Archive for general health

Allergy Ear Pain

When my patients talk to be about allergies, they exhibit a lot of symptoms. Besides a stuffy nose, ear pain is another prevalent symptom.

The sinuses and ears are connected inside your head. So clogged sinuses may cause ear pressure.

Common examples of ear discomfort says the website Livingstrong.com are “ear popping and sensations of the ear feeling full, states the American Academy of Family Physicians. This can occur if the mucus produced by an allergic reaction, drains into the Eustachian tube. If the lining of this tube becomes inflamed, then the ears may start to feel full and pop. This can lead to a loss of balance, dizziness and even vertigo.”

In an interesting post on the website WebMD There are various treatments to help the allergy sufferer with earache. They include:

Lubricating sinuses by using a nasal saline spray several times a day or use a humidifier. Also the use of a warm moist washcloth and hot showers is recommended; over-the-counter medicines such as Aleve, Tylenol or Motrin can ease ear pain; use nasal sprays in the short-term (not more than 3 days) or decongestant tablets; avoid temperature extremes; avoid suddenly movements to your head; blow your nose gently; flush your body with plenty of fluids especially at night–this makes the mucus more fluid; avoid caffeine, salt, alcohol, and tobacco products. These substances change blood circulation and can affect your ears.

Flying is another problem that people with earaches should avoid. If you have to travel by air, before boarding the plane, take nasal spray or oral decongestant at least 30 minutes to an hour before takeoff, since it takes time for them to kick in.

Finally, see an allergist if the ear problems are persistent; you have a fever, head, face, or ear pain doesn’t dissipate after taking non-prescription medication; and symptoms last for more than week, or keep coming back.

For further information: http://www.nycallergydoctor.com/allergy

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Food Allergies And The International Traveler

All lot of my patients love to travel. Experiencing another culture is great way to broaden your horizons. But beyond the sights and sounds of distant locales, a primary component of any traveler’s experience is dining out in those countries.

For the food allergy traveler, this can be daunting. But there are four ways for you to dip into cuisine of these countries, safely.

Carry allergy cards. In 2004, a couple’s daughter returned from her trip through Europe, complaining that she couldn’t or was wary of eating most foods there due to her nut allergies. She only ate vanilla ice cream, shishkaboobs and bread throughout her trip.

So her parents started SelectWisely.com. It is company that produces allergy alert cards that are laminated and the size of a business card. The card states the allergy the traveler is susceptible to in English and one of 60 foreign languages and shows a picture of the allergy itself.

Allergy FT: Allergy Food Translator App Screens. This mobile app for iOS only (www.allergyft.com) lists 62 food allergies and translates them into French, German and Spanish– which claim its developer–will help you navigate cuisine in 57 countries around the world that speak these languages. All you do is select the language, then select the allergy and the allergy warning in those languages pops up on the screen. Allergy FT said is updating its app to include more languages.

IAMAT Directory. If an allergic reaction to food does occur while your traveling abroad, an indispensable resource to have is International Association for Medical Assistance To Travelers (IAMAT) directory. It lists the local hospitals of a particular country that assistant travelers and that speak English. Contact them at (www.iamat.org.)

Ep-iPen. The IAMAT states travelers with food allergies should carry at least two vials of epinephrine in case of a anaphylactic reaction.

For more information on food allergies: http://www.nycallergydoctor.com/allergy

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What You Should Know About COPD

A lot of my practice deals with allergies and asthma. But I also deal with a disease that can be confused with asthma, COPD.

Chronic obstructive pulmonary disease (COPD), according to the Mayo Clinic, is a group of lung diseases that block airflow and make breathing difficult. The two primary examples of COPD are emphysema and chronic bronchitis.

States the Mayo Clinic website, “in chronic bronchitis, there is an inflammation of the lining your bronchial tubes, which carry air to and from your lungs. Emphysema occurs when the air saces (alveoli) at the end of the smallest air passages (bronchioles) in the lungs are gradually destroyed.

Now there are similarities between COPD and asthma. In an interesting article in the Medscape Journal, the publication characterizes the commonality of symptoms: It states “both are characterized by a reduced rate of pulmonary airflow from increased inflammation. Airway obstruction is typically fully or nearly fully reversible in patients with asthma, whereas COPD is characterized by airway obstruction that is not fully reversible.”

However, the causes of asthma and COPD are different. Asthmatics may have a genetic predisposition to their illness, which tends to run in families. However, not all predisposed family members may get asthma. Some experts theorize that respiratory infections in infancy or early childhood may play a major role in the disease.

COPD on the other hand, has a more definitive cause. Smoking constitutes a majority of cases in 85 to 90 percent of COPD deaths. Moreover, exposure to air pollution, chemicals, and secondhand smoke can also cause it. In rare cases, says the American Lung Association, there is a genetic defect called alpha-1 antitrypsin deficiency, constituting 2 to 3 percent of all COPD cases.

COPD is often not diagnosed in people until they reach 40 years of age. Asthma cases are diagnosed very early; children often exhibit symptoms at the age of 5. COPD is a progressive disease, unlike asthma, where is some cases some children may even outgrow the condition as they get older.

While medical treatment for COPD may not repair structural changes in already damaged lung tissue, it can slow down the progression of the disease.

 

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Are Your Allergic To Your iPad?

In my practice, I see a lot of pediatric rashes: heat rashes, medicine rashes, ringworm and even swimmer’s itch, among others. But now there’s a rash that’s connected to our web obsessed culture–the iPad rash.

It appears that the Apple’s i Pad has been cast as the culprit in reports of unexplained allergic rashes in children, according to an interesting story I recently saw in the Washington Post. The paper reported the iPad allergy outbreak from a study in the medical journal, Pediatrics.

The study profiled an 11- year old boy who had an itchy body rash which wouldn’t go away, who was treated at a San Diego hospital. The Daily Mail, a London-based newspaper stated “the boy had a common skin condition that causes scaly patches, but he developed a different rash all over his body that didn’t respond to usual treatment. Skin testing showed he had a nickel allergy, and doctors traced it to his iPad, which he had used daily.”

The boy improved after he put his iPad in a protective case.

However, the 11-year old isn’t an isolated case when it comes to nickel allergies. At the beginning of this year, people who brought the fitness tracker, Force- a wearable band– reported developing contact dermatitis from wearing this device. The manufacturer, Fitbit recalled the band after it was revealed that nickel was involved in the production of this product. Some wearers tried to cover the nickel port with tape, but it didn’t stop rash.

Dr. Sharon Jacob, a dermatologist at the San Diego hospital where the 11-year old was treated stated that “nickel allergies are becoming more common, or increasingly recognized.” And said that “national data showing that about 25 percent of children who get skin tests for allergies have nickel allergies, versus about 17 percent a decade ago.”

If you or your child have developed a rash that won’t go away or won’t respond to over-the-counter treatments, see your allergist.

For more information: visit http://www.nycallergydoctor.com/allergy

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Buteyko Breathing Method May Help Asthmatics

Patients of mine who are asthmatics take a variety of medications and inhalers to help cope with their asthma. But many of them have asked me, “Dr. Lubitz, is there anything else that I can do to help me with my symptoms?”
I tell them there are a number of exercise techniques that may help them during an asthma attack or even help them reduce their reliance on medication.

I know of one such method that is called Buteyko Breathing Therapy (BBT). It was developed by a Ukranian physiologist, Konstantin Buteyko in 1952. Basically, he observed that when sufferers of asthma have an asthma attack, they hyperventilate thus triggering a response of gasping for air. Adds Jane E. Brody in an interesting article in the New York Times that asthmatics “breathe too fast and too deeply and through the mouth and this lowers the level of carbon dioxide in the blood and that the airways constrict to conserve it. They don’t realize that too much air can be harmful to health and trigger a bronco spasm.”

The Buteyko method takes a different approach. Jane E. Body explains that the method trains people –especially during asthma attack–“to breathe shallowly and slowly through the nose, breaking the vicious cycle of rapid, gasping breaths, airway constriction and increased wheezing.”

A study in the UK, published in December in 2003 for the British journal Thorax, tested 384 asthmatic adults who practiced the Buteyko method. The findings stated that these patients reduced their reliance on rescue inhalers and halved their need for steroids within six months. The British Thoracic Society has given the Buteyko method a “B” rating, meaning that positive results of the trials are likely due to the breathing method itself.

Other support for Buteyko–albeit qualified– comes from the National Asthma Council’s Asthma Management Handbook, an Australian publication from that country’s asthma association. It states that “controlled studies have found that Bueyko breathing can help improve symptoms and reduce the use of reliever medicines in some people. However, these studies did not show that Buteyko breathing altered carbon dioxide levels or measures of airway inflammation or lung function.”

It is recommended by many medical associations and physicians that people should not start practicing the Buteyko technique on their own, but train under the supervision of a trained professional.

There are Buteyko centers and practitioners around the world. Buteyko Center USA is the North American representative of the Buteyko Clinic in Moscow and is headquartered in Woodstock, NY.

People suffering from asthma, however, are advised that any new treatment or exercise should be cleared after consulting a qualified allergist who will determine its efficacy based on the patient’s symptoms.

To learn more, visit http://www.nycallergydoctor.com/allergy

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Late Allergy Season Expected To Be Intense

Was it just six weeks ago that we experienced driving rain, snow and unrelenting cold temperatures? Dubbed the “polar vortex,” we didn’t know when it would end.”

Now spring has arrived and according to most experts, we’re headed for another vortex–“the pollen vortex”. I’m telling my patients to be prepared for the onslaught of a bad allergy season. According to the Washington Post this pollen vortex will consist of “a tidal wave of pent-up pollen could be coming our way as the area heads towards the height of allergy season this month.”

I know, I know. What’s a New Yorker to do? Well, for starters whether you’re staying in the city or going cross-country, know what pollens to watch out for. Here’s a sample of the 10 top pollens to recognize and the regions they predominate according to Warren V. Filley, MD a spokesperson for the American Academy of Allergy, Asthma and Immunology:

Hayfever–comes from beautiful plants and trees growing in your neighborhood. It’s an allergy, that is unfortunately, widespread in many regions of the country. It’s hard to avoid, but try to stay away from it mid-day.

Ragweed– about 75% of Americans who are allergic have this allergy. You’ll see it in the fields, riverbanks, roadsides of the Midwest and Mississippi River basin. You see it around the fall and summer months.

Mountain cedar–it’s in the mountainous areas of Arkansas, Missouri, parts of New Mexico, Oklahoma, and Texas. Appears in the spring.

Ryegrass–you find it in dry, cool lawns, meadows and pastures. Predominates in the northern parts of the United States in spring and summer.

Maple–it’s found in areas along streams and woods. Found all over the eastern United States and Canada. It peaks in the early spring. There’s a lot of it in New York.

Elm–found in cultivated and wetland habitats. It is widespread in the eastern and midwestern regions. Also found in New York, especially in city parks and along streets. In the spring it is known as American Dutch Elm. In the fall, lace bark elm.

Mulberry–you see it in woods and river valleys. All over the eastern US. The season stretches from winter to summer. The pollens are from cherry and crabapple tree blossoms and contributes to hayfever.

Oak–found in wooded areas. The states that predominate are the Coastal Plan from Texas to Virginia, and Florida. It’s season is spring time and oak trees produce the most pollen for the season.

Tumbleweed–found all over the western and northern US. It’s season is spring to fall.

Arizona cypress–wherever you’ll go in the southwestern US, you’ll find this. It appears during the spring although the pollens can last for six or seven months throughout the year in some yearly cycles.

To learn more, visit http://www.nycallergydoctor.com/allergy

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Tiny Nasal Filter Claims To Help Allergy Sufferers

You know the saying, “wake up and smell the roses.” Well, for a lot of my patients, smelling roses or for that matter, any flowers, trees or grasses at this time of year may give them a severe allergic response. So when a walk in the park is no walk in the park, what can an allergy sufferer do?

Well a new device that you wear in your nose–about the size of a contact lens and works like a miniature air filter for a furnace–might make life easier for some of the estimated 500 million people worldwide who suffer from itching, sneezing and a runny nose as soon as the pollen season starts.

Known under the brand name, Rhinix, the filter is supposed to be on market this spring and claims significant reduction in spring allergy symptoms.

The filter was developed from the results of a study by a medical team from Aarhus University in Denmark; the results were published in the Journal of Allergy and Clinical Immunology.

The Journal states that “the research group included 24 people with a known allergy to grass pollen. They were exposed to a amount of grass pollen for 30 minutes at a time until they had 210 minutes of exposure. One time they wore the device without the filtering membrane ( a placebo used for comparison). Another time they wore the device with the filtering membrane.”

The filtering membrane “helped reduce nasal symptoms by 21 percent. Daily itching was decreased by 36 percent, daily runny nose dropped by 12 percent, daily sneezing reduced by 45 percent and throat irritation was reduced by 75 percent.”

The lead author of the study, Peter Kenney said that the filter is disposable and is only meant for daily use. He said “some people will probably use it the entire day whereas others might just use them when they are in an exposed environment (such as a park).”

Since the filters are held together by a small plastic ring, there have been comments that for some, it may prove uncomfortable or not cosmetically pleasing.

Also commenting on the Journal’s study was Dr. Mark Glaum, vice chair of the rhinitis, rhinosinusitis and ocular allergy committee of the American Academy of Allergy, Asthma and Immunology, who expressed reservations on the study saying, “the changes in the individual’s symptoms weren’t huge, but for people with just nasal symptoms, it might help to a degree.” He also expressed the hope that a larger study on a group of people be conducted to see if they had the same results.

To learn more, visit http://www.nycallergydoctor.com/allergy

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Measles Outbreak Reported In NYC

Parents are very concerned about the health of their children–what they eat, are they getting enough exercise, etc. A lot of my patients who are parents remind me of my mother who still lives in Brooklyn. Even now, at 93, my mother still comments on my weight. Well, that’s mothers for you.

Yet some parents are very lax in getting their children vaccinated against childhood diseases such as mumps and measles. They figure that those diseases are a thing of the past, that they don’t exist anymore. Well I’ve got news for them. Those childhood illnesses are making a comeback.

Just a few weeks ago, the Health Department of the City of New York reported an outbreak of measles in the city. The initial cases started in the Bronx and spread to the Lower East Side. The 25 cases reported then included 12 children and 13 adults. Today it is 28 cases.

The Health Department defines “measles as a virus that is highly contagious whose symptoms included a generalized rash and high fever, accompanied by a cough, red eyes, and runny nose, lasting five to six days. The rash begins on the face and spreads down the body, and may include the palms of the hands and soles of their feet.”

Most of the New York cases of the measles occurred after individuals or immigrants visited countries that had measles outbreaks. Other cases occurred by random exposure to sick individuals. So it is important when traveling abroad to pay attention to US Consular health advisories concerning foreign travel.

I cannot say enough that the vaccines are very safe and that any side effects are minimal and may include soreness where the shot was given.

Those who should be inoculated are babies at 12 months of age. Two doses are measles vaccine are required for full protection. Children usually get the second dose at 4 to 6 years of age before going to school. Also older children and adults should get the vaccine if not already done so. It’s never too late to be vaccinated.

 

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Home Environment Linked To Asthma Cases

Last week I spoke about the hygiene hypothesis that is linked to rising peanut, food and other allergies in Western countries, particularly in the US. The hygiene hypothesis says that due to our sterile environment, we have less “dirty” microbes to fight allergies and asthma. But concerning asthma, that is only a partial explanation.

I read an interesting article in the New York Times which quotes Dr. Harold S. Nelson, a doctor at the specialty hospital National Jewish Health in Denver. He cited the reasons for higher asthma rates are due to “lower levels of Vitamin D, exposure to spray cleaning compounds, and a wider use of acetaminophen in place of aspirin have contributed to the asthma epidemic.”

The problem, he continues in saying is that with household cleaners, “the spray mist can be inhaled and irritate the lungs, increasing risk for asthma. The biggest culprits appear to be glass cleaners and air fresheners. A major European study of cleaning product use found that people faced double the risk of adult asthma. And Australian researchers have also found a link with household cleaning sprays and asthma in children.”

Also, concerning low vitamin D levels, the Journal of Allergy and Clinical Immunology stated in 2007 that researchers from Brigham and Women’s Hospital in Boston showed “a link between low D levels in mothers and childhood asthma “Coupled with inadequate intake from foods and supplements, this then leads to vitamin D deficiency, particularly in pregnant women, resulting in more asthma and allergy in their offspring,” states the journal.

In an another study of 200,000 6 and 7 year olds, the use of acetaminophen in the first year of life with associated with a 46 percent increase in prevalence of asthma symptoms.”

Dr. Nelson concludes to limit asthma risk, people should do the following. Use liquid cleaners or pump sprays that don’t generate a fine mist. Eliminate use of spray air fresheners. Pregnant women and mothers should talk to their physicians about taking vitamin D supplements and also discuss pain relievers with their pediatrician.”

 

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Overcoming Teenage Smoking

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The National average of teenagers who smoke – a whopping 18%!

It is common knowledge now that  smoking causes cancer, emphysema, and heart disease; that shortens your life by as much as a decade; and cigarettes alone cost smokers thousands of dollars a year.  Why do people smoke?  Addiction.

Two facts that must be addressed to reduce the number of teen smokers.

  1. 90 percent of smokers began before the age 21.
  2. 3,900 adolescents under 18 years of age try their first cigarette each day and about 950 of them will succumb to a smoking habit.

The Mayo Clinic Offers 10 Tips to Keep Teens Smoke Free

1. Set a good example

It’s a fact teens are more lickely to smoke if their  parents smoke.  The earlier a parent quits – the less likely the teen will smoke. Need help quitting?  Visit http://www.nysmokefree.com/ for tips, support and information.  Your docotr is a great resource, too. Help is available. 

A smoking parent can also take these measures to discourage their child from smoking:

  • Don’t smoke in the house, in the car or in front of your teen,
  • Don’t leave cigarettes where your teen might find them.
  • Tell your child how unhappy you are with your habit,
  • Explain how how difficult it is to quit and that you’ll keep trying until you stop smoking for good.

2. Understand the attraction

Did you smoke? Remember why you or your friends started.  Was smoking a form of rebellion, to feel independent? Did you smoke because your friends did?

Ask your teen how he or she feels about smoking and ask if any of their friends smoke. Discuss the consequences of consequences of bad choices.  And point out the marketing efforts of tobacco companies that are trying to influence  ideas about smoking, like product placement in films,  print advertisements and store displays.

3. Say no to teen smoking

Remember who the parent is and tell your teen that smoking isn’t allowed. Teens whose parents set the firmest smoking restrictions smoke less than do teens whose parents don’t set smoking limits. Parental disapproval carries greater weight than most parents believe.

4. Appeal to your teen’s vanity

Is smoking really cool and glamorous? Smoking is actually dirty and smelly. It results in bad breath, yellow teeth  and facial wrinkles. Cigarette smoke makes clothing and hair smell. Smokers have less energy for sports and activities and leads to a chronic cough.

5. Do the math

Smoking is expensive! 
6. Expect peer pressure
Overcoming peer pressure may be as simple as ,”No thanks, I don’t smoke.”  Other children who smoke can be convincing, but as a parent you can provide your child with the knowledge that will allow them the strength and integrity to refuse cigarettes. Discuss peer pressure and rehearse how to handle tough social situations. 

7. Take addiction seriously

Every new smoker believes that they can quit at any time.  Teen and adolescent smokers become addicted with occasional and low levels of smoking. Remind your teen everyone was a new smoker at one time and that most adult smokers start as teens. Once you’re hooked, it’s tough to quit.

8. Predict the future

Children believe they are bulletproof and bad things only happen to other people.  The terms cancer, heart attacks and strokes in relation to cigarette smoking has become cliche’ and children see these terms only int he abstract. Explain how smoking has affected loved ones, friends, neighbors or celebrities and use their experiences with illness related to smoking as real-life examples.

9. Think beyond cigarettes

The Mayo Clinic reminds us that:

Smokeless tobacco, clove cigarettes (kreteks) and candy-flavored cigarettes (bidis) are sometimes mistaken as less harmful or addictive than are traditional cigarettes. Teens also often think that water pipe (hookah) smoking is safe. Nothing could be further from the truth. Kreteks, bidis and hookahs all carry health risks. Don’t let your teen be fooled.

10. Get involved

Take an active stance against teen smoking, discuss the consequences of smoking with your child. Make sure your child understands that never smoking or stopping now is one of the best things everyone and anyone can do for a lifetime of good health.
As a parent participate in local and school-sponsored smoking prevention campaigns, and get your child involved. Support efforts to make public places smoke-free.  These actions can help reduce the odds that your child will become a smoker.

I would like to add 11. Discuss with your healthcare provider

As a physician we have a number of tools available to help you maintain or achieve a smoke-free home.  Cigarette smoking is the basis of so many health problems and is 100% preventable.

If you smoke – get help to stop.  If you don’t smoke – Don’t start!

 

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