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NEWS & RESOURCES

At Quail Creek ENT we want you to have the best quality of life possible and that means quality of hearing and otolaryngological health. There is no disorder of the ear, nose OR throat in children or adults that we are not prepared to address. 
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QUAIL CREEK ENT
Nov 8, 2019

The 3 Different Types of Cough


Coughing is a natural reflex that is important in keeping your lungs and airways clear and functioning properly. While coughing is often not bothersome, a persistent cough that does not seem to go away is both bothersome and may be related to an illness.

There are three different types of coughs: acute, subacute and chronic.

Acute Cough

Acute coughs usually only last up to about three weeks and are usually caused by a virus. This cough may be either productive (produces mucus) or non-productive (dry, no mucus). An acute cough is usually caused by the following illnesses:

Cold Flu Pneumonia Sinus infection Croup Whooping cough Bronchitis Pulmonary embolism

Unfortunately, studies have not found existing treatments for acute coughs to be effective. In fact, there is a movement away from even using cough suppressants to ease your symptoms unless a cough is causing other problems.

If the cause is a treatable bacterial infection like pneumonia, then antibiotics would be the proper treatment to help fight the underlying cause of a cough. In most cases of an acute cough, however, the cause is a virus and your body must fight off the infection on its own. Talk to your doctor about your specific circumstance and if any treatment options will be beneficial for you.

Subacute Cough

Subacute coughs typically last between three to eight weeks. A subacute cough may need to be evaluated by a physician depending upon the severity of symptoms, as 60 percent of subacute coughs spontaneously resolve. In other words, there's a pretty good chance of a subacute cough going away on its own.

Common causes of a subacute cough include:

A post-infectious cough (most common) Post-nasal drip Cough-variant asthma Eosinophilic bronchitis

If your physician suspects that the cause of your subacute cough is a post-infectious cough or postnasal drip, he may prescribe antihistamines plus a decongestant (such as chlorpheniramine and pseudoephedrine) for approximately three weeks to see if a cough will clear up.

Chronic Cough

Chronic coughs last longer than eight weeks. Causes of a chronic cough can sometimes be difficult to pin down. To help isolate the cause of your chronic cough, your doctor may find it necessary to run several tests or even recommend that you see another specialist.

The most common cause of a chronic cough is smoking, however other common causes include:

Asthma Allergies Post-nasal drip Gastroesophageal reflux disease (GERD) COPDMedications, notably ACE inhibitors Heart failure Lung cancer (rare)

If you are a smoker, it is important for you to begin a smoking cessation program. Smoking not only will likely be the cause of your chronic cough but will also put you at risk of developing other health-related disorders. Get started today.

Treatment is targeted to the specific cause of a cough. Your physician will take a thorough history to look for likely causes of a cough.

If you are on ACE inhibitors for blood pressure, your physician may have you try an alternative medication to see if your cough resolves.

Your doctor might also want a chest X-ray and another test called spirometry to help figure out the cause of your cough. If the chest X-ray is abnormal, a high-resolution CT scan of the lungs and/or a bronchoscopy may be necessary.

Unfortunately, there are not many physicians willing to specialize in a chronic cough. Initially, you may find that you are referred to a pulmonologist to "work-up" or diagnose a chronic cough, but many of the best pulmonologists may be unwilling to see patients for a chronic cough and refer you to either a gastroenterologist or back to your primary care physician (PCP). Finding a physician you like that is willing to be patient is probably the key to success in treating your chronic cough.

When a Cough Is an Emergency

Because our cough reflex is natural and protective, sometimes it is our bodies way of letting us know of an impending emergency. If you have a sudden bout of coughing and have the potential for any of the following disorders, you should seek medical attention immediately.

Allergic reaction (anaphylaxis)Asthma or COPD exacerbation, when medications can't control the symptomsInhalation of a foreign objectPertussisPneumonia

In addition to coughing, you may also experience difficulty breathing, or other worrisome symptoms such as swelling of the tongue.

If you have problems breathing, especially if you are at risk for any of these emergent conditions you should not delay seeking medical treatment, as these can be life-threatening conditions.


 

QUAIL CREEK ENT
Nov 7, 2019

Causes of Frequent Bloody Noses

"What causes frequent bloody noses?" "What causes frequent bloody noses?"

Doctors hear this question a lot, especially from parents. They may report that their children sometimes bump their noses or fall down and get nosebleeds. While this can be distressing, at least these parents know the cause.

More concerning are nosebleeds that seem to happen without a cause. Sometimes children will wake up in the morning with blood on their pillows or dried blood around their nose or face. While the causes of this are numerous, the simple fact is that some people are more prone to frequent bloody noses, particularly during dry weather or as a result of habits they may not even be aware of.

Causes

The following conditions or illnesses make developing a bloody nose more likely:

Dry mucous membranes from low humidity or dehydration Very cold air Allergies Chemical irritants Frequent nose picking or rubbing Blowing your nose or sneezing too hard Overuse of nasal decongestant sprays Nasal infections Deviated septum Colds and other upper respiratory infections Inserting a foreign object into the nose Injury or trauma

Less common but often more serious causes of nosebleeds include:

High blood pressure Blood-thinning medications such as aspirin or warfarin Blood-clotting diseases, such as hemophilia Hereditary hemorrhagic telangiectasia (HHT), a genetic disorder that leads to abnormal blood vessel formation Nasal or sinus tumors

Children tend to get bloody noses more than adults because they are more likely to pick or rub their noses or put foreign objects into their nostrils. With that being said, people of all ages can get bloody noses and need to be treated appropriately to stop the bleeding.

How to Stop a Nosebleed

If you or your child experiences a sudden nosebleed:

Sit down, rather than lying down, to reduce the blood flow. Pinch the soft part of the nose, just above the nostrils, for 10 to 15 minutes. Lean forward and breathe through the mouth so that the blood drains down the nose instead of the back of the throat. Placing an ice pack on the bridge of the nose can also help. 

If a nosebleed doesn't stop after 20 minutes, see a doctor immediately or go to your nearest emergency room. This is especially true if the bleeding is profuse, was caused by a blow to the face, or is causing dizziness or fainting.

Treatment

Managing the underlying causes of frequent bloody noses is likely to be the most effective way to keep them from recurring. Sometimes this approach may need to be combined with other treatments.

There's limited research on the treatment of frequent bloody noses. However, the American Academy of Otolaryngology recently released a study reviewing different treatment options. The research shows that chemical cauterization (spraying a chemical into the nose to shrink blood vessels), surgical ligation (tying-off a burst blood vessel in the nose), embolization (blocking bleeding blood vessels) were most likely to keep bloody noses from recurring long-term.

Patients who underwent these procedures had better results and shorter hospital stays than patients with bloody noses who were treated with, for example, nose packing.

Despite its efficacy, nasal embolization carries the risk of stroke, ophthalmoplegia (restriction of eye movement), facial palsy, and hematomas (blood clots). Speak with your doctor to understand the benefits and risks of the procedure

Prevention

Not all nosebleeds can be prevented. But, if you're experiencing frequent bloody noses, here are some things you can try that may reduce their number and/or severity:

Use a cool-mist humidifier placed near the bed while you sleep. Try an over-the-counter saline nasal spray (but avoid inserting the tip too far up the nose as this can further damage tissues). Use a neti pot. Treat any underlying allergy or nasal infection. Try not to rub or pick your nose. Clip your child's fingernails regularly.


 

QUAIL CREEK ENT
Nov 6, 2019

Why Do I Get Congested at Night?


Have you ever noticed that congestion seems to get worse at night? Right about the time you'd like to go to sleep you might notice that you can't breathe because your nose is too stuffy.

Is it all in your head? Not really, although to some extent this phenomenon can be due to the fact that congestion is less noticeable during the daytime when you are busy and there are many things going on to distract you. This definitely isn't the whole story, however.

Reasons Behind Nighttime Congestion

One explanation has to do with gravity and the way that we tend to position our bodies at night. Many people think that congestion and a feeling of stuffiness are caused by excess mucus blocking the nasal passageways.

Excess mucous may contribute to a feeling of stuffiness, but the real culprit in congestion is engorged and/or inflamed blood vessels inside the nasal passageways.

This is a very simplified explanation, however, as congestion has many causes (more on some of those later).

When we lie down our blood pressure changes, and we may experience increased blood flow to the upper part of our body including our head and nasal passageways. This increased blood flow can make the vessels inside our nose and nasal passageways even more inflamed. Increased blood flow also commonly causes congestion in pregnant women.1

A lying-down position also makes it more difficult to clear mucus from our nose and sinus cavities. For example, while we are standing up during the day, mucous is constantly running from our nose and sinuses into the backs of our throat and being swallowed. Most of the time we don't even notice this. At night, however, this mucous may pool or back up. Many people notice that their congestion starts to improve an hour or two after they get up in the morning. That's gravity doing its work.

Even if we aren't lying down in bed ready to sleep we tend to start lounging in a more relaxed supine position a couple of hours before bedtime. This is why you might notice your congestion getting worse not long after the sun goes down.

This also explains why people with conditions like a cold virus or allergies might feel their congestion increase at night.1 But what if you're not sick and don't experience any symptoms during the day?

Studies have shown that even without the presence of daytime congestion, nasal resistance (the ability to breathe) is impaired when we're lying down.

Another culprit you might not suspect could be to blame: acid reflux (heartburn). Fairly common symptoms of acid reflux or gastroesophageal reflux disease (GERD) include sore throat, coughing, postnasal drip, wheezing, and hoarseness.2 These symptoms tend to be worse when you wake up in the morning. Many of these symptoms occur when individuals with an impaired esophageal sphincter (valve) and a stomach full of acid lie down at night. The acid in the stomach can migrate up the esophagus and irritate the back of the throat, which also happens to be connected to the nasal passageways. The really interesting thing is that some medical professionals now believe there's a definite link between GERD, chronic sinusitis, and even nasal congestion.3


How Can I Treat My Nighttime Congestion?

So now that you understand a little bit more about what causes nighttime congestion what can you do about it?

If you frequently suffer from congestion at night, you should see a doctor. One key reason: Studies show that the negative effects of congestion on your sleep quality are significant.

In the meantime you can try these tips to help reduce congestion and sleep better:

Elevate the head of your bed instead of lying flat, don't eat within a couple of hours before going to bed or lying down, use a cool-mist humidifier at the side of your bed, drink plenty of water, stop smoking

While these tips are helpful for anyone who suffers from increased congestion at night your doctor will likely recommend further treatments once the cause of your congestion is identified. For example, allergies can be treated with antihistamines, nasal steroids, or immunotherapy. Medications such as antacids and proton pump inhibitors are commonly used to treat GERD.


 

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