Machine Gun Sneezing

ABC News on November 11, 2009 aired a story about a 12 year old girl with an unfortunate condition called "machine gun sneezing". Apparently, she sneezes up to 16 times a minute all day except while sleeping and started after recovering from a mild cold.

To be frank, it's a condition I've never seen before.

Per an allergist interviewed for this story, the condition is extremely rare and "can be triggered by hundreds of causes, including allergies, sinus problems, or growths in the nasal passage."

Read more here. A video of the report can also be found at the link.

A personal thought of mine, the absence of sneezing during sleep suggests a psychogenic or habitual process. It might not have started out that way, but with all the attention, which is now national, there may be positive feedback from all the doting, to perpetuate the problem.

NYT: Single Gene Mutation Allows Humans to Talk and Not Animals

In the Nov 11, 2009 New York Times Science section, a story has been published titled "Speech Gene Shows Its Bossy Nature" where a single gene known as FOXP2 has been found to be responsible for speech (or lack thereof). All animals have an FOXP2 gene, but the human version’s product differs at just 2 of its 740 units from that of chimpanzees, suggesting that this tiny evolutionary fix may hold the key to why people can speak and chimps cannot.

Read more of the story here.

Google Flu Shot Finder

The brainy folks at Google has been at it again... Not only did they produce a map showing the flu trends in the US... but now they have produced a Flu Shot finder based on zip code for both seasonal as well as H1N1 vaccines. The locations are displayed on their Google Maps page.

Check it out here!

McGovern Nipple for Infants Born Unable to Nasally Breathe

I recently received a phone call regarding a newborn who the pediatrician suspected had bilateral choanal atresia. This is a situation in which the infant is not able to breath through the nose. This inability to nasally breath is a major problem because newborns are obligate nasal breathers (newborns do not know how to mouth-breath unless they are crying).

As such, there are two options to immediately perform in order to allow a newborn to breath to stay alive. Intubate... or place a McGovern Nipple. A McGovern Nipple is made by (see picture below):

1) Cutting off the tip of the nipple used in a milk-bottle creating a hole about 1cm in size. Try to preserve as much length as possible!
2) Inserting the nipple into the newborn's mouth
3) Placing a surgical mask such that the mask part is behind the baby's head and using the strings to keep the nipple in place inside the infant's mouth.

This forces the newborn to mouth-breath. Without this contraption, the child will literally suffocate.

I have specifically created this blog article because I had a lot of problems trying to find a picture of this contraption to show the pediatrician. Hopefully, this will make it easier for others to figure out what the heck a McGovern Nipple is and how to make and use one.

The only way to definitively correct this problem is by surgically removing the blockage that is blocking the infant's nasal passage.



Source:
Cummings Otolaryngology Head & Neck Surgery 4th Ed. Chapter 178: Congenital Malformation of the Nose. Volume 4, Page 4101.

RANDOM: Washington Post Cartoon Making Fun of ENT

A patient of mine brought the funnies from the Oct 28, 2009 Washington Post of a cartoon by John McPherson poking fun at ENT.

New Voice-Mail Phone # for Patients With Difficulty Hearing

Due to patient demand, we have established a voice-mail phone number that our patients who have difficulty communicating over the phone due to hearing loss can call and leave a precise message on a voice mail. This service is available only to our established patients who have been seen in our office.

This avoids frustration and difficulty communicating when talking to our front desk (because you can't hear what we say over the phone).

We will check this voice mail several times a day.

The Audiology Voice-Mail phone number is: 540-316-0588

Of course, if you want to talk to a staff member, you can still call our regular main office number at 540-347-0505.

Washington Post Medical Mystery: Rare Severe Sore Throat Caused by Lemierre Syndrome

On Nov 3, 2009, the Washington Post Medical Mystery section published a story titled "Annoying bug turned out to be much more" where a 19 year old female presented with a sore throat which rapidly progressed to a blood clot in her jugular vein, pneumonia, and massive swelling in her neck.

What she ended up having was "Lemierre syndrome" suspected by the diagnosing doctor at Georgetown University Medical Center based on the two telltale symtoms of a jugular infection and presence of a blood clot.

Read the story here.