Archive for Sinus

It May Not Be a Cold

Sinusitis and the common cold are often confused as they have similar symptoms including congestion, post-nasal drip, fever, and coughing. However, the common cold usually only lasts a couple of weeks, at most, and a serious case of sinusitis can last for months.

Sinusitis can also develop after a bout of the common cold and that may be a reason people confuse it. It may start as a cold but then the inflammation of the sinuses leads to an infection that will persist after the virus itself has been cleared from the patient’s system. With winter on the way, colds are soon to start interrupting our daily lives again with some regularity. If your cold seems to be persisting and is coupled with headaches that seem to be located behind the eyes and facial pain, you may be suffering from a sinus infection. If you are concerned you may have a sinus infection, particularly if symptoms have persisted for 8 weeks or more, see a doctor. Live in the NYC area? Feel free to contact my office for a consultation.

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6 Tips to Ease Sinus Congestion, Pain & Pressure

Cold NYC weather means upping the heat, lowering humidity and for many – painful sinus headaches.

If you are experiencing sinus pain here are 6 Tips that may help.

  1. Recognize what is causing your sinus problems

Are your sinus problems caused by a physical ailment?  Narrow sinus passages, a deviated nasal septum, nasal polyps, allergies, or chronic infections? Each can interfere with sinus drainage. To alleviate pain, congestion and chance of infection, it is important the sinus pathways stay open, uncongested and moist for proper drainage.

  1. Humidify Your Indoor Air

Heated indoor air wreaks havoc on delicate nasal membranes.  As dry air dries out nasal passages, mucus becomes much thicker, clogging sinuses, and resulting in sinus pain and pressure.

A standard recommendation is to use a room humidifier in your bedroom from October until April, maintaining humidity at 30%. Higher humidity levels can aggravate asthma and can encourage mold growth.

  1. Irrigate Your Nasal Passages

Many people find sinus relief by irrigating nasal passages with a saline solution.

Irrigation helps to rinse out allergens, irritants, and excess mucus. There are saline sprays available at your local drugstore, or you can make your own solution at home.  To make your own saline mixture, combine about 16 ounces (1 pint) of lukewarm distilled, sterile water with 1 teaspoon of salt. You can also add 1/2 teaspoon of baking soda make the wash gentler on nasal membranes.  Place the mixture into a Neti pot.  Leaning over the sink at a 45-degree angle, place the spout into your top nostril and gently pour the wash in. The saline water will flow through your nasal cavity into the other nostril and out. Blow your nose to get rid of remaining water. Repeat the steps on your other nostril.

  1. Keep sinuses open and draining

Drinking plenty of fluids will help thin the mucus. A warm, moist washcloth applied to your face several times a day or inhaling steam two to four times a day, can help open spaces in your sinuses. Be cautious when inhaling steam. To avoid burns, try sitting in your in the bathroom with the hot shower running.

  1. Avoid Sinus Irritants

Pollution, cigarette smoke, cleaning products, hair spray, perfumes, air fresheners can irritate your sinuses. If you suffer from allergies, avoiding allergens or allergy triggers is central to keeping inflammation down and sinuses draining properly. During winter months, allergies to pets and mold can be especially hard on those susceptible to dander and mold triggers.

  1. Treat Sinus Problems

Using medications to help control your sinus symptoms can be effective in the short term. Do not use other the counter sprays for more than 3 days or other the counter oral medications for more than 7 days.

Decongestants can help reduce the swelling in your nasal passages along with easing stuffiness and pressure.

Pain relievers and anti-inflammatory medicine can be used to treat the pain of sinus pressure, but be sure to follow the label directions carefully. Again, do not use these medications for more than 7 days.

Allergy medicines, antihistamines can help if your sinus problems are related to allergies. Over-the-counter antihistamines include cetirizine (Zyrtec), diphenhydramine (Benadryl, Genahist, and others), fexofenadine (Allegra) and loratadine (Claritin). It is important to see an allergist for recurring allergy related sinus problems or if your allergic sinus condition leads to reoccurring sinus infections.

Need more help?

If the 6 preceding tips don’t help, we still ease your symptoms.  We can use intranasal or oral steroids to decrease inflammation and mucus production in the lining of the nose. Nasal steroids can also treat nasal polyps that often cause obstruction. While there are OTC steroid nasal sprays, do not use them for over 7 days without consulting a physician.

Take control of your reoccurring sinus problems and remember that you don’t have to suffer with sinus pain, pressure or infections. We have the technology to discover the cause of your sinus condition and the tools to end your pain and discomfort.

Contact my office with your questions or concerns or read more about Allergic Conditions on our website at


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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

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Is It A Winter Cold Or Allergy? The Difference

This season, some of my patients have complained to me that they have symptoms of a runny nose and sometimes, a scratchy throat and think it’s a cold. But in reality, I tell them it’s probably a winter allergy.

Colds, I tell my patients, usually display symptoms of a low-grade fever, sore throat and a cough. But as Dr. William Schaffner, a chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn. says in a report for ABC News, “you might a have a little bit of a sore throat with allergies, but’s mostly runny nose and red, itchy eyes.” Other symptoms include sneezing and dark circles under the eyes.

Also, colds can be accompanied by body aches and fatigue; symptoms not generally associated with allergic reactions.

So the question my patients ask if spring and summer brings pollen allergies, what causes the onset of winter ones.

Good question.

The winter season brings on a number of allergies associated with holiday celebrations. For instance, as Discovery Health. com states, “a stored Christmas tree and holiday ornaments or even a menorah may contain dust or even mold. A live tree’s scent may cause sinus congestion in some people. Furthermore, additional winter blankets, carpeting and clothes that been stored since the previous winter can release dust mites and old spores into the air and around the house when they are removed from storage.”

I recommend the following to limit allergen exposure: Keep pets outside as much as possible and limit them to a specific area in the house; wash all linens and clothes have been stored before using them again; keep humidity levels at 40% as recommended by National Jewish; use a HEPA air filter to clean dust from the air; and if necessary, buy a synthetic Christmas tree.

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What You Should Know About Dry Coughs

Even though pollen counts are subsiding, a number of my patients are still experiencing dry coughs.

Dry coughs can continue after allergy, cold, or sinus symptoms have dissipated or occur without other symptoms due to certain factors.

An interesting report on WebMD states, “chronic dry coughs are usually caused by irritation from cigarette smoke, environmental irritants, allergies, postnasal drip, or asthma. Several chronic lung diseases also cause a dry hacking cough. Some people cough out of habit for no clear reason.”

Other common causes for dry coughs, says the website Patient.Co.UK “are occupational exposure to irritants (including farm workers, workers exposed to hot acidic conditions in a bottle factory); COPD; whooping cough–in young adults and may be more common than previously supposed, influenza; heartburn; gastroesophageal reflux disease (GERD); and medications such as an Ace Inhibitor (Lisinopril, Enalarpil, Ramipril, etc.).”

The website goes on to say that a qualified physician is required to evaluate the causes of the cough and look for the following symptoms associated with a dry cough: “systemic signs, e.g. fever, weight loss; upper air-way signs, e.g. hoarseness, nasal speech; focal chest signs; cardiovascular system; and peak expiratory flow rate (how fast the air flows out of a person’s lungs when they exhale hard).”

Have questions about your dry cough? Feel free to contact my office for a consultation at 214-247-7447 or read more about common environmental triggers located on my website under common allergies

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Sinus Headache Pain

During allergy season, many patients suffer from sinus headache pain. Occurring in the center of the face, the bridge of the nose and the cheeks, it often appears in tandem with nasal congestion and clear or opaque nasal discharge.

First we must understand what sinuses are. Sinuses are air-filled spaces positioned within bones of the head, lying beneath, above, between the eyes, surrounding the nose. Both the nose and sinuses are lined with a thin membrane that swells and produces mucus when irritated. The sinuses normally discharged through small openings called ostia which connect the sinuses to the nasal passages.  Allergies, irritants or other conditions may cause nasal or sinus membranes to constrict which can block the ostia. This results in a sinus headache.

At home treatments for occasional sinus flare-ups:

  1. Take an antihistamine. This will block the action of histamine, a substance released during an allergic reaction. Histamine causes swelling of the lining of the sinuses and ostia and stimulates mucus production.
  2. Take guaifenesin (OTC Mucinex is one brand), which thins the mucus so that it drains more easily. You may also use a decongestant, which reduces membrane swelling and opens the nasal and sinus passages.
  3. Inhaling steam or a steam bath is also beneficial.  Exercise caution so not to burn your face or skin.

If nasal discharge is yellow or green, there may be a bacterial infection of the sinuses present. Bacteria live throughout the nose and sinuses. Normally bacteria drains from sinuses in mucus. But if a sinus is plugged up, the bacteria can propagate within the sinus.

To treat a sinus infection, you’ll need an antibiotic and a decongestant, but no antihistamine. (Antihistamines dry out the mucus membranes and make drainage more difficult.) If a decongestant does not offer sufficient relief, we can prescribe a steroid nasal spray.

If your sinus discharge is yellow or green or your sinus condition becomes chronic or is unresponsive to at home treatment, contact my office for a consultation- 866-632-5537.  We can relieve the pain and pressure of sinus headaches as well as getting to the cause of reoccurring sinus conditions.

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Understanding Rhinosinusitis through Genetic Profiling

Researchers used high-resolution microbiome genetic profiling to compare sinus microbiota (microorganisms that typically inhabit a bodily organ or part) from patients undergoing sinus or nasal surgery, 10 of which had chronic rhinosinusitis and 10 of which were healthy.

NY allergy doctor discusses genetic profiling of sinusitis


Nicole A. Abreu, from the San Francisco State University in Hensill, and colleagues found that the sinus microbiota from patients with chronic rhinosinusitis was less diverse, with a depletion of lactic acid bacteria and an enrichment of a single bacterial species, Corynebacterium tuberculostearicum. Inoculating mice with C. tuberculostearicum in the presence of a depleted microbiome induced sinusitis, while mice with a replete mucosal microbiota were protected from this species.

The presence of Lactobacillus sakei, which the microbiome analysis had indicated was potentially protective, was a defense against C. tuberculostearicum, even when the sinus bacterial community was depleted.

“These studies demonstrate that sinus mucosal health is highly dependent on the composition of the resident microbiota as well as identify both a new sinopathogen (an infectious agent within sinuses) and a strong bacterial candidate for therapeutic intervention,” Abreu and colleagues conclude.

If you suffer from sinus pain and pressure, an allergist may be able to provide you with some relief. If you live in the NYC area, feel free to contact me for a consultation.  Together we can ease your sinus symptoms.

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2 Netipot Deaths – FDA Issues New Guidelines

A neti pot is a vessel that resembles a teapot is used to flush the nasal passage.  Many netipot users find temporary relief from allergies, congestion and colds by proper use of the netipot.

Last month, FDA reported two more incidents in Louisiana in which patients contracted infections after using netipots filled with tap water contaminated with an amoeba called Naegleria fowleri , commonly found in lakes, rivers and springs.

Although this kind of infection is rare, it primarily occurs when people swim or dive in lakes or rivers.  The naegleria fowleri travels through the nasal passages into the brain, where it causes primary amoebic meningoencephalitis. This disease attacks brain tissue and is almost always fatal. According to the CDC, of the 123 known cases occurring in the US from 1962 to 2011, only one person has survived.

Why doesn’t drinking Naegleria fowleri harm you? Stomach acid kills the amoeba, drinking contaminated water does not lead to infection.

If you are a regular reader of this blog – you know that last year Louisiana reported 2 more deaths from using infected by tap water in netipots.  Both of these people had also used water contaminated with Naegleria fowleri.

The FDA has announced new warnings and suggestions for the use of netipots – use bottled water or water that has been boiled and cooled prior to use.

Statistics from the CDC help to keep  the risk of Naegleria fowleri contamination in perspective. Millions of people swim and dive in lakes and rivers each year, yet from 2002 to 2011 there were only 32 reported Naegleria fowleri infections far less than the 36,000 drowning deaths.

And while these most recent cases of amoebic infection may be terrifying, the public should not be alarmed or fearful about freshwater swimming or neti pot use according to Dr. Philip T. Hagen, vice chairman of the Mayo Clinic’s division of preventive medicine.

“If you talk about the general population, there are more common things to be aware of and worry about than a scary amoebic infection,” said Dr. Hagen, who is also the editor of “The Mayo Clinic Book of Home Remedies.” “It’s an opportunity to remind people to be cautious and use good cleaning approaches and maintenance of their neti pot.”

If you are suffering from chronic sinus conditions, the proper  use of a netipot may provide temporary relief. An allergist can help you identify the triggers and devise a plan that can lead to permanent  sinus and/or allergy relief.  Feel free to contact my office for a consultation 866-632-5537 – 5 convenient Manhattan locations.

Dr Lubitz discusses netipots

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Zetonna on the Market

The maker of Lunesta launched a new medication Zetonna, a dry, once-a-day nasal aerosol for allergies.  Approved by the  FDA in January the release to the public was delayed due to negotiations with the company’s partner, a company spokesperson said.

Materials suggest Zetonna is appropriate for patients with either seasonal or perennial allergic rhinitis that are at least 12 years old.  The recommended dosage is one blast per nostril, per day.

It is estimated that Allergic Rhinitis affects approximately 60 million people in the United States. Symptoms can include nasal stuffiness, runny nose, sneezing, itching, and breathing difficulty.  If you suffer from nasal allergies and live in the NYC area, call my office for a consultation.  There are solutions to ease your symptoms and improve the quality of your life.



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Treating Sinusitis

Mold allergy, sinus infection, hay fever, whatever the trigger – sinusitis is
unfortunately an autumn staple in NYC.  Spurred by the body’s reaction to bacterial infiltration or allergic reaction, the sinus cavities become inflamed and swollen causing painful, pressure in the face.  Sinusitis causes nasal congestion,  from excess mucus and the swollen nasal membranes, much like a cold.  As a matter of fact, sinusitis feels like a cold you just can’t beat. The body may mount an immune response, adding fever and fatigue to the discomfort of congestion.

How is sinusitis treated? After proper exam, if the diagnosis is chronic sinusitis, antibiotic therapy and/or a corticosteroid nasal spray may be provided for treatment.  Antibiotics treat the infection and the steroid treats the inflammation.

If you have reoccurring sinus infections, or sinus condition that seems to defy treatment, call my office for a consultation.  Treatment and relief are within reach, same day appointments are available.


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