How Does Immunotherapy Work?

Environmental allergies are tough to cope with, especially in the spring. If you are tired of taking daily medications with limited results, you may be a candidate for immunotherapy.

Allergy shots (subcutaneous immunotherapy) are the most common form of immunotherapy. They can be used as a long-term treatment for seasonal, indoor and insect sting allergies.

Allergy shots work by getting your body used to what you are allergic to slowly, with the hope that you will develop an immunity or tolerance to the allergen. The process typically takes place in two phases, the build-up phase and the maintenance phase. The build-up phase involves a small amount of the allergen being injected into the upper arm once or twice a week for a few months. The dosage is gradually increased at each visit. The length of the build-up phase depends entirely on your body’s reaction. Once you have reached the effective dose, typically the most you can handle without showing symptoms, the maintenance phase will begin. The dosage is no longer increased at each visit and the number of shots is decreased. Once you are in the maintenance phase you will only receive an allergy shot once every month; this phase can last for three to five years.

Since allergy shots contain a substance you are allergic to, there are some risks involved. Swelling and redness usually develop at the site of injection but are quick to clear up. Sneezing, nasal congestion and hives may develop, as well as more severe reactions such as wheezing or chest tightness. Anaphylaxis, the most serious reaction, rarely occurs. Since these shots are administered in our clinic by a medical professional, any reaction that does occur can be easily treated.

Allergy symptoms will not improve overnight; symptoms typically improve over the first year of treatment and continue to improve over the next few years. The shots may even decrease symptoms for other allergens and prevent new allergies from developing.

Sublingual immunotherapy (SLIT) is another type of allergy treatment that is gaining popularity. SLIT is used to treat allergies to specific grass pollens and ragweed, without the pain and common side effects. Tablets or drops are placed under the tongue for one to two minutes and then swallowed as they dissolve. The process is repeated three to seven days a week for at least three years. After the first dose, the tablets or drops are even safe enough to be taken at home.

If you are interested in ending your allergy symptoms once and for all, contact your allergist.

Parkinson’s Disease and Speech Therapy

Parkinson’s disease is a progressive neurodegenerative disorder that disrupts the nerve cells in the brain responsible for dopamine production, affecting movement. Symptoms develop gradually; minor hand tremors are a common early sign, with patients eventually experiencing an increase in tremors, stiffness in the joints, muscle rigidity, slow movement, gait and balance problems, changes in speech and writing ability, and swallowing difficulty. There is no cure for Parkinson’s disease, but treatment can help reduce symptoms and improve the patient’s overall quality of life.

A speech-language pathologist (SLP) is trained to assess, diagnose, and treat speech, language, cognitive, and communication disorders. The SLP can help people with Parkinson’s disease maintain their ability to communicate effectively and improve speaking skills. Common speech impairments associated with the disorder include an inability to pronounce words correctly, hoarseness, strained voice, and slurred speech.

These symptoms are the result of weakened muscles in the larynx, tongue, mouth, lips, and throat. Speech therapy focuses on the following areas:

• Improving voice quality, loudness, articulation, inflection, and speech intelligibility.
• Teaching nonverbal communication skills. This includes utilization of residual speech, expressions, and gestures.
• Improving communication techniques to assist with daily activities.

The SLP will recommend specific exercises to help Parkinson’s patients improve vocal function. These may include:

• Repetition to improve muscle control.
• Vocal stretches.
• Proper breathing techniques.
• Vocal function techniques.
• Singing therapy.

Additionally, there are techniques patients can try at home in order to improve and enhance communication, such as:

• Choosing a quiet environment.
• Speaking slowly and articulately.
• Communicating face-to-face with other individuals.
• Relying on short phrases.
• Maintaining a comfortable posture.
• Resting your voice prior to communication.
• Writing down what you say if the other person has trouble understanding.
• Discussing the conversation topic in advance.
• Spelling out words to enhance understanding.

There are a number of tools and devices that can help Parkinson’s patients communicate, as well. Palatal lifts are retainer-like dental tools that lift the soft palate, preventing air from escaping from the nose during speech. Personal amplifiers can increase volume, and TTY telephone relay systems utilize a keyboard-equipped telephone and rely on a relay operator to read the conversation out loud.

If you or a loved one is experiencing Parkinson’s disease that has impacted communication and speech abilities, contact your local SLP today for help.

These are NOT Your Mother’s Hearing Devices

Remember the days of bulky hearing devices that stuck out from the ear and whistled whenever anyone got too close? Those days are long gone.

Today’s hearing devices have advanced to include numerous benefits above and beyond basic hearing assistance. Those living with hearing loss today can enjoy:

Discrete Design: Today’s hearing devices are extremely discrete, often smaller than a watch battery! Even behind-the-ear hearing devices are smaller than ever before while some in-the-canal style hearing devices are 100% invisible to the outside observed.

Advanced Technology: Recent advances in digital technology have created devices that provide a more accurate simulation of the way the ear works. While first-time hearing aid users will still experience an adjustment period, sounds come across clearer and more naturally through todays devices than ever before.

Automatic Adjustments: Many of today’s hearing devices feature automatic adjustment to changing listening environments. Whether riding a motorcycle, chatting in a crowded restaurant, or listening to a favorite album with friends, these hearing devices can automatically adjust. This reduces the need for manual operation by the hearing device user. These devices may not be suitable for all types and severities of hearing loss.

Adaptive Dual Microphones: Communication clarity is made possible by microphones that focus on the sound source while reducing or eliminating irritating and distracting background noise.

Open Fit Technology: Previous generations of hearing devices caused a stuffed up or “talking in the barrel” feeling. Many of today’s devices feature a slim design that leaves the ear canal as open as possible. This style is available depending on the type and severity of hearing loss, and results in comfort and clarity of speech.

Feedback Management Technology: No one enjoys a whistling hearing aid. Thanks to modern feedback management technology, today’s hearing devices can recognize feedback and squelch it right when it starts, or even before it has begun.

Cellphone and Bluetooth® Compatibility: Many of today’s cellphones are hearing aid compatible (HAC). If your phone has an HAC label, you’re in the clear. Cell phones with a microphone rating of M3 or M4 work well with hearing devices. If your hearing device has a telecoil, look for a phone with a telecoil rating of T3 or T4.

To determine how well your hearing device pairs with your phone, check the rating on both devices. A hearing device is rated from M1 to M4. A telecoil is rated from T1 to T4. When you combine the two ratings, the higher the rating the better the sound. A combined rating of 6 is excellent, 5 is average, and 4 is usable.

Getting Help for Your Hyperacusis

Hyperacusis is a heightened sensitivity to everyday sounds that most people can tolerate easily. A person suffering from hyperacusis may find sounds like a running dishwasher, a nearby conversation or even the shuffling of papers unpleasantly loud or painful. For some, the sensitivity is only to certain frequencies or pitches.

Hyperacusis is rare, affecting only one in 50,000 people. This number is higher among tinnitus sufferers, however, affecting about one in 1,000. Hyperacusis can affect people of any age, and it can occur in one or both ears. Untreated hyperacusis can cause social isolation, phonophobia (fear of sounds), and depression.

It is extremely uncommon for someone to be born with hyperacusis. Hyperacusis can be caused by a number of diseases including Bell’s palsy, Lyme disease, Meniere’s disease, head injury, temporomandibular joint (TMJ) syndrome and noise induced hearing loss. Hyperacusis is also linked with neurologic conditions such as PTSD, epilepsy, depression, migraines, cerebral palsy and autistic spectrum disorder (ASD).

For those whose hyperacusis is the result of trauma to the head or hearing system, symptoms may go away as the injury heals. Identifying the underlying cause is always the first step in treating hyperacusis.

Some suffering from hyperacusis may seek relief by wearing earplugs or earmuffs. While this may help in the short-term, it actually decreases the already poor tolerance of noise, increasing sensitivity in the long run. This result is most obvious immediately after removing the ear protection.

An effective treatment option for hyperacusis is sound desensitization, a form of therapy where an audiologist works with the patient and exposes them to specific types of noise over time. This treatment may take six months to a year, and may be even longer for certain patients.

If you suspect you may have hyperacusis, you should seek an evaluation by an audiologist who will conduct a full audiologic evaluation, including a hearing test. The audiologist will take a record of your medical history to accurately diagnose your condition and determine your Loudness Discomfort Levels (LDL). They will then recommend an appropriate treatment plan, tailored to meet your needs.

Understanding Feeding and Swallowing Disorders

A feeding disorder is defined as a delay in the development of eating and drinking skills and is characterized by the inability to gather and/or suck, chew or swallow food effectively. A swallowing disorder, also known as dysphagia, references any difficulties related to the management of saliva, the intake of medicines and the introduction, transfer and transport of food and liquid from the mouth into the stomach through the esophagus. The most common symptom of dysphagia is the inability to swallow solid food without the sensation of the food becoming “stuck” or regurgitation.

Causes of feeding and swallowing disorders include:

• Autism
• Neck and head abnormalities or muscle weakness in those areas
• Cerebral palsy, meningitis or other nervous system disorders
• Gastrointestinal conditions (e.g., reflux, "short gut" syndrome)
• Heart disease
• Low birth rate
• Cleft lip and/or palate
• Respiratory or airway difficulties
• Medications that may cause lethargy or decreased appetite
• Problems with parent-child interactions at meal times

Severe feeding and swallowing disorders may result in malnutrition, poor hydration and reduced respiratory health.

Treatments by a Speech-Language Pathologist (SLP) for a feeding disorder will consist of the development of a behavioral feeding program that focuses on learning a new behavior (i.e. learning to chew), practicing the new behaviors and completing the learned behavior with different foods in a variety of environments.

The SLP will make the diagnosis for a feeding or swallowing disorder after a review of symptoms and medical conditions, the strength and movement of the muscles involved in the swallowing process, observing eating and drinking behaviors and performing special tests as necessary. Treatments for swallowing disorders include recommendations for exercises and positions to improve swallowing and suggestions for foods and liquids with textures that are easier to swallow.

If you have any questions about our office or are interested in making an appointment, please give us a call at 877-EAR-NOSE or visit us online for more information. To keep up with the latest from our office, be sure to visit our Facebook Page.

How Diabetes is Connected to Hearing Loss

Diabetes can cause blurry vision, hunger, thirst and fatigue; a lesser known associated condition is hearing loss. In fact, the National Institute on Deafness and Other Communication Disorders (NIDCD) found hearing loss to be about twice as common in adults with diabetes compared to those without the disease.

This study is alarming to many otolaryngologists and audiologists because there is no recommendation for hearing loss screenings in a diabetes care regimen. Awareness is critical in increasing screening and discovering diabetes patients who suffer from hearing loss. Many doctors fail to recommend a hearing test at the annual checkup of diabetes patients. It’s important for those with diabetes to take an active role in their health care and seek treatment for any associated conditions they may be at risk for.

"Hearing loss may be an under-recognized complication of diabetes,” senior author Catherine Cowie, Ph.D. said. “As diabetes becomes more common, the disease may become a more significant contributor to hearing loss. Our study found a strong and consistent link between hearing impairment and diabetes using a number of different outcomes."

The reason for this connection is not definitive, but some evidence is suggestive. The NIDCD study reports diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear.

Afflicting nearly 21 million people in the United States, diabetes is a major cause of heart disease and stroke and the most common cause of blindness, kidney failure and lower limb amputations in adults. Pre-diabetes, which causes no symptoms, affects about 54 million adults in the United States. This high incidence of pre-diabetes and the connection between dangerous associated conditions are encouraging many to evaluate their risk of developing diabetes. See your doctor if you think you might be pre-diabetic or if you suffer from diabetes and believe you may have the beginning stages of hearing loss.

If you have any questions about our office or are interested in making an appointment, please give us a call at 877-EAR-NOSE or visit us online for more information. To keep up with the latest from our office, be sure to visit our Facebook Page.

Are Allergies Hereditary?

Do you suffer from severe allergies? If so, you may be able to blame your parents (just this once). If just one of your parents has allergies, there’s a 50/50 chance yours were inherited. If both of your parents have the same allergy, those odds go up to about 75 percent.

Are Allergies Hereditary? 

Yes and no. Though allergies can be passed down from parent to child, they’re not always. And more amazingly, allergy-free parents can give birth to children who have severe allergies. So if allergies aren’t always inherited, how do you “get” them?

Scientists think a few other factors come into play when it comes to why someone has an allergy. In addition to genetics, your environment, air pollution levels, and diet all play a role in whether or not you’ll have allergies.

Most Common Allergies 

An allergy is really just your body’s immune system mistaking a harmless substance for a dangerous pathogen. When you eat, drink, smell, or touch something you’re allergic to, your body responds by attacking it, rather than letting it pass through (which is what it really should do).

The most common allergies are:

• Drug allergy 
• Food allergy
• Contact dermatitis
• Seasonal allergies 

Signs and Symptoms of an Allergic Reaction 

What makes allergies so interesting is that their severity ranges a lot from person to person. Two people who are allergic to the same thing, like almonds, could have completely different reactions once they come in contact with one. For example, one person could experience nothing more than itchy hands, while the other person’s throat could begin to close.

Most often, signs of an allergic reaction are:

• Trouble breathing 
• Wheezing 
• Sneezing 
• Coughing
• Skin irritation 

If you have any questions about our office or are interested in making an appointment, please give us a call at 877-EAR-NOSE or visit us online for more information. To keep up with the latest from our office, be sure to visit our Facebook Page.