Media Type: Blogs

Provided by: Michael Goodman, MD

Allergist/Immunologist

The fall can be a challenging time of year for asthma sufferers. Whether you are trying to enjoy some cooler temperatures before the onset of winter or your favorite fall festivities, asthma can get in the way

One extremely susceptible group is those with allergic asthma triggered by ragweed. While the severity and exact timing of ragweed season varies from year to year, it generally runs from the beginning of August until early October. Ragweed can be quite a potent allergy for those allergic to it. As we breathe in the pollen, it makes its way down into the airways and can trigger an asthma attack. While often not as potent, mold during the fall can also be an issue. While fallen leaves are great for pictures and fun for kids to play in, decomposing plants serve as a great place for mold to thrive.

It helps to watch ragweed pollen and mold counts in your area and avoid spending a lot of time outside when counts are high. If you do spend time outside when counts are high, it helps to change your clothes and take a shower/bath to limit your overall exposure. While opening windows in the fall is tempting, it can allow allergens to enter the home. It helps to keep windows closed and an air purifier running inside to help reduce exposure.

Aside from allergens, there are other significant asthma triggers in the fall. Cold air is a common asthma trigger. Be prepared by watching the weather forecasts and planning your clothing appropriately. Try to keep a jacket nearby, just in case. Smoke is another common trigger, whether from wildfires hundreds of miles away or the campfire in your backyard. The fall also marks the start of cold and flu season. Getting a flu shot can help. Even if it doesn’t keep you from getting the flu, it can reduce the severity of the infection.

Medications are an important part of controlling asthma. Before the onset of fall is a great time to ensure your albuterol rescue inhaler is not expired. Keep it on hand, as asthma flares can surprise you in the fall. It’s also essential to make sure your asthma is well-controlled to start with. The better controlled your asthma is, the less likely you are to have an asthma flare, and the less severe a flare is likely to be if one occurs.

The board-certified allergists at Ohio ENT and Allergy Physicians are experts in asthma care. We can help determine your allergy triggers and how controlled your asthma is and partner with you to develop appropriate allergy and asthma treatments to keep you healthy this fall and the rest of the year. Don’t wait! Schedule today before your asthma stops you in your tracks this fall.

Provided by:  Steve Hirsch, MD

ENT

Ohio ENT and Allergy Physicians are on the forefront in identifying and treating previously undiagnosed hearing loss.

Research has revealed a compelling link between hearing loss and an increased risk of cognitive decline, including dementia. The reasons are multifaceted:

1. Cognitive Load: When hearing is impaired, the brain has to work harder to process sounds, which can divert resources from other cognitive functions such as memory and thinking.

2. Social Isolation: Hearing loss can lead to social withdrawal, as communication becomes more challenging. Social isolation is a known risk factor for cognitive decline.

3. Brain Changes: There is evidence suggesting that hearing loss may accelerate brain atrophy or shrinkage, particularly in areas associated with processing sound and speech.

Addressing hearing loss early can be a proactive step in maintaining cognitive health. This might include regular hearing check-ups, using hearing aids, and engaging in social activities to keep the brain active.

Beginning in September 2024 all of our central Ohio office locations will offer free hearing screenings to patients over age 50.

Steve Hirsch MD FACS

Provided by: David Straka, MD

ENT

With a few more weeks of summer ahead, there’s still plenty of time to enjoy the pool, and with that, it’s a great time to talk about swimmer’s ear. Also known as otitis externa, swimmer’s ear is an infection or inflammation of the external ear canal. The ear canal connects the auricle (external ear) to the ear drum, where ear wax is created. Swimmer’s ear can be caused by a buildup of ear wax that gets wet and never dries out, leading to an overgrowth of bacteria or fungus.

Otitis externa is common and can happen at any age, even without swimming. Just enough water from bathing or excessive sweat with earbuds can trap moisture and create an environment for infection. Other factors that can cause otitis externa are putting items in the canal to clean or scratch the ear, most infamously Q-tips. Symptoms of swimmer’s ears can be the sensation of fullness or blockage, foul drainage, pain in the ear canal or external ear, hearing loss, redness, or swelling.

Treatment for otitis externa can involve cleaning out impacted wax and using medicated ear drops or, in severe cases, oral antibiotics. Tips for preventing swimmer’s ears are to use ear plugs while swimming, use a hair dryer after water exposure to dry the ear canal, have your ear cleaned by a medical professional, and avoid putting anything in your ear – as the common adage goes, “never put anything in your ear smaller than your elbow.”

If you or your family member have recurrent episodes of swimmer’s ear or have a severe case, you may be referred to an otolaryngologist (ENT) for evaluation.

Provided by: Megan Goebel, MD

Allergist

Distinguishing between allergic, viral, and bacterial conjunctivitis (pink eye) can be a challenge. Exposure to a known allergen is often associated with eye itching, burning, tearing, and eyelid swelling. These symptoms typically occur in both eyes and resolve after the allergen is removed. Discharge is watery and clear in color. 

With allergies, you often will also have a runny nose, congestion, and sneezing. Treatment involves reducing allergen exposure when possible. Closing windows in the home and car during peak pollen season, as well as washing your face and changing clothes after being outdoors, is helpful. Keeping pets out of the bedroom and vacuuming is recommended. Dust mite-proof covers on the pillows and bedding are helpful. 

Cool compresses to the eye and drops, including an antihistamine, will provide relief. Many of these are now available OTC, including olopatadine and ketotifen. Your friendly allergists at Ohio ENT and Allergy Physicians are always happy to help with diagnosis and management!

Provided by: Scott Kramer, MD
ENT

Your nose starts to feel congested. Your throat gets that scratchy feeling. Perhaps you develop a sinus headache, or your mucus turns green. Does this sound familiar? Often people wonder if these symptoms mean they have a common cold or if a sinus infection is developing. Many folks probably don’t know there is a difference. This article is meant to help clarify some questions you may have about the common cold versus bacterial sinusitis.
Viral upper respiratory infections (URI’s), better known as “colds,” are the most common infectious diseases on earth. These illnesses are caused by viruses with particles so small they can’t be seen with even the most powerful light microscope. They are passed from person-to-person through “droplets” generated by coughing, sneezing, or wiping the nose or eyes. Viral particles can survive on hard surfaces such as door handles or railings for several hours. Symptoms of viral URI’s include nasal congestion, sore throat, feeling tired or generally ill. Once a viral URI starts, the goal of treatment is to relieve symptoms by using anti-inflammatory medication such as ibuprofen, nasal sprays, or salt water gargles. Cold symptoms usually last 5-7 days, and nothing has been proven to shorten their duration, so preventing an infection altogether is the best line of defense. Avoiding touching your face, nose, or eyes and washing/sanitizing your hands frequently are the best means of prevention.
Bacterial sinusitis, better known as “sinus infections,” can feel similar to colds because they also can cause congestion, facial pressure or pain, and sore throat. But there are some key differences. First, symptoms on one side of your face or nose only suggest a bacterial infection. Dental pain in your upper teeth is more consistent with sinusitis, and low-grade fever can also occur. Often patients can start with a viral URI, get better after several days, and then get worse again because of a “secondary” bacterial infection. Treatment can either consist of symptomatic relief (see above paragraph) and close observation or with oral antibiotics.
Importantly, the color of your nasal mucus (green, yellow, etc.) does NOT help differentiate between a cold or sinus infection. As always, you should talk to your primary care doctor if you have questions about your specific care and what the best treatment options are for you as an individual.

Provided by: Megan Goebel, MD (Allergist/Immunologist)

o   Grass pollen counts are high through the Summer, Trees in the Spring, and Weeds/Ragweed in the Fall

o   Keep windows closed in the home and car

o   Air filters/ air conditioners help

o   Shower, wash face and hair, and change into clean clothes after being outside

o   Wear protective clothing and sunglasses outside, especially if mowing or gardening

o   Nasal steroid sprays and oral antihistamines are typical first line treatment

o   A board-certified allergist can evaluate your symptoms and determine the best treatment plan including prescription medications and/or allergen immunotherapy

Provided by: Scott Kramer, MD

Do you have a child that has had ear infections?  Middle ear infections (otitis media) are among the most common infections of childhood.  The majority of kids will experience an ear infection at some point during their childhood.  Symptoms vary from child to child but can include fever, fussiness, ear tugging, poor sleep, and pain (depending on the age of the child).  Initial treatment may include observation (some ear infections will resolve on their own) or oral antibiotics.  

Many kids will have an occasional ear infection that responds well to antibiotics.  Some kids, unfortunately, will have recurrent ear infections and require multiple courses of antibiotics.  In these cases, often, the child will build up fluid in one or both ears and are never able to clear it.  If your child has experienced three or more infections in the past year, your primary care provider may refer you to an otolaryngologist (ear, nose, and throat doctor, or “ENT”).  As otolaryngologists, we perform a comprehensive evaluation of each patient’s head and neck anatomy, can assess for hearing difficulties and may offer to proceed with ear tubes if indicated.

Provided by: Michael Goodman, MD

Winter Allergies

As we move from fall to winter, many allergy sufferers will experience relief as plant pollens have gone away and mold spore counts drop. However, many allergy sufferers can actually experience an increase in symptoms. During the late fall and winter our exposure to other allergens, often less obvious allergens, can increase. 

Causes of Winter Allergy Symptoms

Much of the increase comes from spending more time indoors. For people with pets, both you and your pet spend more time indoors. This leads to more exposure to their dander and an increase in symptoms. Our exposure to dust mites, a very common allergen, also increases in the winter. During cold months, we do not open our windows and doors as much, reducing the amount of air exchange occurring. We bring out clothes and holiday decorations that have been accumulating dust and potentially mold. Symptoms can also be magnified by nonallergic factors. When we begin to use heat in our homes, the air can become very dry. The dry air irritates our nose and eyes and can increase inflammation that results in feelings of congestion and eye irritation. 

What Can Help?

There are steps you can take to help reduce your symptoms. Keep humidity between 40-50%. Above 50% leads to increases in dust mites and indoor mold growth. Below 40% can contribute to drying of your mucosal surfaces and irritation. If you use a humidifier, check regularly to ensure no mold growth occurs inside the humidifier. Cool mist humidifiers with an ultrasonic membrane should be checked regularly for mineral deposits that can become vaporized and irritate our lungs. Dust mite encasements can be used on mattresses, box springs, and pillows to reduce our exposure while in bed. Washing sheets and blankets once a week also helps in reducing exposure. HEPA air filters can help remove pet dander, dust mite allergen, and mold spores that find their way into the air. Saline nasal spray or moisturizing nasal gels can help soothe the nasal mucosa and reduce inflammation. Before wearing clothes that have been in storage for months, try to wash them to remove allergens. Wear a dust mask when bringing out old decorations. Try to store decorations in a cool dry area in covered containers to protect them from mold and dust. Regularly vacuuming your living space to remove dust can also be helpful, but be careful, as it can also pull allergen off of surfaces and spray them into the air. Using a vacuum with a HEPA air filter, wearing a dust mask, and running an air filter while cleaning can help.

The allergy team at Ohio ENT and Allergy Physicians can help determine what you are allergic to. We can provide guidance on reducing exposures and will work with you to create an effective treatment strategy customized to your situation and goals. 

Provided by: Megan Goebel, MD (Allergist) 

Allergic to penicillin? Maybe not!

The good news is that over 90% of people reporting a history of penicillin allergy are actually able to tolerate this antibiotic.  Many people outgrow this allergy as they get older, while some were never actually allergic to begin with.  Penicillin and amoxicillin, as well as other beta-lactam antibiotics, are important treatment options for sinus, ear, skin, and pulmonary infections. 

Allergists are able to perform skin testing in the office for the major and minor determinants of penicillin in as little as 15-30 minutes. If these skin tests are negative we will observe your first dose of the antibiotic in our office to ensure safety.  Our goal is to remove this medication allergy from your list so that you can be treated with the best antibiotic when indicated.