Many of out of town patients have their initial physical exam and consultation immediately prior to scheduled surgery. During this consultation, the doctors will discuss the surgery in full detail.
Are patients outside of the Los Angeles area able to have a consultation and surgery on the next day? We can help you with Travel Arrangement (For more info click here)
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10:00am - 4:30pm Pacific Time
A generally accepted definition of asthma is that it is a disease that is characterized by increased responsiveness of the trachea (windpipe) and bronchi (main airway) to some type of trigger that causes widespread narrowing of the airways that changes in severity either as a result of treatment, or spontaneously. Roughly 5% of the population lives with asthma. Not all people with asthma have allergies. Not all allergies cause or develop into asthma. There are triggers like infections, exercise and certain food and drugs that trigger the attack. Generally, the more triggers present, the worse the attack.
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Anaphylaxis is an acute allergic reaction which affects the whole body and requires immediate medical attention. Symptoms include anxiety, itching of the skin, headache, nausea and vomiting, sneezing and coughing, abdominal cramps, swelling of tissues such as lips and joints, diarrhea, shortness of breath and wheezing, low blood pressure, convulsions, and loss of consciousness. A quick, decisive epinephrine injection (an emergency hormone) can literally be a life-saver in the case of exposure to an allergen that has previously caused an anaphylactic reaction.
Diagnosis is essential for successful treatment that the allergens responsible for the symptoms are accurately identified. There are different ways to arrive at a diagnosis.
I. Case history
The case history should form the basis for all allergy investigations. In order to give the doctor an idea of the mechanisms and allergens causing the trouble, the doctor will question the patient or ask him/her to fill in a questionnaire which consists of all the ways and means the symptoms developed ,with respect to seasons, weather, physical activity , drugs and foods. Knowledge of personal habits such as smoking, occupation, hobbies, etc., will be necessary and some information about the home can be important (e.g., whether there are pets, or fitted carpets in the house or if cleaning aggravates symptoms).
II.Skin and patch tests
Skin test procedures are used by many doctors to identify allergens responsible for the symptoms. Drops of the suspected allergens are put on the skin of the forearm and the skin is either pricked or scratched (prick or scratch test) through the drops. Suspected allergens can also be injected into the skin of the back (intradermal skin test). After 15-20 minutes, if there is an allergy to one or more of the substances, a round wheal with a flare forms on the spots where the substances were injected. This may identify and confirm the allergy.
In patch tests which are performed by using a small piece of blotting paper, moistened with the suspected substance, or a prepared strip containing various standard allergens. The paper or strip is taped to an area of healthy skin for 24 or 48 hours. If you are allergic to the substance tested, skin rash will be seen where the test substance has been in contact with your skin.
III.Provocation and elimination tests
These tests are performed in the eyes and nose in hay fever sufferers. A highly diluted allergen extract is dropped into the nose or eyes or is inhaled,the test is continued in this way, using more concentrated allergens until the allergic symptoms are provoked. When allergy to food is suspected, different foods (usually those most commonly associated with allergy) are eliminated to see if the symptoms disappear. They are re-introduced into the diet, one by one, to see if any of them causes a return of the symptoms. The most common food sensitivities are to cow's milk, corn, wheat, eggs and soy.However they will be needed to be done with extreme care and caution or they could cause more harm and suffering to the person being tested.
IgE (a type of immunoglobulin) plays an important role in allergic rhinitis, allergic asthma and in some forms of skin allergies. Detecting and accurately measuring the amount of IgE may be of great importance when diagnosing allergies. Today, there are laboratory tests available that accurately measure IgE, and a small blood sample is sufficient for allergy testing. Another allergy blood test is called RAST (radioimmunoabsorbent test). These blood tests are significant primarily if the identified substances cause patient symptoms. RAST is especially helpful in very young children.
It is necessary for successful treatment that the allergens are accurately identified. There are three main objectives in the management of allergic disease:
to eliminate causative factors from the immediate environment, where possible.
to reduce irritation in the tissue (i.e., to treat the symptoms with different drugs).
to decrease immunological reactivity by vaccination (specific hyposensitization)
In an immunotherapy the patient is gradually vaccinated against progressively larger doses of the allergen in question. This can either reduce the severity or eliminate hypersensitivity altogether. Delivery can occur via allergy injection, or through, allergy drops taken under the tongue.
Several antagonistic drugs are used to block the action of allergic mediators, preventing activation of cells and release of allergic chemicals . They include antihistamines, cortisone, epinephrine (adrenaline), theophylline and Cromolyn sodium. These drugs help alleviate the symptoms of allergy but play little role in chronic alleviation of the disorder.
TYPES OF ANESTHESIA
General Anesthesia , in which case you'll sleep through the entire operation and do not feel any pain.
* The Information Presented On This Website Is Intended To Be Used For Informational Use Only; It Is Not Intended To Be A Substitute For Professional Advice. If You Are Planning On Having A Procedure Performed Or If There Is Anything You Don't Understand Or Have Questions About Your Procedure, Time, Price Variation Due Patient Comorbidity, Blood Work, Additional Cost for General Anesthesia, Post Surgery Recovery, Combination Of The Different Procedures. Please Consult Our Physician Who Will Be Happy During Your Free Consultation To Go Over In Details With All Your Questions.
Following are some common questions asked by those considering REVISION RHINOPLASTY
Question: I think my first surgeon took too much from my nose. Can you fix this?
Answer: This is a common reason for revision rhinoplasty. No matter where in your nose too much has been removed, Doctor's experience is that improvement is often possible.
Question: I want my nose to look natural again. Can you do this?
Answer: This is the most common request our patients have, and is perhaps the most important objective in revision rhinoplasty. Doctor is experienced at repairing the "over-operated" nose. While each case is different, in Doctor's experience it is usually possible to make significant improvement.
Question: My nose is too small. Can you make it bigger?
Answer: Yes, if a patient's nose has been over-operated and now looks too small, Doctor can generally improve it. He also can generally fix noses that are too short, too long, too narrow, too wide, twisted, and so forth.
Question: Is there a lot of pain or nausea?
Answer: Not typically. Time after time, Doctor's patients are surprised at how little pain and how little nausea there is. After-surgery pain is usually well-controlled with a mild narcotic. We are especially proud of our anesthesia team, who provide expert anesthesia that keeps after-surgery nausea to a minimum.
Question: What is recovery like?
Question: What is the recovery period?
Question: I live far away, how do I arrange to see you and to have surgery?
Answer: You can contact Doctor's office and arrange an appointment. Many patients come for an initial visit and schedule surgery at the end of this initial visit. They then return for their surgery. Occasionally a patient may wish to come into town for consultation followed by surgery the next day. This is possible but obviously must be arranged in advance.
Question: The tip of my nose looks pointy, twisted and abnormal. Can you fix my nasal tip?
Answer: Yes, it has been Doctor's experience that significant improvements are possible in this relatively common problem.
Question: Do you do Computer Imaging?
Answer: Yes. Computer imaging is a very helpful way to communicate surgical goals. It is important for the surgeon to know what the patient wants to accomplish, and the patient must know what the surgeon envisions as a goal for the surgical result. Computer imaging is extremely useful to communicate this information, and we therefore perform computer imaging on virtually all patients prior to surgery.
Question: I'm not sure what I need to have done, I just know I don't like it!
Answer: We understand! Some patients know how they want their nose to look, but other revision rhinoplasty patients are frustrated, angry, and even a little scared. They know they don't like their nose, but they are upset and confused and just want someone to help them! We understand this and will take the time to work with you to help you have a happy outcome.
Question: I am scared!
Answer: We understand! You have had a bad experience, so it is okay to feel that way. It is important for you to be confident in the surgeon you choose to perform your revision rhinoplasty. Doctor is proud of his surgical results, but he also wants his patients to feel at ease. Doctor's staff plays an important role in helping his revision rhinoplasty patients feel more at ease before and after surgery.
Question: How do I know if I am a candidate for revision rhinoplasty?
Answer: If you have had a rhinoplasty and do not like the way your nose looks, and if you are in good health, then you are eligible for a revision rhinoplasty consultation. The next step is to meet with a skilled surgeon to see if surgery can meet your expectations. In Doctor's practice, Doctor talks to you in detail and examines you. Then, he explains his realistic expectations for your surgery and will let you know if he thinks you are a good candidate.
Question: Is this outpatient surgery?
Question: Ever since my rhinoplasty, I can't breathe well through my nose. Can you fix this?
Answer: Yes. Unfortunately, this is a common complaint. Fortunately we are usually able to substantially improve nasal breathing. A number of the patients in the Photo Album had this problem. Many times, patients request improvement in breathing and appearance