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Surgery does not treat the allergy itself or the source of the allergy. Taking a scalpel to open up nasal passages does nothing to address the immunological properties associated with your body's reaction to certain susbstances. However, in some individuals, they can have anatomic malformations and drainage can be impaired. Yes, in these rare individuals, surgery can perhaps help with SYMPTOMS. However, this is not the cause of the "allergy" itself and the vast majority of people do not have anatomical malformations like a deviated septum. Even with surgery, patients will require standard treatment of their allergies. Surgery is discussed in your article as an adjunct therapy which is fine only after a patient has already been worked up and treated with standard treatment first. If a patient has seen an allergist, has been compliant with treatment and is still not experiencing relief, the allergists themselves will often refer to an ENT to see if such malformations are present. But for the overwhleming majority of people, they will not require such a consult.
No respectable physician would recommend that a patient seek surgical options prior to trying standard treatment including surgeons. Surgery carries significant risks as we all know. There is adverse reactions suffered from anasthesia including death. Then there is risk of bleeding, developing deep veinous thrombosis and infection/sepsis. In fact, last month, I got consulted on a 22 year old girl who just had a tonsillectomy done by an ENT and she began to suffer from cardiac arrhythmias following surgery. So seeking an ENT for a surgical consult is only done after a patient has not found relief with standard treatment.
AZ...
FYI. I was not recommending surgery. I said I had 3 surgeries for allergy relief, the last one done at Mayo Clinic who are supposed to have the most reputable ENT's and surgeons.
And the reasons were the tubinates were infected by pollens and needed to be reduced, and the septoplasty to enlarge the passages to aid in air passage. The infections caused severe swelling, mostly from hay fever, though cat hair and other pollens acerbated the problem, surgery need to be done.
The moderater cut out a non copyrighted part of an article that actually related to my situation and the procedures.
In the name of balance, I have not had a single sinus infection since moving here from IN, nor have I gotten sick . I have been here nearly 1 year. I feel better since moving here. Granted I am not a true allergy sufferer, just sinus problems. I feel much better living here. I understand I may develop allergies/sinus after a year or two, but that's how it is right now. I do still get mild sinus migraines, just no infections.
AZ...
FYI. I was not recommending surgery. I said I had 3 surgeries for allergy relief, the last one done at Mayo Clinic who are supposed to have the most reputable ENT's and surgeons.
And the reasons were the tubinates were infected by pollens and needed to be reduced, and the septoplasty to enlarge the passages to aid in air passage. The infections caused severe swelling, mostly from hay fever, though cat hair and other pollens acerbated the problem, surgery need to be done.
The moderater cut out a non copyrighted part of an article that actually related to my situation and the procedures.
"You'll need to find a good ENT here if you move here"
That is your quote. That implies that people with allergies need to find an ENT. As I stated previously, people do not need to seek an ENT for allergies. They should start with their primary care physician and then an allergist if their PCP is unable to resolve their symptoms.
I'm aware of that surgery prior to you posting it but you misunderstand what that surgery is about. Allergies can cause congestion and rhinitis. Some individuals have anatomic malformations to which they are unable to properly drain their passages either through a deviated septum or malformations within their sinus tracts themselves. Thus they feel miserable and medications don't correct the anatomical problem. However, this is not a first line treatment and someone with allergies should certainly not seek out an ENT first as they are not the most knowledgeable nor are they the most well trained in the field of allergy immunology.
Furthermore, people who undergo that surgery still require treatment for their allergies. The surgery itself does not correct the allergies. Allergy is an immunological problem not an anatomical one. It doesn't matter that your ENT is from the Mayo Clinic, that fact does not change human physiology. You will still have pollen and other substances that will affect your turbinates; that won't change. What has changed is that you are able to drain the passageways more effectively and thus your symptoms have improved.
Quote:
Originally Posted by nitram
AZ...
The infections caused severe swelling, mostly from hay fever, though cat hair and other pollens acerbated the problem, surgery need to be done.
The moderater cut out a non copyrighted part of an article that actually related to my situation and the procedures.
Hay Fever is not a separate substance in the air, it's a process namely inflammation of the nasal passageways secondary to an allergic reaction to substances in the air which include pollen, dust, cat hair etc. Hay fever is the colloquial term for Allergic Rhinitis.
Last edited by azriverfan.; 02-10-2011 at 11:00 PM..
Well we have the right to agree or disagree, and I'm not here to debate but state the fact that our family physician recommended an ENT, before that I saw 5 allergists and they all recommended 2 ENT's for my situation and that's what I stated originally, not trying to argue the point. At Mayo I saw an allergist specialist and he sent me to one of their ENT's. All said people in my situation with the allergy problem I had that the surgery was the best remedy along with Nasacort. I really don't need to discuss my medical history on the internet. Just mentioning what I went through and that ENTs were recommended.
You have your opinion, as well as thousands of other doctors. I feel comfortable with whom I've dealt with.
Here is another article for allergy sufferers to see an ENT...
In the name of balance, I have not had a single sinus infection since moving here from IN, nor have I gotten sick . I have been here nearly 1 year. I feel better since moving here. Granted I am not a true allergy sufferer, just sinus problems. I feel much better living here. I understand I may develop allergies/sinus after a year or two, but that's how it is right now. I do still get mild sinus migraines, just no infections.
FWIW: My allergy problem didn't show up untill after I was here about 7 years.
I am getting blasted by allergies this year - pollen, dust, etc. It has been terrible for me this year.
Anyone else getting hit hard?
This is probably not just allergies. Phoenix has one of the worst air quality rankings of any area in the country (Environmental Protection Agency). It is likely a combination of the multiple sources of pollution we suffer from in the area. There is a reason why asthma development rates in Phoenix area children matches that of inner city Los Angeles.
This is probably not just allergies. Phoenix has one of the worst air quality rankings of any area in the country (Environmental Protection Agency). It is likely a combination of the multiple sources of pollution we suffer from in the area. There is a reason why asthma development rates in Phoenix area children matches that of inner city Los Angeles.
According to the Asthma and Allergy Foundation of America, Phoenix was ranked 62nd out of the top 100 cities for Asthma. It was not even in the top 50. There is a PDF file on this site that shows the detailed rankings.
Furthermore, Asthma is influenced by so many factors that to lay people, they will find one factor such as pollution and conclude that Phoenix has one of the highest asthma rates when in reality asthma is influenced by much more than pollution. There is weather. Cold weather causes bronchoconstriction and exacerbates asthma. Cities with extreme weather changes and changes in barometric pressure (Dallas) can exacerbate asthma. Exposure to smoking influences asthma so cities with strong anti-smoking ordinances affect rates. Humidity itself can act as a trigger for asthma and influence the creation of dust mites and mold.
Well we have the right to agree or disagree, and I'm not here to debate but state the fact that our family physician recommended an ENT, before that I saw 5 allergists and they all recommended 2 ENT's for my situation and that's what I stated originally, not trying to argue the point. At Mayo I saw an allergist specialist and he sent me to one of their ENT's. All said people in my situation with the allergy problem I had that the surgery was the best remedy along with Nasacort. I really don't need to discuss my medical history on the internet. Just mentioning what I went through and that ENTs were recommended.
You have your opinion, as well as thousands of other doctors. I feel comfortable with whom I've dealt with.
Here is another article for allergy sufferers to see an ENT...
Again, as stated above I'm not here to debate, so if you are a doctor, I recognize your opinion but not necessarily agree with it.
I'm not advocating not seeing an ENT for allergies but just not initially. In your case, an ENT was warranted. However, the standard of care in the treatment for allergies is not to see an ENT and seek surgical options prior to more conservative treatment with medication and shots. That is not my opinion. That is the standard of care that all physicians are taught with regard to the treatment of allergies. These are tested on nationalized board exams. Your Mayo trained allergists would agree with this as well. Physicians work together but it is a systematic process. You don't recommend surgery initially because it carries risks. Conservative treatment is sought first prior to undergoing surgery. In your case, surgery was warranted. You sought conservative treatment first and it failed to provide relief so you sought surgical options which was warranted. However, people should not seek out an ENT initially because that is not the standard of care and if a patient can be controlled with more conservative measures like medications and shots, that should be attempted first prior to seeking out surgery.
Furthermore, not everyone is a surgical candidate. We have to remember that. Even if the patient has narrowing of their turbinates, an ENT will likely not perform this procedure on a patient who is deemed a surgical risk such as a patient with cardiovascular risks such as a history of stroke, valvular disease, and arrhythmias or has a bleeding disorder. An ENT is not going to put a patient's health at risk over allergies. And even if the patient is not a surgical risk, the patient may not be a candidate for the surgery meaning he or she has normal anatomy and no malformations with regards to their nasal turbinates.
Finally, even after a patient undergoes surgery, the patient will still require treatment for allergies, they don't go away with a surgery because allergies are an immunologic problem not an anatomical one. So the patient will have to establish care with an allergist or primary care physician anyway because their followup care and management of their allergies will be done by a PCP or Allergist not an ENT. Hence the reason why you should see a PCP or an Allergist first.
Now after reading this, if you still believe that people should seek out an ENT prior to seeing a PCP or Allergist for seasonal allergies then we will agree to disagree and I won't respond. I did want to respond in case others are following our conversation and considering their options.
Last edited by azriverfan.; 02-11-2011 at 10:50 AM..
This is probably not just allergies. Phoenix has one of the worst air quality rankings of any area in the country (Environmental Protection Agency). It is likely a combination of the multiple sources of pollution we suffer from in the area. There is a reason why asthma development rates in Phoenix area children matches that of inner city Los Angeles.
Top contents in the air are going to include dust, but also ozone here. The Valley forms a natural pocket where air just sits. On days like the past few, the wind kicks up a lot of stuff in the air. This is how many people get Valley Fever.
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