Updated on Jun 30, 2022 | Allergy, Common Illness, Ear Nose Throat, Pulmonary Disease
This is the second in a series on indoor allergies—of which cats are common culprits. For people allergic to cats, the major allergen (substance that causes an allergic reaction) is found in the cat’s saliva, urine and dander (dried flakes of skin).
How can I reduce cat allergen in my house?
The most effective way is to rid the house of the cat. This is not acceptable to most people, and after pet removal, the allergen will remain in the house for 6 months or more. The second choice might be to keep the cat outside, which is not possible in certain climates. And, if the outdoor cat is played with, the sticky allergen makes its way into the house anyway.
What about bathing my cat?
Studies have shown that washing a cat can reduce the amount of allergen on it (the allergen is mostly in cat saliva, and is transferred to the fur by licking). Based on scientific studies, twice weekly washing would be required—and a lot of rinsing, too—so this is not very feasible, nor favored by cats. Perhaps a Cleopatra-style bath (milk bath) would be acceptable to the cat!
What are some other options to reduce cat allergen?
• Removing reservoirs for the allergen, such as carpets, sofas and other upholstered furniture
• Using vacuum cleaners with effective filtration systems
• Installing HEPA-type air filters in rooms, particularly the bedroom
• Increasing ventilation in the house
Is there anything else I can do?
I like to recommend making the bedroom (where we spend most of our indoor time) a “cat-free zone.” After the room is closed off to the cat, it should be cleaned thoroughly, including damp mopping the sticky allergen off the walls, and cleaning window treatments and bedding. After this cleaning, the cat cannot reenter the room (ever), otherwise the allergen level will increase. This means the door to the room needs to remain closed at all times. But, cats are sneaky, so this is not so readily accomplished.
Stay tuned for more information on indoor allergies.
To find an allergist who is right for you, please call the Physician Referral Service at 1 (866) 804-1007 Monday through Friday, 9 am to 5 pm.
Updated on Jun 30, 2022 | Allergy, Dermatology, Ear Nose Throat, Primary Care, Pulmonary Disease
Nasal allergy symptoms (rhinitis) and asthma caused by allergens that are inhaled usually have seasonal patterns. While symptoms from various pollens occur in the spring, summer or late summer/fall, nasal allergy symptoms in fall and winter are due mainly to indoor inhalants and also usually seasonal. But in the case of indoor allergens, this seasonal pattern is the result of spending more time indoors in these months, with the windows closed and heat on, leading to both increased exposure times and increased levels of indoor allergens.
Dust mites—microscopic insect critters that live in our bedding—are the most important culprit among the indoor allergens causing allergic disease. Our pillows and mattresses are loaded with them. When you buy a new mattress that weighs, say, 100 pounds, it will weigh 102 pounds within a couple of years. That extra 2 pounds are from the accumulation of living and dead dust mites and their droppings. Fortunately, dust mites do not bite, though in addition to their role in causing nasal allergy and asthma, they probably also contribute to flares of eczema in certain patients.
Why Dust Mites Love Us
The diet of a mite consists mainly of human skin scales, of which we shed a lot in the course of a day. This is why they love our bedding.
The life cycle of dust mites is related to humidity. They love the humid days of summer and proliferate wildly. Then, when the heat goes on indoors in autumn, the humidity falls and they die off, leaving additional particulate matter to breath in.
If you want to read some of the scientific research on dust mites, Google the name “Thomas Platts-Mills,” who is a world expert on mites and gives very entertaining lectures on the subject.
Diagnosis
There is no way to know if one is allergic to dust mites without being tested. If you tested positive to “house dust” years ago (a test most allergists don’t do anymore), you should be tested again. Since house dust is a mixture of dust mites, animal dander, insect material and other dusts, allergy to any of these components would have resulted in a positive house dust test. Today, we test for the individual components of house dust.
Treatment
1. The treatment for dust mite allergy is, first and foremost, avoidance.
Bedding – Various companies market breathable covers that seal the bedding. Mite covers have even been shown to reduce the risk of developing asthma for children born into families with a history of allergic disease.
Humidity – The use of humidifiers in most houses in winter is not recommended, as it encourages mite growth. Optimal humidity in the home of someone with respiratory illness is in the 30% to 40% range; most homes are within that range or higher in winter. If you are not sure, you can measure it with a hygrometer.
2. The second line of treatment is medication for the symptoms of rhinitis, asthma or eczema. These include various combinations of prescription and over-the-counter medications, including pills, nasal sprays, eye drops and, in the case of eczema, creams and ointments. Antihistamines (ocular and oral) are the only medications for rhinitis that are available over the counter without a prescription. Any over-the-counter medications for asthma should be avoided, particularly Primatene, which is not very safe.
3. For patients who do not respond sufficiently to the above measures, or those wishing to reduce their use of medications, immunotherapy (allergy injections) might be in order.
I hope your holiday season is happy, and that you can avoid the sneezin’ and wheezin’!
To find an allergist who is right for you, please call the Physician Referral Service at 1 (866) 804-1007 Monday through Friday, 9 am to 5 pm.
Sep 27, 2012 | Ear Nose Throat, Speech Pathology
Wonder what it’s like to have swallowing problems? If you have ever received a local anesthetic for dental work, you know that the numbness in your mouth made it hard to eat or drink until the sensation subsided.
For someone with certain kinds of neurological or muscular problems, chronic numbness in the lips, tongue and throat cause swallowing problems. Swallowing problems result in the inability to control liquid or food in the mouth. People with swallowing problems have to struggle with drooling, coughing or even choking.
Any development of swallowing problems, such as spitting out chewed food, gagging on water, painful swallowing or feeling food getting stuck, should be discussed with your doctor. Your physician can help determine the reason and provide some solutions.
You may be referred to a speech pathologist, a rehabilitation specialist who can correct some swallowing problems by helping you strengthen the chewing and swallowing muscles and by gradually introducing different foods—pureed, soft and chopped—into your diet.
Go to the doctor if you are experiencing swallowing problems. There are solutions so that you can regain and retain your quality of life.
Felicia Gironda, PhD, CCC-SLP, is a certified Speech Language Pathologist at Beth Israel Brooklyn.
Updated on Jun 30, 2022 | Ear Nose Throat
Chronic throat clearing is a symptom of many different conditions ranging from post-nasal drip to chronic sinusitis to acid reflux. Gastric reflux is the back flow of stomach contents and gastric acid up from the stomach into the esophagus, the tube that connects the throat to the stomach. Gastric acid can damage the esophagus and cause irritation. With chronic exposure to stomach acid, sufferers feel symptoms of indigestion and heartburn. These symptoms are from a common disorder known as GERD, or gastroesophageal reflux disease.
Beyond GERD and Up to the Throat
Sometimes, the back flow of stomach acids goes beyond the esophagus, reaching up into the voice box and throat and sometimes even go into the nose and sinuses. As the reflux progresses, there are many associated symptoms, including hoarseness, post-nasal drip, a lump in the throat, pain, shortness of breath, difficulty swallowing, a chronic cough and, the most common, excessive throat clearing.
This syndrome is called laryngopharyngeal reflux or LPR. People who suffer from LPR may not experience heartburn and indigestion because the stomach acid is going higher than the esophagus. Sufferers of LPR may experience a range of symptoms, only a few or many. Because these symptoms can be masked, LPR is often called “silent reflux.”
Diagnosing Silent Reflux/LPR
Since there are many causes of throat clearing, silent reflux may sometimes go undiagnosed. If you experience any of the symptoms, especially throat clearing, see an ear, nose, throat (ENT) doctor. Making a diagnosis of LPR is not painful. Usually, a flexible endoscope is inserted through the nose into the throat, which allows the ENT to see the lining of the throat. The stomach acid causes the irritated lining to become red and sometimes there is evidence of damage. The throat is much more sensitive to stomach acid than the esophagus, so even a small amount of acid may cause irritation and chronic throat clearing.
Relieving Symptoms
The most effective way to lessen symptoms and help treat LPR is a modifying the diet. Many foods cause reflux, including citrus, tomatoes, onions, fatty foods and caffeinated foods. Alcohol, particularly red wine, and nicotine also increase symptoms.
Losing weight and easing stress can be helpful, too. The timing of meals is also important. Patients are recommended to avoid eating two to three hours before bedtime to reduce nighttime symptoms.
Some patients may need to take a proton pump inhibitor (PPI), like Nexium, Aciphex, Protonix, a half hour before breakfast every morning. Other patients may be required to take an additional medication like an H2 blocker (Zantac). In some cases, treatment is required for several weeks, and in others, long-term therapy is needed to control symptoms.
As time progresses, with the right, tailored treatment, symptoms may lessen. It is always important to keep your physician up to date on all of your symptoms, so that treatments can be tweaked as necessary. Be especially careful to alert your doctor to all your symptoms and their severity, even if you feel it may not be related. For instance, some LPR cases cause ear pain and nasal congestion.
