The Docs

Noise-Induced Hearing Loss

Genevieve Spiliopoulos of Rex Ear, Nose & Throat Specialists at Wakefield is board-certified in audiology. She is a member of the American Speech and Hearing Association and is also a licensed Fast ForWord® provider.

Are the crickets chirping when the sun is shining? Is the tea kettle whistling when there’s no water on? These sounds you’re hearing may be due to noise-induced hearing loss (NIHL).

I have been practicing audiology for over 15 years. I have always known about the dangers of excessive exposure to loud sounds. It wasn’t until recently, though, that I truly understood how loud the world is.

I think this realization came to me when I moved to North Carolina from New York City. Now you may say to yourself, how could this be? The City is much noisier than peaceful North Carolina, and you would be correct. The lifestyle in North Carolina, however, leads to more recreational sports, chores that expose us to loud sounds, extracurricular activities such as playing in the band, and let’s not forget about just listening to our MP3 devices at maximum volume levels.

Exposure to loud sounds over a period of time or exposure to a sudden, intensely loud sound for a short period of time can lead to noise-induced hearing loss. According to the American Academy of Audiology, approximately 36 million Americans have hearing loss. It is estimated that one in three of these individuals developed their hearing loss as a result of noise exposure. Noise-induced hearing loss is not just an adult issue, but a pediatric concern as well. There are approximately 5 million children between the ages of 6 and 19 with reported noise-induced hearing loss. Once sound levels reach 85dB, our ears are at risk if exposed to those sounds levels for longer periods of time.

Below is a chart of common sounds and their decibel equivalents:

SoundChart

How loud is too loud? There are many sound-level meter apps that can be downloaded to your smartphone. If you decide to use a downloadable app, be sure to place the phone near your ear to get an accurate reading.

If you don’t feel like using an app, there are some other common sense ways of knowing how loud is too loud. If you have to raise your voice to be understood by someone you are talking to, if the noise physically hurts your ears or if you develop a ringing or hissing sound in your ears, then your environment is too loud. You should either walk away or use hearing protection.

There are various types of hearing protection, and their appropriateness is dependent on each person’s needs. At the very least, if you find yourself in a noisy environment, use disposable earplugs, which are sold at most drugstores.

However, if you are routinely exposed to loud sounds, you should seek advice from your audiologist on the most appropriate hearing protection to suit your needs. Noise-induced hearing loss is 100% preventable as long as consistent and proper hearing protection is used in dangerously loud environments.

Whether you are hunting, mowing the lawn, riding on an ATV, playing the saxophone in your school band or just listening to your tunes – protect your hearing. Your ears will thank you for it!

Genevieve Spiliopoulos recently joined Rex Healthcare’s newly opened Ear, Nose & Throat Specialists at Wakefield.  In addition to Genevieve Spiliopoulos, audiologist, the practice also consists of two board-certified otolaryngologist, Dr. Brett Dorfman and his colleague, Dr. Esa Bloedon.

The new practice provides a full range of medical and surgical ear, nose and throat treatment for adult and pediatric patients. In partnership with Rex, a member of UNC Health Care, patients have access to all of the resources and specialty care that Rex and UNC have to offer.

Call 919-570-5900 to schedule an appointment.

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Tips for Common Winter Infections

Dr. DorfmanDr. Dorfman of Rex Ear, Nose & Throat Specialists at Wakefield is board-certified in Otolaryngology. His clinical interests are medical and surgical diseases of the ear, pediatric ENT, allergy, and head and neck, sinus, thyroid, facial plastic and reconstructive surgeries.

It wasn’t long ago that we were all enjoying those last few long summer days with lots of sunshine and warm weather. But, the reality is clear. Winter is here, and this is prime time for colds, influenza (flu), and other respiratory illnesses.

While viruses are active year-round, fall and winter are when we’re all most vulnerable to them. This is due in large part to people spending more time indoors with others when the weather gets cold.

 What can you do to avoid getting sick?

  •  Wash your hands often. Teach children to do the same. Both colds and flu can be passed through coughing, sneezing, and contaminated surfaces, including the hands.
  • Alcohol-based hand rubs may be used if soap and water are not available. They are not as effective if the hands are dirty.
  • Try to limit exposure to infected people. This is particularly important for premature infants, children with significant asthma, and those that are immunosuppressed.
  • Practice healthy habits:
    • Eat a balanced diet.
    • Get enough sleep.
    • It can help the immune system better fight off the germs that cause illness.
    • Do your best to keep stress in check.

It can be hard to differentiate between a common cold and a sinus infection (sinusitis).

How can you tell if you have a sinus infection instead of a cold?

Colds:

  • Common colds are viral infections that usually last for 5 to 10 days.
  • Symptoms are most severe between days 3 or 5, and then improve and disappear.
  • Nasal discharge usually starts clear and watery, and after a day or two, the nasal discharge may become thicker with white, yellow, or green color.
  • After several days, the discharge becomes clear again and dries.

Sinusitis (Sinus Infections):

  • Sinusitis is an inflammation of the mucosal lining of the nose and sinuses.
  • The infection can begin with inflammation from a viral cold, which can lead to narrowing of the drainage passages of the sinuses. This narrowing can also be related to swelling from an allergy flare up.
  • Symptoms like nasal discharge, headaches, and facial pressure last more than 10 days without improvement or get worse after a week of a common cold.
  • The headaches in sinusitis in general are behind or around the eyes, and they get worse when bending over.

Once you have figured out if what you have is a cold or a sinus infection, what is the best way to manage the infection?

Colds:

  • Common colds are treated only with over-the-counter medications based on the symptoms they cause.
  • Decongestants for difficulty breathing through the nose are available in oral forms, notably pseudoephedrine (e.g. Sudafed), and topical sprays, i.e. oxymetazoline (Afrin). Note that the decongestant sprays can be used for a maximum of 3 days.
  • For those with thick mucus or pus from a common cold, nasal rinses and neti pots are useful to irrigate the nose.
  • Ibuprofen (Motrin, Advil) and acetaminophen (Tylenol) work well for pain.
  • Thick mucus in the nose and chest can be treated with guaifenesin (e.g. Robitussin, Mucinex), and dextromethorphan (Delsym) is helpful for cough.

Sinusitis (Sinus Infections):

  • For a bacterial sinus infection, all of the same over the counter medications and treatments listed above can be helpful for symptomatic relief.
  • However, in the case of a bacterial sinus infection, antibiotics (and sometimes oral steroids) are also indicated, so see your health care provider to confirm the diagnosis and get an appropriate prescription.

Dr. Brett Dorfman recently joined Rex Healthcare’s newly opened Ear, Nose & Throat Specialists at Wakefield. Board certified otolaryngologists Dr. Dorfman and his colleague, Dr. Esa Bloedon, have a combined 22 years experience in Raleigh.

The new practice provides a full range of medical and surgical ear, nose and throat treatment for adult and pediatric patients. In partnership with Rex, a member of UNC Health Care, patients have access to all of the resources and specialty care that Rex and UNC have to offer.

Call 919-570-5900 to schedule an appointment.

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AAA: Abdominal Aortic Aneurysm and How It’s Treated

Post featuring Jason K. Kim, M.D. Dr. Kim is a vascular surgeon and a member of Rex Vascular Surgical Specialists. He is double Board Certified by the American Board of Vascular Surgery and American Board of General Surgery. 

The aorta is the largest artery in the body. It carries blood from the heart to all the vital organs in the body and to the legs and feet. An abdominal aortic aneurysm (AAA) can occur when the wall of the aorta weakens and it begins to bulge. If undetected, this bulging aorta can grow larger, silently and without symptoms, and eventually rupture. The risk of rupture is related to the size of the AAA, and rupture of the AAA can lead to severe internal bleeding and death.

If detected early, AAA can be permanently cured. It is estimated that more than a million people are living with undiagnosed AAA, and over 95 percent of these can be successfully treated if detected prior to rupture. AAA causes very few symptoms, but some patients may feel a pulsing sensation in their abdomen, or severe unexplained pain in their abdomen or back. Nearly two-thirds of patients who suffered a ruptured AAA never knew they had the aneurysm until it ruptured.

Risk factors for AAA include age over 60-years old, history of smoking, family history of AAA, high blood pressure, and COPD or chronic lung disease. A painless and risk-free ultrasound based screening can diagnose AAA and determine the need for treatment. Men who have smoked at least 100 cigarettes, and men and women with a family history of AAA should undergo a screening ultrasound.

Once diagnosed, treatment options include medical management, minimally invasive endovascular stent graft repair, and open surgical repair of the aneurysm. The safest and most appropriate treatment of the AAA will depend on the size, location, and other anatomical factors that will be determined by your vascular surgeon. The vascular surgeons of Rex Vascular Surgical Specialists at Rex Healthcare have undergone specialized training and have full access to the most advanced endografts and tools available to successfully treat AAA.

Call 919-784-2300 to schedule your screening AAA ultrasound with Rex Vascular Surgical Specialists.

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No Incision, No Problem


Post featuring Dorian J. deFreitas, M.D. Dr. deFreitas is a vascular surgeon and a member of Rex Vascular Surgical Specialists. He is board-eligible in vascular surgery and board-certified in general surgery. 

The aorta is the largest artery in the body. It starts at the heart and runs down the chest and abdomen until it divides to supply the legs. If the walls of the aorta weaken, a bulge can develop, which is called an aneurysm. If it is not treated, it can rupture and cause life-threatening problems.

“Our noninvasive approach involves making a small puncture in the skin, eliminating the need for an incision,” says Dr. deFreitas. “We evaluate if patients are candidates for this approach based on several factors, including the aneurysm’s shape and location and size and the amount of calcium in the wall of the femoral vessels.”

During the procedure, a graft is inserted through the puncture site, under fluoroscopic guidance, and it is deployed in the aorta. The hole in the artery is closed using a series of percutaneously placed sutures. When the graft is released the blood flows through it, allowing the aneurysm to shrink and eliminating the threat to the patient.

“We have excellent results with this approach,” Dr. DeFreitas says. “Patients are usually ready to go home the next day after surgery, and they have minimal post-operative pain.”

For more information on this noninvasive procedure, please call Rex Vascular Surgical Specialists at (919) 784-2300 or visit rexvascularsurgery.com.

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Medical Emergency? You Are in Expert Hands

What is an emergency physician?

Of all the medical specialties, emergency medicine may be the most demanding. Emergency physicians work any time of the day or night. In a single shift, they may see dozens of patients in a hospital emergency department. And while other specialists are expert in one field of medicine, emergency physicians are highly trained to treat all manner of diseases and injuries. Read more…

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Anniversaries – An Excuse for Reflection

Dr. Yale PodnosDr. Yale Podnos is the director of Surgical Oncology at Rex Cancer Center and a Surgical Oncologist at Rex Surgical Specialists. Dr. Podnos specializes in surgical oncology focused on liver, colon and solid organ tumors.

I have been in Raleigh for six years. And what a six years it’s been!

The time has seen a son born, friends made, colleagues arrived, and patients cured. Since anniversaries are an excuse for reflection…

The most incredible thing I have learned in this time is not to underestimate people. I have seen so many people, in such dire circumstances, exude levels of poise and dignity I didn’t know people had and don’t think I am capable of. Read more…

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Sunscreen: True or False?

Dr. David TsaiPost by David Tsai, M.D. of Rex Primary Care of Holly Springs. Dr. Tsai is the medical director at Rex Primary Care of Holly Springs. He is a board certified family physician with a focus on primary care and sports medicine. To schedule an appointment with Dr. Tsai, please call (919) 552-8911.

Summer is finally here and the sun has been scorching. Are you a master of the tan or a raisin ready to happen? Read on to find out which of the following statements are true or false.

  1. SPF (sun protection factor) indicates protection from UVA and UVB.
    False! SPF is only a rating on a sunscreen’s ability to block ultraviolet B (UVB) rays. UVB causes sunburn and skin cancer. UVA causes skin aging/wrinkles and skin cancer.
     
  2. SPF 30 is 2x’s better than SPF 15.
    False! SPF 15 products block about 94% of UVB rays, and SPF 30 products block 97% of UVB rays, and an SPF 45 products block about 98% of rays.
     
  3. Read more…

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Mind Full or Mindful?

Dr. Grace TangDr. Grace Tang is a physician with Rex Family Practice of Wakefield. Her “A day in my life” blog series brings you an inside look at the daily routine of a family physician, both inside and outside of the office.

I was eating lunch at my desk about half a year ago, quickly wolfing it down in the 15 minutes before the afternoon session started. The following is a list of everything I was thinking and doing in that 15 minutes:

  • Eating (of course)
  • Answering patient messages
  • Refilling medications
  • Intermittently answering questions from passersby
  • Figuring out what to make for dinner
  • Making a grocery list
  • Charting patient notes from the morning
  • Making lists of gifts I needed to get for birthdays
  • Making a list of chores I needed to complete that evening
  • And on and on…

What did I eat? No idea. What did it taste like? No idea. What did I get done? Not much! I got a lot of partial stuff done, probably forgot to do some stuff. Also, at the end of my 15 minute break I felt stressed! Read more…

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Show me the Money!

Dr. Grace TangDr. Grace Tang is a physician with Rex Family Practice of Wakefield. Her “A day in my life” blog series brings you an inside look at the daily routine of a family physician, both inside and outside of the office.

Everyone knows smoking is not good for their health. For example, it:

  • Increases risk of heart disease by 2-4 times
  • Increases stroke risk by 2-4 times
  • Increases the risk of men developing lung cancer by 23 times, women by 13 times
  • Increases the risk of dying from emphysema by 12-13 times
  • Increases the risk of leukemia, bladder cancer, cervical cancer, esophageal cancer, kidney cancer, voice box cancer, mouth/ oral cancer, pancreatic cancer, stomach cancer
  • Increases the risk of infertility, preterm delivery, low birth weight, SIDS

Although the list of serious, life threatening health effects goes on and on, sometimes it’s not quite enough…a little extra nudge is needed. Read more…

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Fun in the Sun

Dr. David TsaiPost by David Tsai, M.D. of Rex Primary Care of Holly Springs. Dr. Tsai is the medical director at Rex Primary Care of Holly Springs. He is a board certified family physician with a focus on primary care and sports medicine. To schedule an appointment with Dr. Tsai, please call (919) 552-8911.

Following my last blog post on encouraging everyone to exercise, we need to be smart and safe exercising in the heat. Every summer we hear about heat related illness. It kills an average of 318 Americans every year and puts hundreds more in the hospital. The good news is it’s one of the most preventable injuries.

Heat illness can be as mild as heat cramps but can progress to heat exhaustion and later to heat stroke. Symptoms occur when the body is unable to deal with high temperatures and is unable to cool itself. Read more…

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