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May 29, 2014

May 26, 2014

Upper Lip Tie and Posterior Tongue Tie Treatment Without Sedation

It seems that in the past few years, upper lip tie and posterior "hidden" tongue tie has become increasingly recognized as factors affecting breast-feeding which correspondingly has led to higher numbers of referrals for evaluation and treatment. Prior to 2011, I probably received only one or two consultations a year to evaluate these two conditions. Ever since than, it seems more and more infants are being diagnosed with these two conditions, especially by lactation consultants…
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May 18, 2014

Hearing Test Administered Over the Phone

I was just made aware of this service in a Washington Post article published May 16, 2014. This screening hearing test is taken over the telephone and accomplished by listening to three-digit sequences presented in a background of white noise. The test-taker has to then enter the digits using the telephone keypad. Based on accuracy of the response, the test than adjusts the next query. Normally, the cost to take this telephone hearing test is $8, but at least for the month of May 2014, it …
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May 15, 2014

Top 4 Causes of Dizziness (Table)

Dizziness is an extremely common disorder that afflicts an estimated 10-20% of individuals older than 70 years old. Even for those younger, dizziness is a not uncommon problem. Several studies have been performed over the years to try and quantitate what are the most common causes of dizziness to help narrow the possibilities given the workup for dizziness can be long, tedious, and time-consuming which often frustrates patients. Also frustrating is the fact that without a diagnosis, trea…
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May 14, 2014

Whooping Cough Without the Whoop - The Bad Lingering Cough

Although I have been practicing medicine since 2000, the first time I diagnosed whooping cough was in 2011 and ever since, I have been diagnosing more and more cases each year thereafter. However, what makes these cases a little unusual is that for ALL cases of whooping cough I have diagnosed, there was no characteristic whoop for which it is named after. Rather, the common characteristics for all patients I have diagnosed include: • "Mystery" cough that has been going on f…
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May 11, 2014

Cure Hiccups by Pulling on the Tongue

There are many different ways to treat hiccups (otherwise known as singultus). Some of the more bizarre ways of treating hiccups include rectal massage and tongue pulling. Tongue pulling treatment is most commonly attributed to Sir William Osler (1849-1919). However, origins of tongue pulling can be found in much earlier French references including Jean Laborde (1830-1903), Jean Viaud (1862-1946), and Raphaël Lépine (1840-1919). It is hypothesized to work by stimulating the vagus nerve…
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May 05, 2014

Anal Massage Cures Hiccups?

So... I came across a few references addressing treatment of hiccups (otherwise known as singultus), but perhaps the most bizarre treatment for hiccups I saw was rectal massage. Digital rectal massage (see references below) has apparently been reported in the literature to help stop hiccups, mainly by disrupting the vagal afferent limb of the hiccup reflex arc. Name says it all. Essentially, you stick a finger up the bungholio and massage the area firmly until the hiccups stop. It appar…
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May 04, 2014

How Common is Hoarseness?

At some point, we all have suffered from a hoarse voice whether from illness or from yelling. However, it was unclear exactly how common this malady is until now... and apparently, the answer is "very common"... According to a study looking to answer this question, hoarseness affected 17.9 million adults in 2012.   The average age was 49 years old and 63% were women. Overall, 10% saw a health care professional for their hoarseness and 40% were given a diagnosis. Infectious la…
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May 03, 2014

Cricoid Pressure May Minimize Symptoms of Reflux (LPR)

Specifically throat symptoms attributable to reflux such as globus , throat-clearing , phlegmy throat , chronic cough , etc. However, cricoid pressure may not be realistic nor practical even if it does help. In one of the more unusual studies I have seen, researchers deliberately infused 60 cc of hydrochloric acid into the esophagus of 14 patients who suffered from LPR as well as 12 healthy controls. 9 patients exhibited confirmed LPR (laryngopharyngeal reflux) events, but none in the co…
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Map of Vaccine-Preventable Outbreaks Over Time

Image by Council of Foreign Relations The council of foreign relations have produced an interactive map the shows the concentration of vaccine-preventable outbreaks throughout the world over time. Such diseases include measles, mumps, rubella, polio, and whooping cough . The take-home point of the map is that diseases that were once considered "eradicated" due to near-universal vaccinations have now made a tremendous comeback which is felt almost certainly due to the anti-vacci…
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Hearing Loss Over Time

It is well-known that professional musicians have a higher risk of hearing loss and tinnitus compared to non-musicians. According to one study , the risk for musicians is 1.5x for hearing loss and nearly 4x for tinnitus. And although people understand that as you get older, hearing loss increases, what is less clear is how quickly hearing loss occurs over time. After analyzing over 3 million subjects , here is the graph of hearing loss with age. Intuitively, I thought there would have bee…
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A Single Sneeze Can Spread Throughout Entire Building

MIT researchers using high-speed cameras and applying fluid dynamics have discovered that although ejected droplets from a sneeze typically fall to the ground, the "cloud" of moisture from a single sneeze actually floats and can enter ventilation ducts and can potentially spread throughout an entire building or airplane. Watch video below. These findings have profound implications as to how infections may travel within buildings and other contained structures like cruise ships a…
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