University Health System Blog

Dr. Mary Beth Hogan answers the question: “Why do I have nasal itching and sneezing, as well as, coughing and wheezing this fall?”

Weeds and molds are common culprits for respiratory allergy symptoms in the fall. Particular activities which can exacerbate these allergies include raking or jumping in the leaves, and hayrides. These activities are relatable to mold allergy.

Indoor allergies also start making their appearance as the house is closed up for the winter. These allergies can be attributed to mold, dust mite, and pet allergy. Feather bedding and stuffed animals can be reservoirs for these allergens. Dust mite covers can help decrease exposure to these allergens in the bed. HEPA filters can help with mold and pet allergy symptoms.

Do not overlook the possibility of common everyday exposures acting as irritants to cause these symptoms. Cleaning agents and highly scented candles, potpourri, and air fresheners can cause both nasal symptoms of sneezing, congestion, and runny nose along with coughing and wheezing. This is most notable in those patients who have underlying undercontrolled allergy and asthma. These agents are also strong enough irritants to be triggers for patients with no allergies and undercontrolled asthma.

Evaluation for common indoor allergens and degree of asthma control can help pinpoint the source of these triggers.

Mary Beth Hogan, M.D. is professor of pediatrics and section chief  of pediatric allergy, immunology and pulmonary medicine at the University of Nevada School of Medicine. Dr. Hogan is based out of Reno, Nevada.

Have a question? University Health System doctors answer select questions from readers like you.

Dr. Ronda Keller answers the question: “What exactly is shingles?”

Shingles is a very painful viral infection caused by the chickenpox virus.

Ninety-five percent of children are exposed to the chicken pox virus by the time they are 15; it comes back in adulthood as shingles if one has had chicken pox as a child.

Symptoms include pain and a rash usually confined to one specific area of the body. Patients may notice the pain in an area they can’t explain (or a general sense of not feeling good) that starts in the nerve endings and works its way to the skin’s surface.

A skin outbreak of weeping blisters appears several days later and can be extremely painful even after the rash goes away.

Sixty percent of shingles cases occur in adults over the age of 60, while just 35 percent occurs in those under 60.

A vaccine is available to prevent an initial outbreak and is highly recommended for those ages 60 to 70.

There is not enough information available to determine if the vaccine benefits those who have already had an outbreak. The vaccine is not given to those under age 60. There are plenty of medications to treat the nerve pain after the outbreak passes and come in both pill and topical cream format.

Ronda Keller, D.O. is an internist practicing in Reno, Nevada at University Health System. She attended medical school at Western University of Health Sciences and completed her residency at Legacy Good Samaritan Hospital and Medical Center.

Have a health question? University Health System doctors answer select questions from readers like you.

Dr. Mary Beth Hogan answers the question: “Why is my asthma worse at night?”

This is a frequent frustration for asthma patients who make doctor appointments for sick visits and by the time they arrive at the doctor they are no longer wheezing. It is commonly known that asthma symptoms may actually be worse at night rather than during the day.

There are several proposed reasons which may explain why asthma worsens at night. One such reason is that the body’s ability to control the root cause of asthma—swelling in the breathing tubes, or bronchioles—is less at night than during the day. The breathing tubes are also much tighter at night than they are during the day. In addition, exposure to allergens or other triggers during the day can cause swelling in the breathing tubes multiple hours later after the initial exposure.

Gastroesophageal reflux, or heartburn, is frequently worsened by lying down and reflux is a known trigger of asthma. Sleep apnea is a known trigger for asthma.

The effects of some asthma medications taken at bedtime can wane away overnight. This is particularly true for “rescue” medications such as albuterol which last approximately four to six hours before needing to be redosed.

Mary Beth Hogan, M.D. is professor of pediatrics and section chief  of pediatric allergy, immunology and pulmonary medicine at the University of Nevada School of Medicine. Dr. Hogan is based out of Reno, Nevada.

Have a question? University Health System doctors answer select questions from readers like you.

Dr. Kami Larsen answers the question: “As a parent, what should I know about child immunizations?”

In my practice as a pediatrician, I encounter concerned parents every day. Many times their concerns are about common illnesses, diet and sleep patterns. Lately however the same question keeps recurring—How safe are my child’s vaccinations?

It’s a question I hear over and over and typically I can spend 30 minutes or more informing families about this. The truth is that in recent years the Web has made it easier for families to find information about vaccinations. The problem however is that not all of this information online is complete, accurate or up-to-date and some information can even be harmful to your child’s safety.

Most parents want to do what’s right for their child, and so do most pediatricians. In recent decades, vaccines have played an unbelievable role in decreasing the number of serious illnesses, hospitalizations and deaths in children. Without childhood vaccinations, thousands of kids each year would die from illnesses like measles, chicken pox and whooping cough. Due to this dramatic decline, many people believe that these illnesses that pediatricians vaccinate against have been wiped off the face of the earth. Unfortunately this simply isn’t true. We still have outbreaks of measles, pertussis (or whooping cough) and other vaccine preventable diseases. Just this winter (2007), Clark County (or metropolitan Las Vegas) faced an outbreak of mumps.

As parents we tend to have a false sense of security and assume that the miracles of modern medicine will keep our children out of harm’s way. For our parents and grandparents the reality of infectious disease is only a memory away. Before immunizations 20,000 cases of paralytic polio were reported each year. These epidemics left thousands of children in braces, wheelchairs and iron lungs.

Before measles immunization was available, now part of the MMR vaccine, nearly everyone in the U.S. got measles. What we tend to forget is that about 450 children each year died from the infection. Up to 20 percent of those infected with the virus are hospitalized and encephalitis with concurrent brain damage may result. Many of the cases we see today are a result of travelers visiting the U.S. and carrying the infection with them. In a city like Las Vegas, the number of visitors is large and outbreaks among residents who aren’t immunized are common.

Pediatricians also commonly see outbreaks of whooping cough, another serious illness. Unfortunately the most serious complications of this infection are in children. According to the Centers for Disease Control and Prevention, between 1990-96, 57 people died from pertussis—49 were babies (less than six months old). The coughing fits associated with the illness are so severe that many children can’t eat, drink or sleep. They may end up with pneumonia, seizures and even brain damage.

This is just the beginning of the story. Today our children are fortunate enough to have vaccines that prevent against several forms of meningitis, hepatitis, tetanus, chicken pox and other life-threatening infectious diseases. Many of these illnesses are viral and can’t be treated with antibiotics. I can’t count the number of times I’ve heard a parent say to me, “We all had chicken pox and survived.” The truth is not everyone who’s had chicken pox has survived. Disease that once were common aren’t today. That is the benefit of immunizations.

Despite this many parents recently have decided against vaccinating their children for multiple reasons. However more often bad information is behind these decisions.

There’s a misconception that vaccinations cause autism. It’s important to note that there has never been a scientific link between autism and childhood vaccinations. Many proponents of this theory blame thimerosal, a preservative commonly used in the past. In 2001 a recommendation to remove thimerosal from immunizations was passed. The only immunization currently in use containing thimerosal is the inactivated influenza vaccine.

Any medication has the risk of side effects and this holds true for vaccines. However, in general, the risks are minimal and the risk of a serious side effect are rare. Concurrently the risks associated with acquiring the illnesses I mentioned above outweigh those of immunizations.

It’s important that parents get accurate information and facts. Helpful information is easily accessed online at the American Academy of Pediatrics or from your child’s pediatrician.

As a mother of two, I’m faced with the same decisions as any other parent. Each day I fight to protect my children and help nurture them into happy and healthy adults. Don’t gamble with your child’s health. Talk about immunization with your child’s pediatrician today.

Kami Larsen, M.D. is a pediatrician at University Health System in Las Vegas, Nevada. Dr. Larsen is assistant professor of pediatrics at the University of Nevada School of Medicine and medical director of Kids Healthcare Clinic.

Have a question? University Health System doctors answer select questions from readers like you.

Dr. Evan Klass answers the question: “Can thyroid disease affect your mood?”

Thyroid disease can definitely affect your mood. We often think that thyroid disorders affect only metabolism- weight gain if the thyroid is underactive and weight loss if overactive- but thyroid hormone is definitely active in the brain.

An overactive thyroid or hyperthyroidism may make one edgy or agitated, short-tempered, cause difficulty in sleep, cause problems in “focusing”, or even cause depression. Underactivity of the thyroid or hypothyroidism is more commonly associated with a “foggy” feeling, depression, and also with being “snappy” or short-tempered. Severe hypothyroidism can make one very fatigued.

It is important to remember that once the thyroid function has been returned to the normal range the effect of the disease on mood ends. Any mood issues that persist after the thyroid has been stabilized are not thyroid related and need to be evaluated separately.

Evan Klass, M.D. is an endocrinologist practicing in Reno, Nevada at University Health System. Dr. Klass completed his fellowship training in endocrinology at George Washington University Medical Center.

Have a health question? University Health System doctors answer select questions from readers like you.