New Webpage on Temporomandibular Joint Disease (TMJ)

We have a new webpage on TMJ disorders uploaded. As most people know, TMJ is a joint found immediately in front of the ear where the jaw joins with the skull. What many people may not recognize is that TMJ disorders have numerous symptoms which is often confused as coming from the ear when in actuality, there is nothing wrong with the ear. Such symptoms include ear pain, crackling/popping in the ear, tinnitus (ringing in the ears), pulsating sounds in the ear, etc. Strategies to treat TMJ is also discussed on the webpage.

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www.VirginiaHearing.org

Fauquier ENT has offered hearing tests, hearing aids (dispensing and repairs), custom ear molds, and assistive listening devices for over a decade. In order to better promote and make our community aware of what we offer, a new web address has been created called:

http://www.VirginiaHearing.org

This web address will take a person directly to our audiology section of our main website (www.FauquierENT.net).

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Hear Better & Improve Your Quality of Life!

What to Expect With Hearing Aids
There are three important rules to remember. First: the most important thing to remember is that “We hear with our brain, not with our ears”. Second: hearing aids will not restore normal hearing. Hearing aids help your damaged auditory system work as well as it can. Third: hearing aids are only half of the process towards better hearing. You will be learning to listen and process sound again. Everything will sound different. Voices will be louder and clearer. Your own voice may sound strange. There will be different sounds in your environment that were not there before. Expect a period of adjustment.

History of Hearing Aid Technology and Circuitry
1950 – Analog
1990 – Analog Programmable
1996 – Digital
2004 – Open Fit and Receiver-In-The-Canal
2007 – Wireless Bluetooth

What Hearing Aids are Best
There are several different hearing aid manufacturers on the market. The manufacturers that our office works with primarily are WIDEX, OTICON, and PHONAK. Hearing aids are manufactured with different sizes of shell styles and internal circuitry. Styles are either in-the-ear or behind-the-ear. Hearing aid internal circuitry ranges from entry level to advanced. All of the aids dispensed at our office have the most technologically advanced circuitry, ensuring the best sound quality available. The four factors to consider when choosing an aid are (1) type and degree of hearing loss (2) lifestyle and listening environments (3) dexterity and vision (4) budget. The most appropriate level of circuitry for each individual will depend on these four factors.

The Bottom Line
The cost for one hearing aid ranges from $800 to over $3000 depending on the style and type of circuit selected. In our office, the cost of a hearing aid is determined by the level of internal circuitry and not the shell style.

A complete hearing evaluation takes only minutes and you could be on the road to better hearing.

Our office also provides custom ear plugs for musicians and swimming as well as assistive listening devices & technology such as infrared loop systems for TV and radio, amplified phones, personal body-worn amplifiers, and FM systems.

A full list of our audiological services can be found here.

http://www.VirginiaHearing.org

--Catie Chalmers, MS, CCC/A

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Washington Post Medical Mystery: Severe Chronic Sinus Headache

The Washington Post on November 13, 2007 published a story of a gentleman who suffered from a sharp headache due to Sluder's neuralgia centered in the "anterior ethmoid neurovascular complex".

The amazing thing about this story is that the patient himself figured out what was causing his headache by finding a reference on a microfiche he found in a 1963 article in the British Journal of Laryngology & Otology.

Read the story here.

To read the 1963 journal article entitled "The Anterior Ethmoid Nerve Syndrome" describing this patient's condition, click here.

There was a subsequent correspondence to this article (periodic migrainous neuralgia) you can read here.

Read more about this problem here.

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New Videos Produced Showing How Trans-Nasal Endoscopy is Performed

A couple videos have been produced by our office showing how a trans-nasal endoscopic exam is performed and what one would see from this type of exam. Instead of publishing these videos on our website, they have been added to our YouTube homepage. The videos can be found here or viewed below in the embedded player.

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Fauquier ENT Technorati Homepage Created

Our office has created a homepage presence on Technorati, a leading monitor of weblogs. Check us out here!

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Creation of Our Practice's Website

OR, stated another way, "How much did our physician website cost?" So, there have been a few requests over the years on how our website was created which prompted me to write this particular blog where I will go into the details and costs.

•• Summary of Costs ••
Before I go into details, it is important to make sure the costs of running a website is reasonable. After all, if the costs do not justify the expense, no point having a website. A recent blog describing the current costs of setting up a website can be found here.

In any case, here is an overall summary of how much it costs me (one of the physicians in the practice) to develop and maintain our practice's website excluding costs related to time spent. It does help that I as a physician know how to make websites that helps keep costs down.

Expenses
Our domain name "www.FauquierENT.net" purchased at GoDaddy.
• $9.99 per year
Hosting on a Godaddy server the website:
• $50.88 per year
A 128-bit secure SSL for online prescription requests, website email form, appointment requests, etc purchased at Wufoo. Obviously, this is an optional expense. One could just as easily create a webpage stating to call our office for prescription refills or make a form that a patient would have to print out and than fax.
• $24 a month ($288 per year)

Profits
Google Adsense from targeted online advertisement
• About $25 a month ($300 per year)

The wufoo account for online prescriptions, website email, appointments, etc is actually kept as an office expense. The profits I keep to help defray the costs of my expenses maintaining the website.

Keep in mind that our website contains >200 webpages since most web development companies charge for each additional webpage created and maintained.

•• Creating the Website ••
To put it bluntly, one must have some knowledge of how to program in HTML if one wants to have a reasonable appearing website. The creation and maintenance of the website is all performed on my Macintosh MacBook Pro laptop where I have the entire website mirrored on my hard drive. Changes are made on this mirrored website on my computer's hard drive, checked for errors, and than uploaded onto the internet. Given this background, I use the following programs:

Adobe Dreamweaver
My true workhorse program for creating all the different content, images, video, audio, links, etc on the website. Think of it as the Microsoft Word for text documents.

Adobe Photoshop
Powerful graphics program I use to optimize images for web production.

iMovie HD
Free program for owners of Mac computers, I use this program to perform all video editing for web production. This program was heavily used for all the audio-visual effects of the hoarse voice section of our website. The videos themselves were produced on a KayPentax digital system using a chip-on-tip flexible scope.

Adobe Flash
Program used to create the interactive elements of the website. It is used in conjunction with Adobe Dreamweaver. This program is what allows for color changes when a cursor passes over a link or simple animation like a photo slideshow.

DreamsTime
Purchase royalty-free clip art to add to your website for a very low price (less than one dollar). Important as you can't just use random artwork in other websites due to copyright infringement concerns.

Microsoft Word and Adobe Acrobat
These two programs were used to create all forms and documents for patients to download and print at home. Adobe acrobat is the program used to create pdf files which can be opened on any computer whether it be a Windows PC, Mac, Linux, etc.

That's pretty much all that is needed to create and maintain a website!

•• Miscellaneous Website Enhancements ••
So there are various features I have added to the website to make it more useful for visitors such as a google search engine, real-time allergy report, interactive map of our office location, etc. The key thing here is that all these various features are FREE as again, my main motivation is to make the website better without adding cost.

Google Account
This is by far the most important free account to have as Google provides so many free services that many other companies would charge for. Through this account, you can:
• Obtain infinite number of free email accounts with your domain name for everybody in your office (ie, userid@FauquierENT.net). Some knowledge of server protocols is needed, but google does provide a step-by-step instruction.
• Create/Edit your listing under Google's yellow pages.
• Create a Blog (this one!).
• YouTube account for videos.
• Webmaster services to optimize the website for being found by google's search engine.
• Adsense account to insert targeted advertisement within the webpages for which you can get paid
• Get a google search engine for your website.

Google Maps
Add a google map to your website for free pinpointing your office's location. Some programming knowledge is needed.

FeedBurner
A google owned website where you can link info within a blog to your website automatically. You can see this in action on our practice's website (the rotating headlines towards the bottom). This services also provides free enhancement utilities to improve your blog.

Statcounter
Free service which will inform you about your website visitors: how many, which webpages, how long were they on each webpage, what webpages a given visitor saw and in what order, at what time, from where in the world, etc. This is EXTREMELY important information that allows you to figure out how to improve your website from a visitor's perspective.

Pollen Report
Free pollen count report can be added to your website for free. Some programming knowledge required.

Free Web-Based Surveys
Surveys are wonderful tools to determine what patients think of your practice. In the case of a website, it allows you to tap into their thoughts should they volunteer to answer questions you pose to them. SurveyMonkey as well as Wufoo both provide free web-based surveys as well as a more sophisticated format that costs money. I think that for most practices, the free version provides everything you would need. The survey we currently have on our website is located here.

www.LinkTiger.com
This free web-service checks your website weekly for any broken links. That way you can immediately make changes to keep all links functioning because nothing is more aggravating to a website visitor than a website full of broken links.

•• Time Factor ••
People have asked me how much time have I spent creating and maintaining the website. The answer is continuously. Although there may not be any changes needed, I'm constantly thinking of ways to make it better. Questions I keep asking myself are:

• What can I do to make this webpage look better?
• Can I add a piece of relevant artwork without making the webpage too long?
• Why do visitors spend only 5 seconds on this webpage, but 10 minutes on another?
• Are there any new webpages I can add to increase visits to the website?
• Etc

I honestly can't say that our practice's website will ever be completed. Though I don't spend hours and hours every week on it, I do spend a few minutes making minor changes several times a week. Making minor changes on a website takes no longer than making minor changes in a MS Word document, but instead of "saving" the changes, one "uploads" onto the internet any changes.

•• Summary ••
I hope this info is helpful for other medical practices thinking of adding a practice website without the costs from hiring a Web Development Company. I do feel that having a website is imperative in this day and age and I absolutely believe that it has enhanced our practice both in attracting new patients who may have gone elsewhere as well as retaining current ones.

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