Pediatrician administers vaccination to child

Got Allergies and Don’t Like Shots?

Some people just don’t like shots, even if they might help them with severe allergies. Well, now there is another way to receive the relief allergy shots may give you without the needles.

Sublingual immunotherapy (SLIT) is an alternative way to treat allergies without injections. An allergist gives a patient small doses of an allergen under the tongue to boost tolerance to the substance and reduce symptoms. According to a 2009 World Allergy Organization (WAO) paper, SLIT is widely accepted and used in European, South American, and Asian countries as well as in Australia and is gaining interest from allergists in the United States, including those at the ENT Center of Utah.

According to the American College of Allergy, Asthma and Immunology, an allergist must first use allergy testing to confirm the patients sensitivities. Once this is determined, an allergen extract is prepared in drop form and the patient is directed to keep it under the tongue for two minutes and then swallow it. The process is repeated daily with an average of three-to-five year commitment.

Is Sublingual Immunotherapy Effective and Safe?

Most clinical trials and surveys published over at least 20 years show that SLIT is relatively safe and effective for the treatment of rhinitis and asthma caused by allergies. In addition, it might prove an effective therapy for children with mild atopic dermatitis (eczema) and asthma. Side effects among both children and adults are usually local and mild, most often occur early in treatment, and include itching in the mouth or stomach problems.

Learn more about this therapy and get relief by consulting with an allergist at the ENT Center of Utah.

Audiology for ringing in ears

Ringing in the Ears: New Guidelines from AAO-HNS

Whether it started with that rock concert that got a little too loud or the excruciating pop in the wood shop years ago, many of us have persistent ringing in the ears from time to time.

More than 50 million Americans suffer from tinnitus, or the perception of sound without an external source. Experts say it’s the most common service-related disability among U.S. military veterans. Yet many people remain unsure what can be done about it.

The nation’s largest group of ear, nose and throat specialists, the American Academy of Otolaryngology – Head and Neck Surgery, has come out with new guidelines for treating the condition, based on the latest research.

The group says many cases are minor or go away on their own, but about 20 percent of patients need some type of medical intervention.

A good place to begin is a targeted history and physical exam, which you can do with the specialists at the ENT Center of Utah. This may include a hearing test when it is appropriate. Patients who also suffer from hearing loss may benefit from a hearing aid evaluation.Most patients will learn that there are plenty of methods to handle the annoying condition.

The Academy recommends against routine scans and MRIs to diagnose the condition the guidelines discourage the use of medications such as antidepressants and anticonvulsants. Some tinnitus sufferers have found relief from natural supplements but the panel also recommended against dietary supplements such as Ginkgo biloba, melatonin and zinc, or the use of a technique called transcranial magnetic stimulation, which involves the use of magnetic fields to stimulate nerve cells in the brain.

The guidelines are neutral on the effects of acupuncture for treating tinnitus, neither recommending nor warning against this popular form of alternative medicine.

While it falls short of a cure, doctors say patients with persistent, bothersome tinnitus may benefit from learning about strategies for managing their condition, and from cognitive behavioral therapy to help them cope.

Thyroid image for the ENT Center of Utah

Has Thyroid Cancer Been Overdiagnosed in South Korea?

Just before the run of the century, the South Korean government began a national program of cancer screening about 15 years, including cancers of the breast, cervix, colon, stomach and liver. Doctors and hospitals added ultrasound scans for thyroid cancer for a small additional fee.

What they have discovered in the last 15 years has alarmed some specialists in the field. The incidence of thyroid cancer has increased by 15 times and surpassed lung, breast and colon cancers. Thyroid cancer is the most common cancer in the nation.

However, many thyroid cancers are slow growing and easy to treat. In fact, some studies have shown almost one-third of autopsies show that people have thyroid cancers that were undetected throughout their life and were not the cause of death. Occasionally the best response to a report of thyroid cancer is to do nothing after consulting with an expert ENT physician.

In the United States, doctors caution against extreme treatment of many thyroid cancers. Few people die of thyroid cancer. Specialists at the ENT Center can help diagnose thyroid cancer and the appropriate response to any screenings.

See a full report of this story in the New York Times.

Nose ring issues

Your Nose: To Pierce or not to Pierce?

Nose piercing in the U.S. have increased dramatically. But is it the same as getting your ear pierced? NO! Compared to piercings in the ear lobe, nose piercings can become infected more easily and the sensitive tissue may be damaged.

When considering a nose piercing the first thing you should do is to consult your ENT doctor, as any of our specialists will be able to give you some advice on if such a piercing is going to be right for you. If you already have a pre-existing health condition, a piercing can quickly lead to complications, so seeking medical advice is a must.

Oh, you say you already have a nose ring? Taking care of your piercing is important and you must keep it clean. Ideally, you should wash the area at least twice each day with an antiseptic solution. A tougher admonition is refraining from touching your nose or the jewelry as a habit — a prime cause for harmful infection. If you do not want the piercing anymore, simply take it out and the hole will not take too long to completely heal; and usually no scar will be left behind. Just make sure to keep the hole filled or you will have to get the piercing all over again.

Here are a few things to keep in mind while caring for your nasal jewelry. Ensure the stud doesn’t fall out when you are asleep and get lodged int he nasal passages. Without proper care, the hole can easily become infected, causing pain, disfigurement and bleeding. When first wearing a new nose ring or stud, simple actions such as blowing your nose and sneezing with a nose ring can be a new experience.

Utah allergies woman sneezing

Allergies in the Middle of the Summer? C’mon!

Many of us struggle with allergies but they often peak in spring and fall leaving summer a nice time of relief. So if your nose is running and you’re sneezing like crazy in the middle of summer, what gives?

Well, the biggest summer allergy trigger is pollen. When pollen finds its way into the noses of sensitive airways, it triggers the runny nose, itchy eyes, and other allergy symptoms. The higher the pollen counts, the worse you may feel.

Trees are usually done pollinating by late spring, so if the leafy giants are your primary triggers then you are feeling pretty good at mid-summer. But if you are allergic to grasses and weeds, you may be feeling the full effect.

The Worst Summer Allergy Plants

  • Ragweed
  • Cockleweed
  • Pigweed
  • Russian Thistle
  • Sagebrush
  • Tumbleweed
  • Bermuda Grasses
  • Blue grasses
  • Orchard
  • Red Top
  • Sweet Vernal
  • Timothy Hay

One thing to be aware of, especially in Utah, is that a potent and and common summer allergy trigger is on its way — ragweed, which usually arrives in August. Ragweed can travel for hundreds of miles in the wind. Even if it doesn’t grow where you live, it can make you feel bad if you’re allergic to it.

Summer air pollution can make allergy symptoms worse. One of the most common pollutants is ozone, which is created in the atmosphere by a combination of sunlight, nitrogen oxide, and hydrocarbons from burning fuel. The stronger sunlight and calmer winds during summer can create clouds of ozone around some cities, like Salt Lake City and Logan during inversions.

Inside, molds love damp areas, including the basement and bathrooms. Their spores get into the air and can cause problems for allergy sufferers.

Dust mites — microscopic insects — peak during summer. They thrive in warm, humid temperatures (luckily we rarely experience high humidity in Utah) and nest in beds, fabric, and carpets. Their residue can get into the air, triggering sneezes, wheezes, and runny noses.

Tips to Minimize the Effects without Medication

  • Try to stay indoors whenever the pollen count is high.
  • Keep your doors and windows closed whenever possible to keep allergens out. Use an air purifier.
  • Clean air filters in your home often. Clean bookshelves, vents, and other places where pollen can collect.
  • Wash bedding and rugs in hot water to eliminate dust mites and other allergens.
  • Wash your hair, shower, and change clothing after going outside to wash away pollen.
  • Vacuum often. Wear a mask, because vacuuming can kick up pollen, mold, and dust trapped in your carpet. Use a vacuum with a HEPA filter.
  • Wear a mask when you mow your lawn to avoid grass pollen.
  • Keep the humidity in your house between 30% and 50% to prevent the growth of dust mites.

How to Treat Summer Allergies without Seeing a Doctor

Over-the-counter allergy treatments include:

  • Antihistamines
  • Decongestants
  • Nasal spray decongestants (They shouldn’t be used more than three days.)
  • Corticosteroid nasal spray (Nasacort)
  • Cromolyn sodium nasal spray
  • Eye drops
  • Nasal irrigation like a Neti Pot

When You Should See a Doctor

If over-the-counter remedies don’t help, see a specialist such as one of the physicians at the ENT Center of Utah. Your doctor will talk to you about your symptoms and your allergy history. He may suggest allergy treatments. In some cases, he may refer you to an allergy specialist who may do a skin test (often called a scratch test), which exposes the skin of your arm or back to a tiny sample of allergen. If you’re allergic to a substance, a small red bump will form. A blood test can also diagnose allergies.

The doctor may recommend one of these prescription medications:

  • Corticosteroid nasal sprays
  • Leukotriene receptor antagonists (LTRAs) such as Singulair
  • Atrovent (ipratropium bromide) nasal spray
  • Immunotherapy in the form of allergy shots or oral tablets or drops
Vocal cord lesions screaming boy

Does Your Child Scream So Much That It’s Unhealthy?

Parents probably all agree that their kids scream too much. It’s a child’s warning system, can be an expression or fear or glee and a way to garner attention. Besides the impact on the hearer’s eardrums, is there a point where a screamer can damage vocal chords? The answer is, unfortunately, yes. On the bright side, it’s usually a temporary condition.

Screamers, or singers for that matter, may develop vocal cord lesions, which refer to a group of noncancerous, abnormal growths within or along the covering of the vocal cord. Vocal cord lesions are one of the most common causes of voice problems and are generally seen in three forms: nodules, polyps, and cysts.

Vocal cord nodules are also known as “calluses of the vocal fold.” They appear on both sides of the vocal cords, typically at the midpoint, and directly face each other. Like other calluses, these lesions often diminish or disappear when overuse of the area is stopped.

A vocal cord polyp typically occurs only on one side of the vocal cord and can occur in a variety of shapes and sizes. Depending upon the nature of the polyp, it can cause a wide range of voice disturbances.

A vocal cord cyst is a firm mass of tissue contained within a membrane. The cyst can be located near the surface of the vocal cord or deeper, near the ligament of the vocal cord. As with vocal cord polyps and nodules, the size and location of vocal cord cysts affect the degree of disruption of vocal cord vibration and subsequently the severity of hoarseness or other voice problem.

Surgery followed by voice therapy is the most commonly recommended treatment for vocal cord cysts that significantly alter and/or limit voice. Doctors at the ENT Center of Utah can help determine what procedures are right for you.

A reactive vocal cord lesion is a mass located opposite an existing vocal cord lesion, such as a vocal cord cyst or polyp. This type of lesion is thought to develop from trauma or repeated injury caused by the lesion on the opposite vocal cord. A reactive vocal cord lesion will usually decrease or disappear with voice rest and therapy.

The exact cause or causes of benign vocal cord lesions is not known. Lesions are thought to arise following “heavy” or traumatic use of the voice, including voice misuse such as speaking in an improper pitch, speaking excessively, screaming or yelling, or using the voice excessively while sick.

A change in voice quality and persistent hoarseness are often the first warning signs of a vocal cord lesion. Other symptoms can include:

  • Vocal fatigue
  • Unreliable voice
  • Delayed voice initiation
  • Low, gravelly voice
  • Low pitch
  • Voice breaks in first passages of sentences
  • Airy or breathy voice
  • Inability to sing in high, soft voice
  • Increased effort to speak or sing
  • Hoarse and rough voice quality
  • Frequent throat clearing
  • Extra force needed for voice

The most common treatment options for benign vocal cord lesions include: voice rest, voice therapy, singing voice therapy, and phonomicrosurgery, a type of surgery involving the use of microsurgical techniques and instruments to treat abnormalities on the vocal cord.

Treatment options can vary according to the degree of voice limitation and the exact voice demands of the patient. For example, if a professional singer develops benign vocal cord lesions and undergoes voice therapy, which improves speaking but not singing voice, then surgery might be considered to restore singing voice.

In the end, most of us just need to rest the vocal cords and we’ll all feel better. Speech therapy is usually the next choice for treatment. Even if surgery is required, the specialists at the ENT Center of Utah can diagnose and provide lasting solutions for the issue. To schedule an appointment, please call (801) 328-2522. 

man on plane

Do Your Ears Hurt when Flying?

Many people who don’t normally fly are taking trips for summer vacation during the next few months. For some, an trip via air translates to uncomfortable ear pain. It varies from person to person but usually is most noticeable when the plane descends to land. The pain is worse the lower the aircraft descends in elevation and can be quite acute on landing.

The pain is caused by unequal pressure that develops between the air that is trapped in the middle ear and the air outside the ear. This air space is connected to the back of the nose by a tiny channel called the Eustachian tube. The air on either side of the eardrum should be at the same pressure. As a plane descends the air pressure becomes as you get ready to hit the tarmac. This pushes the eardrum inwards which can be painful. To relieve this, the pressure inside the middle ear has to rise quickly too. Air needs to travel up the Eustachian tube into the middle ear to equalise the pressure.

The Eustachian tube is normally closed but opens from time to time when we swallow, yawn or chew. In most people, just normal swallowing and chewing quickly cause air to travel up the Eustachian tube to equalize the pressure. Many passengers choose to crew gum or suck on hard candy when taking off or coming in for a landing.

However, the Eustachian tube in some people does not open as easily and so the pressure may not be evened so quickly. Consider that some people may have a narrow Eustachian tube than normal and some have conditions — like a cold, infection or hayfever — that causes a blockage to the Eustachian tube. For those passengers, the air can’t travel up the tube quickly enough. Ideally, anyone with a cold, respiratory infection, or ear infection should not fly. However, not many people will cancel their airplane trips for this reason. but, come on, who wants to let a little cold ruin a week or two of fun at some exotic locale.

Here are some tips to alleviate possible ear pain:

  • Suck on hard candy when the plane begins to descend. Air is more likely to flow up the Eustachian tube if you swallow, yawn or chew. For babies, it is a good idea to feed them or give them a bottle upon descent to encourage them to swallow.
  • Breathing Technique Breathe in deeply and try to breathe out gently with your mouth closed while pinching your nose. This way, no air is blown out your mouth while you are gently pushing air into the Eustachian tube. If you do this you may feel your ears go ‘pop’ as air is pushed into the middle ear. This often cures the problem. Repeat this every few minutes until landing or whenever you feel any discomfort in the ear.
  • Do not sleep when the plane is descending to land. If you are extra-tired, ask the flight attendant to wake you when the plane starts to descend. Alert passengers can make sure to try techniques like the sucking or breathing ideas above, and thereby encourage air to get into the middle ear.

What if you have tried all of those tips and you still get pain in the ear while flying?

  • Antihistamine. Take the recommended dose the day before and the day of travel. This may help to limit the amount of mucus that you make. Mucus often blocks the inner ear tubes.
  • A decongestant nasal spray can dry up the mucus in the nose. Try and find one with xylometazoline, like Otrivin. Spray the nose about one hour before the expected time of descent. Spray again five minutes later. Then spray every 20 minutes until landing.
  • Air pressure regulating ear plugs. These are cheap, reusable ear plugs, such as EarPlanes, that are often sold at airports and in many pharmacies. These ear plugs slow the rate of air pressure change on the eardrum. Basically, you put them in before the door of the aircraft is shut. Some people then wear them for the entire flight. Some people take them out when the plane reaches cruising height, and then place them in again just before the plane starts to descend to land.

If the all of these measures fail, rest assured that the pain normally goes away quickly. If not, you can take over-the-counter pain medicine. Fluid sometimes accumulates in the middle ear for a few days after the flight, which may make hearing rather dull for a while. But if it doesn’t soon subside, please see one of our doctors to get treatment.

summer vacation

Health Concerns after Summer Vacation

The end of a “relaxing” vacation can sometimes spell the beginning of health issues. Address them before they build into major health concerns.

That long trip to the beach, that time in the salt or chlorinated water under the sun, dancing on the sand and late night conversations can come back to haunt you once you return your summer vacations. Post-holiday blues may often come from budding health problems as much as the doldrums of regular schedules again.

Dehydration
You experience severe fatigue and loss of energy after a vacation. Resulting from extensive traveling and new food habits, a weakened body may end up as flu or susceptible to new allergies, if not treated on time.

Remedy: Drink a lot of water to keep your body hydrated. Substitute oily food products with fresh fruits and vegetables. Do not bounce back to doing serious work that will tire you easily. If possible, resume your full work schedule after a day or two of adjustment.

Hayfever
This is one of the most common health concerns that people face after a vacation. Perhaps your body got accustomed to the pollution-free air at your dream destination and now finds the balance disturbed back at home. These respiratory concerns like clogging of the nose and a sore throat may be followed by high fever.

Remedy: Treat yourself with home remedies like ginger juice and honey or turmeric. They work better than antibiotics, since it is not a common cold, but a result of sudden change in climate conditions.

Depression
Depression and post-vacation blues usually present themselves as soon as all the fun comes to an end, and you know you will have to get back to the grind. It can also affect you physically. You usually do not catch up on a lot of sleep during vacation during the excitement of seeing new places. This leads to a lack of concentration and an inability to settle down to your routine.

Remedy: Ensure that you catch up on your sleep and recover, both mentally and physically. Do not start unpacking and washing, as soon as you come back, give yourself some time to settle down.

throat disorders

Ever Feel like Something Is Stuck in Your Throat?

Do you ever feel like something is stuck in your throat? At one time or another, many of us experience an itchiness or ‘blockage’ right behind the tongue or tonsils. This feeling may drive us mad or be a mild irritant. It may only happen once in a while, while others experience these symptoms nearly everyday. Sometimes, we feel like these throat irritants when we feel other symptoms, which may include pressure in the chest, excess saliva, hoarseness, loss of appetite, or weight loss.

For most people who experience occasional difficulties swallowing, it’s probably not a big deal. However, persistent difficulties should motivate you to seek medical attention at a highly regarded ear, nose and throat center, such as the ENT Center of Utah. The main reasons we have difficulty swallowing, which is called dysphagia, are because of an actual blockage or it could be due to muscle and/or nerve issues.

After examination, doctors may suggest these one of these therapies:

Antibiotics for throat infections like tonsillitis

Stomach acid reduction medications for symptoms caused by GERD and esophagitis

Diet restrictions to help you avoid food that can cause allergic reactions or intolerances, such as coffee, sour foods, alcoholic drinks, and spicy foods.

Minor surgery or procedure to remove objects that are actually stuck in the throat

Surgery and radiotherapy may be necessary to remove a tumor inside or around the throat

Behavioral therapy is good for some who just need to chew food carefully and eat slowly

Of course, early detection and effective treatment of the underlying cause behind throat issues can lower your risk of more serious problems. Contact us if your symptoms persist for more than one week. But if you ever have sudden difficulty breathing, call 9-1-1 immediately as it might be life threatening.

guy picking his nose

Be Careful when You Pick Your Nose or Pluck Your Nose Hairs

Everybody picks their nose, right?

You need to pick now and then. Maybe something is hangin’ out or it itches like crazy. However, if you pick too frequently, or really get into it, then you could cause cuts or irritations, as well as infections. Tears of the nasal septum, the partition separating the nostrils, are common among people who mine their nostrils for 15-30 minutes or more a day, according to a study from Wisconsin’s Dean Foundation. The less time you spend picking and more care you take to extract those little piece of dry mucus, the better.

You also pluck your nose hairs.

Keep in mind, those hairs are there for a reason. At the same time, no one likes to look at tufts of hair descending from the nostrils of friends or co-workers. Experts say these hairs keep contaminants and harmful microorganisms from entering your brain and respiratory system. But when they aren’t even in your nose? Trim the tips but keep the bases embedded in the nostrils. If you pluck them out, you create tiny open wounds in the skin inside your nose and you become susceptible to infection from all those same microorganisms caught in the protective, surrounding hairs.