Summertime Allergies – AAHH CCHHOO

Posted in Uncategorized on July 19th, 2016 with No Comments
Do you feel that your allergy symptoms get worse during the late spring and early summer? It’s possible that you may have a grass allergy. The summer season is grass pollination season, causing an array of bothersome symptoms in individuals who are allergic to it. The condition is called seasonal allergic rhinitis. Common complaints of allergic rhinitis include recurrent sneezing, a runny nose, water/itchy eyes, postnasal drip, nasal congestion, or throat congestion. Those with severe grass allergies may report itchiness of the skin or urticaria (hives) after contact with grass. Other conditions that are associated with grass allergies include asthma, eczema, conjunctivitis, nasal polyps, sinusitis (sinus swelling), sleep apnea, laryngitis, and ear infections. Some individuals with grass allergies may also suffer from oral allergy syndrome (OAS), a condition marked by itchiness of the mouth and throat after consuming raw fruits and vegetables (tomatoes, potatoes, peaches). The first step in minimizing allergy symptoms is to see what grass pollens you are allergic to. This can be accomplished via allergy testing. Patients are often tested for several different grass species usually dependent on which grasses are found in their area. A typical New England panel may include Rye grass, Bermuda grass, Timothy grass, Bahia grass, and Johnson grass. Allergy testing can be performed via a quick, pain-free skin test or by a blood test, which is often sent away to a reference lab. Both testing methods are safe and effective for diagnosing grass, as well as other types of environmental allergies. Skin testing is advantageous in that it can be performed in the office setting, the results are readily available, and multiple grass allergens can be tested. Modifying your environment can be very effective way to decrease grass allergy symptoms. This includes keeping home windows closed, staying indoors on high pollen days, not drying clothing outside, showering before bedtime, and wearing appropriate clothing when mowing the lawn. Medical management includes over the counter antihistamines (e.g. Claritin, Zyrtec) and intranasal steroid sprays (e.g. Flonase), decongestants as well as some other otc type medications. For patients who are interested in long term improvement and decreased usage of allergy medications, immunotherapy can be considered. Immunotherapy is a method to improve the body’s immune system against those allergens that one is reacting to negatively. Immunotherapy can be administer subcutaneously (SCIT – “allergy shots”) or sublingually (SLIT – “allergy drops”). Multiple studies over the past 50 years have consistently demonstrated that SCIT is a safe and effective way to minimize allergy symptoms. SLIT is the most common form of allergy treatment in Europe and many studies have show it to be as safe and effective as traditional “allergy shots”. The major disadvantage for SLIT is that it is currently not FDA approved (although the drops are made from the exact same extract as allergy shots), and therefore this treatment would not be covered through medical insurance. Many of our patients have been successfully treated with both types of immunotherapy over the past 15 years. If you or family members have questions or concerns regarding grass allergies, please do not hesitate to contact Colden & Seymour Ear, Nose, Throat, and Allergy to schedule an examination. Opinions expressed here are those of Daryl Colden, MD, FACS, and Christopher Jayne, BA. These opinions are not a substitute for direct medical evaluation and advice.

Noise Induced Hearing Loss- What?????

Posted in Uncategorized on May 9th, 2016 with No Comments
Humans are exposed to all kinds of sounds on a daily basis; including cars, engines, televisions, or radios. Under most circumstances, these sounds are at safe levels and do not affect our hearing. However, when we are exposed to loud noises, sensitive structures inside the inner ear can be damaged. This condition is referred to as noise induced sensorineural hearing loss. Hearing is a complex mechanism which requires several structures to work together. The outer ear includes the pinna and external auditory canal. The pinna functions to collect sound waves and direct them into the auditory canal. Because of its unique structure, sounds are amplified as they travel towards the back of the auditory canal. The captured sound waves then reach the tympanic membrane (eardrum) at the back of the canal, causing it to vibrate back and forth. The eardrum represents the separating barrier between the outer and the middle ear. As the eardrum vibrates, three tiny bones behind it begin to shift with it. These tiny bones are considered the smallest in the body, and are called ossicles. The last tiny bone, commonly referred to as the stapes, then transfers the vibrating motion to the organ of hearing, the cochlea. It is inside the cochlea where tiny structures called “hair cells” convert the vibrating energy into an electrical signal. The signal travels to the brain where perception occurs. When noises are too loud, the tiny hair cells within the inner ear are damaged and eventually die. This results in decreased hearing. Noise induced hearing loss can be caused by a one-time exposure to an intense sound (such as a blast) or by continuous exposure to loud sounds over an extended period of time (working in a loud shop). Leisure activities can also put one at risk for noise induced hearing loss. This might include listening to MP3 players at high volumes or attending loud rock concerts. There are many other causes of hearing loss besides noise, and these causes include aging (presbycusis), genetics, disease (history of recurrent middle ear infections, viral inner ear infections, and Meniere’s disease), and trauma .The severity of hearing loss depends on all of these factors , which can co-exist and be additive. Individuals with a mild hearing loss might only experience difficulty hearing with background noises. Individuals with a severe hearing loss may experience difficulty during normal conversation, which can impact their personal and professional life significantly. Another common symptom of hearing loss is ringing or buzzing in the ear, which is referred to as tinnitus. Tinnitus will often come and go, and can be extremely bothersome to patients. Machines that create masking sounds (white noise) can be used to “cancel-out” the tinnitus in many cases. Noise induced hearing loss is the only type of hearing loss that can be completely prevented. The best way to do so is to avoid loud noises. If one cannot avoid excessive noise, hearing protection is recommended. Ear plugs or ear muffs are frequently used to help decrease loud noises. Proper assessment of hearing loss requires a hearing evaluation. If one suspects that their hearing has decreased it is important to see an otolaryngologist (Ears, Nose, and Throat physician) or licensed hearing professional who can perform a specialized hearing test. Depending on the results and exam, a patient may be a candidate for a hearing aid or other assistive listening devices. Other modalities include fabricating a custom ear plug that can minimize additional noise exposure if one is routinely exposed to loud noises at work or during hobbies (i.e. musicians). If a patient wishes to pursue hearing aids, a hearing aid evaluation is set up. During a hearing aid evaluation a trained audiologist or hearing instrument specialist will meet with the patient and help them find a hearing aid model which works best for them. If you have any questions about Noise Induced Hearing Loss or want to set up an evaluation with one of our Board Certified Ear Nose Throat specialists, or licensed audiologists or hearing instrument specialists, please contact us at Colden & Seymour Ear Nose Throat and Allergy at 978-997-1550, or through our website.

Springtime Allergies…Ahhh…those allergies!

Posted in Uncategorized on April 25th, 2016 with No Comments
Springtime has arrived and so have spring allergies. The spring is notoriously referred to as the “tree allergy season”. With warmer weather comes the onslaught of tree pollination. Billions of tiny airborne pollen particles are released into the environment and are carried great distances by the winds. As the pollen particles waft through the air they are easily inhaled by allergy sufferers which trigger a series of bothersome symptoms. This condition is sometimes referred to as “Hay Fever,” or seasonal allergic rhinitis, and affects roughly 30 to 60 million people in the United States on an annual basis. Seasonal allergies can cause a variety of symptoms. The most common include recurrent sneezing, a runny nose, watery/itchy eyes, and nasal or throat congestion. Severe allergies may cause polyps to form in the nose and sinus, further blocking the ability to breathe comfortably through the nose and triggering recurrent sinus infections. Conditions associated with hay fever include asthma, eczema, conjunctivitis, nasal polyps, sinusitis, sleep apnea, laryngitis, and ear infections. Individuals with asthma may become more symptomatic when exposed to tree allergens, and often report increased wheezing, shortness of breath, or coughing. Another strange symptom that may indicate that you have seasonal allergies is itchiness of the mouth and throat after eating raw fruits (apples, bananas). This condition is called oral allergy syndrome and is highly prevalent in individuals with tree allergies such as birch. The first step in minimizing spring allergies is to determine which trees you are sensitized (or allergic) to. An allergy test determines whether your body has an allergic reaction to a specific substance in the environment, in this case tree pollen. Because tree pollen particles have very unique proteins (and therefore have less cross-over between different types of trees), patients are often tested for several different tree species, usually dependent on which trees are found in their region. A tree allergy test panel for New England may include oak, elm, maple, sycamore, and birch to name a few of the more common tree pollen offenders. Allergy testing can be performed either via a quick pain-free skin test or by a blood test. Both types of testing are safe and can be effective for diagnosing tree allergies, as well as other types of allergies. Skin testing has the advantage of being performed in the office setting, and other benefits may include: immediately available results, the ability to test for multiple tree allergens, and the immediate patient feedback regarding how they react to certain tree pollens in their environment. In preparation for skin testing, patients are advised to discontinue taking antihistamines and other types of medications that may interfere with test results. Tree allergies can be treated in variety of ways. Firstly, environmental modifications are recommended for anyone who is allergic to pollen. This includes keeping home windows closed, staying indoors on high pollen days, not drying clothing outside, and showering before bedtime. If environmental modifications are not enough, medical management may be necessary. This includes over the counter antihistamines (e.g. Claritin, Zyrtec) and intranasal steroid sprays (e.g. Flonase). Other types of medications include nasal inhaled antihistamines, mast cell stabilizer nasal sprays, and oral decongestants. For patients who are interested in additional improvement and decreasing their usage of allergy medications, immunotherapy should be considered. Immunotherapy can be given in two different ways, including subcutaneous immunotherapy (SCIT or allergy shots) and sublingual immunotherapy (SLIT or allergy drops). SCIT (allergy shots) has shown repeatedly over the past 50 years to be a very safe and effective way to minimize both seasonal and year round allergies. SLIT (allergy drops) is the most common form of allergy treatment in Europe, and has been shown to be as effective and safe as traditional allergy shots, but has the added benefit of being able to do this treatment in the convenience of your home (you can self-administer the drops daily). The major disadvantage of SLIT is that it is currently not FDA approved in the USA (although the drops are made from the exact same allergy extracts that are used to create the allergy shots), and therefore this treatment would not be covered through medical insurance. If you or a family member have any concerns regarding spring allergies, please do not hesitate to contact Colden & Seymour Ear Nose Throat and Allergy and schedule an allergy evaluation as your first step towards symptom relief. Opinions expressed here are those of Dr. Daryl Colden and Christopher Jayne, BA. They are not intended as medical advice and cannot substitute for the advice of your personal physician.
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