Our Blog
Tinnitus and Cognitive Therapy
by Leila Miller, PA-C, DMSc April 8, 2023
Tinnitus is the perception of sound – only heard by the patient – in the absence of an external source. They may hear ringing, ocean waves, roaring, crickets, a dial tone, sirens, hissing, buzzing, their heartbeat, and even music. It may be heard in one or both ears, or throughout the head, and is intermittent or constant. One out of six Americans complain of having tinnitus; of these, one out of three suffer from tinnitus distress.
Tinnitus distress is when tinnitus starts to elicit a constant negative emotional response, such as depression, anxiety, irritability or shame. This usually comes on abruptly and is traumatic.
There is a misconception that as there is no cure for tinnitus, there are no effective management options available to patients suffering from tinnitus distress. Many approaches exist. The most common include education, counseling, masking devices, sound therapy, dietary supplements, acupuncture, transcranial magnetic stimulation, and cognitive behavioral therapy. Cognitive behavioral therapy is the most researched, clinically proven program for tinnitus today!
Hair Loss and Covid
by Colleen Reisz, MD January 3, 2023
Most Covid-related hair loss falls under the category of telogen effluvium. This type of hair loss is reversible and is characterized by an increase in shedding. Before the pandemic, telogen effluvium was most associated with the post-partum period. Pregnancy confers complex metabolic changes on the mother that alter fluid volume, insulin sensitivity, thyroid function and ectopic fat deposition. Shedding starts 3-4 months after delivery and corrects with time over 6 months to a year. Other recognized triggers for telogen effluvium include new medications, a prolonged medical illness, surgery and rapid weight loss associated with ketogenic diets, to name a few. Telogen causes the hair to shed from all over the scalp, distinguishing telogen from androgenetic alopecia, which targets the frontal scalp and crown. Telogen effluvium should be temporary, as the loss of the hair shaft initiates the renewal process. Hair grows approximately a centimeter a month, so the first signs of regrowth are often seen at the junction of the forehead and frontal hair line.
When should I be concerned about a spot?
by Nicholas Maxwell, PA-C August 2, 2022
One of the most common questions I am asked, “When should I be concerned about a spot?”. This is a complex question without one simple answer; however, I try to alert my patients to clues their bodies are telling them. The three biggest players in skin cancer are Basal cell carcinoma (BCC), Squamous cell carcinoma (SCC), and Melanoma. Fortunately for most of these malignancies, treatment is straightforward, safe and effective...if we catch them early.
Typically, BCC and SCC will tune you into their unwanted presence. These types of skin cancers generally show up as raised or depressed bumps or sores that will never completely heal, and may periodically bleed from time to time with/without trauma. These are also going to change in size, shape and color. A good rule of thumb I tell my patients, “Any spot that is bleeding easily, not healing, or if you have a particular spot that is keeping you awake at night thinking about… come in and let me look at it”. Either I’ll let you know that it is nothing to worry about, or we can start treatment ASAP, which gives us better outcomes medically and cosmetically.
Is My Dizziness an Inner Ear Problem?
by Brian M. Hendricks, DO September 27, 2022
There are many causes of dizziness, and the word “dizziness” can mean different things. Conventionally, we think of dizziness as an inner ear problem, but this is not always the case. Typically, inner ear problems manifest as vertigo. “Vertigo” is a distinct symptom that is characterized by “spinning.” The patient may feel like they are spinning or the environment is spinning. Other symptoms, such as “lightheadedness” or “unsteadiness” are usually not inner ear related and can be caused by an number of other different problems, including blood pressure issues, cardiac conditions, peripheral nerve weakness or a problem with the central nervous system.
Understanding and defining the symptom you have can help better direct you to the appropriate provider you need to help you, and can cut down on unnecessary visits. If you are experiencing vertigo, we would be happy to evaluate and treat your condition.
What is the Best Sunscreen?
by Joseph B. Schneider DO May 17, 2022
I am often asked "Dr. Schneider, what is the best sunscreen?"
My short answer is, 'The one you don't mind putting on'.
Much like a treadmill, purchasing it is only the first step. You must use it appropriately and re-apply every few hours. If it stings or is bothersome, you are unlikely to use it appropriately. Generally speaking, I like the physical sunscreens better than the chemical type. Zinc oxide and titanium dioxide are the physical blockers. They sit on top of the skin and reflect the damaging ultraviolet (UV) rays. Most available physical sunscreens are now microencapsulated, meaning they do not look as white as the early versions of zinc oxide (like the stereotypical lifeguard of the 1970s). At dermatology offices, you can often find some that are tinted, so they blend in very well.
SPF of 15 will block out 94% of the suns harmful rays, SPF 30 get you to 97% and a 45+ is about the best you can get and maxes out at 98%. So don't be fooled into thinking 45 is 3x better than 15. The higher SPF, usually the greasier the product, so if you really hate the greasy feel, then go with the SPF 15 or 30.
