Elbowed by Your Spouse While Sleeping? You May Have Sleep Apnea!

Canadian researchers have determined that if a patient answers in the affirmative to two questions:1) Do you get elbowed/poked while sleeping for snoring?2) Do you get elbowed/poked while sleeping for stopping breathing?There is a significant chance that the patient may have obstructive sleep apnea (OSA) with AHI score  more than 5.This quiz has been dubbed the "Elbow Test".Actual diagnosis for OSA is by sleep study.Should OSA be actually diagnosed...

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Why Patients Travel a Long Distance for Care

The decision for a patient to travel hours away for their medical care is a highly personal decision or a matter of necessity, especially if the care is unavailable locally.Assuming care IS available locally, based on my own personal observations, the reason to travel for medical care ultimately is due to level of anxiety... either the patient or the surgeon.Patient A:I recently saw a patient with a small parotid tumor... about 1.5cm in size that...

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Alternative Digital Archival System for KayPentax Strobe System

As a long-time user of the chip-on-tip all-digital KayPentax strobe system, I can certainly vouch for its amazing clarity of visualizing vocal cord pathology.However, it's digital archival system to record, edit, and store video exams is to put it bluntly, subpar.Which is why I've ditched that system, and put together a different one based on the Macintosh using its free (and included) but extremely powerful iMovie software which puts KayPentax's...

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"Mother's Kiss" to Remove Nasal Foreign Bodies

In 1965, a general practitioner Vladimir Ctibor described the "Mother's Kiss" technique of removing nasal foreign bodies in a child.Essentially, a trusted adult (like a mother) places her mouth over the child's mouth as if to perform mouth-to-mouth resuscitation. While pinching off the unaffected nostril, the adult than blows gently into the child's mouth until resistance is felt caused by the child closing the glottis. At that moment, the adult...

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What do Earthquakes Have to do with Thyroid Masses?

I'm not sure what is going on within the Italian Court system, but in October 2012, the Italian Court convicted 7 scientists to jail terms for not accurately predicting the 2009 L'Aquila earthquake that ended up killing over 300 people.Also in October 2012, the Italian Supreme Court ruled that cell phones caused one man's brain tumor.Since when does the Court decide on matters of scientific validity?And even more importantly, what does this...

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Cheerleading A Dangerous Sport from an ENT Perspective

The American Academy of Pediatrics (AAP) published its first policy statement regarding cheerleading due to the increasing rate of injuries found in this increasingly competitive sport.Who knew that although the overall risk of injury is lower than other sports, it has one of the highest rates of catastrophic injuries including closed-head injury, skull fractures, cervical spine injuries, paralysis, and even death.After all, cheerleaders do not wear...

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Cell Phones Caused Brain Tumor Rules Supreme Court

On October 12, 2012, the Italian Supreme Court ruled that cell phones caused one man's brain tumor. The Court felt that there was a causal link between businessman Innocente Marcolini's brain tumor diagnosis and his phone use which he used up to 6 hours per day for over a decade. Although the brain tumor was a benign trigeminal neuroma, it required surgery and badly affected his quality of life.This "causal link" between cell phones and brain tumors...

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Periodic Fevers in a Child - PFAPA

Fever in a child is not uncommon. After all, they get a lot of infections whether it be ear infections, tonsillitis, viral syndromes, etc.However, what can be particularly vexing and confusing for both physicians and families is a child who keeps getting recurring fevers every few weeks out of nowhere for seemingly no reason and no obvious infectious source.The typical scenario is a child with abrupt onset of fevers to ~102 degrees F or higher that...

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Why Are Some Patients Sensitive to Narcotics and Others are Not?

Blame cytochrome P450 2D6, also known as CYP2D6.Found in the liver, it is responsible for metabolizing drugs including many narcotics.It also determines how "sensitive" a patient is to these drugs.For example, codeine is not bioactive until it is metabolized by CYP2D6 into morphine, the bioactive form that helps with pain.As such, how "sensitive" a patient is to codeine is determined by how active their CYP2D6 is. The more active, the more quickly...

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Deaths Associated with Codeine Usage in Young Kids

For decades, surgeons have provided young children with prescriptions for pain control after tonsillectomy and/or adenoidectomy surgery, most commonly tylenol with codeine (otherwise known as tylenol #3). Millions upon millions of such prescriptions have been filled and taken without any problems, but there is now a growing concern that such narcotics may be causing more harm than good in a small percentage of kids and perhaps an even greater percentage...

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Nasal Spray to Help Motion Sickness

Over the years, many NASA initiated research has resulted in new products and treatments geared towards advancing the space-program, but has eventually led to benefits to us earth-bound mortals including:the computer mousetelemetryweather satellitescochlear implantNASA publication Spinoff highlights these research innovations that has benefitted the general public.Well, you can now add dizziness treatment to another NASA innovation to help motion...

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"Bitter" Taste Sense Contributes to Immune Defense

As children, we all learned about the 4 different taste qualities the human tongue can appreciate: salty, sugar, bitter, and sour. Savory or umami was added in 1985. "Calcium" has been proposed in 2008 as well as more recently, "fatty" taste.However, we are slowly learning that "taste" is much more complex than simply the ability to perceive the taste qualities associated with food.That tongue map we all memorized in elementary school? It's a lie......

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Pacifier Use Increases Risk of Ear Infections in Infants

There are many reasons why an infant may suffer from ear infections... parental smoking, not breast-feeding, daycare, etc.However, what many parents may not realize is that pacifier use is also an additional well-known independent risk factor for causing ear infections as well.Numerous studies have documented this association and depending on what study you look at, the risk can be quite significant.Furthermore, the longer and more frequently the...

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Is Flu Shot Safe for Patients With Egg Allergy?

It is the season for flu shots... and with that... we invariably get phone calls from patients asking whether it is safe to receive the flu shot if they are egg allergic. Generally speaking, the blunt answer is that it is safe... even if you have a life-threatening egg allergy.Why the concern? The flu shot vaccine (both H1N1 and seasonal) are grown inside eggs which is where this concern arises. It also doesn't help that the pre-flu shot questionnaire...

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Why Does Burping after Drinking Soda Burn the Nose?

I do not believe this question has actually been scientifically studied... but I can hazard a guess.Sodas are those flavored fizzy drinks like Coca-Cola and Pepsi.The "fizziness" is due to carbonation or carbon dioxide dissolved within the drink. When sodas are made, carbon dioxide is forced into the liquid under pressure so that there's more gas dissolved in the liquid than at regular air pressure. The bubbles you see and feel is caused by the carbon...

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Feeds for Fauquier ENT Blog Has Changed

Fauquier ENT blog has recently changed its email subscription service from FeedBurner (run by Google) to FeedBlitz.Why?Well, it is because Google appears to be shutting the FeedBurner service down.• FeedBurner API will be shut down on October 20, 2012. At that point, feed metrics will be gone, though feedburner itself will continue to work.• FeedBurner Twitter and Blog accounts were abandoned on July 26, 2012.Though Google has not specifically stated...

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ENT Surgeons Who Use daVinci Robot

Readers know my skepticism on the practicality of the daVinci robot in ENT head and neck surgeries.However, that does not mean that I do not doubt its effectiveness in certain unique situations... as well as market forces that use such high (and expensive) technology to market a given hospital's services.In any case, plenty of patients have asked me if there's any ENT surgeons who use the daVinci robot in the region.There are... and here are two...

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Does Social Media Advance Medical Knowledge?

According to a recent paper, the answer is absolutely!A survey was distributed via email to a random sample of 1695 practicing physicians in the United States in March 2011 with responses from 485 physicians (28.61%). Rather than rehashing what was said, I quote from the abstract,Overall, 117 of 485 (24.1%) of respondents used social media daily or many times daily to scan or explore medical information, whereas 69 of 485 (14.2%) contributed new...

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Mozart May Help with Tinnitus

Currently, there is no fast, good, and cheap way of resolving tinnitus. Tinnitus is in essence hearing a ringing or buzzing that does not exist in reality. At best, it may be something you hear, but does not bother.At worst, it can literally drive a person crazy.Neuromonics is perhaps one of the very few treatment protocols that has been proven to work resolving/improving tinnitus in 80-90% of patients over a period of months.However, it is expensive......

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