George A. Sprecace M.D., J.D., F.A.C.P. and Allergy Associates of New London, P.C.
www.asthma-drsprecace.com


FREQUENTLY ASKED QUESTIONS

Q) What kind of room air cleaner should one consider purchasing?
A) Only an air cleaner whose mechanism involves or includes HEPA and/or Electrostatic Air Cleaner with charcoal filter should be considered.  Pure "Ionizers" do not work adequately, unless combined with one of the other mechanisms as a major factor.

Q)    HOW CAN I TELL IF I HAVE A COLD?
A)    The symptoms of a common cold and of allergy are often similar at the outset:  runny/stuffy nose, post-nasal discharge, throat irritation, cough.  A cold generally  is accompanied by  tiredness  and muscle aches, although a prolonged allergic reaction may also give similar symptoms.  But a definite sore throat, and especially purulent mucus from the nose, throat or chest (yellow, green - what one of my patients calls “earth tones”) means a cold, viral and/or bacterial.  Also, a cold is gone within two to seven days, especially if treated promptly with the “initial treatment of a cold” instructions found with our Environmental Control section.  And the frequency of colds normally is two to three times per year.  More prolonged “colds” or greater frequency  often  means the presence of associated allergic reaction, and should be evaluated for such a likelihood.  Regarding antibiotics, normal colds in “normal” people rarely require antibiotic use.  But a prolonged cold in anyone,  or  the development of a cold in an asthmatic or bronchitic person or one with tendency to “sinus infections” warrants the use of appropriate antibiotic within 24 hours of onset.  When in doubt, start the “cold regimen” and observe for further developments.  GS

Q)    MY CHILD IS (TWO TO FOUR) YEARS OLD, IS ALWAYS STUFFY, HAS FREQUENT COLDS  AND FREQUENT EAR INFECTIONS.  WHAT SHOULD I DO?
A)    To paraphrase Shakespeare, “Get thee to an Allergist”.  GS

Q)    MY CHILD COUGHS ALL THE TIME.  THE DOCTOR ALWAYS FINDS HIS CHEST CLEAR.  WHAT SHOULD I DO?
A)    See answer above.  The child probably has “cough variant asthma”, otherwise called “allergic bronchitis”,  and requires a proper evaluation.  Meanwhile, a trial of treatment with Intal and a bronchodilator  would be appropriate, in addition to Environmental Control.  GS

Q)    WHAT ARE HIVES ALL ABOUT?
A)    Most often, hives are an allergic response to some “allergen” (see the section on “allergy immunotherapy”, elsewhere on this web site).  The cause is either obvious to both patient and doctor - or obscure to both.  This situation is made more complex by the fact that hives can  also be a manifestation of infection anywhere in the body  (eg. teeth, urinary bladder...) or can be a sign of internal diseases (eg. hepatitis, lupus...).  Hives, especially when accompanied by “angioedema” (firm swelling of face, lips, tongue...),  warrant prompt evaluation and treatment  by your physician and /or allergist.  GS

Q)    WHAT IS ALL THIS ABOUT SECONDARY SMOKE AND CHILDREN?
A)    Secondary smoke inhalation can be more dangerous for the bystander than smoking is for the smoker.  In addition, when children are involved, secondary smoke in  their household  is likely to stunt the ultimate size of their lung growth.  In my opinion, parents who, after being so advised, continue to smoke - or to allow smoking - in their household  when raising a child, are guilty of child abuse.  GS

Q)    HOW MUCH EXERCISE MUST I DO TO GAIN CARDIOVASCULAR BENEFITS?
A)    It has been shown that even modest, leisure time  physical activity protects against cardiac arrest and benefits the blood  lipid system.  So, anyone but a couch potato can tap into these lifestyle health benefits.  Remember, 50 percent of all illness affecting Americans is lifestyle-related and lifestyle -remediable.  GS

Q)    HOW CONCERNED SHOULD I BE ABOUT HIGH BLOOD PRESSURE?
A)    You should be very interested in getting a  proper diagnosis; and you should be very interested in getting effective treatment if you are found to have Essential Hypertension, defined as frequent or persistent blood pressure readings of over 140 systolic  and /or over 90 diastolic.  This disease is frequently overlooked, or denied,  for many years until the heart has  become  enlarged and  weakened, the kidneys have been affected-or worse, a stroke or heart attack has become the first obvious sign.  All this is avoidable.  Treatment is excellent.  GS

Q)    I HAVE A PEPTIC ULCER (OR GERD) PROBLEM.  HOW LONG CAN I USE THE STRONG AND EFFECTIVE MEDICATIONS LIKE PRILOSEC OR PREVACID?
A)    These agents are very effective, as “proton  pump inhibitors”, in  markedly reducing stomach acid and in relieving symptoms and tissue injury.  They have been used for over 15 years in Europe without ill effect.  The original worry  relating to the development of  small bowel tumors (carcinoids) has been found to be restricted to mice.  The worry about a prolonged absence of acid in the stomach possibly leading to stomach cancer has been found to be a non-issue-except in patients who have infection with  Helicobacter pylori.  Therefore,  all patients taking prolonged proton pump inhibitors should be tested for  H. pylori,  either by blood antibody tests, or preferably by the  breath test.  If  found, the infection should be treated and eradicated.

GS


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