New Webpage on How to Give Allergy Shots Properly

A new webpage has been created describing how to administer allergy shots correctly. Often, patients are not able to get their weekly injections at the allergy office and as such, have their shots given at a more conveniently located medical office. However, many medical offices are not completely familiar with how to give allergy shots since it is administered differently than most vaccines. Incorrect administration increases the risk of anaphylaxis which everyone wants to avoid.

This webpage provides the necessary information to non-allergist health professionals as well as interested patients on how to correctly give allergy shots.

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Our Office Switching to Electronic Medical Records!

Starting on February 21, 2008, our office officially started using electronic medical records or EMR made by NextGen corporation. NextGen EMR is used by over 40 physicians in Warrenton, VA which hopefully will allow for better communication between physicians, reduced medical errors, and decreased chance of ordering tests already performed in another medical office.

Please be patient with us as we make this very difficult transition.

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New Webpage on How BOTOX Treatments Work

A new webpage has been added discussing how BOTOX treatments work. The article goes through how BOTOX achieves its effects, dosages used, side effects, and conditions treated by BOTOX injections. In particular, how one goes about adjusting the BOTOX dose is discussed in order to minimize side effects, yet achieve the desired effect.

Dr. Chang performs BOTOX injections every Friday afternoon. The list of conditions he treats can be found here.

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New Video Example of "Non-Organic Stridor"

A new video example of a young patient with audible wheezing on fast breathing due to "non-organic stridor" has been posted. Patients with non-organic stridor are often erroneously diagnosed with vocal cord dysfunction (VCD) or exercise-induced asthma. Indeed, the only thing wrong with patients with non-organic stridor is the fact they produce a wheezy noise while breathing which can be simply controlled by breathing in through the nose or slowing down their breathing rate. No medications or really any other treatment is required.

The typical patient with non-organic stridor is a young female athlete whose symptoms occur during heavy exercise. Usually, the noisy breathing is described as wheezing or stridor and most prominent on inhalation though could occur on exhalation.

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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.

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New Video Example of Vocal Cord Papillomas

A new video has been posted illustrating vocal cord papillomas. Needless to say, the vocal quality is quite raspy. Click here to watch the video.

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New ADductor Spasmodic Dysphonia Audio Samples Posted

A patient with a very mild case of ADductor spasmodic dysphonia speaking a variety of phrases has been posted. The nice thing with this case is that only when saying certain "voice-weighted" phrases does the loss of vocal fluency become most apparent. The spasmodic dysphonia can be made less apparent when speaking "voiceless-weighted" phrases. Click here to hear the various audio clips.

As an FYI, the voice-weighted phrases which accentuate ADductor spasmodic dysphonia are as follows:
• Counting from 80 to 89
• "We mow our lawn all year."
• "We eat eels every day."
• "A dog dug a new bone."
• "Where were you one year ago?"
• "We rode along Rhode Island Avenue."
• "Eeee eee eee."

These voiceless-weighted phrases are MUCH easier to say for patients with ADductor spasmodic dysphonia:
• Counting from 60 to 69
• "Peter will keep at the peak."
• "We eat eels every day."
• "When he comes home, we'll feed him."
• "Tap the tip of the cap, please."
• "Keep Tom at the party."
• "See see see."

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Books on voice therapy found to be a useful ADJUNCT to botox injections:

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