Enoch Choi, MD  
Male, 46
Palo Alto, CA

Specialties: Family Medicine

Interests: sinusitis, Migraine, Low back pain
Palo Alto Medical Foundation
Urgent Care
Palo Alto, CA
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headin' to LA

Nov 30, 2007 - 0 comments

can't wait to share disneyland with the kids, they've never been!

Grand Rounds is here!

Nov 29, 2007 - 0 comments







grand rounds







The weekly roundup of the best blog posts of medbloggers is here at my "Doctor Geek, M.D." blog on 12/4/07.


10 Tips to Dodge Holiday Weight Gain

Nov 28, 2007 - 1 comments














The holidays are a delightful time for enjoying great food with family and friends.  Entirely too delightful for our waistlines, unfortunately.  The most troublesome thing about holiday weight gain is that it's really hard to get the pounds off after you've put them on.  Here are some tips to help keep off the pounds:

- Eat with your eyes, not with your fingers.  Much of the enjoyment of a meal comes from seeing a beautiful spread and the wonderful aroma that wafts from the table.  Try to focus on how much you enjoy the beauty and scent as you eat.  Slow down and savor your mouthfuls.

- Enjoy your company.  The more you can focus on fun conversation with friends and family, the less you'll dig in.

- Take small portions.  There's so much to try, limit yourself to small portions of your favorite dishes.  Chefs know that you get all of the pleasure from food from the first 3 bites.  After that, it's just about filling you up.  If you feel stuffed, you've eaten too much.

- Use a smaller plate.  Many people love to see a full plate.  If your plate is smaller, you can get the same enjoyment with less puttin' down.

- Watch out for high-calorie drinks.  Some folks do really well with limiting their diet and forget how many calories are in juice, wine and beer.  These are empty calories without much nutritional value, however enjoyable they are.  Try not to overdo it and you'll help slim yourself.

Now, if you've already overdone it, as I had over Thanksgiving, here are some ways to shed the pounds:

- Commit to exercising more than you eat.  What does that mean?  Weight loss comes when you burn more calories than you consume.  The more you walk, in excess of the calories you swallow, the more you'll lose.

- Lose weight gradually.  Many folks yo-yo between extremely restrictive diets that are so low in nutrition they're harmful, then bounce back up to gorge themselves.  That's a sure way to harm yourself by both gaining weight and depleting your body of nutrition.  Make a goal of 1/2 a pound a week, which is sustainable by most people.

- Limit your portion size.  Most cafeterias serve such gigantic portions that I've taken to eating half of my lunch at noon then the rest of the half for dinner.  If you keep busy enough, you can distract yourself from the nagging hunger.  One way to feel full is to drink lots of water, to a goal of at least five 8 ounce glasses a day.  That helps be ward off the hunger.

- When you're lonely, pick up the phone, not the fork.  One thing i learned from Dr. Roger Gould's "Shrink Yourself" online program is that I eat when I miss my wife, after a long day in clinic and she's already asleep with the kids.  Instead of snacking, I've tried to chat with friends who are similar night owls and that's helped avoid the nighttime munchies.

- Take a walk.  You'd be surprised at how much it helps to take a walk before work or at breaktimes.  Regular exercise can increase your muscle mass and metabolic rate so that you burn more calories even when you're sedentary at work, at rest at your desk.  Try it out!

Hope these tips help you out, and good luck over the coming holidays!

tympanostomy tube placement

Nov 20, 2007 - 1 comments

tympanostomy tube





desertgirl in the ENT forum had questions about tympanostomy tube placement and I wanted to give an overview here:

Placement of tympanostomy tubes allows ventilation of the middle ear, circumventing the poorly functioning eustachian tube which otherwise drains fluid away.

Tympanostomy tubes are indicated when long-term ventilation of the middle ear space is desired with Otitis media with effusion

ENT follow-up after tympanostomy tube placement often is necessary at four- to six-month intervals. ENT follow-up continues until at least one year after extrusion or removal of tubes and healing of the TM, normal eustachian tube function, and normal hearing have been established.

Referral to the otolaryngologist earlier than regularly scheduled follow-up may be necessary for:

      - Chronic, recurrent, or bloody otorrhea (ear drainage)

      -  Persistent ear pain, worsening hearing, or balance issues.

      -  Suspected structural disease of the tympanic membrane.

      - If the tube is obstructed and causing pain, or cannot be visualized.

      –  An extruded tube (fell out) that cannot be removed from the ear canal.

      -  A tube that has migrated into the middle ear space.

      -  The tube has been retained for more than two years.

A tympanostomy tube is working if it spans the eardrum, its lumen is unobstructed, and no middle ear effusion is present

Complications of tympanostomy tubes include persistent perforation of the tympanic membrane (permanent hole), tube obstruction, tympanosclerosis, focal atrophy of the tympanic membrane, and cholesteatoma.