Frequently Asked Questions
I invite all of my patients to freely ask questions. Here I have listed the most commonly asked questions along with brief answers. I invite you to visit me in the office so that we can discuss your individual concerns.
Dr. Philip K. Robb Sr.
I have had a lot of sinus infections. What do I do?
Sinus infections result from blockage of the openings to the sinuses, thus trapping bacteria within the sinuses and set up an environment for infections. These infections often cause headaches, facial pain, pressure, nasal congestion and blockage, drainage down the back of the throat, even upper tooth pain, and fatigue. A decreased sense of smell can also be associated with an acute or chronic sinus infection. A chronic sinus infection is one that has gone on for greater than three weeks, and many times it smolders on the sinuses for years. Active or acute sinus infections are treated with antibiotics, decongestants, decongestant nasal sprays, and sometimes oral steroid pills.
Chronic sinus infections can often be managed by obtaining a CT scan, and sometimes surgical opening of the sinus openings can resolve the sinus infections. Allergy evaluation is sometimes considered during a visit and also treatment with nasal steroid spray and/or decongestants. Treatment is individualized depending on which symptoms affect the patient the most.
What do I do when my baby has an ear infection?
Ear infections in children are caused by bacteria getting into the middle ear and infecting fluid that has formed in there. This results in frequent or recurrent ear infections with fever, pain irritability, and possible loss of appetite. These infections are generally treated with systemic or oral antibiotics. The fluid that forms in the middle ear causes hearing loss because it prevents the eardrum and the tiny middle ear bones from vibrating properly and thus conducting sound into the inner ear. The definitive management of recurrent ear infections with fluid that persists longer than 3 months is ventilating tube insertion, whereby, under general anesthesia and using a microscope to see, a tiny incision is made in the eardrum and fluid is sucked out of the middle ear cavity and a tube is placed to keep air circulating through the middle ear so that the lining can heal properly. Tubes stay in the eardrums anywhere from 6-18 months. A small percentage of children may require a second tube insertion. The tubes can cure the ear infection by allowing air to circulate through the middle ear, preventing fluid accumulation, and allowing the natural normal eustachian tube to mature and develop properly so that it can take over the function of getting air to the middle ear.
My son has had 6 episodes of strep throat in the past year. When is enough, enough?
Strep throat or strep tonsillitis and pharyngitis are caused by the strep bacteria. This causes a sore throat, upset stomach, fevers, inability to eat or drink, and can lead to absence from school. Strep throats can be diagnosed by a rapid strep test or throat culture and is treated by antibiotics. Sometimes the strep bacteria continue to survive in the center or core of the tonsil and the child may become a carrier or when stressed or tired the bacteria can pop out and cause another infection. If this becomes a recurrent situation, then tonsillectomy is indicated to rid the child of the strep bacteria and the inflammation of the tonsils. This cures the recurrent strep throats and removes the strep bacteria from the bloodstream, which even these days can cause serious kidney or heart problems. Tonsillectomy is a simple and commonly performed surgery and the recovery varies from 5-10 days depending on the age of the patient. The hardest part about recovering from tonsillectomy is the sore throat and inability to eat due to pain. It is well worth the discomfort of recovery to rid the body of this persistent recurrent infectious process.
My husband snores every night and stops breathing during sleep. Is this serious?
Your husband may be suffering from obstructive sleep apnea, which we consider a very serious life-altering condition. Sleep apnea results in blockage of the airway during sleep, thereby resulting in the oxygen level in the blood dropping, which in turns wakes the brain up, signaling the patient to gasp, choke or cough in his sleep, often resulting is waking of the patient. This waking of the brain at night results in daytime sleepiness, the ability to nap, fall asleep anywhere or anytime, falling asleep at inopportune times such as at work or the wheel of a car. The main cause is blockage of the airway either in the nose or the throat. There can be nasal blockages such as a deviated nasal septum or nasal or sinus polyps and in the throat there can be floppy tissue of the soft palate or the root of the tongue, or tonsil enlargement. There are several excellent treatments of sleep apnea, which often requires an overnight sleep study examination at an accredited sleep center for accurate and proper diagnosis. Management options include oral appliances, Continued Positive Airway Pressure (CPAP) machine, surgery, weight loss, or lifestyle changes with stopping smoke and alcohol use. Sleep apnea can lead to serious medical conditions such as heart problems and strokes and should be treated. Resolving obstructive sleep apnea results in a dramatically improved quality of life in just about every aspect.