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Latest Posts

You’ve Heard Of Kidney Stones, But Did You Know You Could Get A Salivary Gland Stone?

The Doctors TV show actually produced a great (and accurate) segment on a relatively new procedure called sialendoscopy. This procedure allows a surgeon to remove a stone that may be blocking your spit gland from draining saliva into the mouth. This is analogous to a kidney stone which blocks urine from draining from the kidney into the bladder resulting in painful swelling of the kidney (causing flank pain).

How does a person know if they have a salivary gland blockage due to a stone? There is a painful swelling located right in front and/or below the ear if the parotid gland is affected, or under the jawbone if the submandibular gland is blocked.


If the blockage persists long enough, it may lead to an infection of the gland itself (sialadenitis). Read more »

*This blog post was originally published at Fauquier ENT Blog*

Dense Nasal Hair May Reduce Asthma Risk In Allergy Sufferers

Researchers in Turkey found that there is an association between nasal hair density and risk of asthma developing in patients with seasonal rhinitis patients. No joke… They published their findings in the International Archives of Allergy and Immunology in March 2011.

The rate of asthma found in patients with little or no nasal hair was 44.7% whereas only 16.7% of patients with a dense forest of nasal hair had asthma.

They hypothesize that increased nasal hair improves allergen filtration thereby preventing the allergens from irritating the airway. The assumption here being that allergen irritation of the airway can potentially cause asthma.

IF this is true (and that’s a big if)… patients with allergies should be encouraged to grow nice thick nasal hair to prevent future asthma!

Read the research abstract here!

Reference:
Does Nasal Hair (Vibrissae) Density Affect the Risk of Developing Asthma in Patients with Seasonal Rhinitis? Int Arch Allergy Immunol. 2011 Mar 30;156(1):75-80

*This blog post was originally published at Fauquier ENT Blog*

Should Home Allergy Shots Be Permitted?

DISCLAIMER: This post is not meant to condone or promote allergy shots to be given at home. It is meant to promote discussion and make patients aware of the issues involved.
Allergy shots, unlike medications like claritin and flonase, offer patients with significant allergies a way to potentially be cured of their misery without the need for daily medication use. However, there is a small, but substantial risk for anaphylaxis and even death with allergy shot administration. After all, a patient is being injected with the very substances that cause their allergies. As such, many allergists will allow allergy shots to be administered ONLY within a medical setting. Also, the American Academy of Allergy Asthma and Immunology (AAAAI) specifically forbids allergy shots to be administered at home.

Furthermore, the allergen extracts used to make the allergy vial serum used for allergy shots carry a black box warning on the medication package insert: Read more »

*This blog post was originally published at Fauquier ENT Blog*

Asymptomatic Strep Throat: Should We Treat It?

Occasionally, I see patients who have received throat swabs for strep that have come back positive… even if they have no signs or symptoms of pharyngitis.

In this situation, there are 2 main actions a physician may take (I am biased towards one):

1) Prescribe antibiotics until throat cultures are normal
2) Do nothing

Personally, if a patient is without throat symptoms and has no history of rheumatic fever or kidney damage, I would not have even bothered obtaining a strep test. What for??? Read more »

*This blog post was originally published at Fauquier ENT Blog*

Kids, Upper Respiratory Viruses, And Ear Infections

According to a new study published this month, more than 20 percent of young children with colds or other upper respiratory viruses will develop middle ear infections.

This finding isn’t that surprising. Eear symptoms along with a viral upper respiratory infection (URI) are common, including ear fullness and difficulty popping the ear. Although adults tend to be able to keep their ears clear by swallowing, chewing gum, yawning, or ear popping, most kids don’t know what to do when their ears feel full.

Whether in adults or kids, when the ears don’t ventilate or clear properly it can lead to ear problems including fluid buildup and middel ear infection. Why does this occur?

With a viral URI the lining of the nose swells, leading to symptoms of runny nose, nasal congestion, and sometimes nasal obstruction. This swelling doesn’t just occur in the nose, but also in the eustachian tube, which connects the back of the nose to the middle ear. When the ear “pops,” the eustachian tube opens to allow pressure and fluid to drain from the ear into the back of the nose. This is why yawning, swallowing, or noseblowing can cause an ear to pop normally.

When the lining in the eustachian tube swells up, the tube becomes blocked and prevents the ear from popping, leading to symptoms of ear pressure and fullness, fluid buildup, clogging, and often ear infections.

Read more about eustachian tube dysfunction here.

REFERENCE:

Clinical Spectrum of Acute Otitis Media Complicating Upper Respiratory Tract Viral Infection.” Pediatric Infectious Disease Journal. February 2011, volume 30, issue 2, pp 95-99.

*This blog post was originally published at Fauquier ENT Blog*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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