Zepbound, the First Medication FDA Approved to Treat Obstructive Sleep Apnea (OSA)

On December 20, 2024, the U.S. Food and Drug Administration (FDA) has approved Eli Lilly's Zepbound (tirzepatide) as the first medication for treating moderate to severe obstructive sleep apnea (OSA) in adults (older than 18 years) with obesity.  OSA is a condition characterized by repeated interruptions in breathing during sleep due to airway obstruction, leading to fragmented sleep and reduced oxygen levels. Traditionally, treatments have included lifestyle changes, continuous positive …

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Risk of Burns from Jewelry NOT Removed During Surgery

It is common practice to require patients to remove all metal jewelry before surgery due to risk of skin burns. But how significant is this risk? Why would it even happen? During surgery, electric cautery is very commonly used to stop any bleeding. The device used, called a monopolar, has a small metal tip when electrically active, can result in an electrically induced burn to any tissue it touches. This is analogous to how some people can accidentally electrocute themselves when taking a bath …

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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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