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October 04, 2015

5 Signs of Helicopter Parenting in the Exam Room

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The Millennials are the primary beneficiaries (or victims) of parents who have the means and ability to obsessively guide, educate, and most importantly, over-protect them from the world/life. Such helicopter parents ultimately raise kids into adults who researchers feel at worst never learn to cope with adversity, lack the ability to make hard decisions, and are prone to anxiety disorders.

It is from the education perspective that most helicopter parents and their kids are discovered, but believe me that it is alive and well in the medical world.

Here are 5 signs you may be a helicopter parent (or the victim of one) from an ENT perspective:

ONE: You are making medical decisions for your child... who is over 21 years old. I'm amazed how many young adults are unable to make medical decisions for themselves. It is not uncommon for me to see a young adult with a simple health issue (i.e., nasal obstruction due to a deviated septum) who would than request that I call their mom on their cell phone... and the mom who may live out in Colorado will than decide what treatment to pursue and when without any input from their adult child.

TWO: On the flip side... You fight over medical records of your adult child that you have no right to... Due to the HIPAA privacy law, in our new patient registration paperwork, there is a clarifying question regarding who else we can talk to about any medical issues that may arise with the option "PARENT" that can be selected.... and is often not selected. If you are a concerned parent calling regarding questions about your adult child's medical care... by law, we CAN NOT disclose anything without permission from your adult child. Please don't argue that because you are their mom or dad that I must provide information.

THREE: You provide excessive praise for your child... Giving participation trophies for a soccer game is SO yesterday... You provide not only get balloons and animals, but also a trophy for your child who successfully underwent a 2 minute ear tube placement for chronic ear infections. Even in the clinic, never mind stickers or lollipops... I've had one parent say to their 7 years old child that they'll give them a brand new iPhone if they'll cooperate with a physical exam.

FOUR: You (and the not the patient) determine how much pain your child is in... After surgery, it is not uncommon that narcotics are prescribed for pain control. However, there is a very real risk when somebody other than the patient decides how much pain is present and therefore how much narcotics should be given. I find that helicopter parents tend to either give too little or too much narcotics.

In one particular case I remember, a mom called me upset that her college-aged daughter was in so much pain after a tonsillectomy. I asked how much narcotics has she taken so far... apparently none because the mom was concerned about side effects and possible addiction. GIVE THE NARCOTICS to help with the pain!!!

Or another case where a helicopter mom was still giving regular doses of narcotics to her teenage son one week after septoplasty surgery resulting in significant side effects of nausea and constipation. I asked how much pain was he in... to which she answered "none." Narcotics should ONLY be given if significant pain is present, but the mom was so concerned that he be in no pain whatsoever, constant regular dosing was provided regardless whether he was in pain or not when most likely it was not necessary (vast majority of patients do not need to take narcotics beyond a few days).

FIVE: You desire ONLY the very best healthcare/surgeon for your child, even for routine procedures. It is not uncommon that I see parents of children who need ear tubes placed for ear infections or tonsillectomy needed for chronic tonsillitis. These are very common and routine procedures that community surgeons/hospitals can take care of very well. However, such helicopter parents ultimately decide to take their child to a facility with a national reputation performed by the world's foremost surgeon (i.e., Johns Hopkins, Mayo Clinic, etc) without any resident involvement. And even then, 4 or more second opinions may still be pursued.

Being there for your children is awesome... but in order for your child to learn life-skills, at some point, you just have to let go and allow them to learn how to fend and make decisions for themselves.
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October 01, 2015

Singer Kelly Clarkson Cancels Concerts Due to Vocal Cord Injury

On Sept 25, 2015, Kelly Clarkson released a statement on her website that she's canceling the rest of her concerts for 2015 on orders of her doctor, presumably due to vocal cord nodules.
"Regretfully, due to instruction of her doctor, Kelly Clarkson must remain on vocal rest for the remainder of the year resulting in the cancellation of her scheduled tour dates in Canada and the UK. All tickets will be refunded at the original point of purchase. "I am truly sorry that I have to cancel the remainder of my tour dates. I was so looking forward to sharing this tour with all my amazing fans in Canada and the UK. Unfortunately my doctor is telling me I have to stay on vocal rest, but I am working hard to get better as fast as possible." [link]
Year 2015 is ending up to be a terrible year for celebrity singer. Here's a running list of singers sidelined by injured vocal cords.

• Kelly Clarkson - September 2015
Donny Osmond - August 2015
• Miranda Lambert - July 2015
• Meghan Trainor - July 2015
• Chad Kroeger - June 2015
• Sam Smith - April 2015
• Nathan Sykes - April 2013
• Nicki Manaj - August 2012
• Florence Welch - July 2012
• Maxwell - June 2012
• Keith Urban - Nov 2011
• Adele - Oct 2011
• John Mayer - September 2011
• Scott Weiland - September 2011

September 29, 2015

Devices to Help with Eustachian Tube Dysfunction During Airflight and SCUBA

EarPlanes Ear Plugs
It is not uncommon that patients who suffer from eustachian tube dysfunction resulting in symptoms of clogged ears and inability to pop them easily participate in activities that WILL worsen their ear problems. Such common activities include SCUBA diving and airplane flying.

Of course, treatment of eustachian tube dysfunction is best, but may take several weeks, and that airplane flight or SCUBA diving trip is happening in a few days before resolution is expected.

In this situation, cutting a hole in the eardrum with or without placement of a tube would prevent the painful ear squeeze by preventing any pressure from building up within the ear. This WILL absolutely work. However, many individuals absolutely refuse this course of action believing it to be too invasive. Furthermore, SCUBA divers are at risk for ear infections should any (dirty) water enter the ear canal. Typical precautionary steps divers would take to prevent water entry into the ear canal include use of ear plugs and a hood.

So what else can be done to minimize ear discomfort?

Here are two products that may help, but be aware, it may only partially or not work at all resulting in significant ear discomfort.


This device is for those who are flying. It works by significantly slowing down the pressure changes in the ear during airflight elevation changes via a valve within the plug allowing more time for a patient to equilibrate their ears. So rather than rapid ear pressure changes that occur with rapid elevation changes during airflight, use of these plugs will make the experience more akin to driving up/down a mountain. Available for purchase in most gift shots in the airport as well as on Amazon for both adults / kids.

Pro Ear Mask

This is obviously for the SCUBA divers. It basically is a SCUBA mask with watertight ear muffs. The ear component of the mask prevents water pressure being transmitted into the ear. Available for purchase on Amazon.

Superior Semicircular Canal Dehiscence (VIDEO)

I learned about this video from a House Ear Clinic doctor who learned of it from one of his patients. It is a well made video allowing others to "hear" what it is like to suffer from Superior Semicircular Canal Dehiscence. This condition is due to a hole in the bone allowing a communication between the superior semicircular canal and the brain. Treatment is essentially brain surgery, but of the bone rather than the brain itself. Symptoms include:

• Hearing your own voice and other body noises (heartbeat, eye movements, chewing, etc) unusually loudly
• Loud sounds will cause dizziness
• Feeling of fullness in the ear
• Tinnitus
• Low-frequency hearing loss

September 27, 2015

Many Different Saline Sinus Rinse Bottles

Who knew the humble Netti-Pot kettle would eventually mutate into so many different shapes, sizes, and designs which all basically do ONE thing... rinse/flush the nose with saltwater.

Here's a few I have encountered with link to where it can be purchased. Given all it does is rinse the nose... I would take price into consideration.

September 23, 2015

New Physician Directory Smartphone App


I don't know about you, but one of the most frustrating things about online doctor info sites is that they bury key information like phone numbers, fax numbers, addresses, etc.

As such, I've developed a new online physician directory called NovaDr. com that has all this information within 3 clicks, whether online or thru the smartphone app. Currently this directory contains doctor information for only 3 hospital systems in Northern Virginia including Fauquier Health, Haymarket Medical Center, and Prince William Medical Center. We plan to add more over the years.

The app is available for free on both Android and iPhones on Google Play and App Store respectively. The landing page address for links to both can be found here.

Check it out! Otherwise, you can go straight to the store below:

Banner Map

lump in throat clogged ears