Dr. Angela Chang

Dr. Angela Chang was recently honored with the Top Doctors Award in San Diego Magazine.  Released in their October/November issue, this list recognizes the best physicians in San Diego who are defining the future of San Diego’s healthcare.  Physicians are peer-nominated and undergo rigorous research, review, and screening by Castle Connolly, a nationally respected source for recognizing physicians.

Dr. Chang was also nationally recognized with the Castle Connolly’s Exceptional Women in 2020 award.

We remain committed to your health and safety, and have made changes in our office during this pandemic.

During this current pandemic, we have continued to serve our patients with in-person office visits under guidelines recommended by the Center for Disease Control, World Health Organization, and the American Board of Otolaryngology.  We are also now offering video telemedicine appointments for non-urgent needs or for those who prefer to stay home. Please call our office at 858-208-0030 to set up your in-office or telemedicine appointments.

Your safety, as well as the safety of our staff, is our highest priority.  We have instituted the following preventive measures in our office during this time:

• Patients and staff are required to wear face masks
• Screening patients for symptoms of cough, fever, shortness of breath at appointment confirmation and again at check-in.
• Temperature is taken at check-in.
• Increasing already-rigorous cleaning and sanitization protocols
• Hand-sanitizing stations throughout the office
• Direct entry into exam room if more than one person in waiting room

Please exercise good hand hygiene with frequent washing for 20 seconds, and avoid touching your eyes, nose, and mouth. ​ More information on COVID-19 can be found on the CDC website.

OUR OFFICE DOES NOT OFFER COVID-19 TESTING. As you might know, testing is very limited. If you believe you may have COVID-19, please call your primary care provider for further instructions. You may also call the dedicated COVID-19 Scripps nurse hotline at 888-261-8431.

We will continue to closely monitor the COVID-19 pandemic. We will keep you informed of any changes, and appreciate your flexibility and patience.

Disclaimer: This article is not to be taken as medical advice. Dr. Angela Chang enjoys writing and publishing informal articles like this one to share her general thoughts on healthcare and healthy living in San Diego. If you have any questions or concerns about your specific medical conditions or symptoms, please call Dr. Angela Chang’s office to schedule an appointment or contact another qualified physician in your area.

clinic By Dr. Angela Chang

Why Does Cold Weather Make My Nose Bleed?

I used to have frequent nosebleeds as a child.  They would start in late fall and continue through the winter. They seemed to occur at the most inopportune times, and although they would usually stop after a few minutes, they were quite a nuisance!  Fortunately, like many things in childhood, I grew out of it and no longer suffer frequent nosebleeds.

But for many people — both children and adults, epistaxis (the medical term for nosebleeds) can be problematic this time of the year. Lower humidity, colder outdoor air, and heated indoor air cause the delicate lining in the nose to crack and bleed.  Colds are also more common in the winter and lead to more frequent nose blowing and use of medications that may dry the nasal lining and make it more prone to bleeding.

I receive a lot of question about this in my clinic so I thought it would be helpful to post an article with some tips for preventing nosebleeds.

5 Best Ways To Prevent Nosebleeds

1. Use a nasal saline spray on a daily basis.  This prevents dryness in the nose. Just like our skin, the nasal lining can crack and bleed when it’s dry. Moisturizing the nasal lining can prevent nosebleeds.
2. Try using a humidifier at night.  This provides moisture to the membranes in the nasal cavity.
3. Place a small amount of ointment/gel in your nostrils to promote healing of irritated nasal lining and keep the nasal cavity moist.  NasoGel and Ayr are commonly found at your local pharmacy, but Vaseline ointment works too! 
4. Avoid overly hot liquids that might temporarily dilate blood vessels.
5. Avoid using decongestants and other cold/allergy medications too frequently.  These can often dry out your nose. If you have a cold, gently wipe your nose instead of blowing your nose forcefully.

If the nosebleeds continue despite these efforts, evaluation with an ENT physician is recommended.  Nasal cauterization (burning of the small blood vessels) or other procedures may be necessary. Frequent nosebleeds can also be a sign of a more serious problem that an ENT may be able to diagnose.

Disclaimer: This article is not to be taken as medical advice. Dr. Angela Chang enjoys writing and publishing informal articles like this one to share her general thoughts on healthcare and healthy living in San Diego. If you have any questions or concerns about your specific medical conditions or symptoms, please call Dr. Angela Chang’s office to schedule an appointment or contact another qualified physician in your area.

Super Bloom, Super Allergies

Social media has been blooming this spring with pictures of hillsides awash with color. The California Super Bloom has been in full swing and parents have been taking full advantage of it by collecting precious pictures of their kids posed perfectly in rolling fields of wildflowers. Of course my own attempts to do the same have resulted in nothing more than blurry snapshots of my kids running around in excitement, chasing various insects and lizards. But even though my Instagram account shows no evidence of it, our family hikes have been especially enjoyable this year.

What hasn’t been pleasant, however, are the unusually strong seasonal allergies. And I know it’s not just my husband and I that are feeling this, because many of my patients have been complaining about the same thing. And even though the wildflower bloom seems to be winding down in San Diego, the unusually intense allergy season will continue well into summer as wildflowers give way to natural grasses that don’t look as colorful, but actually produce more harmful airborne allergens – more people are allergic to grass pollen than any other airborne allergen.

So what options are available to people suffering from seasonal allergies? Should you tough it out? Get over the counter symptom relief? Talk to a doctor about allergy drops or shots? As always, it depends. For many people, seasonal allergies are annoying but harmless and you can try some of the tips I’ve listed below to seek relief as necessary. But for some people, prolonged exposure to allergens can cause problems like nasal polyps and chronic sinus infections which may require surgery. If you are concerned, you can always call my office to schedule an allergy test or discuss other allergy-related conditions like nasal polyps and chronic sinus infections.

Best Ways To Manage Seasonal Allergies

1. Limit your outdoor activity when pollen counts are high. I know this is a tough one, because being able to enjoy the outdoors is a big part of why we all live in San Diego. But sometimes you just need to give your body a break by staying inside and away from clouds of pollen. You can always, of course, visit the beach. Sea breezes in Southern California typically blow pollen inland.
2. When you do go outside for extended periods of time, be sure to change your clothes and take a shower to get the pollen off your hair, clothes, and skin. Even though you can’t see it, the pollen is there and will continue to trigger your symptoms.
3. Use saline nasal sprays and rinses to flush the allergens out of your nose and sinuses.  The longer the allergens stay in your nose, the more prolonged your symptoms will be. Worried about trying nasal saline rinses for the first time? Try using an nasal saline mist and ease yourself into using the sinus rinse bottle or Neti-Pot.
4. Try an over-the-counter oral antihistamine like Claritin or Zyrtec.  These medications will help with allergy symptoms and typically do not cause significant drowsiness.  Flonase, a nasal steroid spray, can also be used to manage nasal congestion and runny nose, but many patients feel it can take at least a few days of daily use for it build up to its full effectiveness.
5. Allergy drops or shots.  If you find that you’re using allergy medications more than you would like to, or if your symptoms are not well-controlled despite medications, you may want to consider allergy testing.  Allergy testing not only tells you what you’re allergic to and how severe your allergy is, but it can also help guide immunotherapy. Immunotherapy (allergy shots or drops) can be used to teach your body to become desensitized to these allergens so that you won’t need allergy medication in the future.

Our office offers sublingual immunotherapy allergy drops, which is a good alternative to allergy shots.  My patients enjoy the convenience of doing it at home and not having to come in every week for an allergy shot – they also love that it’s painless!  Schedule an appointment for an evaluation and to learn more about allergy testing and immunotherapy.

Disclaimer: This article is not to be taken as medical advice. Dr. Angela Chang enjoys writing and publishing informal articles like this one to share her general thoughts on healthcare and healthy living in San Diego. If you have any questions or concerns about your specific medical conditions or symptoms, please call Dr. Angela Chang’s office to schedule an appointment or contact another qualified physician in your area.

It’s incredibly rewarding for me to hear that my patients are enjoying a better quality of life after sinus surgery.  I enjoy being a part of my patients’ recovery process and watching them improve week to week. Despite recent advancements, recovery from sinus surgery can still be somewhat uncomfortable for many.

A while back I was invited to appear on a KUSI’s Good Morning San Diego show to discuss my experiences with Propel, a dissolvable stent that is placed in the sinuses after surgery to decrease inflammation and scar formation. (Disclaimer: I don’t have any business ties to the company that sells Propel, but my experiences with using it in the OR have been positive). I began thinking that I should share some tips for a quick recovery after sinus surgery.

Please don’t take this list as a substitute for post-operative care instructions from your surgeon. Depending on the specific procedure performed as well as your own personal medical history, your surgeon will give you post-operative instructions for you to follow and you should follow those directions carefully. But generally speaking, recovering from sinus surgery can be eased with these universal tips:

1. Keep your head elevated when you sleep for the first two weeks. Some of my patients just sleep in a recliner for that period. You can also elevate your upper body in bed using 3 to 4 pillows. This allows your sinuses to continue draining properly and will minimize overall swelling and pain.
2. Rinse your nose during the day and use a humidifier at night.  I recommend that my patients rinse their nose with saline several times a day immediately after sinus surgery.  This rinses out the mucus while keeping the membranes moist after surgery. At night, there is no need to wake up to irrigate, but a humidifier can be very helpful.  The humidifier at our home gets a lot of use during the school cold and flu season each year. Just as it helps kids who are battling a cold sleep more comfortably by keeping the nasal, throat, and lung passages moist, it can also help relieve some of the discomfort you might feel following surgery by preventing the mucus in your nose from getting dry and irritated during that crucial healing period.
3. Rest and take it easy. Avoid bending over and have someone else do all the lifting. If you have taken a few days off work to recover, don’t use that as an opportunity to get some overdue house cleaning done. Any sort of physical exertion can cause bleeding and cause more inflammation, and certainly set you back a few days on your road to recovery.
4. Be aggressive in preventing a cold or flu virus.  That’s the last thing you want to throw into the mix when your sinuses and nasal passages are already inflamed. Wash your hands frequently, avoid crowded places,, drink of plenty of water and get a lot of rest.
5. Believe in your ability to get through the recovery process. It will be uncomfortable at times and you will feel some pain along the way, but you will get through it!  Of course, depending on your specific situation, your surgeon will certainly be able to give you some prescription pain medication which you can take when/if necessary. However, pain medications are not meant to completely eliminate all the pain.  After a few days, most patients should be able to manage with nothing more than Tylenol and a little bit of determination…and perhaps an entertaining movie or book for distraction.

Disclaimer: This article is not to be taken as medical advice. Dr. Angela Chang enjoys writing and publishing informal articles like this one to share her general thoughts on healthcare and healthy living in San Diego. If you have any questions or concerns about your specific medical conditions or sinus health, please call Dr. Angela Chang’s office to schedule an appointment or contact another qualified ENT doctor in your area.