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The next couple blogs will focus on common medications and how they can affect vocal function. Today we will specifically focus on antihypertensive medications.  We will specifically focus on to classes of blood pressure medications - angiotensin-converting enzyme inhibitors (ACE-I) andangiotensin receptor blockers (ARBs.)

Both ACE-I and ARBs are common medications utilized to control elevated blood pressure.  They work by blocking the effects of angiotensin, a chemical that narrows blood vessels.  By doing so, they help widen the blood vessel and allow blood to flow more easily, which lowers the blood pressure.  This also reduces stress on the heart.  Unfortunately, they both can cause side effects which are specific to the throat and voice.

A common side effect of both classes of medications is a nagging, dry cough.  Symptoms can start at the onset of medication use.  However,side effects can also develop years later. In general, patients who develop a cough while on this medication can be difficult to treat.  Symptoms can include a dry cough, but also can present as a lump in the throat sensation or a constant need to clear one’s throat. Often patients will have to be switched to a different class of blood pressure medication in order to improve the cough.  Is always advised to seek evaluation by an ENT physician or Laryngologist for the cough as there can be other causes.  However, if an endoscopy is normal, the patient is often referred back to their primary care physician to discuss other options for blood pressure control.  Some common ACE inhibitors and ARBs are listed below.


ACE inhibitors                                                                    ARBs

Lisinopril                                                                              Azilsartan

Quinapril                                                                             Candesartan

Ramipril                                                                               Eprosartan

Benazepril                                                                           Irbesartan

Captopril                                                                              Losartan

Enalapril                                                                               Valsartan









By Andrew Celmer, M.D. - MMC Comprehensive ENT Specialists

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

Are your legs tired, swollen, restless or have ropey veins?Have you been told you have varicose veins or venous reflux disease?

It may be time to visit MMC’s Vein Center and get your beautiful, healthy legs back.

What is venous reflux disease?

Venous reflux disease occurs when there is not proper blood flow in the leg veins. This is often characterized by painful, swollen, or restless legs and can result in unsightly varicose veins. More than 30 million people have undiagnosed varicose veins.

Is there a treatment?

The MMC Vein Center provides patients diagnosed with venous reflux disease with several minimally invasive treatment options. Some of these in-office treatments include Venefit™ and Sclerotherapy procedures. MMC Vein Center helps patients experience less discomfort, bruising and downtime.

Is there anything I can do to prevent unsightly varicose veins?

While varicose veins may be unavoidable for some people, here are somethings you can do to ease pain and prevent varicose veins from getting worse.

  • Take care of your body – exercising and losing weight may help
  • Don’t wear tight, restricting clothing
  • Relax your legs – avoid standing for long periods of time and elevate your legs every once in a while

Don’t live with leg pain, give MMC’s Vein Center a call to set up a consultation. Our team of three, Board Certified Vascular Surgeons is passionate about helping patients have healthy legs for life.Having performed over 5,000 vein procedures in the past 10 years, it is evident their knowledge and skills are unmatched. The state of-the-art treatments offered at the MMC Vein Center are safe and effective, with little downtime,and provide proven results.

Posted by Murfreesboro Medical Clinic | Topic: News  | Category: Vein

Can I make my own saline rinses?

September 2nd, 2020

You’ve probably heard of nasal rinses and the many benefits they can bring: preventing sinus infection, improving breathing, reducing swelling, washing away mucus and allergens, etc. They are an efficient way to keep your sinuses healthy. Many patients are recommended to use nasal saline irrigations as part of treatments for multiple nasal diagnoses. Administration of nasal saline rinses can be done with a variety of products including a sinus rinse bottle, neti pot, or a nasal lavage device. Nasal saline rinses provide away to wash the sinus and nasal cavities, while also allow for administration of medications in some patients. It cleanses the nasal cavities of debris or mucus providing a great sense of relief for most patients immediately.

You have many different brands and method of using a saline rinse. They come in shapes like a teapot to a squeeze bottle. Many patients have questions about how to make saline rinses at home, and whether it is safe to do so. Yes, it is!  First, it’s very important that you use boiled water (that has cooled), or distilled water to avoid any unnecessary contamination that could occur from using tap water. Distilled water is available by the gallon at many retailers for less than $1. Once you have filled your rinse bottle with water, you can make saline by adding a salt packet purchased at your local pharmacy. These contain all the necessary ingredients for your rinse. These are available in the aisle where sinus rinse bottles and nasal sprays are available for purchase. You can clear your sinuses and breathe easily for just a couple dollars.

Lots of people want to make their own saline mix at home instead of purchasing the packet. Here is a recipe you can follow to do so:

  • 1 cup (8 oz) distilled water or boiled water that has cooled
  • ½ teaspoon of salt
  • ½ teaspoon of baking soda

Shake to mix. 

If you need a refresher on how best to administer saline rinses, here is a video that you might find helpful.

Visit mmclinic.com/ENT for more information, or call 615-867-8110 today to schedule an appointment!






By Britni Caplin, M.D. - MMC Comprehensive ENT Specialist

Dr. Caplin spent her early life in West Virginia, prior to attending medical school and completing residency at Vanderbilt University in Nashville.  Prior to her arrival at MMC, she worked in private practice in Massachusetts, then served as the Chief of Otolaryngology within the Tennessee Valley Healthcare System, while also holding an appointment as an Assistant Professor at Vanderbilt University Medical Center in the Department of Otolaryngology – Head & Neck Surgery. 

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

Murfreesboro Medical Clinic & SurgiCenter is committed to meeting the needs of Rutherford County’s growing community. In the midst of a global pandemic, now more than ever, primary care is critical in caring for our citizens. 

Elizabeth Bunch, D.O. is board-certified by the American College of Osteopathic Family Physicians.She graduated from the University of Central Florida in 2013 before receiving her medical degree from Lincoln Memorial University in 2017. Originally from the Florida panhandle, she fell in love with Tennessee while receiving her degree in the state. Dr. Bunch completed her residency training in Murfreesboro and says she is excited to continue serving the area. Dr. Bunch will be practicing at MMC’s Garrison Drive Location.


Kayla Wienczkowski, M.D. is a board-certified by the American Board of Pediatrics. She graduated from Lipscomb University in 2012. She then completed her medical degree and residency as Chief Resident at the James H. Quillen College of Medicine at East Tennessee State University. After spending 7 years in the mountains of East Tennessee, Dr. Wienczkowski says she is excited to move back to Middle Tennessee,where she was born and raised. Dr. Wienczkowski will be practicing at MMC’s newest location in Murfreesboro located on Shelbyville Pike.

To learn more aboutMMC’s newest physicians or to schedule an appointment, visit mmclinic.com.

Posted by Murfreesboro Medical Clinic | Topic: News  | Category: News

Murfreesboro Medical Clinic & SurgiCenter is proud to announce the addition of Kayla Wienczkowski, M.D. to its Pediatrics Department.

Dr. Kayla Wienczkowski is a board-certified Pediatrician.She graduated from Lipscomb University in 2012. She then completed her medical degree and residency as Chief Resident at the James H. Quillen College of Medicine at East Tennessee State University.

After spending 7 years in the mountains of East Tennessee, Dr. Wienczkowski says she is excited to move back to Middle Tennessee, where she was born and raised. In her free time, she enjoys running, gardening, and spending time with her husband and Great Dane.

Dr. Wienczkowski will be practicing at MMC’s newest location in Murfreesboro located on Shelbyville Pike.

For more information about Dr. Kayla Wienczkowski or to make an appointment, visit mmclinic.com/pediatrics or call 615-867-8020.

Posted by Murfreesboro Medical Clinic | Topic: New Physicians  | Category: News

Murfreesboro Medical Clinic & SurgiCenter is proud to announce the addition of Elizabeth Bunch, D.O. to its Internal and Family Medicine Department.

Dr. Elizabeth Bunch is board-certified by the American College of Osteopathic Family Physicians. She graduated from the University of Central Florida in 2013 before receiving her medical degree from Lincoln Memorial University in 2017. Originally from the Florida panhandle, she fell in love with Tennessee while receiving her degree in the state. She completed her residency training in Murfreesboro and says she is excited to continue serving the area.

Dr. Bunch lives in Murfreesboro with her husband, Louis, and their two dogs. They enjoy spending time on the lake, exploring Nashville and game nights with friends.

Dr. Bunch will be practicing at MMC’s Garrison Drive Location.

For more information about Dr. Elizabeth Bunch or to request an appointment, visit mmclinic.com/IFM or call 615-867-8010.

Posted by Murfreesboro Medical Clinic | Topic: New Physicians  | Category: News

The next couple blogs will focus on common medications and how they can affect vocal function. Today we will specifically focus onantihypertensive medications. These are more commonly known as blood pressure medications.

Generally, all blood pressure medications have a drying effect on the upper airways. Patient's will often experience dry mouth. This can also affect the normal lubrication required within the throat for proper vocal cord function. Without proper lubrication, the vocal folds do not vibrate naturally. Patients with generally experience a dry, raspy throat. Proper hydration with water both before and after speaking engagements and performances can go a long way toward preserving normal vocal function. The natural remedies such as ginger have also been shown to help with lubrication of the voice. Future blogs will address homeopathic remedies.








By Andrew Celmer, M.D. - MMC Comprehensive ENT Specialists

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

Amanda W. has lived in Murfreesboro for 15 years and uses Murfreesboro Medical Clinic for all of her family’s medical needs. She appreciates the convenience of having accessible doctors close by to fit her family’s busy schedules. 

In June of 2018, she was referred to Dr. Brannon Mangus, one of MMC’s Comprehensive ENT Specialists, after her primary care physician examined a swollen lymph node in her neck.  Dr. Mangus quickly scheduled surgery for Amanda, and was able to give her the diagnosis of Stage One Non-Hodgkin's Lymphoma.

Non-Hodgkin's Lymphoma is a cancer that starts in the lymphatic system of the body. The condition occurs when the body produces too many abnormal lymphocytes, a type of white blood cell. Many times,it is first noticed by the patient or their PCP when they feel a swollen lymph node in the neck. Surgical removal of the lymph node is not a cure, but rather is necessary to diagnose what type of lymphoma it is.

“He came in, shook my hand, sat down with me,got on eye level with me, and explained to me that we did not have the news that we had hoped for; however, he assured me that this was a season -- this was not going to be my life. We were going to get through this and move forward to the next step.”

Although Amanda was devastated by this unfortunate news, she was comforted by Dr. Mangus and his staff and the time they took to encourage her.

“Dr. Mangus showed that he really cared and that I wasn’t just a patient. He really cared about my health and my well-being.”

Amanda’s initial scans, surgery and diagnosis were all obtained at MMC.

“It was so nice to just be 15-20 minutes down the road because I would be at the doctor’s office sometimes twice a week.”

Amanda was able to continue on with her life and caring for her kids, even in the midst of her treatment. 

“I felt like they really cared. They knew me by my name, they knew me by my face, they knew my story.”

Today, Amanda is in remission and is living a happy, healthy life. She and her family still use Murfreesboro Medical Clinic for all of their healthcare needs and are grateful for the care they received at MMC by Dr. Mangus and his staff.

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

Tips for a Summer Pregnancy

July 29th, 2020

Summer is a great time to be outside,with all of the barbeques, picnics and ball games. However, there can be some difficulties with tolerating the summer heat if you are pregnant. Here are some tips from MMC Obstetrician and Gynecologist Colleen Bratsch, D.O. on how to make the most of your summer pregnancy:

  1. Clothing: A lot of women prefer sun dresses, just make sure you’re comfortable and not restricted. When picking shoes,remember that comfort is key. However, hesitate in wearing flip flops because they can be a tripping hazard.
  2. Hydration: Make sure you have a water bottle with you at all times, and aim to drink 80 to 100 ounces of water a day.
  3. Activity: Remember to seek activities that you can do and do safely.

a. Walking: Walking in the heat of the day can be difficult; however, morning walks and evening walks can be good for your pregnancy.

b. Biking: Biking is limited to first trimester and second trimester; however, you can safely bike and get good exercise.

c. Swimming: We all love the pool! Pools are great for exercise and relaxation during pregnancy. You have increased buoyancy and relaxation for your muscles. You can do water aerobics or water walking.  

Watch Dr. Bratsch’s video here:

If you have any questions or would like to schedule an appointment with MMC Obstetrics and Gynecology, please call 615-867-8030.






Colleen Bratsch, D.O. - MMC Obstetrics and Gynecology

Dr. Bratsch joined Murfreesboro Medical Clinic Department of Obstetrics and Gynecology in 2008. She had previously practiced in Jefferson City, Tennessee for five years. Dr. Bratsch is a graduate of the Philadelphia College of Osteopathic Medicine. She completed a medical internship at Doctors Hospital in Columbus, Ohio. This was followed by her residency in Obstetrics and Gynecology at Christiana Care Hospital in Newark, DE. Dr. Bratsch served as Chief Resident in her final year of residency. She became board certified in 2005 and is a Fellow of the American College of Obstetricians and Gynecologists. She also is a member of the American Medical Association, Tennessee Medical Association, and the American Osteopathic Association.

Posted by Murfreesboro Medical Clinic | Topic: News  | Category: OBGYN

The state of Tennessee has lifted the stay-at-home orders inmost areas, and the weather is heating up. Pools are opening here in Murfreesboro, and the lakes are overflowing with people going outside to rediscover a sense of normalcy here in Middle Tennessee. However, frequent water activities and humidity can lead to an increase in water related ear infections.

The type of ear infection that can present when habitually around water or humidity is called otitis externa, or more commonly, swimmer’sear.  Otitis externa simply refers to the inflammation of the outer ear, which can include the ear canal or auricle.  Children ages 5-15 have the highest likelihood of developing swimmer’s ear, but persons of any age can be affected. Signs and symptoms include pain,drainage, itching of the ear, and decrease in hearing.  The ear has several inherent defense mechanisms to protect itself, including hair follicles and cerumen (ear wax).  Cerumen is important because it is an acidic medium that helps inhibit the growth of both bacteria and fungus. Water or excess moisture leads to cerumen breakdown which changes the flora and acidity of the ear canal, making it more susceptible to infection. Frequent water exposure is the most well-known risk factor for swimmer’s ear infections, but anything that causes cerumen destruction or trauma to the ear canal can also stimulate an infection.  Therefore, Q-tip use is discouraged!

The most common causes of a swimmer’s ear infection are bacterial, fungal or dermatologic (i.e. related to skin conditions). Each of these types of infections is treated differently, and therefore requires a thorough ear, or otoscopic, examination for differentiation. The otoscopic examination is also important to assess for other possible diagnoses like otitis media and tympanic membrane perforation. Some mild forms of otitis externa with only mild drainage and swelling may only require antibiotic ear drops for treatment. Other more severe infections that severe pain, edema, and hearing loss may need more extensive cleaning, a wick to relieve an occlusion, an ear culture, or even a hearing test.

All our providers at Murfreesboro Medical Clinic ENT are specially trained to diagnose and treat these ear infections, so if you need our services feel free to call and arrange an appointment.

Recommended at home treatment and prevention for swimmer’sear:

  • Dry ears out with hairdryer after swimming
  • Consider fitted ear plugs for swimming (can be fitted for you at your Murfreesboro Medical Clinic ENT appointment)
  • Homemade ear drops with half rubbing alcohol, half vinegar can help to evaporate water in the ears and prevent a swimmer’s ear infection
  • If a perforation (hole in the eardrum) or ear tubes are in place, consult with your Murfreesboro Medical Clinic ENT doctor before using ear drops
  • Do not use q tip or other foreign bodies to clean ear wax






Chad Richardson, FNP-C - MMC Comprehensive ENT Specialists

Chad Richardson moved to Rutherford County to attend college at Middle Tennessee State University in 1999. He currently lives in Murfreesboro with his family, including his daughter and son. His interests include hiking, baseball, hunting, fishing, and golf. 

Chad studied nursing, and received his bachelor's degree from Middle Tennessee State University in 2004.  While completing his bachelors he began his MMC journey by working in the Pediatric department. After graduation he then left the clinic to work in Vanderbilt Pediatric Emergency Room.  After 3 years away from the clinic he then returned to work at MMC in 2007 and worked both in the PACU and OR in the SurgiCenter.  While working in the SurgiCenter, he then completed his master's degree studies from Tennessee State University, and became a board certified nurse practitioner in 2018. 

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

Murfreesboro Medical Clinic | 615-893-4480 | see all locations
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As of July 1, 2020, face coverings (covering the wearer’s nose and mouth) will be required at all MMC locations for all patients and visitors ages 2 and above. Due to an increase in COVID-19 positive cases locally, across our state and around the country, MMC believes that it is in the best interests of our community, patients and staff. While this may not be convenient, our goal is to protect our community. Everyone is encouraged to bring their own face coverings to enter the building. If patients or visitors do not have a face covering they will be given one. Any person who chooses not to comply with this policy will have their appointment rescheduled. Thank you for understanding. 

Your health is our mission.

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