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Acoustic Neuromas & How We Treat Them

Acoustic Neuromas, also known as vestibular schwannoma, is a slow growing  benign tumor on the balance nerve connecting the inner ear to the brain.

This is an uncommon condition, found in roughly 1 in 100,000 people. The most common symptoms include hearing loss, tinnitus (ringing in your ear), and vertigo (a feeling of imbalance). Because these symptoms are present with many conditions, it is important to see your doctor if they persist more than a few weeks. Your healthcare provider will make a referral to an ENT surgeon or to a Neurotologist if they feel you need further evaluation. Neurotology is a sub-specialty of  otolaryngology (ears, nose, and throat) specializing in the neurological conditions of the ears and brainstem (also referred to as skull base surgery. if an acoustic neuroma is suspected). The neurotologist may conduct a clinical evaluation, hearing and balance tests and imaging studies, such as MRI, to make the diagnosis. 

Once diagnosed, there are many options to consider:

  • Observation with a repeat MRI scan in 6 months. If the scan shows no growth,  repeat scanning at annual intervals for 3 years is recommended. If the tumor size is stable, the scan will be repeated after 2 years thereafter. If at any interval the tumor grows, the other treatment options should be considered.
  • Radiosurgery is an option which ...

Surgical treatment options for GERD

Gastroesophageal reflux disease (GERD) is the most common disorder of the upper gastrointestinal track.  It's estimated that up to 40% of Americans take some form of anti-acid medication at least once a month, making it one of the most commonly used types of medication in the world. 

Heartburn is simply a burning sensation behind the breast bone, and is not necessarily from GERD.  It can be caused by a variety of other disorders, including heart disease, musculoskeletal disorders, and disorders of other parts of the gastrointestinal track, including the stomach, pancreas, gall bladder, liver, or intestine A simple way to differentiate GERD from heartburn is to take antacids or over the counter acid suppressants.  There are two classes of acid suppressants: H2 blockers like ranitidine/zantac; and proton pump inhibitors (PPIs) like prilosec/omeprazole.  If the symptom partially or completely responds, it is likely caused by stomach acid, particularly GERD.

How is GERD managed?

GERD is rarely life-threatening and can generally be managed symptomatically.  Some may ...

What to expect when your child is in the Pediatric ICU (PICU)

Just the mere mention of the Pediatric ICU (PICU) can be frightening to both kids and parents.  But having a basic understanding of what people and equipment can be found in the PICU can help to lessen the anxiety.

What is the PICU?

The PICU at Swedish is a section of the hospital that provides the highest level of medical care for your child (0 to 18 years).  The PICU is different than just the regular pediatric floor because it allows for more intensive nursing care of your child and advanced continuous monitoring of their blood pressure, heart rate, breathing and more.  Patients in the PICU may also require more intensive therapies such as ventilators (a breathing machine) and certain medications that require close monitoring.

Who is hospitalized in the PICU?

Kids who are seriously ill whose medical needs cannot be met on the regular Pediatric unit will be in the PICU.  PICU patients may have breathing problems such as asthma or pneumonia, have had a lengthy surgery, have seizures or any other physical condition.  Time spent in the PICU depends on....

Wheezing in children

Wheezing is one of the most common symptoms in children and adults. Wheezing refers to the high pitched, "musical" sounds generated from the respiratory tract. It may originate in multiple areas, from the nose, to the throat, to the lungs. When physicians use the term "wheezing", they are usually indicating the sounds produced by tightness in the lower airways ("bronchial tubes").

Wheezing is especially important in pediatrics because children have frequent respiratory infections. These infections are generally caused by viral infections which cause much irritation in the airways. In addition, the airways of children are small and more "sensitive," predisposing them to wheezing. The location of the irritation may be in the upper or lower respiratory tract. This means that wheezing can occur with just a cold as well as bronchitis or pneumonia.

Wheezing in most children will respond to treatment with ...

Gallstone disease and gallbladder removal

Gallstone disease is one of the most common reasons for patients needing surgery and the source of a great deal of misery.  Fortunately, for the vast majority of patients, gallstone disease can be dealt with safely and fairly easily.

What is Gallstone Disease?

One of the many things your liver does is produce bile. This bile is secreted into your intestine through the bile ducts. In the intestine, it acts to dissolve the fat that we eat that the fat can be absorbed by the intestine.

In between meals, a small muscular valve closes where the bile duct enters the intestine.  The bile that is produced then gets backed up into the gallbladder, which acts as a reservoir, both holding and concentrating the bile.  After a person eats, the presence of food in the stomach and duodenum sets off a signal to the gallbladder which then contracts, adding bile to mix in with the food.

Approximately 20% of people (1 out of 5) form gallstones in their gallbladder. Most stones are made of ...

Ketogenic diet as a treatment for seizures

The ketogenic diet is a high-fat, low-carbohydrate diet that has proven to be effective in the treatment of seizures. In fact, the ketogenic diet is one of the oldest and most effective treatments available for patients with seizures regardless of age, from infancy through adulthood. The ketogenic diet must only be started under direct medical supervision.

Here are some frequently asked questions about the ketogenic diet:

What is the ketogenic diet?
The ketogenic diet is a special high-fat diet that often includes heavy cream, butter and vegetable oils to provide the necessary fat. The diet eliminates carbohydrate rich foods such as bread, rice, cereals, pasta, cookies, and cakes.

How effective is the diet at controlling or eliminating seizures?
Studies that have followed children on the diet for long periods reveal that at least 2/3 of all children on the diet have a significant reduction in seizures by over half. 1/3 of children on the diet will have a greater than 90% reduction in seizures, with half of these children ....

Fecal incontinence: New treatment options

If you have been living with incontinence, you may have modified your daily activities around bowel movements.  Some people become homebound, fearing an accident in public. 

The good news is that you don’t have to live with incontinence.  Over the last few years, more treatment options have become available which can provide additional ways of improving lifestyle.

What is the cause of incontinence?

Both men and women can be affected by incontinence.  There are several causes of incontinence.  The most common causes include damage to the anal muscles or nerves during childbirth.

After a thorough history and physical examination, you and your physician will formulate a treatment plan that is right for you.  One or more treatment options may be recommended to address your particular symptoms:

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