November 9th, 2011 by Lucy Hornstein, M.D. in Opinion
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Cancer is a dreadful disease. Just dreadful. Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously dysfunctional either/or approach to palliative care and hospice we’re stuck with in this benighted country.
The problem is that in order to qualify for hospice, patients must not only have a certified life expectancy of less than six months, but they must also not be undergoing any active treatment for their malignancy. When you stop to think about it, though, this is actually quite discriminatory. We don’t require people on hospice with other diagnoses to discontinue their life sustaining medications. Patients with COPD are allowed to continue their bronchodilators; CHF patients don’t have to stop their ACE inhibitors and digoxin. But if a cancer patient wants to qualify for hospice, they have to forgo curative treatments like chemotherapy.
So what if the oncologists call it “palliative” chemo instead? Read more »
*This blog post was originally published at Musings of a Dinosaur*
November 6th, 2011 by ChristopherChangMD in Health Tips
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Though most people like the professional nose whistler shown here require an instrument to enable the nose to whistle, in others it occurs naturally due to unique anatomic features within the nose.
Why might someone’s nose whistle?
Septal Perforation
The most common reason it may occur constantly is due to a hole in the septum (septal perforation). The septum is a wall that divides the right nasal cavity from the left side. Normally, it should be straight and without any openings.
However, when a hole is present in the septum and it is in just the right size and place, whenever air is breathed in and out of the nose, it will whistle. In this situation, the hole is the “window” of the whistle and the nose itself is the mouthpiece.
Correction of this problem is by Read more »
*This blog post was originally published at Fauquier ENT Blog*
November 6th, 2011 by Toni Brayer, M.D. in Health Tips
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Immediately Post-op Carpal Tunnel release
Carpal Tunnel Syndrome (CTS) is common and is the result of the median nerve becoming squeezed or “entrapped” as it passes through the wrist down into the palm of the hand. Because this is a sensory nerve, the compression causes tingling, burning and itching numbness in the palm of the hand and fingers. A different nerve goes to the little finger and the lateral half of the 4th finger so the sensation there would feel normal. There is often a sensation of swelling even though there is rarely any true edema that can be seen in CTS.
The symptoms of Carpal Tunnel Syndrome usually start at night when people sleep with flexed wrists. As it progresses, the tingling and numbness can be felt on and off during the day. It can cause decreased grip strength and weakness in the hands.
CTS can be worsened by medical conditions like rheumatoid arthritis, diabetes, pregnancy or wrist trauma. Women are three times more likely to develop CTS than men, and it is rare in children. Most of the time no cause is found. The space that the median nerve traverses is very tiny and it doesn’t take much to compress the nerve. Even small amounts of tissue swelling such as occurs in pregnancy can cause severe symptoms.
The treatment for Carpal Tunnel Syndrome starts with Read more »
*This blog post was originally published at EverythingHealth*
November 2nd, 2011 by ChristopherChangMD in Opinion, Research
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I read with astonishment that a class of cancer drugs known as VEGF Inhibitors (ie, Avastin and Erbitux) used to treat colorectal, lung, breast, and kidney cancers can also be used to potentially treat a type of chronic ear infection known as glue ear… at least in theory and in mice. Glue ear is when an individual suffers from repetitive ear infections or upper respiratory infections to the point where the fluid in the ear turns into a maple syrup consistency. It’s thick, sticky and tough to get rid of with standard antibiotic medications. Standard treatment to address glue ear is placement of ear tubes to allow ventilation and drainage of the ear as well as antibiotic/steroid ear drops.
British researchers using the mouse model have determined that Read more »
*This blog post was originally published at Fauquier ENT Blog*
October 29th, 2011 by ChristopherChangMD in Opinion, Research
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24 years old female presents with several week history of progressive stomach pains, substernal chest discomfort, heart palpitations, loss of appetite, headache, insomnia, and growing lump sensation in her throat. Physical exam was essentially normal.
Can this previously healthy female have suddenly developed reflux, globus, paroxysmal supraventricular tachycardia, brain tumor, and throat cancer with possible overlying thyroid disorder? Or perhaps has she contracted some other horrific mystery disease?
Maybe…
But maybe none of the above…
What if I told you she will be giving a doctoral dissertation for her Master’s next week for which she is ill-prepared given a recent breakup with her boyfriend of 5 years and a growing distaste of her school classmates who have been less than supportive.
In other words, Read more »
*This blog post was originally published at Fauquier ENT Blog*
