Top10MD Blog


 3 months ago    Leave a comments (0)

With kids heading off to camp this summer and families headed to the mountains or camping outdoors ticks can be a problem if not a life-long problem if infected with Lyme Disease or other tick related diseases. “It’s a good idea to take preventive measures against ticks year-round, be extra vigilant during the months of April-September when ticks are most active,” says Dr. Jeffery West Ticks transmit over ten diseases to humans and pets. Some of these diseases can be debilitating for the rest of you or your child’s life; it’s important to seek immediate care. Early recognition and treatment decrease the risk of serious complications later on.

Approximately 300,000 people in the United States are diagnosed with Lyme disease yearly; while only 30,000 of these are estimated to be reported to the CDC by state health departments. Ninety-six percent of Lyme disease cases come from 13 states.


  • Avoid direct contact with ticks
  • Avoid wooded and brushy areas with high grass and leaf litter
  • Walk in the center of trails


  • Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours.
  • Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.
  • Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. It remains protective through several washings. Pre-treated clothing is available and may be protective longer.


  • Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks that are crawling on you.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs.
  • Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.
  • If the clothes are damp, additional time may be needed.
  • If the clothes require washing first, use hot water. Cold and medium temperature water will not kill ticks effectively. If the clothes cannot be washed in hot water, tumble dry on low heat for 90 minutes or high heat for 60 minutes. The clothes should be warm and completely dry.


  • Remove the tick as quickly as possible, do not wait for it to detach.
  • Use a fine-tipped tweezers. Grasp the tick as close to the skin as possible, and pull straight up with steady pressure. Then thoroughly clean the bite (and your hands) with rubbing alcohol and soap and water.
  • Kill the tick without touching it and throw it away. If you develop a rash or fever following exposure, see a doctor immediately.


  • Fever/chills: With all tickborne diseases, patients can experience fever at varying degrees and time of onset.
  • Aches and pains: Tickborne disease symptoms include a headache, fatigue, and muscle aches. With Lyme disease, you may also experience joint pain. The severity and time of onset of these symptoms can depend on the disease and the patient’s personal tolerance level.
  • Rash: Lyme disease, southern tick-associated rash illness (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis, and tularemia can result in distinctive rashes:
    • In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called erythema migrans or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite. It may be warm but is not usually painful. Some patients develop additional EM lesions in other areas of the body several days later.
    • The rash of (STARI) is nearly identical to that of Lyme disease, with a red, expanding “bull’s eye” lesion that develops around the site of a lone star tick bite. Unlike Lyme disease, STARI has not been linked to any arthritic or neurologic symptoms.
    • The rash seen with Rocky Mountain spotted fever (RMSF) varies greatly from person to person in appearance, location, and time of onset. About 10% of individuals with RMSF never develop a rash. Most often, the rash begins 2-5 days after the onset of fever as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles and spreads to the trunk. It sometimes involves the palms and soles. The red to purple, spotted (petechial) rash of RMSF is usually not seen until the sixth day or later after onset of symptoms and occurs in 35-60% of patients with the infection.
  • In the most common form of tularemia, a skin ulcer appears at the site where the organism entered the body. The ulcer is accompanied by swelling of regional lymph glands, usually in the armpit or groin.
  • 30% of patients and up to 60% of children, ehrlichiosis can cause a rash. The appearance of the rash ranges from macular to maculopapular to petechial and may appear after the onset of fever.

Tickborne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult for physicians to diagnose. However, early recognition and treatment of the infection decrease the risk of serious complications. Seek medical advice immediately if you have been bitten by a tick and experience any of the symptoms described here.


  • Anaplasmosis is transmitted to humans by tick bites primarily from the blacklegged tick.
  • Babesiosis is caused by microscopic parasites that infect red blood cells. Most human cases of babesiosis are caused by Babesia microtiBabesia microti is transmitted by the blacklegged tick.
  • Borrelia mayonii infection has recently been described as a cause of illness in the upper Midwestern United States. It has been found in blacklegged ticks. Borrelia mayonii is a new species and is the only species besides B. burgdorferi known to cause Lyme disease in North America.
  • Borrelia miyamotoi infection has recently been described as a cause of illness in the U.S. It is transmitted by the blacklegged tick and has a range like that of Lyme disease.
  • Colorado tick fever is caused by a virus transmitted by the Rocky Mountain wood tick. It occurs in the Rocky Mountain states at elevations of 4,000 to 10,500 feet.
  • Ehrlichiosis is transmitted to humans by the lone star tick, found primarily in the south central and eastern U.S.
  • Heartland virus infection has been identified in eight patients in Missouri and Tennessee as of March 2014. Studies suggest that Lone Star ticks may transmit the virus. It is unknown if the virus may be found in other areas of the U.S.
  • Lyme disease is transmitted by the blacklegged tick in the northeastern U.S. and upper Midwestern U.S. and the western blacklegged tick along the Pacific coast.
  • Powassan disease is transmitted by the blacklegged tick and the groundhog tick. Cases have been reported primarily from northeastern states and the Great Lakes region.
  • Rickettsia parkeri rickettsiosis is transmitted to humans by the Gulf Coast tick.
  • Rocky Mountain spotted fever (RMSF) is transmitted by the American dog tick, Rocky Mountain wood tick, and the brown dog tick in the U.S. The brown dog tick and other tick species are associated with RMSF in Central and South America.
  • STARI (Southern tick-associated rash illness) is transmitted via bites from the lone star tick, found in the southeastern and eastern U.S.
  • Tickborne relapsing fever (TBRF) is transmitted to humans through the bite of infected soft ticks. TBRF has been reported in 15 states: Arizona, California, Colorado, Idaho, Kansas, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Texas, Utah, Washington, and Wyoming and is associated with sleeping in rustic cabins and vacation homes.
  • Tularemia is transmitted to humans by the dog tick, the wood tick, and the lone star tick. Tularemia occurs throughout the U.S.
  • 364D rickettsiosis is transmitted to humans by the Pacific Coast tick. This is a new disease that has been found in California.

Dr. Jeffery West is a Rockwall Otolaryngologist specializing in allergies and ENT surgery. Board Certified by the American Board of Otolaryngologists, Dr. West is Medical Director of Lakeside Allergy ENT with offices in Rockwall, Forney, and Wylie Texas. Named Top10MD in 2016 – an honor only 1-in-3 doctors succeeds within the United States. To schedule a consultation with Dr. Jeff West, click on his profile or call his office at 972-398-1131.


IMAGE: Shutterstock


 4 months ago    Leave a comments (0)

As we all know, allergy shots are literally a pain. The bothersome swelling, itchiness, and redness at the injection site are typically repeated monthly, sometimes up to 12 months before noticing an improvement in your allergy symptoms. Treatment is generally continued for roughly three to five years for most sufferers. That’s up to 60 sixty shots! In addition, allergy shots are just not a viable option for some patients. With allergy drops, patients simply drop the liquid under their tongue in the comfort of their own home – a delivery method that is painless and does not require weekly trips to the doctor. Your child will thank you!

Europe has been using allergy drops for the past two decades. Research has shown strong evidence that drop therapy can be more effective compared to other treatments. In 8 of 13 studies performed by John Hopkins researchers, drop therapy produced a 40 percent or greater reduction in coughing, wheezing, and tightness in the chest. Further research shows in nine of 36 studies, there was a reduction in a runny nose, sneezing, and nasal congestion. The methods included in the studies did not directly compare to only shots; it includes such therapies as inhaled steroids, antihistamines, and nasal steroid sprays. Although allergy drops are not yet approved by the U.S. Food and Drug Administration, they’re often prescribed for off-label use and insurance will not cover them.

All immunotherapy comes with risks, such as triggering allergic reactions. However, the evidence does support that allergy drops are less likely to have serious reactions compared to shots. For those who travel or suffer from a fear of needles, there are options. Ask your ENT or Allergist about sublingual immunotherapy – it just might work for you and your family!

Dallas Fort Worth ENT Allergist Dr. Jeff West explains the benefits of drop vs. shot therapy.


 8 months ago    Leave a comments (0)

You put your finger in your ear and feel something nasty and sticky. This is known as earwax. Most of us find it completely gross. Sometimes the thought is since you have ear wax, you did not clean your ears. This is not the case and contrary to popular belief, ear wax is a good thing. Ear wax is one of those things in the body that we find gross and see no purpose for but in actuality serves a major purpose.

What Is Earwax?

Ear wax may also be called cerumen. Sometimes you hear the term cerumen impaction at the doctor. This simply means the impaction of earwax inside the ear canal. Ear wax plays a very important role in the ear. It is part of the ear’s defense system. Ear wax protects the ear from foreign bacteria, debris, water, and insects. Ear wax helps in cleaning the ear as well as lubricating the ear. Some people naturally makes more ear wax than others. Having too much ear wax may seem like you will gain more protection, but it can create problems, specifically with hearing.

What Causes Earwax Impaction?

The more ear wax you make, the greater risk you have of getting wax impaction. Wearing hearing aids and earplugs a lot puts you at risk for ear impaction as well. When you think about cleaning your ears, the first thought is to grab alcohol and Q-tips. This is the worst thing you can do. Q-tips are bad because it pushes the wax further down into the ear canal. The wax ends up building to the point where sound becomes muffled. Sometimes it is not until this happens that you realize how important your ears are for balance. This impaction may cause dizziness as well as ringing in the ears. It may require a doctor’s visit to get the wax removed.

If you notice ear wax impaction, you should look for over-the-counter ear drops. The drops help dissolve the wax. When over-the-counter medications do not work, the doctor may have to use water and a syringe to rinse out the impacted wax. Once the wax is removed, you will feel much better. You will gain your balance back, and your hearing will be restored. Ear wax does not typically cause any damage or anything, so you do not have to worry about follow-up treatment.  

Managing Earwax

If you thought ear wax was disgusting at first, maybe understanding the purpose of it will help you like it more. Everyone has ear wax and some people just has more than others. If wax becomes impacted, it can have a direct effect on your hearing and balance. Although ear wax is good for you, you still need to make sure you clean your ears so that it does not build up. If you are suffering from too much ear wax, get the treatment you need. Make sure your ears are open and clear.  

Fort Worth Otolaryngologist Dr. Marc Dean is a Board Certified by the American Board of Otolaryngology and practicing full time in private practice. Dr. Dean specializes Otolaryngology/Head and Neck Surgery and conditions and diseases of the ear, sinus and disorders of the eustachian tube. Dr. Dean completed an Internship, in General Surgery and his Residency at Louisiana State University Health Science Center, where he now serves as Assistant Professor Otolaryngology/HNS. Dr. Dean is current President and CEO of the Otorhinologic Research Institute. Contact Dr. Dean today on his profile or call 817-332-4060. Dr. Marc Dean was named Top10MD 2015 | 2016. Only 1 in 3 doctors succeeds with this recognition in the United States.


 1 year ago    Leave a comments (0)

Surgeries that some consider routine can still sometimes cause serious complications. No matter how straightforward you think your surgery might be, you still want to be in the absolute best surgical hands.

Today, your surgeon and hospital are especially important for procedures that are new or complex or even routine. You should be concerned and research but your surgeon and the hospital for that matter as most errors happen in a hospital setting according to John Hopkins report in May noting the third leading cause of death is medical errors. In your search for the best surgeon one indicator is how often your surgeon performs the procedure you’re seeking. For example, a study by researchers at New Hampshire’s Dartmouth-Hitchcock Medical Center of people undergoing surgery for pancreatic cancer found that annual death rates were nearly four times higher for those treated by surgeons who performed the fewest operations.

With that being said, how should you choose a surgeon, someone with whom you’ll be sharing some of your most personal information and entrusting with life-and-death decisions? Communication with your surgeon is essential.

Ask your prospective surgeon these questions before going under…

Are you board certified, and is your certification current?

  • Look for a surgeon who has the necessary board certification(s), necessary training, and has maintained their certification(s) in the specialty they are practicing.

Is this surgery necessary?

  • Avoiding surgery entirely is the only sure way to avoid a surgical complication; understanding the effectiveness of the surgery and having exhausted alternatives you then need to compare the results of your alternatives with the possible risks of the surgery. 

What are your success, failure, and complication rates?

  • Not all surgeons are willing to be upfront with this information, but a good surgeon will.

What is your experience with this surgery?

  • Ask your surgeon how many of these procedures he or she has performed and compare that number with other surgeons performing the same procedure. The best surgeon is not necessarily the busiest surgeon; it’s about avoiding the surgeon who has not performed the procedure as much or as often or as well.

What’s the hospital’s infection rate?

  • Seventeen states now make that information public, and many hospitals report their rates voluntarily. Kudos to them! After asking these questions and others relating to your needs, likes, and dislikes, do your homework and make your choice. Your final decision could be one of the most important you’ll make for you and your family.

To locate a Top10MD Surgeon you can trust visit and schedule your appointment today.


 1 year ago    Leave a comments (0)

Balloon Sinuplasty (BSP) has proven to be a safe and effective minimally invasive procedure for sinusitis patients who are not responding well to medication. And have either had a sinus infection for more than 12 weeks or have 4 or more sinus infections each year. These patients are seeking relief from uncomfortable and painful sinusitis symptoms.

With Balloon Sinuplasty, ENT surgeons open inflamed sinuses in the same way that a heart surgeon opens blocked arteries during a balloon angioplasty. The procedure is less invasive than traditional sinus surgery and effective at relieving symptoms of chronic sinusitis. A minimally invasive Balloon Sinuplasty allows patients to return to normal activities quickly. Unlike conventional sinus surgery, this innovative procedure does not include cutting to remove bone or tissue from the nose.

Benefits of Minimally Invasive Balloon Sinuplasty

  • 375,000+ procedures safely performed since 2005
  • Chronic sinusitis patients report improvements in sinus symptoms
  • Quality of life increases following two years post procedure
  • Fast Recovery – Most patients returned to work within two days
  • Balloon Sinuplasty is a minimally invasive procedure
  • 35,000+ procedures have been performed safely in the office or surgery center

If you have been diagnosed with chronic sinusitis and are not responding well to medications, you may be a candidate for a minimally invasive Balloon Sinuplasty procedure. Balloon Sinuplasty is clinically proven to be a safe and effective procedure that improves sinus sufferers’ quality of life.

Is Minimally Invasive Balloon Sinuplasty safe?

With this procedure, there is no cutting of nasal bone or tissue. More than 380,000+ patients suffer from chronic sinusitis have been treated by ENT Surgeons using Balloon Sinuplasty.

How will I feel following a Minimally Invasive Balloon Sinuplasty?

In a study tracking patients, two years following their Balloon Sinuplasty Sinus Surgery, most chronic sinusitis patients report improvements in sinus symptoms and their quality of life.

Recovery following Minimally Invasive Balloon Sinuplasty

While recovery time varies with each patient to patient, recovery is typically quick. Most patients returned to work and normal activity within a couple of days.

In summary, with Balloon Sinuplasty, an ENT surgeon opens inflamed sinuses. The procedure is less invasive than traditional sinus surgery and effective at relieving symptoms of chronic sinusitis allowing you to return to normal activities. Unlike conventional sinus surgery, it does not include removal of bone or tissue from the nose. This procedure is now offered by some ENT Surgeons an office setting or ambulatory surgery center under local anesthesia, with no need to undergo general anesthesia.

Dallas Fort Worth Otolaryngologist Dr. Marc Dean is Board Certified by the American Board of Otolaryngology and practicing full-time in private practice. Dr. Dean specializes in Otolaryngology/Head and Neck Surgery and conditions and diseases of the ear, sinus and disorders of the eustachian tube. Dr. Dean completed his Internship, in general Surgery and his residency at Louisiana State University Health Science Center, where he now serves as Assistant Professor Otolaryngology/HNS. Dr. Dean is current President and CEO of the Otorhinologic Research Institute. Contact Dr. Dean today on his profile or call 817-332- 4060. Named Top10MD 2015 | 2016 a recognition only 1 in 3 doctors succeeds within the United States.


 3 years ago    Leave a comments (0)


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