Decongestant Nasal Spray Addiction (Afrin, Zicam, Sinex, Neo-Synephrine, etc)

I see about 3-6 patients a month for what I consider a decongestant nasal spray addiction . The typical story starts with a upper respiratory infection causing nasal congestion and obstruction. The patient then goes to the store and gets a decongestant nasal spray (ie, Afrin, Zicam, Sinex, Neo-Synephrine, etc) which works great to open up the nasal passages. Unfortunately, even though the upper respiratory infection seems to have resolved, the nasal congestion and obstruction persists leadin…

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How is a Throat Biopsy Performed?

Not uncommonly, a mass is discovered in a patient's throat whether by endoscopy or discovered on a CT or MRI scan incidentally. Depending on the concern (ie cancer), a biopsy of the mass may be pursued. The question many patients have is exactly how the biopsy is obtained given the growth is not easily accessible (unlike a growth in the mouth which can typically be biopsied in the clinic without sedation). There are basically two "flavors" of how a throat biopsy is obtained. If th…

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Understanding a Thyroid Ultrasound Report of a Nodule: The TI-RADS (TR) Score!

Getting a thyroid ultrasound for a thyroid nodule is VERY common. The main concern is whether thyroid cancer may be present which peaks in women around age 40-50 years and in men usually around age 60-70 years. However, thyroid cancer can occur at any  age. Given many patients are able to obtain a copy of their ultrasound reports, it may be educational to understand what is being stated beyond the obvious size description. The KEY information patients should look for in an ultrasound report of…

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Over the Counter Hearing Aids Give Rise to DIY Fixes and Troubleshooting

Historically, hearing aid purchase required seeing an audiologist for hearing testing, hearing aid selection, hearing aid programming, and hearing aid fitting. That's because hearing aids unfortunately are not a one-size-fits-all solution to correct hearing loss due to the complexities of restoring hearing from a wide range of hearing loss patterns to a huge variety of different ear canal shapes/sizes. Of course, when an over-the-counter hearing aid is purchased, the end-user is now respon…

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Adult Tonsillectomy Pain Levels Over Time (0 to 4+ Weeks)

Unlike children under 12 years who undergo tonsil removal surgery, adults undergoing tonsillectomy  is perhaps one of the most painful recoveries anyone will ever experience in their lifetime. The pain can be quite vicious and prolonged, typically lasting about 3 weeks. Adults on average lose about 5 pounds due to inability to eat solid foods and decreased caloric intake. In spite of a liquid diet and multiple prescriptions for pain control , it is still a miserable recovery. In our office, 3 …

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World Cup Soccer Player Wearing Face Mask After Facial Fracture

Son Heung Min South Korean soccer star and captain, Son Heung Min, was seen wearing a face mask during the World Cup in Qatar in November 2022. This was due to an orbital facial fracture to his left eye during a Champions League match for Tottenham for which he had to undergo surgical correction. This fracture was sustained when his face collided with Marseille defender Chancel Mbemba.  Another World Cup soccer player, Croatian Josko Gvardiol, also was seen sporting a face mask to protect a br…

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