Doctor cites prevention for common winter ills

From now until spring, many people will experience one or more of three common winter woes: nosebleeds, ear infections and sore throats.

Dryness is one of many contributing factors, as people tend to stay indoors where a furnace or wood-burning stove is running.

Dr. Tony C.Y. Chuang, an ear, nose and throat specialist, led a Samaritan Medical Center-sponsored education seminar Thursday night at the Italian-American Civic Association, 192 Bellew Ave., where he discussed the diagnosis, treatment and prevention of such problems.

NOSEBLEEDS

When you're in a dry environment and dry mucus in your nose is bothering you, don't pick it. Dr. Chuang said one of the most common causes of nosebleeds in the winter is from people picking the interior of dry, crusty noses.

"One of the easiest things people can do is to stop nose-picking," he said. "The whole thing comes back to mucus hydration, and the dry environment in wintertime."

Nose-pickers may reach far enough into their nose and bleed from the anterior, or front, part of the nose.

Another risk factor for nosebleeds is alcohol abuse.

"The problem with alcohol abuse is it could damage the liver, and when you destroy the liver, the patient will bleed easily," Dr. Chuang said.

Blood disorders, certain medications and people's social history all are contributing factors to nosebleeds.

"People who abuse cocaine, it causes perforation of their nasal septum, and smoking is an irritant and it can manifest a bleeding problem," Dr. Chuang said.

Treatments, he said, are fairly simple.

People with nosebleeds should sit up, tilt their body forward and spit out any blood that may drip down to the mouth/throat area. Pinching the soft part of the nose also will help, he said.

Using a humidifier to keep the air a bit moist can help prevent nosebleeds, Dr. Chuang said. Rinsing out the nose with a saltwater spray, he said, also can help prevent nosebleeds and make breathing better.

EAR INFECTIONS

Also known as otitis media, the inflammation of the middle ear can be caused by a nasal allergy, recurrent upper respiratory infections or streptococcus pneumoniae, among other things. Dr. Chuang said people would be surprised by the number of risk factors they typically wouldn't consider to be associated with ear infections.

Ear infections can occur in bottle-fed children because of the way a baby holds his or her bottle, and liquid could drip into the ear, leading to blocked auditory tubes.

Although reflux is more often associated with older children and adults, it doesn't lead just to heartburn or chest pains.

"When we say reflux, we think of heartburn, but when you're lying flat on the bed, it won't just stay at the stomach," Dr. Chuang said.

Reflux of gastric juices to the middle ear is possible, he said, creating an ear infection.

If doctors look at a person's eardrum, they can see if it's red and bulging, and determine what treatment would work. Sometimes the ear may have to be flushed; other times, children will have tubes placed in their ears or antibiotics will be prescribed.

"Eventually, if a patient has a lot of episodes with ear infections, or complications, I'll be seeing them, and that's where the pressure equalization tube comes in," Dr. Chuang said.

SORE THROATS

People who use their voices a lot are likely to have strains, which is one of the factors that may cause a sore throat. A viral infection looks red and tonsils may be enlarged, Dr. Chuang said, while a bacterial infection "is just pretty nasty."

Sore throats may be precursors of strep throat, sinusitis or scarlet fever, among other diagnoses.

One of the best treatments, Dr. Chuang said, is to drink plenty of fluids, mainly water. Gargling with warm saltwater can kill some of the bacteria, and humidifying the air also may help.

Voice rest and avoiding air pollutants and smoking are encouraged.

"For some patients, it's unfair for their children to suffer with them," Dr. Chuang said. "You can have smoke particles trapped in clothing, but someone could smell that and take it in."

When the home remedies aren't working and a person has difficulty swallowing or breathing, he or she should seek medical attention, he said.

"I don't want people to hang around home suffering when they need help," he said.

People should seek medical attention for fevers higher than 101 degrees, tender or swollen lymph glands in the neck, pus in the back of the throat or a skin rash. Excessive drooling in young children can indicate an infection.

Some common problems seen by JoAnn Wheeler, school nurse at Watertown High School, are strep throat, mononucleosis and viral-related sore throats.

"We've seen a lot of that, almost from the second week in school, and it picks up again in January and February when we start to see some kids with flu," she said. "It all goes in peaks and valleys. We never really are rid of it, and there are no quiet months."

Hand washing is a key part in prevention, she said.