As winter comes to an end, we look toward the warmth of spring, the budding of flowers, and the greening of grasses and trees. Unfortunately for some, the season also signals the onset of seasonal allergies. Also called “hay fever,” the condition brings about itchy and watery eyes, nasal congestion, sore throat, malaise, and rash. Joseph Feldman, MD, FACEP, an emergency physician, and Medical Director for Mount Sinai Urgent Care, explains what you can do to manage your allergy symptoms and when you should consult a physician.

What should I do to combat seasonal allergies?

Seasonal allergies can be caused by pollen from flowers, grasses, weeds, and even mold spores. The first-line treatment is to avoid pollen where and whenever possible. This is best accomplished by keeping the windows closed in your home and car and using the air conditioner.  It is important to frequently clean the filters of the air-conditioning unit to wash away the offending pollen.

It is also helpful to exercise indoors and to shower when entering your home, to wash away the pollen that may be on your body and clothes from being outdoors. Using nasal rinses, like the neti pot, may also help to eliminate the irritants and counteract the symptoms they cause. Drinking lots of fluids and remaining well hydrated will also improve symptoms.

What medications can I take to lesson my symptoms?

The three main types of medications used to treat allergies are antihistamines, decongestants, and steroids. These medications are available over the counter in the form of pills, nasal sprays, eye drops, and ointments.

It can be difficult to choose which medication is right for you. Remember, the correct medication depends on your symptoms, not a brand.

• Look for products containing a nondrowsy antihistamine if you suffer from sneezing or a runny nose.
• Use a combination of an antihistamine and a decongestant if your sinuses are stuffed up. NOTE: Hypertensive patients should not use decongestants as it can raise blood pressure.
• A steroid nasal spray can be used on its own or in conjunction with an antihistamine nasal spray to quickly clear the nasal passages. Be sure to do a saline rinse prior to using a nasal spray in order to wash away pollen and ensure better penetration of the medication.
• Itchy, watery eyes can be treated by trying artificial tears to wash away the offending pollen or antihistamine eye drops can be prescribed.

Pregnant women and small children should always consult a physician before using any medication.

When should I consult a physician about my allergies?

Seasonal allergies can occur at any time in life and can wax and wane in occurrence and severity. If your over-the-counter allergy medication is no longer working you can see your Primary Care Provider or visit one of our conveniently located Urgent Care Centers.  If necessary, you can be referred to an allergist.

Symptomatic treatment in combination with prescribed medications can successfully treat most situations.  An allergist can conduct skin testing to see what specific substances you are allergic to.  If so, arrangements can be made for you  to receive allergy injections that can help desensitize you to the offending allergens.  However, this takes time and does not afford immediate relief of symptoms.

You can start taking preventative measures and your medications as soon as you start being symptomatic.

At Mount Sinai Urgent Care, we want your experience to be fast, easy, and as stress-free as possible. You can walk in without an appointment during our convenient daytime, evening, and weekend hours. Our physicians will prescribe medication and, if needed, obtain an allergist referral. We accept all insurance, many without a co-pay.

Difficulty swallowing (medically termed dysphagia), can occur in both children and adults. Diana N. Kirke, MD, MPhil, Assistant Professor of Otolaryngology – Head and Neck Surgery at the Icahn School of Medicine at Mount Sinai and a laryngologist/head and neck surgeon at The Grabscheid Voice and Swallowing Center, explains the condition and answers some of the most frequently asked questions.

What are the symptoms of dysphagia and what causes the condition?

People suffering from dysphagia may experience symptoms such as gagging or choking, excessive throat clearing, food or liquid “going down the wrong way,” increased eating time, unexplained weight loss, coughing during or after eating/drinking, and/or painful swallowing.

Various medical issues can lead to this condition. However, dysphagia is more common in the elderly and in those with neurological conditions such as stroke, brain injury, and dementia.

When should I see a health care provider about difficulty swallowing?

Acute dysphagia, in which symptoms persist for 24 hours, requires immediate evaluation in the emergency room, as it may be related to food impaction or an ingested foreign body. Symptoms of difficulty swallowing that are present for more than 10 days should be assessed in an outpatient office setting.

What can I expect during my office visit?

Your physician will perform a complete head and neck examination to assess your upper aerodigestive system, which includes the mouth, throat, and windpipe. A fiber-optic nasal endoscopy may also be conducted. Using a topical anesthetic, a fiber-optic endoscope will be passed through your nostril to examine the nasal cavity and throat. This procedure generally does not last longer than one minute. An assessment by a speech therapist will also be undertaken either at the same visit or at a later visit. The speech therapist will assist in gathering diagnostic information regarding the swallow and may provide swallow therapy techniques in order to overcome swallowing difficulty.

Will I need further evaluations?

Depending on your initial assessment, the physician and the speech therapist may perform the following in-office or out-of-office swallow evaluations:

• Using local anesthetic, a transnasal esophagoscopy may be performed to view the esophagus. During the procedure, a small camera is passed through the nostril.
• To view the throat before and after drinking, a static endoscopic evaluation of swallow (SEES) may be performed. During this procedure, a rigid camera is passed into the mouth for observation. SEES can also be used to assess vocal cord vibration.
• Speaking and swallowing tasks may be examined during a flexible endoscopic examination of swallow which is performed using a fiber-optic endoscope.
• To assess the functionality of all phases of swallowing, a modified barium swallow may be performed. During this fluoroscopic X-ray exam, you will ingest barium-containing liquids and coated food. The procedure will also assess whether any food or liquid is entering into the lungs.

What is swallowing therapy?

Following a complete assessment by your treating physician and speech therapist, you may be prescribed swallowing therapy. This may entail dietary modifications and/or exercises that aim to coordinate and strengthen the swallowing muscles. Generally a treatment plan is prescribed and you will be reassessed again at a later date.

Will I need surgery?

It depends. Some cases of swallowing dysfunction, such as Zenker’s diverticulum, may be amenable to an in-office or surgical procedure. In other cases, an aesthetic neurotoxin like Botox® can be injected in the office to weaken the swallowing muscles and allow food to pass more easily. Botox is used to treat dysphagia-causing conditions such as cricopharyngeal spasm—in which throat muscles spasm uncontrollably— or esophageal web—in which thin membranes occur along the esophagus.

Should I wait to see if my swallowing problem resolves?

No. All dysphagia complaints should be assessed and you should see a doctor immediately if your symptoms are affecting your ability to consume food and drink. If you are able to eat and drink normally, you can observe your symptoms at home for up to 10 days before seeing a physician.