Top Ad

Shareholic Button

August 30, 2012

Actor Larry Hagman Treated for Throat Cancer

Image by  Toglenn  from  Wikipedia In June 2011, actor Larry Hagman was diagnosed with stage 2 throat cancer. It is unclear exactly where the throat cancer was localized to (tongue, tonsil, supraglottis, hypopharynx, oropharynx, etc), but it was treated medically with radiation and chemotherapy. Larry Hagman is a well-known actor playing oil baron J.R. Ewing in the soap opera  Dallas  (1980s as well as 2012) as well as Major Nelson in  the TV sitcom I Dream of Jeannie . Most impressi…
Continue Reading

Should Gloves Be Worn When Giving Allergy Shots?

A common question patients ask is whether nurses and or other medical staff be wearing gloves when giving allergy shots (or other forms of immunization). According to the CDC : "Gloves are not required when administering vaccinations, unless persons administering vaccinations are likely to come into contact with potentially infectious body fluids or have open lesions on their hands." [ link ]  As such, the practice of wearing gloves is left up to the discretion of the person a…
Continue Reading

August 29, 2012

Allergies May Prevent Heart Attacks???

Research has been published suggesting an inverse relationship between serum IgE and heart attacks in the US population independent of coronary risk factors. No kidding... This conclusion was reached based analyzing 4002 participants between 2005-2006. They also detected that of the 7 "data-driven, prespecified allergen clusters," house dust mite was the only allergen cluster for which serum IgE is associated with reduced risk for heart attack. For those wondering, serum IgE…
Continue Reading

August 27, 2012

Same Doctor Visit, Double The Cost

On August 26, 2012, the Wall Street Journal published a story describing a situation whereby a patient who sees a physician employed by a hospital essentially pays double out-of-pocket what they would have paid for the same exact office visit with a physician NOT employed by the hospital. I actually wrote about this situation in January 21, 2012. Beyond what the Wall Street Journal reported, what's going on? Assuming all things equal whereby a private practice physician and a ho…
Continue Reading

August 24, 2012

Healthcare Websites and Blogs Worth Anything?

I wrote in the past that healthcare blogging was in some ways a losing proposition when compared to entertainment news in terms of web traffic and search queries. However, when it comes to ad revenue and how much a website is worth to potential buyers, healthcare topics (as well as sports) are king in monetary generation. Flippa is a website that mediates the buying and selling of websites. They also produced a handy visual aid infographic based on their internal statistics. …
Continue Reading

August 22, 2012

Bi-Lobed Zenker's Diverticulum

In the not so distant past, I saw a patient who suffered from a bi-lobed Zenker's Diverticulum. Zenker's diverticulum for those who don't know is the abnormal development of a pouch in the throat causing symptoms of phlegm in the throat , food regurgitation, swallowing difficulties , and aspiration. Most Zenker's Diverticulum is composed of a single central pouch. However, there are more rare varieties such as this bi-lobed pouch seen on barium swallow. However, at tim…
Continue Reading

Bacteremia IS Present During Tonsillectomy!

@ENTHouse brought to my attention a very interesting research regarding the presence of bacteria in the bloodstream during tonsillectomy , both elective and quinsy. Elective tonsillectomy is when the tonsils are removed in the absence of any significant infection. Quinsy tonsillectomy is when the tonsils are removed in the setting of a peritonsillar abscess . The research involved obtaining blood cultures, tonsillar swabs, core tissue, and pus aspirates during the operation on 80 patient…
Continue Reading

FDA Approves New Epinephrine Injector That Talks

Sanofi US has introduced a new epinephrine injector (competitor to the more commonly known EpiPen made by Dey Pharma LP) that is equipped with audio and visual cues that helps a patient or care-giver administer epinephrine in cases of a severe allergic reaction (anaphylaxis). Known as Auvi-Q , it was FDA approved Aug 13, 2012, and should soon become available for purchase by prescription. Just like EpiPen, Auvi-Q comes in two different dosages of epinephrine... 0.3mg for patients who we…
Continue Reading

August 19, 2012

Singer Nicki Minaj with Strained Vocal Cords

Media has reported that pop star Nicki Minaj had to cancel upcoming concerts in England due to injured vocal cords. She apparently saw a doctor who diagnosed "strained vocal cords" after an x-ray and recommended voice rest for a few days. The singer apparently ignored this advice and sang in New York City on Aug 18 causing her voice to substantially worsen resulting in her decision to cancel her concerts this weekend. Details of her vocal cord condition are sparse. However, …
Continue Reading

Financial Issues with Emergency Room Specialist Care

Imagine this scenario... A young child is playing in the yard when her pet dog bites her face. Bleeding, the child is rushed to the emergency room and the emergency room doctor offers to suture up the child's face. The next question a parent will probably ask (or demand) is the desire for a plastic surgeon to suture the face instead of the emergency room doctor. As such, the plastic surgeon is called in and sutures up the face beautifully. The child and family goes home and that'…
Continue Reading

Congressman Putney with Vocal Cord Cancer

Media has reported that Congressman Lacey Putney, chairman of the powerful Appropriations Committee in the House of Delegates, has early stage vocal cord cancer. He is currently undergoing radiation therapy which has a high chance of cure with relatively minimal side effects along with voice preservation. My suspicion is that he is suffering from squamous cell carcinoma which is the most common type of vocal cord cancer. Though radiation therapy is a common form of treatment for this typ…
Continue Reading

August 17, 2012

CPAP + Oral Appliance (All-In-One) Device for OSA

A dentist colleague of mine informed me of a new device that combines CPAP mask with an oral appliance for patients with obstructive sleep apnea ( CPAP Pro + Mandibular Advancement ). The unique benefits of this combo device are several-fold: • No straps • Keeps mouth closed • Addresses tongue collapse that obstruct the airway by bringing jaw forward • Can sleep in any position This device does need to be fitted by a dentist. (For Virginia residents, Dr. Jason Woodside is familiar…
Continue Reading

August 16, 2012

Squid Ejaculates Into Woman's Mouth

It happened in June 2012... A South Korean woman was eating a half-cooked squid when the squid apparently ejected its sperm bag into her tongue causing... "pricking and foreign-body sensation in the oral cavity. Twelve small, white spindle-shaped, bug-like organisms stuck in the mucous membrane of the tongue, cheek, and gingiva..." [ link ] Of course, she immediately spat the squid portion out, but required surgical excision of affected mucosa. Bizarre but true... Source: …
Continue Reading

August 14, 2012

Mouth "Oil Pulling"

The other day, I had a patient ask me about "oil pulling." For those who don't know what oil pulling is: "Oil pulling or oil swishing is a traditional Indian folk remedy that involves swishing oil in the mouth. It is mentioned in the Ayurvedic text Charaka Samhita, where it is called Kavala Gandoosha or Kavala Graha. Ayurvedic literature describes oil pulling as capable of both improving oral health and treating systemic diseases such as diabetes mellitus or asthma. While…
Continue Reading

Intra-Nasal Trigger Point Injections for Facial Headache

Do you suffer from a stabbing headache in the areas denoted in red? Do these headaches seemingly come out of nowhere one day? Perhaps started after a viral upper respiratory infection? You may be suffering from a condition known as  contact point headache  or a type of neuralgia involving one of the nerve plexuses found inside the nose: • Anterior ethmoid neuralgia (Sluder's neuralgia) • Sphenopalatine ganglion neuralgia (Pterygopalatine ganglion neuralgia) This type of headache …
Continue Reading

August 11, 2012

Honey Helps Relieve Coughing in Kids

Ever since the FDA has withdrawn in 2008 common over-the-counter medications to treat cough in kids, there has been a conundrum among pediatricians and their young patient charges on how to address the cough that occurs with viral upper respiratory infections (common cold). Beyond humidified mist, hydration, vapor baths, saline spray, and sleep, there are still some other effective options to try... Sore throats (and coughing) can be soothed by swallowing honey straight-up or slightly dilute…
Continue Reading

August 10, 2012

Child's Allergy Risk Higher If Same Sex Parent Has It

British researchers reported this month their findings that a child is at higher risk of allergies if the same sex parent has allergies. In other words, if a father has bad allergies, his sons are at higher risk for them and if a mother has bad allergies, than her daughters are at higher risk for allergy problems. They based their findings following 1456 children examined at 1, 2, 4, 10, and 18 years of age. History of asthma, eczema, rhinitis, and environmental factors was obtained and s…
Continue Reading

Spider Found Living in Woman's Ear for 5 Days

Thanks to @beubank for alerting me to this story about a spider who lived in a woman's ear for 5 days before being removed. As an aside, in typical media blunder of factual error, in the Huffington Post , a picture is shown of the spider stating an "x-ray photo"... COME ON!!! The picture is NOT an x-ray in any way shape and form!!! It's just a regular ordinary picture one takes with a camera. On that note, August 9, 2012 must be the time for all media to report on all s…
Continue Reading

August 08, 2012

Nasal Congestion or Obstruction During Pregnancy

When a woman becomes pregnant, it is not unusual for the nose to become quite congested ... uncomfortably so, even to the point of being unable to breath through the nose. This condition known as "rhinitis of pregnancy" affects as many as 30% of pregnant women and can start in the second month of pregnancy; it tends to worsen later in pregnancy. The nasal congestion should ease up soon after giving birth and be gone completely within two weeks after delivery. The nasal congest…
Continue Reading

Oral Steroids No Help in Sinus Infections?

Media outlets such as Fox News reported yesterday that oral steroids do not help with sinus infections. This claim is based on a small study of 174 patients with clinical symptoms of an acute sinus infection and given either 30 milligrams per day of prednisolone or placebo pills for one week. Of note, antibiotics were not given. No significant difference in symptom resolution was found. Now why would one even think to give oral steroids for sinusitis in the first place? Steroids decr…
Continue Reading

August 07, 2012

Singulair May Help Cure Mild Sleep Apnea in Children

Singulair  (generic montelukast as of Aug 2012) is a medication often prescribed for asthma as well as allergies and works by blocking the leukotriene receptor. This mechanism is different than that found in common allergy medications like claritin and benadryl which work by blocking the histamine receptor (anti-histamine). Singulair has also incidentally been found to possibly help reduce the size of tonsils and adenoids. Given this beneficial affect, singulair may be a helpful interventio…
Continue Reading

August 02, 2012

Benign Stridor Often Mistaken for Laryngospasm

Laryngospasm causes a high-pitched squeak or wheezing sound when a person is trying to breath due to abnormal vocal cord movement. Watch video regarding this condition. Larygnospasm (the most severe form of vocal cord dysfunction ) is commonly misdiagnosed as asthma and patients may go for years labelled as asthmatic even though they may not have it at all. However, though laryngospasm is often the victim of misdiagnosis, there is a condition known as non-organic stridor which is often m…
Continue Reading

Banner Map

Pediatric Neck Masses

Adult Neck Mass Workup