Cocaine As A Medically Approved Medication

Many people are already aware that marijuana is now legal in some states in the US with a medical prescription.What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.Cocaine is one of the most potent anesthetic AND vasoconstrictor. These two characteristics make it an ideal medication for use during sinus surgery as well as any nasal procedure where bleeding and pain may be an issue.Many physicians...

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Dr. Chang Blog Article Re-Published on KevinMD

One of Dr. Chang's blog article on laryngeal sensory neuropathy as a potential cause of chronic cough has been re-published on KevinMD, an internationally recognized medical blog and contributor to MedPageToday.The original blog article by Dr. Chang can be read here.The blog article re-published on KevinMD can be read he...

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Pet Dogs Reduce Allergies in Children, But Cats Increase Them

Man's best friend also appears to make us healthy in more ways than one including reducing allergies in children by as much as 4 times according to new research from the University of Cincinnati. On the other hand, cats put children at risk of allergies by 13 TIMES!The data to obtain these results were obtained from 636 children enrolled in the Cincinnati Childhood Allergy & Air Pollution Study (CCAAPS), a long-term study examining the effects...

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Dr. Chang Mentioned in Newspaper Regarding Spasmodic Dysphonia

The Culpeper Star Exponent released a story on Sept 27, 2010 regarding an individual suffering from ABductor spasmodic dysphonia. This voice disorder is characterized by voice breaks while talking making it very difficult to talk as well as to be understood.This individual has been treated with botox injections by Dr. Chang who was mentioned in the article:"Taylor has one of the rarest forms of the disorder and therefore the hardest to treat. Nonetheless,...

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Mutter Medical Museum of the Odd, Strange, and Bizarre

In the spirit of Halloween that is coming up soon, I thought to share with everyone a FASCINATING museum located in Philadelphia, PA. The museum's full name is "Mütter Museum of College of Physicians of Philadelphia" and contains a fascinating collection of the bizarre aspect of medical sciences. Many of the exhibits are real and not for the faint of heart.Of course, I should mention that they have a number of exhibits related to ENT... including...

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Tilt-Table Test: An Under-Utilized Study To Evaluate Light-Headed Dizziness

We often see patients for dizziness. Many of these patients do not have an ear etiology for their dizziness given principal complaint of light-headedness, especially with standing/sitting up from a laying down position. In this scenario, a blood pressure issue is the more likely cause. Why? Because when you get up from a laying down position, gravity pulls the blood down and away from your head resulting in a transient lack of adequate blood-flow to the brain resulting in light-headedness... and even a fainting spell if severe enough.Normally,...

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Even in Hawaii, People Have Vitamin D Deficiency!

Ever since I've come across reports that Vitamin D supplementation is helpful to decrease allergy symptoms, I've encountered other interesting factoids including this one...Even in Hawaii where one would expect it's population to get plenty of sunshine, 51% ended up STILL having low vitamin D levels in a study population consisted of 93 adults (30 women and 63 men) with a mean age of 24!!! Read the study here. (For those not in the know, our bodies...

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New Drug Helps Prevent A Cough From Being Contagious

University of Alberta researchers have developed an experimental new drug that may be able to completely eliminate airborne disease transmission due to cough.The way this drug works is by reducing/eliminating the amount of droplets that is expelled during a cough by changing the properties of the lung fluid. The drug comes in the form of a spray that can be inhaled by a sick patient.It is conceived that this drug would help stop the spread of pandemic...

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There are TWO Different Allergy Shot Systems (AAAAI and AAOA)

When it comes to allergy shots, many folks are not aware that there are TWO very different allergy shot protocols available in the United States.The largest allergy shot system available is by the American Academy of Allergy Asthma and Immunology (AAAAI). The physicians who use this protocol come by way of internal medicine training.The other allergy shot system (which is the protocol we use in our office) is available by way of the American Academy...

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NPR: Injuries To Kids From Swallowed Disc Batteries Are No Joke... It Is An EMERGENCY!!!

In fact it is a STAT emergency... NPR published a story on Sept 20, 2010 regarding Chuck E. Cheese's recall of two toys (a light-up ring and glasses) due to a disc battery used to power them.These disc batteries can be access by small children if they smash apart the toy. The Consumer Products Safety Commission says two kids have had problems with batteries; one swallowed it and the other stuck it up his nose.The danger is that when a disc battery...

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UPDATE: iPad and MediTech Electronic Medical / Health Records

Ever since I wrote my initial impressions of using the iPad with Meditech EMR on June 12, 2010, that blog article has received almost a thousand hits since that time, averaging about 20 hits per day. I've even been featured in Meditech news.Also in the interval period, I have received numerous inquiries from health systems all over North America using MediTech regarding more specifics on how the iPad is used/incorporated into MediTech EMR.  Due...

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Using The Internet To Radically Misdiagnose Your Children (Humor)

Saw this from The Onion, published June 2, 2006 (Issue 42; 22)... Though this was meant to be humorous from the folks at The Onion, it does happen unfortunately...

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As A Busy Physician, Why Do I Even Bother Blogging?

As a busy ENT surgeon in private solo practice (read about me), there are several reasons why I blog (FauquierENT) even though I am already quite busy in my medical practice. As some of my readers have pointed out, it is not unusual to see blogs posted by me at all hours of the night and more commonly, early in the morning on weekends. So what motivates me?To stay up to date. There are two aspects to this statement. The first is that I am always...

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Positive Patient Feedback

Dr. Chang received a bonsai tree from Fauquier Hospital for having received positive patient feedback for the past 4 consecutive quarters. How nice!Read other patient testimonies he...

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Difference Between In-Network vs Out-of-Network Health Insurance Coverage

To read more about general ideas (copays, deductibles, etc) of how health insurance coverage works, click here.There are large health insurance companies that offer health insurance plans throughout the United States like Aetna, Anthem, Cigna, etc.HOWEVER, just because you have one of these companies, does NOT mean that the health insurance benefits that apply in the state you live in apply to the other 49 states in the United States. Sometimes,...

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The More Popular You Are, The Earlier You Get Flu (2 Weeks to be Exact)

Actual research was done regarding whether popularity predicts flu trends. Dr Fowler at UCSD and Dr. Christakis at Harvard found that "popular" friends on average get flu 2 weeks before everyone else.The way this friendship paradox works is as follows: If a person is asked to name a friend, that friend is statistically likely to be more popular than the original individual. Such "popular" individuals typically interact with more people increasing...

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Age Influences Botox Response in Patients with Spasmodic Dysphonia

Dr. Chang recently published a book chapter discussing how age influences response to botox injections in patients suffering from spasmodic dysphonia.IntroductionSpasmodic dysphonia is a dystonia (muscle spasms) involving the muscles of the voicebox resulting in involuntary attacks of a strangled sounding voice. Treatment is botox injection to the involved muscles resulting in a decrease of such spasms thereby resulting in a more smooth-sounding...

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Think MRSA Infection is Bad? NDM-1 Infection is Worse!

Image from WikipediaNDM-1 (New Delhi metallo-beta-lactamase 1) is an infection for which there is no (or at best maybe only 1 or 2) antibiotic treatment. It is the superman of superbugs.The NDM-1 actually is a gene that produces an enzyme that deactivates basically all antibiotics and is felt to have originated in India where it was first encountered.This gene most commonly is found in gram negative organisms like E. Coli and Klebsiella, but the...

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Fauquier ENT Rated #1 in Being Most Influential in Otolaryngology

According to WeFollow, a user powered Twitter directory which ranks profiles based on influence and popularity, Fauquier ENT is rated #1 in influence.We are not the most popular, however, ranked #3 behind Massachusetts Eye and Ear Infirmary as well as the American Academy of Otolaryngology Head and Neck Surgery.Check out the rankings here!Further statistics show that in the area of allergy, Fauquier ENT is ranked #15 in influence and #24 in popularity.Not...

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Humor: Breast Surgeon vs. Pathologist [video]

There has been a plethora of cartoon animated videos made thru xtranormal regarding how physicians sometimes interact with each other exaggerated to a humorous degree. Here's one regarding a breast surgeon (which can apply to any surgeon including ENT) interacting with a pathologist.There was an earlier blog post of an orthopedic surgeon vs anesthesiologist he...

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New Reason for Chronic Cough... Playing the Trombone!

NPR published a story on Sept 8, 2010 regarding a trombone player whose chronic cough for over 15 years was ultimately found to be due to a mold called fusarium as well as mycobacterium (cousin to TB) found growing inside his trombone. Each time he inhaled while playing the trombone, these germs inside his trombone was causing an allergic reaction, which led to hypersensitivity pneumonitis, a severe inflammation of the lungs. The doctor who figured...

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Dr. Chang Featured in Magazine Article on Using iPad with MediTech EMR

On Sept 8, 2010, a story was published in MediTech Magazine regarding how Dr. Chang has piloted the use of the Apple iPad with MediTech electronic medical records used in Fauquier Hospital.Click here to read the story (pdf document).Related iPad and MediTech Blog Articles:6/12/10 iPad Use In the Medical Clinic and/or Hospital For the Surgeon Doctor6/19/10 The Perfect Computer for Healthcare and Electronic Medical Records9/20/10 UPDATE: iPad and MediTech...

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Our Office Now Offers Real-Time Video Ear Microscopy

Ever wonder what your ear looks like under the microscope? Ever wonder what it looks like while an ENT is removing earwax from your ear?Ever wonder what exactly is meant by that "hole" in the eardrum along with any other findings mentioned?Well, our office now offers real-time video of everything done under the ear microscope.See exactly what the ENT sees under magnification on a TV screen while he looks into your ear!!!Or not... but at least you...

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Patients Travel From as Far as 8000 Miles Away to See Dr. Chang

A publication (Healthy Happenings Fall 2010) recently featured Dr. Chang regarding how far some of his patients are willing to travel for treatment.One patient, Craig Sutherland, comes a few times a year from the Philippines for vocal cord treatment. Another, Margot Hair, travels from Mississippi for vocal cord dysfunction treatment, also a few times a year.Such long distances that patients are willing to travel to see Dr. Chang is not unusual. At...

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Convert Your iPhone/iPod Into A Hearing Aid With EarTrumpet App!

This fascinating iPhone app called EarTrumpet was developed in collaboration with the Department of Otolaryngology Head and Neck Surgery at University of California Irvine. The app claims to convert your iPhone/iPod into a hearing aid of sorts (hearing enhancer app is the term they use) via headphones with a built-in microphone (the ear buds that come with the iPhone work just fine). In essence, the microphone will pick up the surrounding sound and...

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Voice Problems Trouble Teachers

A hoarse voice is an endemic problem in professions who use their voices a lot including preachers, journalists, lawyers, and especially teachers. In the general population, 1 in 4 report a voice problem at some point in their life. Among teachers, 47 percent report some degree of voice abnormality on any given day; 20 percent of teachers report missing work due to voice problems, and 1-in-10 teachers has been forced to leave the profession by voice...

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Dr. Chris Chang... The Ex-Cellist...

I've had plenty of patients ask me about my musical background given my Eastman School of Music Diploma in Cello Performance hanging in my waiting room.First off... I graduated from the Community Education Division of Eastman School of Music... Not the undergraduate or graduate program. However, it was a very fine education I received there which lasted from 1987-1992 (started playing the cello at age 5 until 24).In order to receive this diploma...

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Caffeine Can Cause ENT Problems

After reading an interesting article in Forbes that described caffeine as a natural pesticide (for real!), I thought I would pipe in and report the types of problems caffeine can cause in humans from an ENT perpective...Caffiene can contribute to (some proven, some suspected, some debatable):• Tinnitus• Meniere's Disease• Migraine Headaches• Headaches• Dizziness• Reflux• Lump in Throat Sensation (Globus)• Chronic throat clearing• Dry throat• Phlegmy...

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Bone Drugs May Increase Risk of Throat Cancer

Well, at least that is what USA Today reported on September 3, 2010 with the title "Bone drugs may raise throat cancer risk". In actuality, bone drugs like boniva, fosamax, actonel, etc may possibly increase the risk of esophageal cancer which is actually not "throat cancer" and is in fact treated by a totally different specialty than ENT who is historically considered the throat expert.Really, the specialty to see regarding esophageal cancer are...

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NPR on Muscle Tension Dysphonia aka (Hyper-)Functional Dysphonia

NPR reported on July 12, 2010 one woman's travail overcoming a raspy voice due to laryngeal hyperfunction (also known as muscle tension dysphonia). Voice therapy provided a cure for her condition.I should state that muscle tension dysphonia (MTD) is NOT the same as spasmodic dysphonia and the two disorders are often confused with each other... and treated completely differently from each other.MTD is when the muscles of the voicebox are too tight...

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