Doctor Column

The nose is a rigid passageway that allows air to pass into the lower respiratory tract. In infancy, air passing through the nose is the primary way how the infant gets oxygen into the lungs. If there’s a significant nasal deformity or blockage in the back of the nose causing air hunger, surgery may be vital to save the infant’s life. In adults, nasal obstruction in compromised patients can also have life threatening consequences. The heart, brain and other organ systems cannot survive without oxygen and it’s important to note how air is delivered to the lungs.

At times, a mother is faced with a worrisome decision, “Should I allow my child to undergo surgery?” Regardless of the type of surgery the child needs or whether he is 13 months old, 23 months old or older, the words “surgery or operation” makes the parent nervous. For the surgeon, to operate on a 13 month old child who weighs 19 pounds makes him think hard and ask, “Why operate?”

Peggy, a 29 year old wife of a Veterinarian saw her physician because of “pus pockets” on her tonsils and “my breath stinks.” At times, white stuff pops out of the tonsil with an awful smell and taste.” It had worsened over the previous eight months in spite of the use of over the counter medications and home remedies. Now her husband is complaining about her bad breath. It has had a terrible effect on how she feels about herself.

In an adult, it’s easy to diagnose a nasal fracture when the nose is “bent out of shape”. However, a broken nose in an uncooperative child with swelling around the nose and face can go undiagnosed. Unrecognized nasal fractures can have serious consequences.

Atrial Fibrillation (AF) is the most frequently encountered cardiac arrhythmia. The degree of patient awareness varies widely, from highly symptomatic patients experiencing chest pressure, shortness of breath, dizziness to those who are completely oblivious. The perceived presence or absence of AF does does not lessen the risk of stroke.

Acute External Otitis (AEO), known as Swimmer’s Ear, is a diffuse infection of the ear canal usually due to bacteria which at times causes horrific pain. It can spread beyond the ear to the jaw and neck glands making it difficult and painful to open your mouth, chew and swallow.

Allergic Rhinitis (AR) has been called Rose Fever, Spring Fever, Summer Cold, and Hay Fever. But, it does not cause a fever. It is not the common cold and it’s not limited to one season… Incidentally, how many people do you know who are allergic to hay?

“I can hear you Doc, but I can’t get a grip on the words”
“Doc, people mumble all the time, they don’t speak up.”
Another patient put it this way: “Have you ever driven on the highway and listened to the same radio station for 40 or 50 miles and then the reception breaks up? Well, that’s how I hear people. When I hear people talk, I don’t have the clarity that I once had.”

Nosebleeds (“epistaxis”) have been a bloody nuisance from the time of Hippocrates to the present. It’s a common problem that can occur at any time, in any place and in any season. It’s most common in children from two to ten years of age and more frequent during the winter months. A blood vessel ruptures, the nose bleeds, parents are rightfully concerned and ready to rush the child to the emergency room.

For years physicians have struggled to identify the optimal blood pressure for a given patient population. The group of experts collectively known as the JNC (Joint National Commission) has been historically tasked to address the use of antihypertensive agents. Every few years, the JNC publishes recommendations on various topics as they relate to hypertension.