Grand Rounds Is Up

Grand Rounds volume 3 number 22 is now up at Pure Pedantry, presented in excellent fashion with an Oscars theme so go check it out.

A Dizzy Diagnosis: Benign Paroxysmal Positional Vertigo

click to view video 

BPPV is a disorder of the inner ear which is a cause of vertigo in approximately 20% of patients who present to their doctor with this complaint. This occurs when otoconia are dislodged from their usual position within the utricle and they migrate over time into one of the semicircular canals (the posterior canal is most commonly affected due to its anatomical position). This Diagnosis can be made using the Dix-Hallpike Test and is frequently treated by use of the Epley Maneuvers.

In my practice, I make this diagnosis more often than many of my peers, mostly I think because I look for it. To me, it is about the only bright spot when dealing with the chief complaint of "dizziness". This is because treatment is so effective and no medicines are required. Patients have called back in a day or two just to tell me that it worked because they are so surprised. Honestly, when I first started doing it, I was surprised as well. It seems like most of the family practitioners that I talk to have heard of this simple procedure, but most of them never try it because for some reason it seems too magical or tricky. For that reason I have created this claymation video to serve as a visual aid for those who are interested. Keep in mind that this is not my specialty, this is not intended to replace a visit to your doctor if you experience vertigo, and you shouldn't try this if you don't have the training to know when you shouldn't do it. This is just a fun little video to give you very basic idea of how it is done. I will gladly accept any criticism of the technique, but don't expect me to change the video because the patient has been thrown out. Enjoy.

Claymation Eye Movement

7 sec., 1.5 Mb, QuickTime

This video was made during the same session as the Dix-Hallpike and Epley Maneuver video was made. I was going to try to demonstrate Rotary (torsional) nystagmus which becomes apparent with a positive Dix-Hallpike test. However the clay was too soft and the toothpicks in the back of the eye kept moving around instead of the eye moving properly, so I just did the best I could at making the eye look around and look as real as possible.

3 Days After The Snowfall, Time-Lapse

This was made over a period of 3 days following the winter's only snow so far. This was just before the 2007 Super Bowl. The pictures were taken every 6 seconds with a webcam and laptop from my bedroom window. They were initially played back at 30 fps but I increased it to four times that speed to make it more interesting.

Super Bowl XLI Predictions Recap

My Super Bowl predictions were pretty terrible, just like the Bears performance. I really don't feel like rehashing it but here it is as promised.

1. Chicago Bears 33-24
-Way off, Colts 29-17

2. The Bears defense will perform well, but not as great as many think will be necessary for them to win.
-I'm not exactly sure how to judge this vague prediction. The second part is definitely correct but I don't really think I can say the defense played very well after the Colts ran the ball like they did.

3. The good Rex Grossman will show up today and get 2 passing touchdowns, only one interception and 1 fumble.
-Nope, he had 1 passing TD, 2 interceptions, and 1 lost fumble. 1 of his interceptions was returned for a TD toward the end of the game which is what really broke their backs. He only had 165 yards passing.

4. Thomas Jones and Cedric Benson will both top 75 rushing yards. With Jones getting a rushing TD.
-Wrong again. Benson went out early after an injury and -1 rushing yard. T. Jones did have 112 rushing yards but no TD's


5. Robbie Gould will kick 4 field Goals.
Man, I suck at predictions. Gould was 1/1 on field goals.

6. Peyton Manning Will have 2 passing TD's, 2 interceptions and a fumble.
-No, He only had 1 pass TD, 1 interception, and 1 fumble.

7. Joseph Addai will have the Colts only rushing TD and will go over 100 yards rushing.
-Nah, He only had 77 yards rushing and no Td's. He did have 66 yards recieving though. D. Rhodes was the game's top rusher.

Before the game I didn't realize just how badly I wanted the Bears to win it all. I was very down about it and have only just now recovered enough that I can discuss it. Altogether it was a fun day though. There is always next year.

Congratulations to Peyton Manning and the Indianapolis Colts.

Super Bowl XLI Predictions

Following last year's Super Bowl XL predictions, I don't think I can do much worse, so here are my confident predictions for Super Bowl XLI.

Most importantly, the winner: The Chicago Bears 33-24, The magical power of "The Bean" is just too strong, even with them all the way down in Miami.

The Bears defense will perform well, but not as great as many think will be necessary for them to win.

The good Rex Grossman will show up today and get 2 passing touchdowns, only one interception and 1 fumble. He has been way up and way down this year, but the bottom line is that they made it to the big game with him leading, and he will get the job done today. He is that kind of player.

Thomas Jones and Cedric Benson will both top 75 rushing yards. With Jones getting a rushing TD.

Robbie Gould will kick 4 field Goals.

Peyton Manning Will have 2 passing TD's, 2 interceptions and a fumble.

Joseph Addai will have the Colts only rushing TD and will go over 100 yards rushing.

As you can probably tell, I not only think the Bears will win but I am also rooting for them. However I find it difficult to go against an all around champ like Peyton Manning, so if the Colts win I will have the consolation of knowing that he will finally have his Super Bowl victory and we can unreservedly place him on that pedestal of all time great players.

Enjoy the Game, I'll be back later to review these predictions.