ALLERGIES AND HAY FEVER

Insight Into Causes, Treatment, And Prevention 
Forty-five million Americans suffer from a recurring problem called allergy. Allergic rhinitis was once known as hay fever because workers would sneeze and develop nasal and sinus congestion when they worked around hay in the fields. Hay fever, asthma, and eczema are the most common symptoms of an allergic reaction.

Allergy symptoms appear when the body’s immune system begins to respond to a substance as though it were a dangerous invader (called an antigen or allergen). It does this by sending specific defenders called antibodies to the entry site. The battle between allergen and antibody results in a release of chemical mediators, such as histamine, into the bloodstream. Those chemical mediators cause changes in the body, which produce the symptoms that we feel.

Symptoms that may be caused by allergy are itching eyes, sneezing, nasal stuffiness, nasal congestion and drainage, and sometimes headache. Some people experience hearing changes, scratchy sore throats, hoarseness, and cough. Other less common symptoms include balance disturbances, swelling in face or throat tissues, skin irritations, and even respiratory problems and asthma.

Some allergy sufferers experience symptoms all year. Others find certain seasons bring on attacks. Allergy symptom control is most successful when multiple management approaches are used simultaneously. Minimizing exposure to allergens, managing symptoms with medications, and desensitization with allergy shots are all methods that can be useful in controlling allergic symptoms.

Medications properly used can be very helpful. Over the counter drugs can be beneficial, but some cause drowsiness. Sometimes prescription medications offer the best chance for good control.

Immunotherapy, or allergy shots, provide the only treatment method that can offer lasting relief or cure from allergies. Before beginning a series of such shots, allergy testing must be performed.

Beware Of The Allergens

Anything can be an allergen. Some substances, because of their chemical make-up, are more prone to generate an allergic response in humans. Pollens, food, mold, dust, feathers, animal dander, chemicals, drugs such as penicillin, and environmental pollutants commonly cause many to suffer allergic reactions.

Hay fever is caused by pollens. The most significant cause of hay fever in the United States is ragweed. It begins pollinating in late August and continues until the first frost. Late springtime pollens come from the grasses, i.e., timothy, orchard, red top, sweet vernal, Bermuda, Johnson, and some bluegrasses. Early springtime hay fever is most often caused by pollens of trees such as elm, maple, birch, poplar, beech, ash, oak, walnut, sycamore, cypress, hickory, pecan, cottonwood, and alder.

Certain allergens are always present. These include house dust, household pet danders, foods, wool, various chemicals used around the house, and more. Symptoms from these are frequently worse in the winter when the house is closed up. Mold spores cause at least as many allergy problems as pollens.

Molds are present all year long, and grow outdoors and indoors. Dead leaves and farm areas are common sources for outdoor molds. Indoor plants, old books, bathrooms, and damp areas are common sources of indoor mold growth. Molds are also common in foods, such as cheese and fermented beverages.

Colorful or fragrant flowering plants rarely cause allergy because their pollens are too heavy to be airborne.

Can Allergies Be Serious?

Allergies are rarely life threatening, but often cause lost workdays, decreased work efficiency, poor school performance, and less enjoyment of life. It is common for allergy sufferers to develop sinus or respiratory infections if allergy symptoms are not controlled. Considering the millions spent in anti-allergy medications and the cost of lost work time, allergies cannot be considered a minor problem.

Treatment And Prevention

A number of medications are useful in the treatment of allergy including antihistamine, nasal decongestant sprays, steroid sprays, and saline sprays. The medical management of allergy also includes counseling in proper environmental control. Based on a detailed history and thorough examination, your doctor may advise testing to determine the specific substances to which you are allergic.

Medicines, Symptoms and Possible Side Effects:

Antihistamine: For sneezing, runny nose, stuffy nose, itchy eyes, congestion. Possible side effects are drowsiness, dry mouth and nose

Decongestants: For stuffy nose, congestion. Possible side effects are stimulation, insomnia, rapid heart beat
The treatments employed by your otolaryngologists will depend on the materials to which you are allergic and the degree of your sensitivity to them. The only “cure” available for inhalant allergy is the administration of injections that build up protective antibodies to specific allergens (pollens, molds, animal danders, dust, etc.). Your physician will oversee your progress and care for any other nasal and sinus disorders that may contribute to your symptoms.

Tips for Controlling Your Environment:

  • Wear a pollen mask when mowing grass or house cleaning (most drugstores sell them).
  • Change the air filters monthly in heating and air conditioning systems, and/or install an air purifier.
  • Keep windows and doors closed during heavy pollen seasons.
  • Rid your home of indoor plants and other sources of mildew.
  • Don’t allow dander-producing animals (i.e., cats, dogs, etc.) in your home.
  • Change feather pillows, woolen blankets, and woolen clothing to cotton or synthetic materials.
  • Enclose mattress, box springs, and pillows in plastic barrier cloth.
  • Use antihistamine and decongestants as necessary and as tolerated.
  • Sleep with a brick or two placed under bedposts at the head of the bed to help relieve nasal congestion.
  • Observe general good health practices; exercise daily, stop smoking, avoid air pollutants, eat a balanced diet, and supplement diet with vitamins, especially C.
  • Consider a humidifier in the winter. Dry, indoor heat aggravates many allergic people. Be sure to clean the humidifier regularly.
  • (SOURCE: http://www.entnet.org/healthinfo/allergies/allergies_hayfever.cfm)

    EARLY CHILDHOOD HEARING SCREENING

    Why Is Early Childhood Hearing Screening Important For Your Child?

    Approximately two to four of every 1,000 children in the United States are born deaf or hard-of-hearing, making hearing loss the most common birth disorder. Many studies have shown that early diagnosis of hearing loss is crucial to the development of speech, language, cognitive, and psychosocial abilities. Treatment is most successful if hearing loss is identified early, preferably within the first month of life. Still, one in every four children born with serious hearing loss does not receive a diagnosis until age three or older. 

    As a copyright holder of this photo, it's prohibited to copy or use it without permission.

    The first opportunity to test a child’s hearing is in the hospital shortly after birth. If your child’s hearing is not screened before leaving the hospital, it is recommended that screening be done within the first month of life. Should test results indicate a possible hearing loss, seek further evaluation as soon as possible; preferably within the first three to six months of life.

    Is Early Hearing Screening Mandatory?

    In recent years, health organizations across the country, including the AmericanAcademy of Otolaryngology – Head and Neck Surgery, have worked to highlight the importance of screening all newborns for hearing loss. These efforts are working. In 2003, more than 85 percent of all newborns in the United States were screened for hearing loss.  In fact, some 39 states have passed legislation requiring some form of hearing screening of newborns before they leave the hospital. This still leaves more than a million babies who are not screened for hearing loss before leaving the hospital.

    How Is Screening Done?

    Two tests are used to screen infants and newborns for hearing loss. They are:

    Otoacoustic emissions (OAE)involves placement of a sponge earphone in the ear canal to measure whether the ear can respond properly to sound. In normal-hearing children, a measurable “echo” should be produced when sound is emitted through the earphone. If no echo is measured, it could indicate a hearing loss.

    Auditory brain stem response (ABR) is a more complex test. Earphones are placed on the ears and electrodes are placed on the head and ears. Sound is emitted through the earphones while the electrodes measure how your child’s brain responds to the sound.    

    If either test indicates a potential hearing loss, your physician may suggest a follow-up evaluation by an otolaryngologist.

    Signs Of Hearing Loss In Children

    Hearing loss can also occur later childhood, after a newborn leaves the hospital. In these cases, parents, grandparents, and other caregivers are often the first to notice that something may be wrong with a young child’s hearing. Even if your child’s hearing was tested as a newborn, you should continue to watch for signs of hearing loss including:

    • Not reacting in any way to unexpected loud noises,
    • Not being awakened by loud noises,
    • Not turning his/her head in the direction of your voice, 
    • Not being able to follow or understand directions,
    • Poor language development, or
    • Speaking loudly or not using age-appropriate language skills.

    If your child exhibits any of these signs, report them to your doctor.

    What Happens If My Child Has A Hearing Loss?

    Hearing loss in children can be temporary or permanent. It is important to have hearing loss evaluated by a physician who can rule out medical problems that may be causing the hearing loss, such as otitis media (ear infection), excessive earwax congenital malformations, or a genetic hearing loss.

    If it is determined that your child’s hearing loss is permanent, hearing aids may be recommended to amplify the sound reaching your child’s ear. Ear surgery may be able to restore or significantly improve hearing in some instances. For those with certain types of profound hearing loss who do not benefit sufficiently from hearing aids, a cochlear implant may be considered. Unlike a hearing aid, a cochlear implant bypasses damaged parts of the auditory system and directly stimulates the hearing nerve and allows the child to hear louder and clearer sound.

    You will need to decide whether or not your deaf child will communicate primarily with oral speech and/or sign language, and seek early intervention to prevent language delays. Research indicates that habilitation of hearing loss by age six months will prevent subsequent language delays. Other communication strategies such as auditory verbal therapy, lip reading, and cued speech may also be used in conjunction with a hearing aid or cochlear implant, or independently.

    (SOURCE: http://www.entnet.org/healthinfo/hearing/hearing_screening.cfm)

    LARYNX CANCER

    For 2007, the American Cancer Society estimates there were over 11,000 new cases of larynx cancer in the United States, and more than 3,500 deaths. Even for disease survivors, the consequences of laryngeal cancer are often severe. Laryngeal cancer is a preventable disease because the risk factors are associated with modifiable behaviors.

     

    The Causes Of Laryngeal Cancer

    Development of this deadly disease is a process which involves many factors, but approximately 90 percent of head and neck cancers occur after exposure to known carcinogens (cancer causing substances) causing a type of the disease called squamous cell carcinoma (SCCA).

    Smoking:More than 95 percent with laryngeal SCCA are smokers.Smoking contributes to cancer by causing mutations or changes in genes, impairing clearance of carcinogens from the respiratory tract, and decreasing the body’s immune response.Tobacco use is measured in pack-years, where one pack per day for one year is one pack-year (or one pack per day for two years, or two packs per day for one year, equals two pack-years).Depending upon the number of pack-years smoked, studies have reported that smokers are about five to 35 times more likely to develop laryngeal cancer than nonsmokers.Other research findings indicate that the duration of tobacco exposure is probably more important overall to the cancer causing effect than the intensity of the exposure.

    Alcohol:This acts as a promoter of the cancer causing process making it another important risk factor for laryngeal cancer. The major clinical significance of alcohol is that it enhances the harmful effects of tobacco at a magnitude that is more than just additive.Essentially, people who smoke and drink alcohol have a combined risk that is greater than the sum of the individual risks.The American Cancer Society recommends that those who drink alcoholic beverages should limit the amount, and one drink per day is considered a limited alcohol exposure.

    Other Risk Factors:Certain viruses, such as human papilloma virus (HPV), acid reflux, and occupational exposure to asbestos likely contribute to causing laryngeal cancer.Vitamin A and beta-carotene may play a protective role in the disease process.

    Signs And Symptoms Of Laryngeal Cancer Include:

    Progressive or persistent hoarseness

  •  Difficulty swallowing
  •  Persistent sore throat or pain with swallowing
  •  Difficulty breathing
  •  Pain in the ear
  •  Lump in the neck
  • Anyone with these signs or symptoms, and having risks for laryngeal cancer, should be evaluated by an otolaryngologist (ear, nose, and throat specialist).The primary treatment options include surgery, radiation therapy, chemotherapy, or a combination of these treatments.

    Remember that this is a preventable disease in the vast majority of cases, because the main risk factors are associated with modifiable behaviors.Do not smoke and do not abuse alcohol.

    Hoarseness or roughness in your voice is often caused by a medical problem.Contact an otolaryngologist-head and neck surgeon if you have any sustained changes to your voice.

    (SOURCE: http://www.entnet.org/healthinfo/throat/Throat_Cancer.cfm)