Feeling Dizzy or Having Vertigo? There's an iPhone App for That!!!

On April 22, 2010, Clearwater Clinical Limited released an iPhone application that helps clinicians diagnose and perform the Epley maneuver in patients with BPPV (Benign Paroxysmal Positional Vertigo). The way it works is by placing the iPhone over the patient's forehead and than following the instructions as shown on the iPhone through each of the Epley steps. When I tried it out, it does seem to correctly take the patient thru the appropriate steps... however, I would add one mor…

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Sudden Hearing Loss Can Be Due to Erectile Dysfunction Medications (Cialis, Viagra, etc)

It's been a few years since the warning has come out from the FDA regarding sudden hearing loss in men who take viagra, cialis, and other erectile dysfunction (ED) medications. In 2007, the FDA authorized more prominent labeling that such drugs may potentially cause sudden hearing loss because of this concern. This concern initially stemmed from a 2007 case report  of bilateral profound unremitting sensorineural hearing loss in a 44-year-old male patient that occurred after ingestion…

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Fauquier ENT YouTube Recognized as a Top Medical Video Channel!

It was with pleasant surprise that I discovered that the YouTube channel our office manages has been recognized by Goomedic (an informatics blog) for providing influential medical videos. We apparently are ranked #13 (out of 30) along with University of Maryland Medical Center (#1), CDC (#8), and British Medical Journal (#10). For those curious, we get about 250,000 views a day on average. Check out our YouTube video channel here . See the full list of influential medical videos here …

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What is High Quality Research?

Patients (and health professionals) are inundated with information overload regarding "research studies" that prove this or prove that on TV, magazines, radio, etc. Who do you trust? How can you determine if a given study is worthwhile while dismissing others? Well, it unfortunately takes some homework... 1) Determine WHO did the research. Clearly, research published by Harvard University is more "trustworthy" than research done by XYZ (XYZ being an institution you ha…

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Does the EARDOC Work?

So I've seen a whole lot of hub-bub regarding a medical device called EARDOC . The way EARDOC is explained to work is through vibrations conducted via the mastoid bone into the middle ear and eustachian tube by placing the device behind the ear and activating it. The main question on my mind is whether it actually works... And on that point, it's less clear. There certainly is a lot of patient testimonials as well as marketing spots in support of its effectiveness. However, …

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NYT: Can botox stop essential tremor (hand, face, etc)?

On April 22, 2010, the New York Times published a short story entitled " Can Botox Stop the Hands From Shaking? " The story goes on to report that "Intramuscular injections of Botox , or botulinum toxin, may play a limited role in the treatment of wrist and voice tremors in patients with essential tremor." Indeed, I do agree with the "limited" role botox has on essential tremor (emphasis on limited) whether the tremor involves the hand or head/neck region wh…

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We Now Offer Sterile Ear Piercing Using Lab-Tested, Hypoallergenic, Packaged & Sealed Earring Studs

Our office offers ear piercing by a doctor to patients in a manner superior to that obtained in most commerical locations. The ear piercings we provide are: • Performed in a sterile manner (numbing offered as well) • Ear studs placed are hypoallergenic • Ear piercing system used has been laboratory tested, packaged, and sealed • Hypoallergenic studs and clasps are individually sealed with disposable earpiercer - avoiding any concern of cross contamination Better yet, we can perform th…

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How Long Can You Survive Without Water or Food???

Well, according to a New Scientist article , with at least a supply of vitamins and water, you can survive over a year without eating. However, with vitamins but no water, survival time is sharply reduced. "A human can be expected to survive for weeks without food, but a thirsty person deprived of water would last a matter of days. Without water, the volume of blood in your body drops, and with it your blood pressure. Blood becomes thicker and stickier, making it harder to pump around …

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Chronic Cough May Be Due to Obstructive Sleep Apnea!

A new study was published in the April 2010 journal Cough entitled " Chronic cough and obstructive sleep apnea in a community-based pulmonary practice ." Apparently 44% of patients with a chronic mysterious cough were found to have obstructive sleep apnea . In these patients, 93% had cough improvement when the obstructive sleep apnea was corrected! Read the abstract here . Of course, there are many other causes of chronic cough including reflux , asthma, allergies , etc. In…

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How a Tracheostomy is Performed Step-by-Step with Pictures

Below is a step-by-step description with pictures of how a tracheostomy is performed. To read more about this procedure as what to expect with swallowing, eating, talking, etc, click here . Step 1:  Neck is sterilized with beta dine to clean the skin and draped to prevent any contamination from the environment. Step 2 : After the incision, underlying fat is removed. Step 3:  Dissection is carried down to the windpipe which is completely exposed in this picture. One can see the faint out…

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Step-by-Step Cartoons of Septoplasty Surgery to Correct Deviated Septum

Below is a step-by-step description with images of how septoplasty surgery is performed to correct a deviated septum. To read more about this surgery, click here . Step 1: A small incision is made inside the nose and the mucosal lining carefully lifted away from the septum on one side. It is during this stage of the procedure that one of the complications of the procedure, septal perforation, may occur. This complication occurs when the lining gets torn resulting in a hole as the mucos…

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Pollen Under the Microscope Appears Unearthly Beautiful Unlike the Misery They Cause!

Using an electron microscope he has in his basement (no kidding), Swiss photographer Martin Oeggerli obtained numerous pictures of pollen at the microscopic level. They are unbelievably beautiful to look at unlike the misery they cause at the macroscopic level. The picture shown below is one of the pollens that cause hayfever... To see more pics, click here . To purchase these and other pollen images, go to this website .

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Not Only Can House Dust Cause Allergies, They Harbor Bacteria That May Lead to Asthma

House dust already has a bad reputation for causing allergies and sino-nasal congestion misery. Now there's another reason to hate dust... In the April 2010 issue of the journal Applied and Environmental Microbiology, researchers have found bacterial populations in household dust may determine whether or not a child living in that home develops asthma. In the paper titled " Environmental Determinants of and Impact on Childhood Asthma by the Bacterial Community in Household Dust…

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Fauquier ENT Blog Included in the Webicina Collection for Otolaryngology!

I was pleased to learn that Fauquier ENT Blog (what you are reading now) has been included in the Otolaryngology section of Webicina , an aggregator of quality medical information, online courses and workshops. Check it out here !

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Doctor Sentenced to 5+ Months Jail For Using Non-FDA Approved Botox on Patients

A Houston physician, Dr. Gayle Rothenburg, was sentenced to 5½ months in federal prison on April 16, 2010 for injecting patients with a Botox product not approved by the Food and Drug Administration for human use. Read the full story here . She did this in order to save money at the expense of patient safety. Please note that in our office, we use ONLY the brand-name BOTOX made by Allergan Corporation . In fact, we purchase our BOTOX directly from Allergan Corporation and not through a th…

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New Webpage on Balloon Sinuplasty to Treat Chronic Sinusitis

A new webpage has been created describing the balloon sinuplasty technique to address chronic sinus infections . Briefly, a balloon catheter (similar to angioplasty used to treat clogged heart arteries) is used to enlarge the openings into the sinus cavities without the need for any cutting or tissue removal. Read more here .

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What a 24 Hour Multichannel pH and Impedance Testing Looks Like

I often order a special test called "24 hour Multichannel pH and Impedance Testing" when working up patients with symptoms of chronic cough , globus , phlegmy throat , and/or throat clearing . This test measures any non-acid and well as acid reflux along with muscle contractility of the esophagus continuously over a 24 hour period of time. The catch is that a catheter needs to be placed through the nose and into the stomach AND left in place for 24 hours. Patients often ask what t…

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New Video On Balloon Sinuplasty for Chronic Sinusitis Uploaded

A new video describing balloon sinuplasty has been uploaded on our YouTube channel . Balloon sinuplasty is a relatively new minimally invasive sinus surgery technique to open up diseased sinus cavities without removing mucosa or bone. In essence, the technique involves threading a tiny guidewire to first identify the sinus opening and than acts as a guide for the balloon catheter. Once the balloon is positioned at the opening of the sinus cavity, it is inflated thereby enlarging the sinus ca…

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New Webpage on Cryptolysis: A Minimally Invasive Procedure to Treat Tonsil Stones

A new webpage has been created describing tonsil cryptolysis , a minimally invasive procedure to treat tonsil stones otherwise known as tonsiloliths. The procedure we offer is similar to laser cryptolysis, but without the risks of laser use. Such risks involved with using a laser include: 1) No risk of airway fire (if a spark occurs due to laser use, it can ignite the air) 2) No risk of blindness (laser can bounce off shiny surfaces like metal and reflect out and burn the retina) 3) No …

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CNN: Obstructive Sleep Apnea Increases Risk of Stroke

CNN on April 8, 2010 aired a story on obstructive sleep apnea (OSA) and the risk it poses to men who do not address it. Apparently, according to a new study out of the March 2010 issue of the American Journal of Respiratory and Critical Care Medicine ("Obstructive Sleep Apnea Hypopnea and Incident Stroke: The Sleep Heart Health Study"), the risk of stroke increases by as much as 3X if left untreated in men with OSA. The risk of stroke increases even in men with MILD sleep apnea. …

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Mouth Breathing Can Cause Major Health Problems

Everyone knows somebody who mouth-breathes due to nasal obstruction ... What many may not realize is that chronic mouth-breathing can lead to health problems whether in an adult or child. Especially in children, over time, whose mouth breathing goes untreated may suffer from abnormal facial and dental development, such as long, narrow faces and mouths, gummy smiles, gingivitis and crooked teeth. The poor sleeping habits that result from mouth breathing can adversely affect growth and academ…

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April 16 is World Voice Day

The American Academy of Otolaryngology-Head & Neck Surgery has designated April 16 to be "World Voice Day." First started in 2002, it is observed every year on April 16. Click here for more info. For extensive information on how the voice works in both health as well as in disease, click here .

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Fox News Story on Spasmodic Dysphonia

A Florida Fox News network aired a story on spasmodic dysphonia on April 7, 2010. Click here and it will take you to where you can watch the entire video segment. Spasmodic dysphonia is a neurologic condition where patients suffer involuntary voice spasms resulting in an intermittent strangled quality voice with voice breaks or cut-offs (listen to examples here ). Spasmodic dysphonia is most often treated with Botox injections to the voicebox . Dr. Chang performs such injections every …

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RANDOM: Giant Stuffed Toys of Cells, Microbes, Germs, & Viruses

I recently learned of a company that makes stuffed animals... except they are not OF animals, but rather they are human cells as well as germs like staph, H1N1 virus, Lyme Disease, Strep, etc. Though the diseases they cause are not fun, these stuffed microbes are cute and friendly. Here are a few of my favorites. For a complete list of toys like these, click here Here is Lyme Disease: Here is a nerve cell: And finally, here is Epstein Barr Virus (otherwise known as mono or ki…

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Office Air Conditioner Broken!!!

Our office air conditioner has been broken the last few days. As such, it is quite uncomfortably hot in the office. We have been working with maintenance to get this fixed ASAP. However, it may be a few days before it gets back in working order. Apparently, parts have been ordered. Please be patient with us and know that WE are just as uncomfortably hot and miserable as you are! In the interim, we have fans going throughout the office until the AC works again.

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Story on Botox in the Washington Post

On April 6, 2010, the Washington Post reviewed a report by Consumer Reports on the use of Botox for a variety of ailments. In the story titled " Consumer Reports examines Botox as a remedy for headaches, back pain, tremors " is largely accurate, though there are some errors in the story. In particular, Botox HAS been found to be effective for migraines contrary to what is stated in the story. A variety of research has supported this particular indication: • Botulinum toxin typ…

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WP: Washington DC Has One of the Highest Pollen Counts in the Nation

The Washington Post on April 6, 2010 published a story entitled " Tree pollen kicks off Washington's allergy season ." The story goes through explaining that though Washington DC is ranked 43rd out of 100 most challenging places to live with allergies (see ranking here ), Washington DC often has one of the highest pollen counts in the nation on any given day during the spring season! In fact, according to a study in last month's Annals of Allergy, Asthma and Immunology th…

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