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February 28, 2013

Why Do Biopsy Results Take So Long? [video]

One of the most common questions I get after a surgical procedure is how long it takes before biopsy results are back... especially when a mass was removed and there is a cancer concern. Does it take a few hours? 24 hours? Days? Disappointingly, it can take up to 7 days if not longer. You want to know why? Well, rather than explaining, watch a 6-minute video that explains the numerous steps that goes into providing a diagnosis after a mass is removed... in this particular case, a neck …
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February 24, 2013

I Am Taking a Reflux Medication & My Symptoms are Not Improving!

On an almost daily basis, I get an email from somebody with the same exact question or near-variation: "Dear Dr. Chang,  I have been taking a [ insert reflux medication ] for [ insert number ] weeks and I see no improvement in my [ insert symptom ]. What should I do?" The reflux medication typically mentioned include nexium, dexilant, prilosec, prevacid, protonix, or some other proton pump inhibitor . The most common symptoms typically mentioned include: • Globus • …
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Reflux Medication Addiction

When a patient suffers from reflux , there is an astounding array of very effective medications to induce acid suppression for symptom relief. Chief among the reflux medications are the proton pump inhibitors that include medications like prilosec, nexium, protonix, prevacid, dexilant, etc. When such medications are taken by a patient, especially one who does not normally take proton pump inhibitors, effective acid suppression occurs. It works EXTREMELY well; even at low doses. Howe…
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February 20, 2013

How Much Tongue Can Be Removed Without Affecting Function?

Unfortunately, whether through trauma or cancer concerns, parts of the tongue may be removed. When a part of the tongue is removed, the principal concern patients have is whether speech and swallow will be affected. The answer to this question depends on 3 main factors. • What orientation is the tongue removed? • How much is removed? • Will nerve function be preserved? The nerve is what makes the tongue move (specifically cranial nerve 12  called the hypoglossal nerve) Regar…
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Split Tongue (aka Forking the Tongue, Snake Tongue, etc)

Photo Source Here Splitting the tongue into two halves is a relatively rare type of body modification, though it is becoming more common. Tongue trauma can also result in such tongue bifurcation as well. There are 3 described basic methods of creating a split tongue. scalpel (cold steel), cautery (electric or laser), and tie-off. Scalpel and cautery methods are performed by a surgeon, but the tie-off method can be performed by anybody. The tie-off method was developed by 19 year old Dus…
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February 17, 2013

What to Do and Care After Vocal Cord Surgery

When surgery is performed on the vocal cords, there are some very specific after-care that is required to allow for optimal healing. In order to understand the "why" such post-operative care is required, one must first understand how the vocal cords normally work. If you already know, just skip down to the bottom. The vocal cords are arranged in the shape of a "V". When breathing, the vocal cords are open to allow air to pass through and down into the windpipe. When talki…
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February 14, 2013

Can You Spot the Gorilla in the CT Scan?

I am not going to go into too much detail regarding a recent news article regarding how 83% of radiologists (physicians who specialize is looking at radiology pictures) failed to see a gorilla on a CT scan of the chest... you can read more of the details here . But, the question is can YOU find the gorilla in the CT Scan that was portrayed? Still can't see it? Look below... Keep going... Keep going... Keep going... I'll point to it...
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February 13, 2013

How Much Radiation Exposure Occurs with a CT Scan? X-ray? Sunlight?

A common concern now is how much radiation exposure occurs with common radiological testing such as x-rays and CT scans, especially given the small increased risk of cancer with accumulated exposure over years. Of note, ultrasounds and MRI scans do not emit radiation. MRI scans use magnets while ultrasounds use sound waves in order to obtain imaging information. So, here's a chart comparing such tests with common environmental radiation exposure such as sunlight. Information taken fro…
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February 09, 2013

Does Acupuncture Help With Allergies?

Image from Acupuncture For All According to one study , it does... Performed by researchers in China and Korea, they divided 238 patients suffering from allergies into 3 groups: active acupuncture, sham acupuncture, and no treatment. They found that acupuncture, even if it was sham, did help significantly with nasal allergies. However, only active acupuncture helped with not just nasal allergies but also allergy symptoms beyond the nose! Of course, when considering all the other researc…
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February 06, 2013

17 Year Old Girl Dies After Tonsillectomy

Patients sometimes focus too much on the intricacies and risks of the surgery itself and not realize that subsequent care AFTER surgery may be just as important and risk-laden. Media reported yesterday about the tragic death of a 17 year old girl after tonsillectomy . Apparently in March 2012, the Pennsylvania teenager underwent a routine tonsillectomy without any problems. While in recovery after surgery (PACU), she was given fentanyl, a powerful narcotic to help with pain, but als…
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How Much Caffeine is Present in Coffee? Decaff? Chocolate?

©  Radu Razvan Gheorghe  |  Dreamstime Stock Photos There are quite a few ENT problems that can potentially be due to caffeine intake. Even death has been attributed to high caffeine intake in young adults who drink a lot of energy drinks like Red Bull. In any case, caffeine can contribute to (some proven, some suspected, some debatable): •  Tinnitus • Meniere's Disease •  Migraine Headaches •  Headaches •  Dizziness •  Reflux •  Lump in Throat Sensation (Globus) •  Chron…
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February 05, 2013

Negative Ear Pressure Causing Inability to Pop a Clogged Ear

Have you ever closed the lid on an air-tight container containing a left-over hot meal and stuck it in the refrigerator? And than when you try to open the lid the next day once that hot meal cools down, it is REALLY hard to open the lid because of the accumulated negative pressure? In essence, the negative pressure has "locked" the lid down. Well, something similar can also potentially happen inside the ear with eustachian tube dysfunction , especially with negative pressure (rather…
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February 02, 2013

Just How Contagious is the Flu (and Other Viral Infections)?

Everybody knows the flu and other viral infections are contagious, but did you wonder just how contagious??? Well, here are some facts gleaned from a few studies: • In just 4 hours, one sick worker can contaminate 50% of surfaces in a typical office • After 8 hours, one sick worker can contaminate 70%+ of surfaces • Non-sick workers have a 40-90% chance of getting infected after spending one day with a sick worker • A sneeze or cough can hurl virus 6 feet away from the mouth • A si…
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Uvula Piercing

It happens, but thankfully rare... Ear piercing I will do, but truly uvula piercing is not something I would recommend given a whole host of problems it may cause including: • Gagging • Snoring • Airway obstruction • Uvular stretching • Uvular bisection • Accidental inhalation if it comes loose • Uvular swelling etc. etc. etc. Indeed, most people would rather get their uvula removed rather than "enhancing" it!
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February 01, 2013

Speech Impediment to Great Singing on American Idol

During January 2013 auditions of Season 12 of American Idol, there was Lazaro Arbos who has a terrible stutter when he talks, but sings beautifully. A week later, we encountered Micah Johnson  who also suffers from a speech impediment, but rather than a stutter, it was due to "nerve damage" sustained during a tonsillectomy . (Watch videos below) With stuttering, the problem mainly lies at the brain level. The brain coordinates how a person uses all of their throat muscles to crea…
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