Do Nosebleeds Cause Stool Blood Tests to Become Positive?

As a general rule, an ordinary nosebleed will not cause a screening stool blood test  (hemoccult or guaiac) to come back positive. However, if the nosebleed is bad enough to consider going to the emergency room... and you are swallowing a lot of it... only than will it be likely that such stool tests will come back positive for blood. To be precise, such stool tests turn positive only if there's at least 2+ teaspoons of blood leaking into the digestive system everyday (or swallowed…

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New Video on Awake Tonsil Cryptolysis to Address Tonsil Stones

A  new video  has been uploaded describing a minimally invasive technique to address tonsil stones called  tonsil cryptolysis . This technique accomplishes the same thing as laser cryptolysis but at lower cost and increased safety. Just like laser cryptolysis, this procedure can be done awake without any sedation using only local anesthesia (the caveat being that the patient must have minimal/no gag reflex with easy visualization of the tonsils). Watch the video below or on  YouTube . Read…

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Dr. Chang's 2013 Lecture Circuit

After numerous inquiries regarding conferences I will be presenting at (as well as other venues), I thought to list them all here for the year 2013... So.. for the year 2013, here you go! There's a few national conferences and even an international conference. If you happen to be present during one of my talks, give a shout-out!  (Full list can be found on my CV .) • Upcoming : Christopher Y. Chang, Wei J, Eisenberg L, Simon LM. Utilization of Social Media in Medicine. Presen…

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How Does Neuropathy Lead to Lump in Throat or Phlegmy Throat Sensation?

To preface, have you ever been to the dentist and received a novacaine injection prior to a dental procedure? Did you notice that where the injection is performed, it feels as if the area feels really swollen and also you feel like you are drooling... but than when you look in the mirror, there's no drooling and there's no swelling either? In this dental situation where novacaine got injected leading to a temporary induced neuropathy...  a similar phenomenon can also occur in the th…

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Why Would a Zenker's Diverticulum Recur After Surgical Treatment?

Zenker's diverticulum is an extremely rare disorder whereby a pouch develops in the throat leading to food and liquids getting caught causing symptoms of swallowing difficulties and food regurgitation. One of the best ways to address this rare condition is a procedure called endoscopic staple diverticulostomy (ESD) . Unfortunately, with any Zenker's treatment including ESD, there is a small percentage (~10%) that the Zenker's diverticulum recurs typically within one year of tr…

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Reflux Increases Risk of Throat Cancer by 78%

Brown University researchers found that frequent heartburn was an independent risk factor for not only esophageal cancer but also cancer of the throat and vocal cords. This conclusion was based on a large population study involving 631 patients with throat cancer and 1,234 without throat cancer as a control group. The study group also did not heavily smoke, drink, or have HPV (other independent risk factors for throat cancer). Individuals with frequent heartburn were found to have a 78%…

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T&A Helps with Pediatric Obstructive Sleep Apnea (But Watchful Monitoring OK Too!)

Researchers published in the New England Journal of Medicine  that removal of the tonsils and adenoids absolutely helps with sleep apnea in kids along with improvements in behavior, quality-of-life, overall well-being as well as significantly greater reduction in symptoms... but apparently putting off surgery does no significant harm as well from a purely cognitive perspective. 464 children ages 5-9 years of age were randomly split into surgery or watchful monitoring groups (children with…

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Pitch Perfect's Vocal Cord Nodules

Becca (played by Anna Kendrick) In the hilarious movie Pitch Perfect , Becca played by the lovely Anna Kendrick participates in an all-female a capella singing group. During a critical juncture in the movie, one of the soloist Chloe (played by Brittany Snow ) reveals she had been living (and singing) with vocal cord nodules . The movie implies that Chloe's vocal cord nodules were surgically removed and that perhaps days later, she resumed singing, though not recovered to the degre…

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Hospital Charges vs Surgeon Charges

Some of the most bitter complaints I get from patients are their hospital bills. Apparently, this complaint is not unique to me given numerous media articles about perceived outrageous hospital charges for seemingly simple procedures ( article #1 and article #2 ). The healthcare system as it currently stands establishes 2 separate charges (surgeon and hospital) with any type of procedure performed in a hospital (even if not in an operating room). There is even a 3rd charge if anesthesia is…

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Gwyneth Paltrow's Dad Had Throat Cancer

Image by Andrea Raffin from Wikipedia Gwyneth Paltrow recently divulged that her father was diagnosed with throat cancer in 1998 and eventually passed away in 2002 due to pneumonia complications. It is unclear exactly what type of throat cancer Mr. Paltrow had, but it could have been anything from tonsil cancer to vocal cord cancer . Depending on the location, symptoms and physical signs (ie, neck mass ) may have been present which ultimately would have required a biopsy. Once the…

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Beyonce Cancels Concert Due to Dehydration (and Exhaustion)

Image by Jingjing Cheng from Wikipedia Media has reported the superstar pop singer Beyonce cancelled her May 14, 2013 concert in Belgium on the advice of her doctors "due to dehydration and exhaustion". Though the rumor mill is churning with the possibility of a pregnancy, I was more interested that a concert was cancelled due to dehydration concerns. Why is hydration so important for voice production, especially in as athletic activity as singing? With hydration, the glan…

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Hearing Loss May be Caused by Aspirin, Tylenol, and NSAIDS

Researchers from Harvard and Vanderbilt reported that men who regularly take aspirin , tylenol , or NSAIDS (like ibuprofen ) are at increased risk of hearing loss . This increased risk of hearing loss is significantly higher the longer the duration of regular use (defined as 2 or more times per week) and if regular use starts under the age of 50 years. For women, however, only tylenol and NSAIDS were found harmful to hearing (not aspirin). Indeed, the conclusion is that regular over-the-…

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Woman Drinks Beer Through Her Ear

Now I am not sure if this woman is actually drinking beer through her right ear at a Czech beer festival as reported by Huffington Post , but is it anatomically even possible? Well the answer is that it IS theoretically possible though highly improbable. In order for this to occur, there must first be a hole in the eardrum . Given an eardrum hole, beer can be sucked up into the ear canal (1), through the hole in the eardrum (2), into the middle ear space (3), through the eustachian tub…

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Google CEO Larry Page Suffers from Bilateral Vocal Cord Paralysis

Image by Marcin Mycielski from Wikipedia Over the past year, there has been concern over the health of Google CEO Larry Page after missing a few important meetings and having a hoarse voice that is unusually soft and prolonged. Apparently, it's because he suffers from bilateral vocal cord paralysis . [ link ] He initially suffered from a unilateral vocal cord paralysis at the age of 14 years old. At that time, his left vocal cord became paralyzed after a viral URI . Beyond a viral…

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Nice ICD10 Booklet for ENTs

The American Academy of Otolaryngology (AAO-HNS) has put out a sample ICD10 booklet of sorts which may come very handy once ICD10 usage becomes mandatory in 2014. ICD stands for "International Classification of Diseases" and is the way physicians code for a given medical problem. It also is one way health insurance determines what tests or surgeries will be approved or not. The current ICD system being used is called ICD9. Within ICD9, an acute ear infection (whether right or…

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Does Milk Cause Increased Phlegm or Mucus Production?

For many individuals, milk and associated dairy products definitely seem to cause an increased production or thickening of mucus in the mouth and throat... the phlegmy throat . It certainly happens to me... Of course, perception is not always supported by research... "Milk and dairy product intake was not associated with an increase in upper or lower respiratory tract symptoms of congestion or nasal secretion weight. [...] We conclude that no statistically significant overall associa…

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What is the BEST Way to Disinfect a Toothbrush?

In my previous blog article , I discussed the debate over whether a toothbrush becomes "contaminated" leading to the practice of throwing them out after a strep throat infection. Although the answer is still ambiguous whether it helps or not, the fact that even NEW toothbrushes contain harmful bacteria brings even more confusion on what to do. Going on the assumption that bacteria on a toothbrush is harmful and if a new or old toothbrush contain such bacteria, perhaps the best …

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Should Toothbrushes be Thrown Out After Strep Throat?

As with so many things with medicine, this question which sounds so straightforward unfortunately has no straightforward answer. After all, there have only been a few studies that have specifically looked to answer this question. And the answer is decidedly ambiguous as the few studies done so far either support or disprove this practice. Two studies have found no difference in recurrent infections whether one keeps using an old toothbrush or replaces it with a new one after a strep th…

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