Subaqua Sternal Rubs

Well, it turns out ENT's do more than removing wax build up out of ears. (I am just kidding, but it does seem that most patients seem to get this service preformed.) After interviews were completed, the members of my group and I took turns examining patients. My patient today was a 13-yo female who was complaining of headaches and dizziness for a number of years. Her ear canals were completely clear, so she avoided that service, but my otoscopic technique elicited a laugh from our preceptor, as my 6′3″ self had to kneel on the ground to get anywhere near the patient's ears. The rest of the exam was normal, except we were able to elicit some nystagmus on lateral gaze. She was diagnosed with vertigo, given a prescription and told to come back in a week for further investigations if things didn't clear up. A logical approach, I think - I mean if it hasn't killed her in 5-10 years, then a week shouldn't matter. Much different from the US, where she would have gotten a CT/MRI immediately to search for zebras and attempt to avoid litigation. (There is a saying in medicine: When you hear hoof-beats, don't think zebras, i.e. what's common is, well, common.) There was also a patient who presented with a swelling on the left side of her face. She was recovering from surgery to remove a lipoma from near the parotid gland, and when asked what could be causing the swelling, I immediately thought blood (since I am that kind of blood and guts person), and said "hematoma." Well, unfortunately I was wrong, and it ended up being a large amount (~40cc) of saliva that was leaking from the parotid. The ENT scheduled her for surgery to place a catheter that would drain the saliva continuously through the Stetson's duct into the mouth. She got quite a deal — only 200EC (around $68US) for the second surgery, as the first surgery cost 1000EC (around $375US), which still isn't bad considering the cost of health care in the US…

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