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FAQs

Frequently Asked Questions.

Allergy

What is Allergy?

Allergies are one of the major causes of sickness in the U.S. Approximately one in five people suffer from allergies. If you have an allergy, your immune system treats anything you are allergic to as an intruder and releases chemicals to protect your body against it.

Some of the most common allergens float in the air, such as pollen, pet dander, dust mites, and mold. Some common symptoms are stuffy or runny nose, sneezing, and itchy & watery eyes. Nasal allergies can be seasonal, year-round, or non-allergic rhinitis that come and go throughout the year.

These chemicals released by the body cause allergic symptoms that can range in severity. Allergic reactions can affect your throat, eyes, nose, skin, lungs, stomach or intestines; they rarely affect the whole body. The most severe reaction is called anaphylaxis- this is life-threatening. Because your body may trigger an allergic response to seemingly harmless substances (ie pollen, common foods, or pets) it is important to go through allergy testing so you can avoid, or be treated for, the correct allergens.

What is Immunotherapy?

Allergy immunotherapy treatment is when a patient is injected with small doses of an allergen on a regular basis. The dosage is gradually increased over time, causing the immune system to become less and less sensitive to the allergen.

Immunotherapy treatment is commonly known as “allergy shots”. Individuals with allergies have high levels of Immunoglobulin E (an allergic antibody) in their blood. The antibody is activated by an allergen and then binds itself to mast cells that release histamine. Histamine is the chemical that is the main cause for your allergy symptoms such as coughing, sneezing, swelling, and congestion.

Keep in mind that Immunotherapy is a long-term commitment and requires multiple treatments to achieve complete relief. The results are gradual but some patients see improvement in their allergy symptoms within a few weeks. Immunotherapy is typically suggested for patients with major allergy symptoms that last at least six weeks out of each year. It can be recommended to patients with many kinds of allergies including asthma, frequent sinusitis, or allergies to insect stings. Immunotherapy is not approved for individuals who have food allergies. During the course of treatment with allergy shots, you may experience adverse reactions.

How are allergies treated?

The first step is diagnosis. Allergy testing allows us to identify what your specific triggers are. Knowing your allergies helps us to make the appropriate treatment decisions, which may include avoidance, medications, or allergy shots.

How often do I have to get a shot?

The first 4-6 months you will come in 1-2 times a week. This is called the "build-up" phase. During this time, your dose will be increased from an initial, very weak dose to the maximum "maintenance" dose. We follow this schedule to reduce the risk of side effects. Once you are at maintenance, you will come every 3-4 weeks.

Immunotherapy for insect allergy follows a slightly different schedule.

CT Scans

What is a CT scan?

One of the most important tools used for diagnosing sinus and ear-related problems is a computed tomography (CT or CAT) scan. CT scanners create 3 dimensional x-ray images of the anatomy, giving the Oregon Ear, Nose and Throat Center (OENT) physicians valuable information for an accurate diagnosis. By using the latest advancements in CT technology, our doctors can now take sinus and ear CT scans in our office a small, open-style, upright CT scanner that creates fast, exceptional quality images of the sinuses and ears, while keeping radiation dosage to a minimum. Even claustrophobic patients have no problem tolerating the scans.

Should I do anything special to prepare for a CT scan?

Facial jewelry will need to be removed.

Can I take my medicine before a CT scan?

Yes, please take medicines before the CT scan, with the exception of diabetic medicines. Consult your physician before the test for instructions.

How long will it take to do a CT scan?

Most CT scans take just a few minutes.

Will the radiation that I receive from the CT scan hurt me?

CT scans are similar to those of conventional X-rays. During the CT scan, you’re briefly exposed to radiation. But doctors and other scientists believe that CT scans provide enough valuable information to outweigh the associated risks.

Sinus

What is sinusitis?

Sinusitis is inflammation of the sinuses caused by infections (bacterial, viral, or fungal) and/or allergies. Acute sinusitis is very common and usually lasts less then 2 weeks, where chronic sinusitis can last months and is much more difficult to treat.

What are nasal polyps?

Nasal polyps are grape-like outpouchings from the nasal sinus linings that are usually indicative of an allergic component to the sinus disease. They often obstruct the normal sinus drainage and airflow creating more congestion, infections and decreased sense of smell.

How is sinusitis treated?

In general, the treatment of sinusitis depends on the duration and severity of the symptoms. Most often multiple medications such as an antibiotic(fights bacterial infections), decongestant (allows drainage), mucolytic (thins mucus), corticosteroid (reduces inflammation), and nasal irrigation are prescribed. There are many appropriate medications in each of these categories and the best treatment plan must be individualized. Infrequently, sinus surgery is needed for acute uncomplicated sinusitis.

When is surgery useful for sinusitis?

Surgery is most beneficial in symptomatic patients with mechanical obstruction to sinus drainage and those with persistent infections that have failed medical therapy. More urgent sinus surgery may be indicated when the eye or brain (which surround the sinuses) are affected by the sinus disease.

Does sinus surgery always work?

When the above indications are met, sinus surgery usually has a dramatic impact on the patients’ symptoms. The patient may still require medication and irrigation to prevent further inflammation and the re-development of sinus obstruction. In the unusual case where the symptoms are not relieved or they recur quickly, the ENT surgeon may investigate other causes such as allergy or Immune-system problems that may be underlying these refractory cases.

Explain sinus surgery and the recovery.

The majority of contemporary ENT sinus surgeons use a technique in which small telescopes are placed in the nose for precise visualization of the sinus obstruction, removal of the diseased tissue, and opening of the natural sinus drainage holes, with less trauma to the normal tissues, allowing quicker healing, less packing, and no facial incisions, as compared to traditional sinus surgery.

Surgery is often ambulatory, pain is usually minimal, and most patients return to work in less than one week. Nasal cleaning and irrigation are done frequently for about the first month after surgery until the nasal lining is clean and well healed.

Sleep Apnea

What is Sleep Apnea?

Sleep Apnea is a breathing disorder. The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

What are the symptoms of Obstructive Sleep Apnea (OSA)?

The most common symptoms of OSA in adults are loud snoring and excessive daytime sleepiness. Almost all people who have OSA snore, but not all people who snore have OSA. Other signs and symptoms of OSA include: episodes of not breathing; Restless tossing and turning during sleep; nighttime choking spells, sweating, and chest pain; waking with an unrefreshed feeling after sleep, having problems with memory and concentration, feeling irritable and tired, and experiencing personality changes; morning headaches; heartburn or a sour taste in the mouth at night; in obese adults, swelling of the legs; getting up during the night to urinate; daytime naps or sleeping during inappropriate times or activities. People with Sleep Apnea may exhibit onset high blood pressure, unexplained weight gain, depression and other health conditions.

What is the most common treatment for Sleep Apnea?

The most common treatment for Sleep Apnea is CPAP, or Continuous Positive Airway Pressure (CPAP), therapy. There are several different types of machines for Positive Airway Pressure (PAP). Treatment involves a PAP machine and a mask.

Surgery

Can I eat or drink anything the night before?

Do not eat or drink anything after midnight before your surgery. This includes mints, water, coffee, gum, candy or any medications taken by mouth unless instructed to do so by your anesthesiologist.

Can I brush my teeth?

You can brush your teeth, but do not swallow the water. It is important to have an empty stomach before surgery.

Do I need any preoperative testing?

Most patients will need preoperative testing.

General

Will medicare pay for hearing aids?

In general, Medicare does not cover routine hearing exams or hearing aids of any type. In some cases, diagnostic hearing exams are covered by Medicare Part B, but this is only when they are ordered by a doctor. If your hearing problem is due to a specific injury or disease such as removal of a brain tumor or head injury, Medicare may cover the charges. Your doctor or hearing specialist will be able to explain which hearing exams are covered by Medicare, and the conditions for a diagnostic hearing exam.

You pay 100% of charges for routine hearing exams and hearing aids. If you are approved by your physician for a Medicare-covered diagnostic hearing exam, you pay 20% of the charges. You must pay your deductible for any Medicare Part B services and supplies before Medicare begins to pay its share. If a doctor, health care provider or supplier does not accept assignment, the amount you pay may be higher.

If your insurance is original Medicare with a supplemental, it is possible that some supplementals cover a portion of the hearing exam. You would need to check with your individual policy to determine if hearing loss is covered. If you are in the process of going on original Medicare and need to purchase a supplemental, check with several different supplemental coverages for specifics on hearing loss coverage.

Where Should I Buy Hearing Aids?

Shopping for hearing aids can be a daunting task. Not only are there many types and brands to choose from, but there are also many places from which you can purchase hearing aids. Who should you trust, which places are more reputable, who has the best prices, who is the most qualified? These are all good questions a weary consumer should ask. Here are a few guidelines to help you choose a hearing aid provider in Medford, Oregon and remember, there’s no harm in shopping around, but always get a professional assessment of your level of hearing loss by a licensed audiologist.

NAME BRAND STORES

Stores like Miracle-Ear in Medford and Beltone in Central Point and Grants Pass only sell devices under their brand name, limiting customer choices. Often times with name brand stores, customers will deal with hearing-aid specialists and won’t necessarily have access to an in-store audiologist. This is important to note, as hearing-aid specialists aren’t required to have the extensive medical background an audiologist has. Essentially, you are dealing with salespeople who know the product very well, but may not understand your hearing needs the way a doctor will.

BIG BOX STORES

While not as popular as brand name stores or medical offices, many big box stores also sell hearing aids. Large chains that carry hearing aids include Walmart, Sears and Costco. Big Box stores are great for buying household items, but when it comes to your health, comfort and daily lifestyle a more personal evaluation of your hearing loss, insurance coverage and hearing device requirements will certainly be of benefit.

ONLINE

It is no secret that you can buy non-prescription hearing aids online without having to have your hearing tested and often times for a fraction of the price. However, “buyer beware” - you get what you pay for. You also get a hearing device that wasn’t checked for fit and comfort. Those of you who wear hearing aids day in and day out know how important comfort can be. These over-the-counter devices lack many beneficial features and are not customized to treat your hearing loss. Without proper auditory testing, medical examination, fitting and follow-up, you may be wasting your money or worse - causing further damage to your hearing. If the savings is too great of a temptation to pass up, just be sure wherever you buy offers a money back guarantee or a good return policy.

Hearing

How do you know if someone has hearing loss?

Often a spouse, relative, friend or business associate is the first to notice a hearing loss. Initially, those who interact with the hearing impaired person often remark, "he doesn't pay attention", or "he ignores me." As time progresses, it is not uncommon for interpersonal relationships to become strained and for family members and friends to become frustrated and even angry with the hearing impaired individual.

In the meantime, the hearing impaired person is going through emotional changes, which usually occur in stages. Being aware of these emotional stages, and the behaviors associated with them, will help you to better grasp how that person is dealing with their hearing loss and at what stage they are in relative to seeking help. This is important if you want to help them move toward help.

What are the stages of hearing loss?

The first stage is denial, which can take two forms: (1) the person doesn't believe he/she has a hearing problem, and/or (2) the person cannot talk about the hearing problem. It is characterized by placing blame or responsibility on others. "I don't have a problem. They mumble. They don't speak clearly. They talk too fast." are common comments during this stage. Denial is usually temporary, and it's important to acknowledge the person's fears and uncertainties. Be reassuring and supportive to help them move toward treatment.

Withdrawal often occurs after denial, since the person simply doesn't expose him or herself to situations where hearing is difficult.

Anger is the next stage. You may notice that the hearing impaired person is "grouchy" or "has become difficult to live with." Hearing impaired people may become less tolerant of others because of the comments, frustration, jokes and anger that have been directed at them. They are angry about the loss and how they are treated when they respond incorrectly or inappropriately in conversations with others. Respond with understanding and compassion.

Bargaining for just one more day of normal hearing or one more day of not having to deal with their problem is the most private stage of the process. Often, it will not be visible to others, including family members. It may stem from guilt that the loss could have been prevented or from being unable to do things that they could in the past. At this stage, they are not ready to accept help for their hearing loss.

Loss of self-esteem, difficulty in doing today what was easy yesterday, suspicion of others, social isolation and loneliness are all part of the depression stage. Making sure the hearing impaired individual is included in conversations, activities and decisions can help to prevent or shorten this stage.

The last stage is acceptance, when the individual admits he/she has a hearing loss and is ready to seek treatment — including hearing instruments, aural rehabilitation and auditory training.

How is the brain affected by hearing loss?

If hearing is lost gradually, the brain has been slowly deprived of the necessary stimulation of the vital sound frequencies for proper hearing. When your hearing deteriorates, the corresponding area of your brain has no input from your ear(s). This results in your inability to hear at normal volume levels.

How long does it take for the brain to adjust to hearing instruments?

This varies from person to person. Success with hearing instruments can be achieved in as little as six weeks or as long as six months.

Typically, success with hearing instruments comes faster for people who make a commitment to:

- Wearing their hearing instruments at all times
- Follow the guidelines of the specified after care program.

Do hearing instruments require care and maintenance?

Hearing instruments operate in a hot and humid environment. They are susceptible to varying degrees of moisture and earwax. These unwanted elements can eventually inhibit the performance and operation of hearing instruments. We suggest following the care instructions listed in the operation manual. You should also visit your audiology professional at least once a year to have your instruments cleaned and checked.