Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Welcome to Meet the Doctor. I'm so happy today to bring you Dr. Kevin Smith. He's a double board certified facial plastic surgeon and otolaryngologist, and he's practicing in the Woodlands, Texas. Thank you for joining me today.

Dr. Smith (00:44):
Well, thank you for having me. I'm very excited.

Eva Sheie (00:47):
Now you have a very interesting specialty and it is extremely rare, and I think I could also fairly say that people are not aware that what you do can absolutely change their lives. So I want to start there. Will you just give us some background on your practice and what your special specialty is?

Dr. Smith (01:06):
Okay, I sure will. I've been in practice for 30 years. I did my residency at the University of Texas McGovern Medical School in Houston, Texas, set up practice there in the medical center for about 17 years, and I've been out here in the Woodlands now for almost three years. So I've been doing this for a long time. And in ENT, we're always doing sinus surgery, nasal surgery to help people with breathing, and I found out that there were some people coming in with some very bad headaches that I would help, and I did this for years and then finally looked at the data and 90% of those folks who came to me had a history of migraine, so I don't diagnose migraine. They all come to me with a history of migraine. And so I kept doing it and kept doing it. Then finally one day went on television and I just said to the people out there, I said, you can have access to my expertise if you have migraine like headaches, because I'm thinking these are migraine imposters. They're originating in the nose. I had been taught in medical school that migraines are in the brain, and so I'm like, these are migraine like headaches. All these people are coming in, they're misdiagnosed. And I told 'em, I said, you can have access to my expertise by getting a sinus CT scan, sending it to my office. I will review it to see if you have the abnormalities I know that cause these severe headaches. So we get these random scans from all over the country and one after another, after another, after another.

Eva Sheie (02:39):
Oh, you didn't know what you were getting yourself into, did you?

Dr. Smith (02:41):
No, I didn't. But all the scans that were sent in had the abnormalities that I knew caused these migraine like headaches. And it was at that point the light bulb went off and I said, wow, I can't ignore these numbers. These are people who have seen the top neurologists in the country. They have the diagnosis of migraine. They all have the abnormalities that I fix and I know I can help them. These are migraines I'm curing. I'm eliminating migraines. And these aren't just sinus migraines. These are migraines of all type that I've had families with migraines who were told they were hereditary, women with hormonal migraines, some of whom had hysterectomies to try and get rid of them. And that's a big surgery.

Eva Sheie (03:27):
That's terrible.

Dr. Smith (03:28):
It is. It is. But that's all they had to offer. Ocular migraines, abdominal migraines, sleep migraines, hereditary, hormonal, complex, hemiplegic migraines that resemble a stroke. And in these people, they come in when they have their migraines, they have tremors and seizures, and they sinkable episodes, and paralysis, and tingling of the arms and legs, and slurred speech and trouble finding words. I mean, the list just goes on and on. And even they're getting better and all those symptoms that they had go away. So that's the super specialty. I think I skipped and went to that one. But in addition to that, I also take care of people with sleep apnea by addressing the root cause. I'm a big, big proponent of let's get to the root cause of the problem. If you have sleep apnea, let me look at your nose. If you have abnormalities, let me fix them. Let me look at your throat also, because that's where most of the snoring comes from. When the uvula, soft palate is a little large or the tonsils might be big. So I take care of that. Breathing disorders, sinusitis, I do balloon sinuplasty. And then on my facial plastic surgery side, I've narrowed it down over the 30 years to mainly facelifts, eyelids and rhinoplasty.

Eva Sheie (04:39):
What would you say the percentage of cosmetic and non-cosmetic is in your practice?

Dr. Smith (04:44):
In my practice, I would say it's probably 75% medical and 25% cosmetic.

Eva Sheie (04:52):
And is that because of the migraine people?

Dr. Smith (04:55):
Yeah. Because of the migraine people. Exactly. And every time I'm really passionate about the migraines, it really strikes a chord with me because I don't have headaches, I don't have migraines. I sleep very well at night. I enjoy my life. I enjoy what I do. And for these people, they just cannot enjoy life at all. They're always living in fear of the next migraine. So I really identify with them and I want them to live their very best migraine free lives. But whenever I say that's all I want to do and I want to transition into that, I'll get a rash of people coming in saying, oh, I need a facelift, Dr. Smith. Oh, I want eyelids Dr. Smith. It's like somebody I joke with my staff and say, who was out on the side of the street corner with a sign saying, Dr. Smith has special going on for cosmetic surgery. <laugh>

Eva Sheie (05:42):
In the Woodlands, it's a dancing banana out there on the corner. Right?

Dr. Smith (05:46):
Yeah.

Eva Sheie (05:47):
Yeah. So people with migraines, they really struggle. They basically, some of them, when they get to a certain point, they cannot even live their lives. I spoke to a young woman a few weeks ago who told me that she didn't even go outside in the summertime because the weather made her get a migraine. So she would just stay inside all summer and spent a decade of her life not enjoying summertime.

Dr. Smith (06:10):
Summertime. Imagine springtime, and the flowers are blooming, then the trees are blooming and the animals are coming out and the wind is blowing and the smell of the cut grass. It's really sad that these people cannot enjoy the little things in life. They can't.

Eva Sheie (06:29):
The things we all take for granted.

Dr. Smith (06:30):
We take for granted. So be thankful for those things. I know I am.

Eva Sheie (06:34):
What is happening anatomically inside somebody's nose or sinuses or in their head that's causing this. Because I think people in general who don't know what you said at the beginning, think it's your brain malfunctioning somehow or rebelling against you.

Dr. Smith (06:52):
Right. That's a very, very good question. And I like to start the answer off by saying this, if you ever had those original covid tests, swabs that went deep into your nose.

Eva Sheie (07:03):
I had a baby right at that time, and I had one of those in my car in a drive-through. It was wretched.

Dr. Smith (07:12):
Right? How did it feel?

Eva Sheie (07:14):
Like they were sticking a poker in my brain.

Dr. Smith (07:17):
Thank you. And that's how people describe migraines, right?

Eva Sheie (07:19):
Yeah.

Dr. Smith (07:19):
That's right. So it's painful until when? Until they remove it. So in your nose, you have structures that can get damaged from injury. I'm sure some of them can be acquired through hereditary means as well, but these structures end up touching other sensitive structures and those sensitive structures called turbinates, they're like the air filters of the nose. They swell and shrink. They respond to eating foods and smelling perfumes and things like that. So they're very dynamic, which is why some people would describe their triggers as being food, cheese, wine, weather, and smells. And when you think about it, when you really think about those triggers in particular, is the brain so sensitive that those things external would make it hurt so bad? I think not. It's covered by a skull, it's covered by cerebral spinal fluid. It's very well protected.

(08:15):
So just by that alone, when you really think about it, it's not the brain. I'm doubting right there that the brain is actually the cause. I'm thinking more like the nose, why? Smells going through the nose, whether it affects the sinuses and the nose and food also, the nose helps enhance the flavor and the taste of food. So I know that it's very dynamic and it reacts to that. So that alone, along with that original covid swab, knowing how bad that hurt, like you said, a hot poker going through your eye or whatever, that will tell you that the nose is very, very sensitive. Now it's close to the brain. It's sitting right there underneath the brain. But most people who get migraines will go to neurologist, they get a brain scan, and 95% of those scans are normal. There's nothing there. There's not a brain abscess, there's not a tumor, there's not anything going on to explain it.

(09:11):
And it's very important, of course, for your first migraine to get a brain scan. You want to make sure you don't have one of those bad problems that need to be fixed immediately. For those who have chronic headaches and migraines though, once you get the brain scan out of the way, it's important to get a sinus CT scan to see if there are any abnormalities in the nose. Why? Because when you boil it down, a migraine is severe head pain, Okay? And the head is comprised of not only the brain, but the nose, the sinuses, the teeth, and even problems in the neck can affect the head with referred pain. So once the brain is normal on its scan, it's prudent for the doctors to look elsewhere, and that's what I do. Other doctors don't because they don't know what I've stumbled upon, but when people get the sinus scan, it's important they have to send it to me because I know what to look for.

(10:09):
I also know you can tell me where you hurt and I know what structures to look at that are more apt to be causing the problem because I've just done it so long. And then I need to approach and take care of the problem with my Smith Sinus Migraine technique, which I've developed and continue to refine as I go. But it's a technique that's highly specialized and designed to correct the abnormalities in the nose and the sinuses to give a 90% success rate in totally eliminating those migraines and getting people back to a migraine free life.

Eva Sheie (10:46):
What kinds of other things have your patients tried before they find you?

Dr. Smith (10:50):
Oh my goodness. Yoga, biofeedback, Botox, massage, all the medications, and those include what blood pressure medications. There might be seizure medications they take there. Of course, all the migraine medications. Again, I've had a few women that have had hysterectomies thinking if I get rid of my uterus and ovaries, that'll take care of the hormones, which are the triggers for my headaches, and they're just desperate and they just will do anything. Then you have the nerve decompression surgery, which is good when indicated for those peripheral nerves that are pinched by muscles either in the forehead or the neck. They do need to be released and that can help. Then you have the nerve stimulator implants that are implanted along with the electrodes that go across the forehead, the battery pack that's implanted in your body with the remote control that you turn on and off when you have these severe migraines. And I've had some people that really like those, but then there are others who it's failed on. It might've worked for three months or so, and then it stops, and then they're back to square one trying to figure out what do I do? So there's a host of things that people do. Ice bads, putting your head in a pool of ice, those ice caps just a myriad of things because these folks you can imagine are just desperate to find relief.

Eva Sheie (12:14):
Yeah. Let's go back to the Botox for a second. One thing I didn't understand about Botox for migraines until recently was that to get that covered by insurance, you have to do it exactly the way they say isn't that, and so you have to have your entire head injected. You can't just say, this is the spot where I'm getting.

Dr. Smith (12:34):
No. Yeah, they usually will inject multiple spots with these, and I just saw on TikTok, there was a woman who got overin injected, couldn't keep her head up and had a neck collar on in the hospital, and she just has to wait it out. And that might be a few months before the Botox fully wears off.

Eva Sheie (12:57):
How did that happen to her?

Dr. Smith (12:59):
I don't know. I don't do Botox for migraines. I do my procedure, I get to the root cause. But for folks who don't know what I know, they're just trying to give patients an option. And so I don't criticize other doctors because nobody really knows what I do. I'm the only doctor that I know of that does this, and there'll come a time I'll have to start training other physicians and going on talks and letting people know. But the problem with that is I have to do it in a right manner because you give a talk and then you have ENTs thinking that, oh, I got it. I know what he's doing, and you really don't.

Eva Sheie (13:33):
Or I thought you were going to say, and then everybody wants to fight with you.

Dr. Smith (13:37):
No, no. I'm just saying people would want to help, but you have to learn my technique because I would hate for somebody to have a procedure done not having it done the way I do it, and then they don't go away. And so then you're left with, oh, I guess I didn't have the migraines Dr. Smith was talking about. Mine must be caused by something else. It's like, no, it just really has to be done by me for right now.

Eva Sheie (13:58):
Have you seen pushback from other specialties like neurology saying that that doesn't work or?

Dr. Smith (14:04):
Right. Very good question. Thank you. Years ago, there was a couple of neurologists in town that had these big migraine practices, and I approached them and said, look, I don't cure everybody. I'm sure you don't either. I would love to work with you for those resistant patients who you just don't know what to do with, and you're at your wit's end. Send those to me. And one told me, no, you're giving out misinformation. I've been on TV talking about what I do. And he said, you're giving out misinformation. You cannot cure a migraine by doing nasal surgery. And I'm like, well, the nose is my expertise. So you really aren't qualified to speak on what I do, respectfully. You know what I'm saying? But I understood the fact that he's of the mindset that migraines are in the brain. That's what everybody knows. That's what everybody thinks. And then I had another guy who I approached and I said, just take a look at my website and let's talk. So I called him back and he goes, oh, he said, this is very controversial in our field. He said, we don't believe that exists, but do you have proof? And I just thought even in that statement, he's telling me that they're allowed to believe one thing, but he wants me to prove my side and I want to just say, well, why can't I just believe too? And why can't we just work together?

Eva Sheie (15:30):
Well, that's the most frustrating thing about it, is there's people whose lives are being ruined by this and they don't want to tell you that there might be another way.

Dr. Smith (15:40):
Just be open-minded to the fact that there might be another. That's my thing. It's how I discovered what I did. I've always been very curious and I've always practiced medicine, do a procedure, observe the results. Do a procedure, observe the results. If I wasn't that curious and inquisitive and observant, then I wouldn't have picked up on the nuances of what I was doing, and I would've just been doing sinus surgery on everybody and they say, oh, my headaches are gone. Oh, good, great. But I was more perceptive about it and observant about it, and it turned out to be very, very rewarding because now I'm practicing my purpose in life, and it's just fantastic. I mean, it just feeds me every day to know that I can help people who just had no hope before.

Eva Sheie (16:30):
For me, that is getting your story out there. That's my purpose in life.

Dr. Smith (16:34):
It is. And you will feel good about this because I had just started going on podcasts to talk about this, so I want to commend you for having me on and be interested, and the fact that you were interested in it because you will also feel the goodness that comes from it when people tell you you're going to get the responses. I know it's coming. I really enjoyed the podcast you had. That doctor was on, and my daughter has migraines, and I'm so happy because she can't go to school, and she was going to go to college on a sports scholarship, but she lost it and she didn't know what to do. She's considering she's depressed, she's got anxiety, she's got PTSD, she's got these suicide ideations. We're going to therapy. You're going to hear all that. And now, because I heard that doctor, she's doing great. It's a really good feeling. It really is. So again, I thank you for having me on the show.

Eva Sheie (17:26):
This is, um, I am not sure if we're on 150 yet, but we're probably getting close. But I've interviewed close to 150 doctors just this year on this podcast, I guess since 2023 when we started. And there's a pattern that started to emerge, which was that some small percentage of the doctors that I've talked to are like you, but it's not everyone. And it's that thing that happens where you spotted a pattern with your patients and their results and you couldn't not pull on the string to see where it went. And that for me is the magic. That's where you find the really special doctors, the ones that are innovating and taking risks and doing things. And I didn't ask you yet, why did you leave the medical center? And it's probably just the traffic, right? You just got tired of it?

Dr. Smith (18:17):
I wanted to get out of the med center, and I'd been there for a long time and wanted to just have my own shingle up in another location by itself and just see how it worked out. And it is a lot of traffic. It's very busy, but I tell you,

Eva Sheie (18:28):
But not everybody goes out on their own after 30 years.

Dr. Smith (18:31):
That's true. That's true. 17. I was 17 years there.

Eva Sheie (18:33):
Oh, 17.

Dr. Smith (18:34):
Yeah. But yeah, it's just kind of a phase. It's like, okay, it's time to move on out and see what's out there. Yeah.

Eva Sheie (18:41):
And your joy is obvious.

Dr. Smith (18:44):
No, I cannot explain to you. I never take for granted what I do. And I used to tell my mother, just bless her heart, I used to say, mom, how does it feel to know that you gave birth to the man who discovered the cure for migraine headaches? And she would just say, oh, I'm just so proud of you, because I don't take for granted. I really don't. I'll look at my hand sometime at night before I go to sleep, and I'm like, these hands cure migraines. That's crazy.

Eva Sheie (19:11):
So it's wonderful to hear what you're doing, and I'm here to help you spread the word and whatever other podcasts I can help get you on, I definitely will.

Dr. Smith (19:21):
Oh, please, yes. If you have contacts, please let them know because I'm here to, like I say, I'm here to spread the word and to let people understand that there is hope to eliminate migraines completely. What I'm doing is actually I'm normalizing your nose. Not everybody gets migraines because you have people out there with normal noses, and then you have people with abnormal noses that happen to get these migraines, and so I'm normalizing your nose. I'm taking a nose that's deformed on the inside, and I'm correcting those deformities to make it normal, so it acts normal and you go live your life without pain.

Eva Sheie (19:56):
Now, do you ever get a patient who you can't help? Does that happen?

Dr. Smith (20:00):
I have, and I know I'm in the right area because over 90% of the people do get well, and it's mainly young females. I don't have quite the same high rated of success. I would think if you looked at the women under 30, my success rate might be 80%, 85. It is still close, but there's just a few that just don't get well. And so there's a couple of things. One thing I questioned was whether or not they have PTSD from the pain that's been so chronic that their brain is almost set up to illicit pain. And so I have a therapist I've referred just yesterday, I referred two or three patients to this guy who is a expert in PTSD. So I said, I'm going to refer all those patients who have not done well to him just to make sure whether or not they might be having this PTSD or something affecting them that needs to be addressed.

(20:59):
So I'm always looking, I'm always searching. I'm always questioning because I know I'm in the right space. And I just told the young girls who I'm going to refer to this same therapist and her mother, they came down. I thought I might find some scar tissue in the nose because that too can cause chronic headaches. She was about to have a procedure the next day we did a scan. I looked in her nose. There was no scar tissue. The sinuses look perfect, the nasal cavity and the things that I operated on, the septum looks perfect. And I said, there's nothing else for me to do here. Unfortunately, I hate to tell you this, if she's still having pain and it's not gotten any better, which I found surprising. And I'm like, you feel no better? And she said, no. I said, well, we are going to have to look elsewhere, so I'm going to call them also and give them the name of the therapist. And then on the very end, the last thing that I question is whether or not in some cases there might be secondary gain because of the attention you get by being the sick one in the family. And that could be too, I don't know. But that's the last thing.

Eva Sheie (22:07):
But it's not a hormonal component that's that group?

Dr. Smith (22:12):
I don't know. Not when the nose is normal. After I've corrected everything and it looks pristine and you say it's absolutely no change. Then I am like, okay, well let's look for the PTSD and then maybe they can kind of figure out that if it's not PTSD, the therapist is going an angle that finds something else out, maybe with the dynamics in the family or something like that. Because those things exist too.

Eva Sheie (22:36):
Maybe. What I do know is that you're going to keep trying to figure it out.

Dr. Smith (22:40):
Oh Yeah. Oh, no, no. Yes, always. I always keep those folks in the back of my mind. I tell 'em all the time, I'm not one where you come here and I pat you on the back and say, well, I did everything I could do. Sorry, I don't know what else to do. I'm going to give you another option. I'm going to still keep thinking. I'm going to still keep looking and wondering what else might exist in there that I'm just not quite seeing at the time.

Eva Sheie (23:03):
Yeah. Okay. What about Dr. Smith outside of work? Who's that guy?

Dr. Smith (23:09):
Oh my. Another very good question. I tell kids all the time that I lecture to that Dr. Smith is what I do, but there's far more behind me than that. It's just what I do. It's one aspect of me, but I'm a lot of things. I'm a father. I love playing golf. That's my relaxation. I took a little few yoga classes earlier in the year, then I got busy. I haven't been back for a while, but I took some yoga because I really think it's important for me. I like to make sure I'm good because if I'm good, then I can make sure other people are good. So I believe in balance. I'll work very hard, but then I'll go on these wonderful golf trips. I recall this summer what really made me most proud of myself this summer, it got so hot in Texas. I couldn't play golf on the weekends. And I found myself saying, you work hard during the week. If you want to play golf, let's do this. Let's think about a place where we can go and fly to that has great weather and good golf and go there for the weekend. So I flew to San Diego three weekends out of five in August and September, including Labor Day. I went and 76 degree weather.

Eva Sheie (24:16):
It doesn't get any better than that.

Dr. Smith (24:17):
No, it was 106 degrees here in Houston. So I'm like, no, I've got to go somewhere. So I said, I don't want to rent a car. I just took the Uber from the airport. There's a Hilton right next to the Torry Pines Golf course. It has two courses. I put my name on the list on Saturday, went off whenever they call me. I was in no rush. I ate dinner at the lodge next door, and do the same thing on Sunday, and then go home. And it was just the best. I told myself I patted myself on the back that Kevin, that was one of the best decisions you've made in a while to just when you had the means, cuz I have a Southwest Airlines card that I'd had hundreds of thousands of points on, so I just used those to fly out there. So that's me.

(24:59):
I've taken art lessons at the Glassell School of Art here where I've done some watercolor, and I would like to do some pen and ink with watercolor at some point when I find the time. I've been on a golf reality show years ago where we traveled across the country and was on CBS on three Saturdays, but we traveled from New York to Pebble Beach over 10 days in an RV with a team, and there's a second team going the opposite direction, and we were competing on TV, and we ended up winning. So we got to go to the AT&T Pebble Beach ProAm on CBS's dime. And I do a lot of stuff like that that are interesting things that just kind of make life fun.

Eva Sheie (25:41):
So none of this is possible without a team. Tell me about your team in the office and your team at home too.

Dr. Smith (25:47):
I sure will. My team here at the office, I have a great office manager's. Been with me for about 10 years who didn't know what she was getting into at first. She'd never worked in an office like mine, but once she figured out what I was doing, was just amazed and bought into it very quickly. So she has helped me greatly as far as we review contracts together, and she's so smart. She'll pick up on things that the lawyers who put together these contracts miss, and she'll have these great questions, but she's the biggest cheerleader and supporter, and she can finish my sentences. She knows exactly what I'm doing, how I'm doing it, why I am doing it. She talks to the patients and they love it. But we have a great, she's put together a great staff too. They're on board with all we do.

(26:32):
Very helpful for the patients because we have patients from all over the country that come to see us. And in fact, I was on Steve Harvey's radio show about 15 years ago, and he remembered me and he had a business partner from Dubai with migraines that he sent to me, and I helped him out. And so they thought that maybe they might want to have a clinic in Dubai. So my office manager and I flew out to Dubai in November. We got to go to one of the smaller Emirates called Sharjah. We met with the Minister of Finance, the Minister of Health. I looked at an office space, and so I think that's on hold now because of the war that's going on near there and all the stuff that's going on. But it's stuff like that that make it very interesting and fun to see that people appreciate what you do and want to help you expand. So yeah, got a great staff. And then at home, I have two lovely daughters. They're grown now, 31 and 32, both engaged.

Eva Sheie (27:28):
Two weddings.

Dr. Smith (27:28):
I don't have any grandkids or anything like that, but one's in the real estate. The other is an event planner.

Eva Sheie (27:37):
So they like helping people too.

Dr. Smith (27:39):
They are. Yeah.

Eva Sheie (27:41):
That's great. I'm so glad that you share so much of yourself with us today. It's been really fun getting to know you. I'm very excited about what you're doing.

Dr. Smith (27:50):
Well, thank you so very much. I'm very excited that you would have me on, and I hope people take heat and like I say, don't try to overthink things. I used to tell people, send me your scan to see if you're a candidate, but since a hundred percent of 'em almost are candidates, I say, send me your scan. You're a candidate if you have chronic headaches or migraines that makes you a candidate. So you're sending me the scan so I can figure out what I need to do because the procedure is customized based on what I find. It's not like a cookie cutter that I do everything the same on everybody because everybody has different abnormalities that I know that can cause the problem.

Eva Sheie (28:26):
So if someone's listening to the podcast today and they want to find out more about you or reach out, send you their scan, where should they go?

Dr. Smith (28:34):
Yes, or you can call the office. It's 7 1 3 7 9 5 0 6 0 0. What's really helpful is my Facebook page, which is Smith Center Otolaryngology, because there's a Smith Center in Las Vegas, which is an amphitheater I think that comes up sometimes. But if you go with the Smith Center Otolaryngology, I have dozens and dozens and dozens of video testimonials of patients with all type of migraines that will just tell their story. And then the website is Kevin Smith md.com. But yeah, call the office (713) 795-0600. My staff will tell you what the next steps are, and we just go from there. By the way, the procedure is covered by insurance. It takes me about an hour to do. The recovery is about a week, and people from out of town, they'll stay in town for about a week and go tour around Houston. And yeah, by the second day, they're usually taking Tylenol. And I tell 'em, get out and about. Go for walks, go to the mall, go see some things. Don't act sick because I already took care of that a couple of days ago.

Eva Sheie (29:40):
I'll make sure we put all the links to everything in the show notes to your website and your Facebook and all that, and hopefully you can come back and talk to us again someday. Thank you, Dr. Smith.

Dr. Smith (29:52):
Oh, thank you so very much for having me. Take care.

Eva Sheie (29:58):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at Meet the Doctor podcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, T-H-E-A-X-I-S.io.