Dr. Melanie Grace Cruz - ENT

SCHEDULE UPDATE: We will be attending seminars from November 29 to December 3. During this time, there will be no scheduled clinic appointments. However, we will continue to offer online consultations by appointment. :)

We appreciate your understanding and look forward to resuming our regular clinic hours on December 4.

Online consultations are still being held daily (usually in the evening) for non-urgent concerns. Please feel free to send us a message to set an appointment.

SCHEDULE UPDATE:

We’re taking a little time off from physical clinics. Face to face consultations will resume on July 17, 2023.

Online consultations are still being held daily (usually in the evening) for non-urgent concerns. Please feel free to send us a message to set an appointment. 🙂

Updated schedule as of April 2023:

Additional by-appointment clinic days:
- Malabon (Tuesdays)
- Diliman, Quezon City (Selected Saturdays)

Please feel free to send us a message for appointments.

Changes in the sense of smell such as Anosmia (absence), hyposmia (decreased), or parosmia (distorted) may be due to several conditions, including viral infections (like COVID-19), nasal problems (rhinitis, polyps, etc), and many other causes.

If this happens, it is important that an Otorhinolaryngologist or an Ear Nose Throat (ENT) doctor is seen for proper assessment and management. In select cases, Smell Retraining Therapy may help in the recovery.

Holiday Schedule:

ONLINE CONSULTATION:
Ongoing. Appointments are accepted daily.

FACE-TO-FACE CONSULTATIONS:
Clinics are open on the following days:
Dec 26 - Monday (ACE Medical Center QC)
Dec 27 - Tuesday (Fatima Valenzuela)
Dec 28 - Wednesday (FEU-NRMF Fairview)

Dec 24, 25, 30, 31, and Jan 1 - NO CLINIC

To set an appointment, please send us a private message.

Happy Holidays, everyone! :)

It is possible that common ENT symptoms such as cough, sore throat, headache, loss of smell and taste, hoarseness, and fever are actually COVID-related. When experiencing these problems, it may be best to stay at home and consult a doctor online to ensure everyone's safety.

Hearing loss is a topic that is near and dear to my heart. It's such a broad subject but here are a few things you need to know about it.

1. There are three types of hearing loss.
2. Hearing loss is not just the complete absence of sound.
3. Hearing loss is not always obvious.
4. There are many causes of hearing loss, the majority of them are preventable.
5. Hearing loss affects people of all ages, not just the elderly.
6. Prevention is always better than cure.
7. For ear and hearing problems, consult an ENT doctor.

Foreign objects in the ear canal are among the several ENT conditions that warrant immediate attention. Beads, small toys, and foam stuck in the ear canal are common among children. While cotton left after self ear-cleaning is more common in adults.

If this happens to you, consult your ENT ASAP.

Here are some of the things you should know about foreign objects in the ear.

Vertigo is one of the most common complaints we see in the ENT clinic. Here are some things you need to know about VERTIGO.

1. Not all people with dizziness have vertigo
VERTIGO is an illusion of movement where you may feel as if you or your surrounding is spinning. DIZZINESS is a broader term that includes vertigo as well as other presentations such as lightheadedness, presyncope (feeling of passing out), and imbalance.

2. Vertigo is a symptom, not a disease
Much like how fever is a sign of an underlying disease process, vertigo itself is NOT a disease. There are many causes of vertigo and the most common is BPPV (Benign Paroxysmal Positional Vertigo.)

3. Keep your eyes open during bouts or attacks
If the cause of the dizziness is BPPV or something that involves the balance organs of the ears, keeping your eyes OPEN and staring at an object may shorten the duration and magnitude of the dizziness. (But make sure you are sitting down)

4. Watch out for other symptoms such as hearing loss, tinnitus, headache, ear fullness, and neurologic changes (numbness, confusion, blurring of vision, weakness of one side of the body, facial drooping, etc)
If you have any of these, it’s likely NOT just BPPV. Please consult your doctor immediately.

5. Do not take unprescribed medications
Unprescribed medications may do more harm than good as they may not be fit to what you need. Taking sedatives or medications that cause drowsiness or sleepiness for prolonged periods (more than 3-5 days) may impede your recovery.

6. Rest but do not forget to exercise
Always stay safe! While it is understandable that you do not want to move when dizzy, complete avoidance of physical activities and movements will prolong recovery. You need to do light exercises recommended by your ENT doctor. These curated exercises will help your balance system to compensate and recover faster.

7. Keep calm and see your doctor
When you are suddenly dizzy, sit down, keep your eyes open, and DO NOT PANIC. Positional vertigo should last for just a few seconds followed by a period lightheadedness and/or imbalance. If your dizziness persists beyond this period and you have other symptoms, it is best to consult your doctor.

With the COVID-19 cases still on the rise, you should protect yourself at all times. Avoid going out of your home unless necessary. If you have non-emergent health concerns, consider consulting your doctor via online channels.

Here are some Frequently Asked Questions (FAQs) about telemedicine.

WHAT IS TELEMEDICINE?
It is the delivery of health care services remotely when the doctor and the patient are not physically present with each other. Some refer to it as an "Online Clinic." There are many platforms but most utilize video consultation between doctors and patients.

WHAT ARE THE ADVANTAGES OF TELEMEDICINE?
It is convenient, accessible, and cost-effective. With the COVID-19 cases still on the rise in addition to the hassle of city traffic and limited transportation, telemedicine is a feasible option to save on travel expenses and unnecessary exposure to infectious diseases. No need to physically line up, simply meet with the doctor during your appointment.

WILL PATIENTS RECEIVE THE SAME KIND OF CARE?
While telemedicine has its limitations, the doctor will still spend quality one on one time with the patient. If the problem is something that can be addressed with medications, a prescription will be provided digitally. Likewise, if laboratory and other diagnostic tests are warranted, they can also be given online. Follow-up consultation and results interpretation may also be done online.

ISN'T IT BETTER FOR PATIENTS TO GO TO THE HOSPITAL?
If your health concern is an emergency, you have to go to the hospital. Telemedicine is best for non-emergent cases. It is also advisable to call the hospital first to coordinate your arrival.

ISN'T A FACE-TO-FACE CONSULT BETTER?
Many conditions can be managed through online consults with your physician. While it is still best for patients to be seen and examined by their doctors personally, due to the current pandemic, it is strongly advised that patients stay home unless there is an absolute need to visit the hospital. This is especially true for high-risk individuals such as senior citizens and the immunocompromised.

HOW WILL I KNOW IF I NEED TO GO TO A PHYSICAL CLINIC?
Discuss this with your doctor during your online consultation. At the moment, most physical clinics are on an appointment basis only with a limited number of patients allowed per day. This is being implemented for everyone’s safety.

HOW IS TELEMEDICINE OR ONLINE CONSULTATION DONE?
It depends on your doctor. We use different platforms but we always have your safety and privacy in mind. Most of us will utilize video consults as this will allow us to assess you better.

(I prefer to use Facebook for appointments and a third party application or website for the consultation.)

DOCTOR'S ADVICE:
Your health concern should never rely on “fake news." There are too many false and unvalidated pieces of health advice circulating on the internet and they may cause more harm than good. Should you have health concerns, it is best to consult your doctor.

One of the most common complaints I see in the clinic is related to ear wax and its removal. Here are some of the common misconceptions about them.

MYTH # 1: "We need to clean our ears daily."
FACT: We don’t need to do it daily. Most of the time, it’s just a force of habit. Our ears are capable of self-cleaning.
Ear wax that is formed inside our ears migrates slowly towards the opening and we only need to clean the outside of our ears.

MYTH # 2: "It’s advisable to use cotton tips, ear spoons, and ear candles."
FACT: On the contrary, none of these are recommended. Cotton tips will just push excess ear wax further inside our ears (and may even damage the eardrum!). Ear spoons can create tiny scratches on the ear canal skin which can cause irritation, swelling, and infection. Ear candling may leave waxy deposits (instead of removing them) and may also cause burns.

MYTH # 3: "Having ear wax is unhygienic."
FACT: Definitely not true. Ear wax or cerumen is naturally produced by our ears. They have protective and antimicrobial properties that keep our ear canals from drying out and becoming infected. They may also serve as a barrier against dirt and some insects. But if it starts causing discomfort and hearing changes, an ENT consult must be considered.

MYTH # 4: "If we always clean our ears, it’s unlikely that we will get impacted ear wax."
FACT: Frequent improper ear cleaning can actually lead to impacted cerumen. Constant ear cleaning can push the natural wax further inside. Once it’s too far in, the ear can no longer “self-clean”. This may lead to accumulation and complete obstruction.

MYTH # 5: "Self-medication with ear drops, baby oil, and hydrogen peroxide is SAFE."
FACT: Never self-medicate. Using them without the advice of a doctor may do more harm than good. Ear drops (even those that were previously prescribed our doctors) have different formulations and indications. Baby oil and hydrogen peroxide may be prescribed for cerumen but it can be harmful to the ears if we have other problems (eg. damaged eardrum, infection, etc.). Also, using them frequently may interfere with the natural self-cleaning ability of our ears.

FINAL ADVICE :
Don’t insert anything inside your ear to clean it. Wiping the outside of the ear with a towel or clean cloth at least once a week should be sufficient. If you feel any discomfort or change in hearing, consult your ENT Doctor.

The Covid war is not over yet. Avoid going out when you can. Send us a message to set an appointment for online consult. If your concern needs assessment done in person or if a procedure is necessary, this will be discussed with you and clinic schedules will be sent to you via the same platform. Stay safe!

Contrary to common belief, ENTs are not just limited to handling problems of the Ear, Nose, and Throat.

Here are the top 10 reasons why you may need to consult an ENT (based on what I commonly see in the clinic).

1. You have ear pain and/or discharge. This is very common.
2. You have decreased hearing or you hear "ringing" in your ears (tinnitus)
3. You feel dizzy or "out of balance."
4. You have nasal problems - clogged nose, frequent sneezing, nasal itchiness, lack of smell/taste, etc.
5. You have throat pain, itchiness, or general discomfort.
6. You have swallowing problems. You may feel that there is a “lump inside your throat”.
7. Your voice has changed. You may have hoarseness, difficulty talking or you may have pain after prolonged voice use.
8. You have masses in the head and neck region. These include lesions of the thyroid, salivary glands, etc.
9. You snore and you always feel tired and sleepy even in the daytime.
10. You've unfortunately incurred facial fractures and/or you want something improved aesthetically.

(P.S. If you're unsure if you need an ENT, ask us.)
(P.P.S. We also do not handle EYE problems. Please consult our Ophthalmology friends for that.). :)