Zacheis David MD

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Mon - Fri:	8:00 am - 5:00 pm

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Phone: (307) 742-9496

Address: 3116 Willett Dr, Laramie, WY 82072

Zacheis David MD

General Practitioners

Headaches
Sinusitis
Endoscopic sinus surgery is a procedure that may be recommended to remove blockages in the sinus cavities that may be causing chronic sinusitis, pain, or impaired breathing. Endoscopic sinus surgery can be used to relieve nasal polyps or septal deviations. It is important to remember that many causes of sinusitis can be treated with oral steroids and antibiotics. Although functional endoscopic sinus surgery is a simple and effective procedure, it should not be the first resort when treating chronic sinusitis.
Medical Weight Loss
Hyperthyroidism is the condition where excessive amounts of thyroid hormones are produced. This may be caused by Grave’s disease or an overactive thyroid. The excess of thyroid hormones speeds up many of the bodily functions that the thyroid is responsible for. You may notice unintentional weight loss, hunger, rapid heart rate, anxiety or irritability, insomnia, sweating, feeling hot, diarrhea, and bulging of the eyes. Some medications can help reduce thyroid hormone production, or some extreme cases may require surgical intervention.
Primary Care
You may come to see our specialists from a referral from your primary care physician. Otherwise, if you are experiencing any of the following symptoms, contact our ear, nose, and throat doctors to
Ear Infections
Ear infections seem to be as common in children as rain in August. In fact, by the time a child turns five, it is more than likely that they have experienced at least one ear infection. Viral ear infections typically resolve on their own while bacterial infections are treated by antibiotics. Sometimes, ear infections and/or fluid in the middle ear becomes a chronic problem that leads to complications including hearing loss or behavior and speech problems. In cases where complications persist, placement of an ear tube by an
Emergency Care
Constipation
Diarrhea
Pneumonia

Ophthalmologists

Glaucoma
In the allergic patient, the release of histamine and similar substances results in congestion and excess production of watery nasal mucus. Antihistamines help relieve the sneezing and runny nose of allergy. Many antihistamines are now available without a prescription. The most familiar brands include Benadryl®, Clarinex®, Claritin®, Allegra®, and Zyrtec.® Decongestants, such as Sudafed®, shrink congested nasal tissues. Combinations of antihistamines with decongestants are also available; for example, Actifed®, Allegra D®, Claritin D®. Preparations with the added decongestant have potential side effects and patients should read the package insert. This is especially important if the patient suffers from high blood pressure, glaucoma, irregular heartbeat, prostate problems, or is pregnant.

Internists

Lung Cancer
Tobacco use is the biggest risk factor for developing head and neck cancers — also referred to as “throat cancer.” In the United States, nearly 200,000 people die annually due to smoking-relatednesses. The good news is, in recent years, the number of Americans dying from smoking-related disease has reduced due to anti-smoking campaigns warning of the risks and urging people to quit using smoking. The bad news is that some of these ex-smokers simply took up chewing tobacco or vaping, assuming it is a safe alternative. This is untrue – they are merely changing the site of the cancer risk from their lungs to their mouth. While lung cancer cases are down, cancers in the head and neck appear to be steadily increasing. Cancer of the head and neck is often successfully treated if diagnosed early. Fortunately, most head and neck cancers produce early symptoms. You should know the warning signs so you can alert your doctor. Remember – successful treatment of head and neck cancer depends on early detection. Knowing and recognizing the signs of head and neck cancer can save your life.

Neurologists

Multiple Sclerosis
Dizziness and vertigo are common problems with many potential causes. Inner ear vestibular organ disorders are quite commonly the cause of true vertigo, especially if it is triggered by head motion or change of position. Central nervous system disorders can cause dizziness, vertigo and imbalance. Degenerative disorders such as Multiple Sclerosis and Parkinson’s disease can contribute to the development of those symptoms. Strokes and TIA’s can also result in the symptoms in question. Migraine headaches can present as a wide range of symptoms including motion sensitivity, dizziness, vision and light sensitivity and disequilibrium. Neck problems and neck injuries can be factors in cases of dizziness and lightheadedness. Many other medical possibilities leading to dizziness exist including Thyroid disorders, high or low blood pressure, vision disorders, cardiac issues, Neuropathy, blood sugar disorders, etc.
Epilepsy
The goal of VNS for people with epilepsy is to reduce the strength, length, and number of seizures. Patients with epilepsy have reported the following improvements in their condition due to vagus nerve stimulation...

Psychiatrists

Depression
Insomnia
Anxiety

Endocrinologist

Hypothyroidism
Hypothyroidism is caused by the lack of thyroid hormones and may be caused by an underactive thyroid, thyroid cancer, or may be the result of thyroid removal. Hypothyroidism slows down the functions that the thyroid is responsible for. This may cause constipation, feeling cold, unexplained weight gain, feel sad or depressed, fatigue, pale skin, thinning hair, slow heart rate, or a puffy face. Hypothyroidism is treated with synthetic hormones.
Thyroid
The different thyroid disorders can cause a variety of symptoms, but there are some symptoms that would steer the thinking toward your thyroid. Some common thyroid-related symptoms include...
Thyroid Cancer
A thyroidectomy is the surgical removal of all or part of the thyroid gland. A thyroidectomy is not typically the first course of action, but may be used as a treatment for disorders including cancer, large goiters that aren’t resolved by other means, or overactive thyroid. How much and what portion of the thyroid that is removed during the thyroidectomy depends on what condition is being treated. For instance, to treat hyperthyroidism, typically just a portion of the thyroid is removed. Thyroid surgeons will attempt to remove just the goiter and the tissue affected, while protecting the integrity of the remaining thyroid. Thyroidectomies performed to treat thyroid cancer may cause the removal of more or all of the thyroid.

Radiologist

MRI
Generally, no. The Inspire device does not interfere with most medical imaging modalities, and if your model does limit MRI, your provider will discuss this specific limitation with you. For the most part, other procedures and medications are safe to take. Your provider will discuss your specific case with you.
X-Rays
Computed Tomography
Cholesteatomas typically require surgical intervention to protect the patient from serious complications. Hearing tests and CT scans may be necessary to determine the exact size, location, and effect of the cholesteatoma. These tests are performed to determine the hearing level remaining in the ear and the extent of destruction the cholesteatoma has caused.
Chemotherapy
Depending on the type and severity of cancer, your medical team will discuss a variety of possible treatment options with you. Some cancers can be treated with the removal of the cancerous tissue or tumor removal, whereas more advanced cancer may involve radiation and chemotherapy.
Radiation Therapy
There are varieties of treatments available (including surgery, radiation therapy, and chemotherapy) to treat skin cancer. Treatment for skin cancer depends on the type and size of cancer, your age, and your overall health.

Surgeons

Ear Surgery
The safest way to dry your ears is with a hair blow-dryer. If you do not have a perforated eardrum, rubbing alcohol or a 50:50 mixture of alcohol and vinegar used as ear drops will evaporate excess water and keep your ears dry. Before using any drops in the ear, it is important to verify that you do not have a perforated eardrum. Check with your otolaryngologist if you have ever had a perforated, punctured, or injured eardrum, or if you have had ear surgery.

Dermatologists

Skin Cancer
Skin cancer is a disease in which cancer (malignant) cells are found in the outer layers of your skin. There are several types of cancer that originate in the skin. The most common types are basal cell carcinoma (70% of all skin cancers) and squamous cell carcinoma (20% of all skin cancers). These types are classified as nonmelanoma skin cancer.
Cyst
Ulcer
A growth in the mouth: Most cancers of the mouth or tongue cause a sore or swelling that doesn’t go away. These sores (or ulcers) and spots of swelling are typically painless unless they become infected. Bleeding may occur, but often times that is not until late in the disease. You should be especially concerned if an ulcer is accompanied by lumps in the neck. Your dentist or doctor can determine if a biopsy is recommended and can refer you to a head and neck surgeon to perform this procedure.
Fungus
An itchy ear is a maddening symptom. Sometimes it is caused by a fungus or allergy, but more often it is a chronic dermatitis (skin inflammation) of the ear canal. One type is seborrheic dermatitis, a condition similar to dandruff in the scalp; the wax is dry, flaky, and abundant. Some patients with this problem do well by decreasing intake of foods that aggravate it, such as greasy foods, carbohydrates (sugar and starches), and chocolate. Doctors often prescribe a cortisone eardrop at bedtime when the ears itch. There is no long-term cure, but it can be kept controlled.
Lesions
Present as pigmented (colored) lesions in the skin with an irregular shape, irregular border, and multiple colors. It is the most harmful of all the skin cancers because it can spread

Physical Therapists

Physical Therapy
Your Physician will help to diagnose and treat any medical conditions that can result in dizziness, vertigo, or imbalance. Your Physician may recommend other Physician consultations for medical work up of specific dizzy problems. Ear Nose and Throat doctors and Neurologists are Physicians who often deal with symptoms of dizziness, vertigo and imbalance. Should the Physician believe your symptoms are related to inner ear (vestibular organ) problems, central nervous system causes, or other sensory deficits such as vision impairment and Neuropathy, he or she will often recommend specialized “Vestibular” Physical Therapy.

Allergists

Allergies
Some over-the-counter medications such as Benadryl and allergy/cold/sinus medications can be taken up to 3 days before your allergy testing. At your visit, your allergy technician will assess if any of the above medications, if taken, will interfere with skin testing. If it is determined that skin testing results will not be accurate, you will need to reschedule your appointment.

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