant literature about the syndrome. In August 2006, Martin met Dr. Steven Houser, an ENT specialist in Cleveland, Ohio who has been treating ENS sufferers—at times by rebuilding the remains of their turbinate tissue. Dr. Houser has performed two implant surgeries on Martin in order to decrease the nasal airway volume. The lesser amount of air entering the nose results in more resistance to airflow, thus less dryness. A second important effect of Dr. Houser’s implants has been to partially restore the pulmonary functioning that was impaired by the “empty” or too-open nasal passages.

Martin, now a family man and school psychologist in his late twenties in upstate New York, writes not as a doctor but as a survivor. He presents here a working definition of ENS and a primer on surgical as well as other medical, dietary, and environmental ways to treat its symptoms. He includes a layman’s guide to turbinate functioning and to the science and politics of turbinate surgery. Having learned to manage his condition, he tells a compelling personal story that adds passion and authority to his presentation. Martin grants, as his research shows, that “conservative” turbinate surgery can often alleviate chronic stuffiness, but his presentation implicates the many doctors and plastic surgeons who continue to remove excessive amounts of turbinate.

-Joe Taylor, Foreword Clarion Review

The frightening thing about the human body is that it can break down in thousands of ways, and it is impossible to prepare for every contingency. Between the endless variety of specialty doctors, conditions dramatized by hospital television shows and words far larger than an average vocabulary, it's easy to be either terrified by the possibilities or caught off guard when an unheard of condition enters your life.

When this happens, the only way to confront the problem is to educate yourself as best you can - and if you have empty nose syndrome (ENS), Christopher Martin's "Having Nasal Surgery? Don't You Become An Empty Nose Victim!" is the ideal resource. One of the first books on the subject, it is ideal for both the typical person considering nasal surgery and doctors who may not know enough about the condition.

ENS, as Martin describes it, is a condition resulting from the removal of inner tissue known as turbinates following nasal surgery. This removal leaves the patient unable to breathe properly, with a string of chronic health problems including shortness of breath, nasal dryness, thick mucus and an inability to sleep. The discomfort caused by these symptoms frequently leads to distraction and depression, especially since many doctors don't even know how to treat ENS.

Martin, who has lived with ENS since 1997, provides it with a much-needed personal connection. He tells his story in detail, beginning with his flawed surgery and showing specifically how the condition impacted his life and the choices he had to make. Through it all, with the exception of a few wistful "what if" statements, Martin maintains a positive tone and a desire to move forward.

The book is not only useful for those looking for a personal story of ENS, but also to anyone who suffers from it and is looking for relief. Martin provides the reader with a comprehensive list of treatments, ranging from practical everyday remedies (even providing recommendations on what brand of nasal spray and gel to use) to recommending a certain type of surgery if necessary. For those who are looking for more in-depth information on ENS, he includes an appendix of medical texts, websites and specialized doctors.

"Having Nasal Surgery?" is an ideal sourcebook on ENS - informative without being dense, written in a coherent style and filled with first-hand experience on the condition. It's a book that all nasal doctors should have on their shelves and be ready to pass onto patients looking for answers.

-Les Chappell, BookReview.com

ENS sufferer, Christopher Martin, has written a very comprehensive book about his experience with ENS. ENS, or Empty Nose Syndrome, is defined in this book as, "...a cluster of symptoms in individuals who had a turbinate reduction or excision surgery that resulted in removal of too much turbinate tissue, leaving the nose "empty or wide open and the turbinates unable to function properly." Turbinates, which are located in our nasal cavities, help to warm and humidify air. When a person has turbinate reduction surgery, this can lead to ENS if too much turbinate tissue is removed. This problem is iatrogenic in origin, meaning that it is caused by medical treatment and not something that is genetic in origin.

An ENS sufferer is described as having, "...the sensation of not getting enough air despite a wide open nasal cavity, nasal dryness, and thick, sticky mucus." In addition to having their quality of life reduced as a result of this, many people that have ENS also are highly susceptible to depression and future sinus problems.

Mr. Martin wrote this book with the hope of making people aware of the complications that can result from turbinate reduction surgery. He offers suggestions for alternative treatments that could be used to avoid having this surgery. People who have sinus, allergy and postnasal drip problems would also benefit from these treatments which include natural, medical, dietary, and environmental remedies.

Mr. Martin has been dealing with this issue for ten years. He openly discusses his experiences with a variety of medical doctors and the differing opinions that he was offered. He felt fortunate to finally be able to find the doctors that were able to help him with his problem. These doctors also help contribute to this book. His personal disclosures make the book very interesting. I was also very impressed with the amount of references that he cites in each chapter to help back up his information.

People that would benefit from reading "Having Nasal Surgery?" include those close to people with ENS, people considering turbinate reduction surgery, those suffering from ENS, those with sinus and allergy problems, and the doctors involved with this type of treatment. I cannot imagine a more comprehensive, yet easy-to-understand source of information for the people whose lives would be improved by accessing this information. I truly hope that people who are planning to have nasal surgery will find this book before they go through the surgery, and not have to experience what Mr. Martin and numerous other people have had to.

-Paige Lovitt, Reader Views