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Doctor Q&A for Dr. Robert Gadlage

A male asked:
Dr. Robert Gadlage
Internal Medicine and Pediatrics 49 years experience
Need exam : Wave to me means sporadic and implies if happens mostly at night, probably positional. This would suggest ear, mastoid or eustachian tube origin, but needs complete examination of these areas endoscopically or via ct scan to find the source. Could be something simple as an insect bite or tick bite, but these may also be serious.
A member asked:
Dr. Robert Gadlage
Internal Medicine and Pediatrics 49 years experience
May not be sinus: Headaches have many causes, sinuses are one of them, usually related to blockage of nasal breathing passages, mouthbreathing and subsequent congestion that causes pain in distribution of nerves going to sinuses, can mimic altitude headaches. Office evaluation of sinuses requires direct and possible endoscopic nasal evaluation and ct sinuses to rule out sinuses as cause.
A 41-year-old member asked:
Dr. Robert Gadlage
Internal Medicine and Pediatrics 49 years experience
Need more general : Need more general information, cold intolerance should be first evaluated by your pcp or internist with a concentration on the thyroid gland and metabolic bloodwork. All the other symptoms you describe could have several causative factors, need good general internal medicine or pcp evaluation first, and if anything discovered in the thyroid or head and neck, may warrant referral to endocrinologist.
A 36-year-old member asked:
Dr. Robert Gadlage
Internal Medicine and Pediatrics 49 years experience
Check on "bump": Cervical adenitis is a common hallmark of uri's, need evaluation of ENT area including flexible endoscopy, cultures, possible blood work and ct sinuses and neck if indicated. Majority of "bumps" in neck are related to URI infections, whether bacterial or viral, but if not resolving in 1-2 weeks, needs evaluation.
A 41-year-old member asked:
Dr. Robert Gadlage
Internal Medicine and Pediatrics 49 years experience
You need a culture: If you haven't had a culture, need to have nose and sinuses looked at endoscopically and ct sinuses if indicated.
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