Updated on Jun 30, 2022 | Allergy, Exercise, Pulmonary Disease, Sports Medicine
In the summer, we are outdoors—and hopefully exercising—more often. About 10% of people who exercise will get exercise-induced bronchospasm (EIB). Symptoms may include wheezing, excessive shortness of breath, chest tightness, or just coughing beginning 5 to 10 minutes after exercise. EIB occurs most frequently in persons with asthma, particularly those whose asthma is not well controlled. Various studies show that up to 90% of people with asthma have EIB. But it can also occur in isolation—in a person without asthma. (more…)
Jun 4, 2013 | Allergy, Ear Nose Throat, Pulmonary Disease, Your Health
Could acid reflux be the cause of my shortness of breath?
Yes. The cause of shortness of breath, recurring bronchial infections and chronic asthma in most patients is acid reflux. In fact, 85 percent of all patients diagnosed with asthma have acid reflux as an underlying cause.
But I don’t have heartburn — isn’t that a symptom of acid reflux?
If all patients with acid reflux presented with heartburn and indigestion, the diagnosis would be easy. As a result, patients would take over-the-counter reflux medication for their uncomfortable, “classic” reflux symptoms. But, what happens when you don’t experience these “classic” symptoms? What if you feel short of breath or keep getting bouts of bronchitis? Naturally, you would go to the doctor, possibly have a breathing test and find that your breathing is not good.
Why doesn’t my allergy medicine help?
Often these patients are diagnosed with allergies or asthma, but their allergy medications and inhalers are not working. They are frequently given recurring courses of antibiotics for bronchial infections. In most cases the diagnosis is not correct and the underlying cause — acid reflux — of all of the symptoms is missed.
How can I tell if acid reflux is the cause?
Inspiratory breathing (in-breath) problems are caused by acid reflux; expiratory breathing (out-breath) problems are symptoms of asthma. Ask yourself: “Do I have more trouble breathing in or breathing out?” When breathing problems are recurring for you and you are frustrated with the symptom management, ask your otolaryngologist (ENT) if you have “silent” reflux.
How can I manage my symptoms?
Conservative management, including avoiding eating 3 hours prior to bedtime, elevating the head of the bed and reducing highly acidic foods, can be very helpful. Some patients require reflux medication. The proper diagnosis and treatment can be very helpful and life-changing for many people.
Have you noticed a wound in your mouth that is not healing? Maybe you also noticed it has a bump or area that seems unnaturally firm to the touch?...
An occasional stuffy nose due to allergies or infection can be annoying or difficult to manage. But if you are experiencing chronic nasal congestion...
Otolaryngologist Isaac Namdar, MD, explains how the change in seasons may cause nosebleeds and why you shouldn’t tilt your head back to stop the bleed.
Acoustic neuromas are benign tumors that cause hearing loss, tinnitus, and dizziness. They are one of the most common brain tumors diagnosed in the...
Sleep surgeon Courtney Chou, MD, urges those who snore to be evaluated as it could be a sign of a serious sleep condition.
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.
Nov 26, 2012 | Allergy, Pulmonary Disease
I guess Santa doesn’t have asthma, since in all likelihood he would have missed some Christmases given the rates of exacerbation for asthma during the fall and winter. Santa would especially be vulnerable during this worse time of year for most asthmatics since he rides around on a sleigh in frigid arctic air and climbs down a smoke-filled chimney. He also laughs a lot (ho-ho-ho). When we laugh (or cry) we breathe in and out rapidly, and our lung airways cool off and cooling of the airways causes asthma. That being said, let’s discuss what the average asthma patient can do to prevent exacerbating their asthma during the fall and winter. (more…)
In the summer, we are outdoors—and hopefully exercising—more often. About 10% of people who exercise will get exercise-induced bronchospasm (EIB). Symptoms may include wheezing, excessive shortness of breath, chest tightness, or just coughing beginning 5 to 10 minutes after exercise. EIB occurs most frequently in persons with asthma, particularly those whose asthma is not well controlled. Various studies show that up to 90% of people with asthma have EIB. But it can also occur in isolation—in a person without asthma. (more…)
