EXPERT
Dr. Vipin Malik, MD
Pulmonologist
Dr. Vipin Malik practices Pulmonary, Critical Care and Sleep Medicine in Denver, CO. A pulmonologist is a physician who possesses specialized knowledge and skill in the diagnosis and treatment of pulmonary conditions and diseases. Dr. Malik manages patients who need life support and mechanical ventilation, and is specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema, complicated chest infections and sleep disorders.
Dr. Vipin Malik, MD
- Denver, CO
- Accepting new patients
Patient's Guide to ICU
I have developed this document to help patients and their families navigate critical care processes and vocabulary. It is not comprehensive and can be modified/corrected as/if...
Treating a paralyzed diaphragm?
Diaphragmatic plication, diaphragmatic pacemaker and Sural Nerve transplantation could be considered. Specialty referral/consultation recommended.
Low oxygen levels during sleep?
Brief drops could be due to suboptimal signal but if persistent and especially if observed during sleep the following morning, consider Sleep Apnea. In that situation consider READ MORE
Brief drops could be due to suboptimal signal but if persistent and especially if observed during sleep the following morning, consider Sleep Apnea. In that situation consider getting overnight pulse oximetry or Home Sleep Study and establishing care with a sleep specialist.
Chest?
More detailed history and testing needed but consider hiatal hernia particularly in presence of symptoms GER (gastroesophageal reflux).
Chronic bronchitis, asthma, vocal cord dysfunction?
I am unable to see values clearly on scanned reports . Flattening of inspiratory FV loops point towards possibility of extrathoracic airway obstruction such as VCD. If patient READ MORE
I am unable to see values clearly on scanned reports . Flattening of inspiratory FV loops point towards possibility of extrathoracic airway obstruction such as VCD. If patient has had any major operations requiring prolonged intubation, subglottic stenosis could be considered given ?BOX like feature of FV loops. Patient should get direct laryngoscopy for evaluation of VCD.
Cannabis smoking can contribute to chronic bronchitis and she should consider stopping smoking.
D-dimer had high negative predictive value and as such borderline elevation might not be that informative. Clinical correlation/examination would be required.
Consider silent gastroesophageal reflux as a cause of constant throat clearing. Avoiding eating or drinking within 3 hours of bedtime and elevating head of bed at night could be helpful in minimizing silent GER.
Cannabis smoking can contribute to chronic bronchitis and she should consider stopping smoking.
D-dimer had high negative predictive value and as such borderline elevation might not be that informative. Clinical correlation/examination would be required.
Consider silent gastroesophageal reflux as a cause of constant throat clearing. Avoiding eating or drinking within 3 hours of bedtime and elevating head of bed at night could be helpful in minimizing silent GER.
Ddimer
Normal D-dimers have high negative predictive value and as such borderline elevated D-dimers might not be informative. Clinical correlation would be required for prognostication READ MORE
Normal D-dimers have high negative predictive value and as such borderline elevated D-dimers might not be informative. Clinical correlation would be required for prognostication regarding PE. Patient can get VQ scan and lower extremity venous dopplers if suspicion for VTE (venous thromboembolism) is high including family history of VTE, use of oral contraceptives, prolonged immobilization, etc..
Heavy chest
Consider Vocal Cord Dysfunction.
