Do NOT Use Decongestant Nasal Sprays (Afrin, Sinex, 4Way, Phenylephrine, etc) for More Than 3 Days!!!

It says so right on the packaging materials. Although decongestant nasal sprays work great to relieve nasal congestion quickly, when used for more than 3 days, these nasal sprays may actually CAUSE nasal congestion leading many individuals to start using these sprays longer and more frequently. In essence, the nose becomes addicted to the nasal spray. When stopping the nasal spray use, the rebound nasal congestion can be quite severe lasting several weeks. The medical diagnosis is rhinitis medi…

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3 Easy At Home Tests for Cervicogenic Vertigo or Dizziness (Vertigo Triggered by Head Movement Due to Spine Problems)

Transient dizziness or vertigo that occurs with head movements is often attributed to a vestibular problem like BPPV  (displaced inner ear crystal). However, cervical spine problems that have nothing to do with the inner ear can also elicit vertigo attacks with head movements. Additional symptoms that suggest a cervicogenic source of dizziness instead of the inner ear include history of headache, neck pain, and limited cervical range of motion. There are three bedside tests which can furth…

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How Popping the Ear can Help Diagnose Serious Heart Conditions

The Valsalva maneuver is a simple procedure that involves the patient exhaling forcefully against a closed airway, typically by closing the mouth, pinching the nose, and blowing as if trying to inflate a balloon.  It is the maneuver used to help clear a clogged ear when flying or swimming deep underwater.  Interestingly, this maneuver can also help diagnose serious heart conditions like aortic stenosis or hypertrophic obstructive cardiomyopathy, a condition that often leads to sudden death in …

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Sudden Sensorineural Hearing Loss Due to a Virus (Pathological Evidence)

At least once a month, I encounter a patient who has suffered a sudden onset significant hearing loss in one ear. One moment, hearing was fine... and the next moment, hearing had significantly degraded without any apparent  triggering event (ie, shooting gun, loud fireworks, loud concert, etc).  No other symptoms are present. Just the hearing loss. Ear examination is normal without any earwax or ear fluid presence. Hearing test shows nerve hearing loss present in the affected ear. There are s…

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SCAM Alert! Scam Emails Pretending to Come From Medical Practices (Including Our Own)

This email is a SCAM! Note the @tidewater.net domain name. A patient recently alerted my practice of a scammer sending emails pretending to come from our medical practice. Here is a picture of what the email looked like. THIS EMAIL IS A SCAM and did NOT come from our office! Note the sender's domain @tidewater.net which is not associated with our practice (even though the username preceding the @ contains the word "fauquierent"). Any emails from our office will either be from @F…

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Epipen Alternative That is a Nasal Spray! (And One Warning Against Its Use)

Called Neffy, it was approved by the FDA on 8/9/24. Neffy is a single dose nasal spray administered into one nostril. As with epinephrine injection products, a second dose (using the new nasal spray to administer neffy in the same nostril) may be given if there is no improvement in symptoms or symptoms worsen.  The cost of neffy is anticipated to be around $199 for two doses via digital pharmacy sites like GoodRx and around $25 for commercially insured patients through a co-pay savings progra…

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