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May 30, 2012

Waking Up to NOT Just Major Colonoscopy Bills...

The New York Times published an article on May 28, 2012 regarding the high anesthesia charges associated with colonoscopy. What people need to realize is that anesthesia charges apply not just to colonoscopy, but ANY procedure that requires general anesthesia... tonsillectomy , appendectomy, gallbladder surgery, ear tube placement in kids, etc. With any procedure requiring general anesthesia, a patient is going to receive THREE bills... not just one which is what most reasonable peopl…
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May 27, 2012

Homemade Sorbet Ice Cream for those Suffering from the Flu!

My wife loves to make homemade ice cream and came across this recipe called "Influenza Rx Sorbet" by Jeni Britton Bauer in her homemade ice cream cookbook . The recipe includes lemon and orange juice for Vitamin C. Ginger and cayenne to help clear nasal passages as well as antiseptic properties. Humectants, honey, and liquid pectin to help a dry, itchy throat retain moisture. Sorbet in and of itself helps calm an inflamed sore throat. Though I would love to regurgitate the…
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Synthetic Vocal Cords [video]

Synthetic vocal cords being under development at MIT and Harvard... Very good video ! What are some of the vocal cord problems that may benefit from such a synthetic gel? Vocal cord paralysis , vocal cord surgery to address polyps, cysts , nodules , granulomas , etc. As an FYI... the synthetic vocal cord gel portrayed in the video is still under development and not available for patient use yet...
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Why Do Humans Have Weak Sense of Smell

Compared to nearly all other animals, humans have the weakest sense of smell. You would think that humans and our closest evolutionary cousins (chimpanzees, apes, etc) would have similar sense of smell, but humans still have a much weaker olfactory sense. Why might that be? Well, research from Karolinska Institutet have discovered that humans are the ONLY mammals whereby no new neurons are formed in the olfactory bulb after birth. Or if there is any, it is VERY little. In all other …
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May 26, 2012

Movie Director John Woo Has Throat Cancer?

Famed movie director John Woo apparently is being treated for throat cancer. The director of such movies including Mission: Impossible II is apparently undergoing treatment in the United States. Details are sparse. However, he apparently "has been admitted into a hospital for 4 months" which leads me to think that his throat cancer is late-stage which usually requires both radiation and chemotherapy for definitive treatment. Surgery may or may not be required, though hard to sa…
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How Does Nasal Packing Stop Nosebleeds?

It is not unusual for an ENT or an Emergency Room physician to see a patient with a very bad nosebleed ... the kind that can potentially be life-threatening given how much active bleeding is occurring. In these situations, nasal packing is the fastest and best way of stopping the nosebleed. For any type of active bleeding, direct pressure tamponades the bleeding thereby stopping it... whether it be a stab wound to the leg or a bad nosebleed . In essence, direct pressure exerts a cert…
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May 22, 2012

Name an ENT Who Has Won an Olympic Gold Medal

He not only won one Olympic Gold Medal, but two in men's platform diving in 1948 and 1952. Dr. Sammy Lee also won bronze medal in the 3 meter springboard and coached Bob Webster and Greg Louganis to their Olympic medals. In terms of his medical career, he studied pre-med at Occidental College followed his MD from University of Southern California (USC) Medical School in 1947. He than went on to become an ear, nose and throat specialist. Yeah! There are other ENTs who are former O…
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TV Show HOUSE Exploring ENT Problems

I must clarify that I never really like TV show House for reasons explained here ... but patients who love watching House have alerted me to some episodes this season that touched on ENT problems. So... here goes... Episode 21 (Season 8): Holding On Diagnosis: Persistent Stapedial Artery 19 years old cheerleader was admitted after suffering from dizziness, massive nosebleed, and auditory hallucinations. It was ultimately determined that he was suffering from a persistent stapedial art…
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May 21, 2012

Noise Charts as It Relates to Hearing Damage

Fun hearing facts collected from a variety of sources... Environmental Noise Weakest sound heard 0dB Whisper Quiet Library at 6' 30dB Normal conversation at 3' 60-65dB Telephone dial tone 80dB City Traffic (inside car) 85dB Train whistle at 500', Truck Traffic 90dB Jackhammer at 50' 95dB Subway train at 200' 95dB Level at which sustained exposure may result in hearing loss 90 - 95dB Hand Drill 98dB Power mower at 3' 107dB Snowmobile, Motorcycle 100dB Po…
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People DO Suffer Hearing Loss After a Loud Concert

Almost everybody at some point in their lives have attended a loud concert or loud nightclub. Almost everybody will also recall a temporary reduction in their hearing with or without ringing afterwards for a short period of time. This phenomenon is called temporary threshold shift (TTS) whereby the affected person has a temporary hearing loss that may last hours to days due to temporary damage of the outer hair cells of the cochlea. If loud nose exposure happens enough times, permane…
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May 20, 2012

Azithromycin Increases Risk of Death Slightly... Well, So Does Tylenol and Ibuprofen

The media has made much fuss about a NEJM study suggesting a slight increased risk of death from taking azithromycin or z-pack. The more unhealthy you are, the higher the risk... no duh... (I would think the sicker you are, the greater the risk of death PERIOD... a sick person by definition is closer to death than a healthy person). How slight? Compared to amoxicillin, about 47 additional cardiovascular deaths per one million courses of therapy. Never mind the blatant biases found in th…
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Australia Ends $500 Million Electronic Medical Records Initiative

First United Kingdom ends their $17 billion electronic medical records initiative in 2011 and now Australia follows suit after 6 years of trying to fund their HealthSMART health information technology project and projected costs went from $318 million to $557 million. This Australian project was to have provided hospitals with software from Cerner, iSoft (now CSC) and InterSystems... the same system which also failed to be implemented by United Kingdom. I said it before and I'll say …
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May 19, 2012

Fauquier ENT Reaches 5 Million Web Visits

It is with some amazement that a certain milestone was reached this past week... Fauquier ENT's online presence received over 5,000,000 web visits since first coming into existence in 2004. This number includes practice website and blog . There has been exponential growth year over year with daily web visits now averaging close to 8,000 hits per day with some occasional peak days exceeding 10,000 views. Our YouTube channel has done even better on its own with over a QUARTER BILLIO…
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May 17, 2012

Can Eye Drop Medications be Used in the Ear?

Can EYE drop medications be used in the EAR for ear problems like ear infections ? For the most part, absolutely, but not vice-versa. For pretty much any EAR drop preparation, there is an equivalent EYE drop preparation which can be used safely in the ear. Why does this matter? For some patients, the ear drops may burn when placed. Given eye drops uses a much "gentler" solution, such patients find that eye drops doesn't burn in the ear nearly as much compared to ear drop…
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May 11, 2012

Actress Reese Witherspoon's Dad is an Otolaryngologist!

It has recently come to my attention that actress Reese Witherspoon's dad is an eminent otolaryngologist! John Witherspoon, MD has practiced with a Nashville, TN otolaryngology group for over 30 years and is an instructor in this specialty at Vanderbilt University Medical Center. He went to medical school at University of Tennessee Health Science Center College of Medicine and completed his residency at Tulane University Hospitals and Clinics. He unfortunately has come under recent …
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May 07, 2012

Chronic Cough Could be Due to Lung Cancer

BBC News recently reported that chronic cough may be due to lung cancer. Here are my two cents on this condition in support of this assertion. I often seen patients for chronic cough ... not the kind that has been going on for only a few weeks, but the kind of cough that has gone on for over 1 or more years. Even 10-20 years. It is not unusual for such patients to have seen an ENT, GI, pulmonary, and allergy specialists to try and stop their cough. In particular, such patients may be…
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May 04, 2012

Beastie Boys Adam Yauch Dies of Parotid Cancer

Image by Patrick Lynch from Wikipedia On May 4, 2012, Adam Yauch, one of the founding members of the Beastie Boys, died of a "rare parotid gland cancer" that he had been battling since its diagnosis in 2009. For those who do not know what a parotid gland is... it is one of the major glands that produce saliva or spit and is located immediately in front of the ear (looks like fish eggs in the picture taken from Wikipedia ). It is about the size of the palm of the hand. It is unc…
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5 Years Old Child Dies After Tonsillectomy from Narcotic Overdose?

The Story On April 7, 2011, 5 years old child underwent tonsillectomy in Delaware for obstructive sleep apnea . Post-operatively, he was given a narcotic nubain (nalbuphine) twice, IV morphine once, and lortab once over the next hour. Lortab was the last narcotic given shortly before 3PM. The child was discharged home at 3:50PM in an "unresponsive" state. He was put to bed once he arrived at home. At 6PM, parents called 911 when the child was found unresponsive and not brea…
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