How Can Nasal Obstruction Cause Post-Nasal Drainage?

Before talking about the nose, consider the way some home humidifiers work. There is a sponge, water supply, and airflow. Humidification occurs by having a fan blow air though the sponge that is soaked by a constant water supply. As the air passes through the wet sponge, evaporation occurs resulting in air humidification. Well, the same thing occurs inside the nose. In a normal nose, about one liter of moisture is produced by the nasal mucosa every day (water supply). This nasal moisture p…

Continue Reading

After Surgery, Do Patients Have Out-of-Pocket Costs for Follow-Up Visits?

Assuming a patient has insurance, the answer is generally no for a certain period of time... For a period of time after surgery, insurance specifies that a surgeon provides any and all routine  post-operative care for "free" without any patient out-of-pocket charges. This period after surgery is called "global period" and is based on the assumption that the insurance has already paid for not only the surgery, but all the post-operative care that goes along with the sur…

Continue Reading

Washington Post Medical Mystery: Rare Severe Sore Throat Caused by Lemierre Syndrome

On Nov 3, 2009, the Washington Post Medical Mystery section published a story titled " Annoying bug turned out to be much more " where a 19 year old female presented with a sore throat which rapidly progressed to a blood clot in her jugular vein, pneumonia, and massive swelling in her neck. What she ended up having was " Lemierre syndrome " suspected by the diagnosing doctor at Georgetown University Medical Center based on the two telltale symtoms of a jugular infection and …

Continue Reading

Washington Post Medical Mystery: Pulsatile Tinnitus (Noises in the Ear)

The Washington Post on July 7, 2009 published a story on a lawyer who suffered from pulsatile tinnitus (hearing one's heartbeat in the ear) which was ultimately found to be due to a carotid artery dissection. A carotid artery dissection could have resulted in a serious ischemic stroke which thankfully did not happen. The story goes thru his experiences in trying to find a diagnosis and treatment. Keep in mind that pulsatile tinnitus is completely different from continuous tinnitus. …

Continue Reading

Washington Post Medical Mystery: A Deadly Sore Throat

The Washington Post on September 23, 2008, published a story of a severe sore throat due to epiglottitis, a severe infection involving the epiglottis, a structure immediately above the airway, which can result in death if not treated quickly. However, due to an accurate diagnosis, treatment with antibiotics and steroids was quickly provided and the patient recovered uneventfully. Read the story here .

Continue Reading

Washington Post Medical Mystery: Chronic Cough Due to Fungal Pneumonia

The Washington Post on February 5, 2008 published a story of a woman who had a chronic cough that never seemed to respond to typical treatments. Only after undergoing a bronchoscopy test was diagnosis reached... a fungal infection of her lungs. A chronic cough behooves a THOROUGH investigation of all possible causes and which unfortunately requires a multitude of tests before an explanation may be found. Read more about chronic cough and the workup here .

Continue Reading