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Concerns for the Throat:
14.What is Tonsils and Adenoids?
15.Do you have trouble Swallowing? Insight into
Dysphagia.
16.What causes swallowing disorders?
17.Gastroesophageal Reflux/Laryngopharyngeal
Reflux (LPR)
18.Tips for Reducing Reflux and
Laryngopharyngeal Reflux
19.What is Hoarseness?
20.What are the causes?
21.When should I see an Otolaryngologist?
22.What can I do to prevent and treat mild
hoarseness?
Concerns for the Sinuses
and Nasal Cavity
23.What is Sinusitis?
24.Preventing Sinusitis
25.What Causes Post-Nasal Drip?
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Allergies:
1.Why do some people have allergies?
Allergies involve the immune system. But,
the most important reason some people
develop allergies and some don't is thought
to be heredity. Preventing exposure in early
life seems to decrease the risk of
allergies. However new research indicates
that exposure to dogs in early life seems to
enhance the development of the immune
system, thus decreasing the risk the child
will develop allergies.
Sometimes people say that they never had
allergy symptoms until they moved to a new
area. Moving to a new area may seem to
trigger the immune response, but authorities
believe these people already had hereditary
tendency toward allergies.
Migraine headaches are not usually thought
to be caused by allergies. However,
allergies can cause excess sinus moisture
which can promote growth of bacteria. This
can result in a sinus infection with
resulting pressure and sinus headache.
It is unlikely that dizziness or nausea is
directly related to allergies. Dizziness and
nausea can be caused by a number of things,
some possibly serious, and these symptoms
should always be reported to your physician
It is thought that allergies can cause some
degree of fatigue. However "trouble
sleeping" and "tired all the time" are
commonly reported symptoms in every area of
medicine. These symptoms should always be
reported to your physician, who can do
routine testing to see if an underlying
medical condition might be causing the
problem.
A sore throat with blisters or enlarged
lymph nodes in the neck, especially if
accompanied by a fever, is usually not a
sign of allergies, but rather a bacterial or
viral infection. See your physician.
Noise in the ears is known as tinnitus.
Allergies can cause sensations of fullness
or popping in the ears, this is sometimes
considered a symptom of allergies. You
should see your physician if you experience
tinnitus.
Coughing may be the first sign of asthma,
especially in children.
Chronic changes in voice and trouble
swallowing should always be checked out by a
physician. These usually do not indicate
allergies, but can be symptoms of serious
conditions.
2.How do I know if I am allergic to cats?
Most patients who've reacted to cats have
reported symptoms ranging from runny nose
and itchy eyes to wheezing and shortness of
breath when around cats. Some respiratory
symptoms are quite severe, therefore,
causing the person to get away from the cats
to breathe.
The most prominent reactions to cat allergy
are respiratory symptoms. However, some
patients do report skin allergies to things
that cause them respiratory symptoms.
If your symptoms persist, you should seek
medical attention.
3.If I'm allergic to tree pollen, can I burn
wood in the fireplace?
Most medical authorities recognize that
smoke is an irritant rather than an
allergen.
However, most experts do agree that wood
often contains mold as well as dust mites.
For persons allergic to these allergens,
having wood logs nearby may cause real
problems.
Many experts also agree that smoke can
trigger an allergy attack, especially in
asthmatics. So can perfumes and other
irritants. While we may not have an allergy
to substances like smoke, perfume, cleaning
solutions, pollutants from industry, car
exhaust, etc., most all of us are affected
by these irritants. For the person who has
allergies, their allergic trigger may be
more sensitive in air polluted by these
common irritants.
Suggestions:
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Keep wood logs outside until ready to burn.
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Change heating/cooling filters regularly.
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Have air ducts cleaned by a professional.
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Use an air purifier to promote clean air in the
indoor environment.
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Smokers should be asked to go outside before they
light up.
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Choose cleaners designed to clean better with fewer
chemicals.
4.How do allergy shots work? And, can I
learn to give my own shots at home?
When a person receives an allergy injection,
he is taking into his body a substance he is
allergic to. The body begins building
antibodies to fight this substance. As the
dose is increased, the body continues to
build more antibodies toward the offending
allergen.
It's a delicate balance. Increasing the dose
too slowly can delay progress toward enough
antibodies to control allergy symptoms.
Increasing the dose too fast can cause
severe reactions to the shot itself. Your
physician will tell you the proper
increments of increasing the dose.
However many other factors play a role. Some
of these include fever or elevated allergy
symptoms before the injection, higher level
of exposure to the allergen in the
environment, or too long an interval between
injections. Any of these can tip the
delicate balance and cause a serious
systemic reaction to the shot.
A severe reaction can also be caused by
human error resulting in a dose that is too
strong. Sometimes a severe reaction occurs
for no apparent reason.
Some physicians do allow self-administration
of injections. It is the responsibility of
these physicians or their staff to teach
where and how to give the injections. They
should also provide verbal and written
instructions of when to withhold the
injection, when to call the physician for
further instructions, and what to do if a
reaction occurs. These physicians prescribe
an EpiPen to be used in case of severe
reactions. Be sure you know when and how to
use the EpiPen, and what to do next. It is
very important that your E.N.T. doctor know
if you are taking a beta-blocker
medication. Beta-blockers affect allergy
symptoms and treatments. Your doctor will
discuss this with you and this may affect
your ability to administer your injections
at home rather than in a clinical setting.
This is especially true if you also suffer
from asthma.
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Concerns For The Ears:
5.I Sometimes Hear Ringing in My Ears. Is This
Unusual?
Not at all, Tinnitus is the name for
these head noises, and they are very common.
Nearly 36 million Americans suffer from this
discomfort. Tinnitus may come and go, or you
may be aware of a continuous sound. It can
vary in pitch from a low roar to a high
squeal or whine, and you may hear it in one
or both ears. When the ringing is constant,
it can be annoying and distracting. More
than seven million people are afflicted so
severely that they cannot lead normal lives.
6.What is the Treatment?
In most cases, there is no specific
treatment for ear and head noise. If your
otolaryngologist finds a specific cause of
your tinnitus, he/she may be able to
eliminate the noise. But, this determination
may require extensive testing including
X-rays, balance tests, and laboratory work.
However, most causes cannot be identified.
Occasionally, medicine may help the noise.
The medications used are varied, and several
may be tried to see if they help.
7.Doctor, why does my child's ear ache?
Otitis media means inflammation of the
middle ear. The inflammation occurs as a
result of a middle ear infection. It can
occur in one or both ears. Otitis media is
the most frequent diagnosis recorded for
children who visit physicians for illness.
It is also the most common cause of hearing
loss in children.
Although otitis media is most common in
young children, it also affects adults
occasionally. It occurs most commonly in the
winter and early spring months
8.What causes Otitis Media?
Blockage of the Eustachian tube during a
cold, allergy, or upper respiratory
infection and the presence of bacteria or
viruses lead to accumulation of fluid (a
build-up of pus and mucus) behind the
eardrum. This is the infection called acute
otitis media. The build up of pressurized
pus in the middle ear causes earache,
swelling, and redness. Since the eardrum
cannot vibrate properly, you or your child
may have hearing problems.
Often after the acute infection has passed,
the effusion remains and becomes chronic,
lasting for weeks, months, or even years.
This condition makes one subject to frequent
recurrences of the acute infection and may
cause difficulty in hearing.
9.What are the symptoms?
In infants and toddlers look for:
· Pulling or scratching at the ear
(especially if accompanied by the following)
· Hearing problems
· Crying, irritability
· Fever
· Vomiting
· Ear drainage
In young children, adolescents, and adults
look for:
· Earache
· Feeling of fullness or pressure
· Hearing problems
· Dizziness, loss of balance
· Nausea, vomiting
· Ear drainage
· Fever
So, remember . . .
Otitis media is generally not serious if it
is promptly and properly treated. With the
help of your physician, you and/or your
child can feel and hear better very soon. Be
sure to follow the treatment plan, and see
your physician until he/she tells you that
the condition is fully cured.
Swimmers Ear Symptoms
· The ear feels blocked and may itch
· The ear canal becomes swollen, sometimes
swelling shut
· The ear starts draining and a runny milky
liquid
· The ear becomes very painful and very
tender to touch, especially on the cartilage
in front of the ear canal.
If you experience these symptoms or if
glands in the neck become swollen, see your
doctor.
10.What causes Swimmers Ear?
When water gets into the ear, it may bring
in bacterial or fungal particles. Usually
the water runs back out; the ear dries out;
and the bacteria and fungi don't cause any
problems. But sometimes water remains
trapped in the ear canal, and the skin gets
soggy. Then bacteria and fungi grow,
flourish, and can infect the outer ear.
11.Is My Baby's Hearing Normal? Three million American children under the
age of 18 years have varying degrees of
hearing loss. You, the parents and
grandparents, are usually the first to
discover hearing loss in your babies,
because you spend the most time with them.
If, at any time, you suspect your baby has a
hearing loss, discuss it with your doctor.
Your baby's hearing can be professionally
tested at any age. Computerized hearing
tests make it possible to screen newborns.
Some babies have more than an average chance
of having hearing loss than others. All
children should have their hearing tested
before they start school. This could reveal
mild hearing losses that the parent or child
cannot detect. Loss of hearing in one ear
may also be determined in this way. Such a
loss, although not obvious, may affect
speech and language.
Hearing loss can even result from earwax or
fluid in the ears. Many children with this
type of temporary hearing loss can have
their hearing restored through medical
treatment or minor surgery.
In contract to temporary hearing loss, some
children have nerve deafness, which is
permanent. Most of these children have some
usable hearing. Few are totally deaf. Early
diagnosis, early fitting of hearing aids and
an early start on special education programs
can help maximize the child's existing
hearing.
12.What is TMJ?
You may not have heard of it, but you use it
hundreds of times every day. It is the
Temporo-Mandibular Joint (TMJ), the joint
where the mandible (the lower jaw) joins the
temporal bone of the skull, immediately in
front of the ear on each side of the head. A
small disc of cartilage separates the bones
much like in the knee joint, so that the
mandible may slide easily. Each time you
chew you move it. But you also move it every
time you talk and every time you swallow
(every three minutes or so). It is,
therefore, one of the most frequently used
of all joints of the body and one of the
most complexes.
You can locate the joint by putting your
finger on the triangular structure in the
front of your ear. Then move your finger
just slightly forward and press firmly while
you open your jaw all the way and shut it.
The motion you feel is the TMJ. You can also
feel the joint motion in your ear canal.
These maneuvers can cause considerable
discomfort to a patient who is having TMJ
trouble, and physicians use these maneuvers
with patients for diagnosis.
Symptoms
of TMJ
· Ear pain
· Sore jaw muscles
· Temple/cheek pain
· Jaw popping/clicking
· Locking of the jaw
· Difficulty in opening the mouth
· Frequent head/neck aches
13.What is Meniere's Disease?
Meniere's disease, also called idiopathic
endolymphatic hydrops, is a disorder of the
inner ear. Although the cause is unknown, it
probably results from an abnormality in the
fluids of the inner ear. Meniere's disease
is one of the most common causes of
dizziness originating in the inner ear. In
most cases only one ear is involved, but
both ears may be affected in about 15% of
patients. Meniere's disease typically starts
between the ages of 20 and 50 years. Men and
women are affected in equal numbers.
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Concerns for the Throat:
14.What is Tonsils and Adenoids?
Tonsils and adenoids are masses of tissue
that are similar to the lymph nodes or
"glands" found in the neck, groin, and
armpits. Tonsils are the two masses on the
back of the throat. Adenoids are high in the
throat behind the nose and the roof of the
mouth (soft palate) and are not visible
through the mouth without special
instruments.
Tonsils and adenoids are near the entrance
to the breathing passages where they can
catch incoming germs, which cause
infections. They "sample" bacteria and
viruses and can become infected themselves.
Scientists believe they work as part of the
body's immune system by filtering germs that
attempt to invade the body, and that they
help to develop antibodies to germs.
This happens primarily during the first few
years of life, becoming less important as we
get older. Children who must have their
tonsils and adenoids removed suffer no loss
in their resistance.
Tonsillitis and its symptoms
Tonsillitis is an infection in one or both
tonsils. One sign is swelling of the
tonsils. Other signs or symptoms are:
· Redder than normal tonsils
· A white or yellow coating on the tonsils
· A slight voice change due to swelling
· Sore throat
· Uncomfortable or painful swallowing
· Swollen lymph nodes (glands) in the neck
· Fever
· Bad breath
Enlarged
adenoids and their symptoms
If you or your child's adenoids are
enlarged, it may be hard to breathe through
the nose. Other signs of constant
enlargement are:
· Breathing through the mouth instead of the
nose most of the time
· Nose sounds "blocked" when the person
speaks
· Noisy breathing during the day
· Recurrent ear infections
· Snoring at night
· Breathing stops for a few seconds at night
during snoring or loud breathing (sleep
apnea)
15.Do you have trouble Swallowing? Insight into
Dysphagia.
Difficulty in swallowing (dysphagia) is
common among all age groups, especially the
elderly. The term dysphagia refers to the
feeling of difficulty passing food or liquid
from the mouth to the stomach. This may be
caused by many factors, most of which are
not threatening or temporary. Difficulties
in swallowing rarely represent a more
serious disease, such as a tumor or a
progressive neurological disorder. When the
difficulty does not clear up by itself, in a
short period of time, you should see an
otolaryngologist - head and neck surgeon.
16.What causes swallowing disorders?
Any interruption in the swallowing process
can cause difficulties. It may be due to
simple causes such as poor teeth, ill
fitting dentures, or a common cold. One of
the most common causes of dysphagia is
gastroesophageal reflux. This occurs when
stomach acid moves up the esophagus to the
pharynx, causing discomfort. Other causes
may include: stroke; progressive neurologic
disorder; the presence of a tracheostomy
tube; a paralyzed or unmoving vocal cord; a
tumor in the mouth, throat, or esophagus; or
surgery in the head, neck, or esophageal
areas.
Symptoms of Swallowing Disorders may
include:
· Drooling
· A feeling that food or liquid is sticking
in the throat
· Discomfort in the throat or chest (when
gastroesophageal reflux is present)
· A sensation of a foreign body or "lump" in
the throat
· Weight loss and inadequate nutrition due
to prolonged or more significant problems
with swallowing, and
· Coughing or choking caused by bits of
food, liquid, or saliva not passing easily
during swallowing, and being sucked into the
lungs.
17.Gastroesophageal Reflux/Laryngopharyngeal
Reflux (LPR)
The term REFLUX comes from a Greek word that
means "backflow", and it usually refers to
the "back flow of stomach contents".
Normally, once the things that we eat reach
the stomach, digestion should begin without
the contents of the stomach coming back up
again . . . refluxing. Not everyone with
reflux has a lot of heartburn or
indigestion.
18.Tips for Reducing Reflux and
Laryngopharyngeal Reflux
Control your lifestyle and your diet!
· If you use tobacco, QUIT. Smoking makes
you reflux. After every cigarette, you have
some LPR.
· Don't wear clothing that is too tight,
especially around the waist (trousers,
corsets, belts)
· Do not lie down just after eating . . . in
fact; do not eat within three hours of
bedtime.
· You should be on a low fat diet.
· Limit your intake of red meat
· Limit your intake of butter
· Avoid fried foods.
· Avoid chocolate
· Avoid cheese
· Avoid eggs
· Specifically avoid caffeine (especially
coffee and tea), soda (especially cola) and
mints
· Avoid alcoholic beverages, particularly in
the evening.
19.What is Hoarseness?
Hoarseness is a general term that describes
abnormal voice changes. When hoarse, the
voice may sound breathy, raspy, strained, or
there may be changes in volume (loudness) or
pitch (how high or low the voice is). The
changes in sound are usually due to
disorders related to the vocal cords that
are the sound producing parts of the voice
box (larynx). While breathing, the vocal
cords remain apart. When speaking or
singing, they come together, and as air
leaves the lungs, they vibrate, producing
sound. Swelling or lumps on the vocal cords
prevent them from coming together properly
and changes the way the cords vibrate, which
makes a change in the voice, altering
quality, volume and pitch.
20.What are the causes?
· Acute laryngitis
· Vocal nodules
· Gastroesophageal Reflux
· Smoking
21.When should I see an Otolaryngologist?
· Hoarseness lasting longer than two weeks
especially if you smoke
· Pain not from a cold or flu
· Coughing up blood
· Difficulty swallowing
· Lump in the neck
· Loss or severe change in voice
22.What can I do to prevent and treat mild
hoarseness?
· If you smoke, quit
· Avoid agents which dehydrate the body,
such as alcohol and caffeine
· Avoid secondhand smoke
· Drink plenty of water
· Humidify your home
· Watch your diet: Avoid spicy foods
· Try not to use your voice too long or too
loudly
· Use a microphone in situations where you
need to protect your voice
· Seek professional voice training
· Avoid speaking or singing when your voice
is injured or hoarse. Don't sing when you
are sick.
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Concerns for the Sinuses
and Nasal Cavity
23.What is Sinusitis?
Acute bacterial sinusitis is an infection of
the sinus cavities caused by bacteria. It is
usually preceded by a cold, allergy attack,
or irritation by environmental
pollutants.Unlike a cold or allergy,
bacterial sinusitis requires a physician's
diagnosis and treatment with an antibiotic
to cure the infection and prevent future
complications. Normally, mucus collecting in
the sinuses drains into the nasal passages.
When you have a cold or allergy attack, your
sinuses become inflamed and are unable to
drain. This can lead to congestion and
infection. Diagnosis of acute sinusitis is
based on a physical examination and a
discussion of your symptoms. Your doctor
also may use X-rays of your sinuses or
obtain a sample of your nasal discharge to
test for bacteria.
24.Preventing Sinusitis
As always, an ounce of prevention is worth a
pound of cure. To avoid developing sinusitis
during a cold or allergy attack, keep your
sinuses clear by:
· Using an oral decongestant or a short
course of nasal spray decongestant
· Gently blowing your nose, blocking one
nostril while blowing through the other
· Drinking plenty of fluids to keep nasal
discharge thin
· Avoiding air travel. If you must fly, use
a nasal spray decongestant before takeoff to
prevent blockage of the sinuses allowing
mucus to drain
· Avoiding contact with things that trigger
allergy attacks. If you cannot, use the
over-the-counter or prescription
antihistamines and/or prescription nasal
spray to control allergy attacks.
Allergy testing, followed by appropriate
allergy treatments, may increase your
tolerance of allergy-causing substances
25.What Causes Post-Nasal Drip?
The glands in your nose and throat
continually produce mucus (one to two quarts
a day). It moistens and cleans the nasal
membranes, humidifies air, traps and clears
inhaled foreign matter, and fights
infection. Although mucus normally is
swallowed unconsciously, the feeling that it
is accumulating in the throat or dripping
from the back of your nose is called
post-nasal drip. This feeling can be caused
by excessive or thick secretions or by
throat muscle and swallowing disorders.
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