Dr. Melissa Hertler has been serving Fremont County at Wind River Ear, Nose, & Throat for a little over a year now. She has more than 12 years of experience with the medical and surgical care of adult and pediatric patients with ear, nose and throat issues, as well as additional training and interest in the management of allergies.

She joined SageWest from Alliance ENT and Hearing Center in Milwaukee, Wis., where she had a busy ENT and allergy practice since 2010. The desire to get out of the big city, and feel as though she were making a real difference in her community brought her and her family to Fremont County.

The change was huge but one that was well received by her and her family.

”We really love the small town atmosphere and how friendly everybody is here,” stated Dr. Hertler. “This is an outdoor wonderland, with so many options for what our family does for fun. We hike, bike, climb, snowboard, ski and fish.”

With 2 middle school aged boys, Dr. Hertler and her husband stay very busy supportIng their various sporting activities. Dr. Hertler commented, “It’s really funny to talk to my family about going to a swim or wrestling meet, soccer or nordic ski tournament that is several hours away. To them it sounds totally crazy, because in the Midwest the towns are close together and there are so many schools or clubs within an hour’s drive in any direction.”

Dr. Hertler works primarily at Wind River Ear, Nose and Throat located at 15 Shrine Club Road in Lander. She also sees patients at the Wind River Clinic located at 1005 College View Drive in Riverton.

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Let’s talk allergies with Dr. Melissa Hertler:

What Can I Expect During at ENT Exam?

As a new patient, we would check your vital signs (blood pressure heart rate, respiratory rate and oxygen saturation), and then you would get a complete head and neck exam: Looking in your ears, nose, mouth, and examining your neck. If you had specific nasal or throat issues, I would also be able to use fiber optic telescopes to look in your nose and/or throat.

What are the most common allergy triggers?

There are many – seasonal triggers include tree, grass and weed pollens, and year-round triggers include dust, mold and animal danders.

Is there a difference in symptoms with winter allergies?

The seasonal and year-round allergy symptoms are nearly the same, however, more people might notice spikes in their seasonal symptoms depending on the time of year, weather and wind, while winter allergies tend to increase once the homes are closed up, and continue even after a hard freeze. Seasonal allergies tend to improve once the cold weather sets in and all the plants are dormant for the winter.

How can I tell if I have allergies or a cold?

A cold is caused by a virus, and may be accompanied by fever, body aches and overall feeling unwell. A typical cold lasts a week to 10 days, and then begins to get better. If it’s allergies, the symptoms can look similar, with congestion, runny nose, sneezing, mild sore throat, and add itchy watery eyes, but they tend to persist long after a cold would begin to get better.

How are allergies diagnosed?

We diagnose allergies by taking a thorough history, examining you for findings consistent with allergies, and offer allergy testing. There is skin testing and blood testing for allergies. We skin test for the most common regional pollens, dust, mold, and animal danders.

We can also test for some foods in the office, however, it is wise from a cost and diagnostic standpoint to select those foods based on suspicious symptoms when you eat them. Many people may have been sensitized to certain foods, such as cow’s milk, when they were infants or young children but have become tolerant or “outgrown” these food allergies, however their tests will still be positive.

It can be challenging to interpret positive tests in a patient without symptoms, and just increases the cost of the testing without much benefit.

Once we identify the environmental triggers for your allergies, we can determine ways to try to avoid or at least reduce your exposure to these things, as well as discuss what medications might be beneficial, or even if you are a candidate for immunotherapy such as allergy shots, allergy sublingual immunotherapy drops or prescription immunotherapy tablets.

Immunotherapy is a way to “train” your immune system over time to stop overreacting to the things that trigger your allergy symptoms. Compared to medications, it causes a long lasting reduction or relief from allergy symptoms even after the treatment course (3-5 years, typically) is complete.

Other common breathing problems

Difficulty breathing through your nose can be congestion due to allergy, or even non allergic rhinitis (nasal inflammation), or it might be something else. Nasal obstruction can be due to anatomical problems in your nose, such as a deviated septum, enlarged turbinates, or even nasal polyps.

Difference between adult problems vs. children

Adults most often complain of classic allergy symptoms: nasal congestion, runny nose, itching of the nose, eyes and even ears, watery eyes, sneezing.

Children tend to complain less, but we see signs in them such as sniffling, sneezing, puffy eyes, and recurrent ear or sinus infections, and even asthma.

For questions or to schedule an appointment, call Wind River Ear, Nose and Throat at 307-206-1440.

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