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Allegry related cough, cold and running nose - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Asthma and Allergy
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
Doctor :   Hi
Doctor :   Dr XXXX here
Doctor :   How may i help you?
User :   hi doctor XXXXX
User :   2-3 days back I chated with Dr. XXXXXXXX and
User :   he adbised few tests for my daughter
Doctor :   Ok
User :   I will give u a background
User : daughter is 26 months old. for the first 1 year she was perfectly fine. from the second years onward she started having cold & cough onin 2 months and on. but this time it started from mid of august and its not going. it starts with running nose then thick mucous from nose and then finally wet cough...1 week she is OK and then for 1-2 weeks she is not well. X-rays were done and doctors here in Bangalore say that she has sinus with enlarged tonsils and androids. so for the past 1 week she is put on steroidal nasal spray and asthaline nebulization. She was OK for 1.5 week and then again from day before yesterday she has started teh same cycle and coughing now. We got haemogra, PS and AEC blood test done and would like to share the result with you
Doctor :   Its fine i am goin through your chat history just give me a moment
User :   typo adenoids
Doctor :   Yes proceed
User :   Dr XXXXXXXX said do these blood test which will give us indication if she is allergic as all the doctors in xxxxx say she is an allergic child...atopic or something....
Doctor :   Ok
Doctor :   When there is increases AEC it signifies allergy
User :   here are the results...hematocrit - high...41.3
Doctor :   ok
User :   rbc distribution width low 10.5
User :   platelet count...low...176...min 200
User :   and abs eosinophil count high...480....max should be 440
Doctor :   Ok
User :   rest all r normal cbc+es+esr all normal
Doctor :   Your location?
User :   what does this signify?
User :   XXXX
Doctor :   Ok
Doctor :   I will breif you Its very common for children in XXXX
Doctor :   As there is a lot of dust and pollen in XXXXX
Doctor :   And any child less than 2 years with respiratory problems as a protocol are treated for allergic asthma
User :   but for 1.5 years she was perfect...i used to see small kids coughing with cold but she never had
Doctor :   In XXXX that a protocol
Doctor :   The allergy will not occur immdiete will take time for occurance
Doctor :   And hope in her early days the child was in home town
User :   only recently it started...initially once a month or once in two months but now its persistent from past 6 weeks
Doctor :   And recently shifted to XXXX
Doctor :   Ok
Doctor :   Though the results are more suggestive of infection
User :   she is not revovering totally this time....2 weeks unwell.... 1week OK...then again 1 week unwell 1 week OK...But not completely OK
Doctor :   As in this age we first consider allergy
Doctor :   As with history of recurrance it most probably due to allergy
User :   can i give her budacort nebulization tonight as she is not able to sleep...coughing a lot
Doctor :   Yes
Doctor :   Do you haev nasal sprays
User :   I hope thats safe
Doctor :   If you are sure she has difficulty in breathing / crepts then give budecort
Doctor :   It an steroid
User :   yes from 23rd onwards Im giving her duonase twice a day...still she got it again...and asthaline twice a day....
Doctor :   You will need nasal decongestants along with budecort neubalisation
Doctor :   Is she having lot of audible breath sounds now
User :   here doctor says its not to do with chest its more of nose and sinus and post nasal drip
User :   not much breath sound...yes it is always..nut little...more of coughing only while she sleeps
Doctor :   Then Budecort is of less use
User :   but
Doctor :   Asthalin will help
Doctor :   And also steam inhalation
User :   Dr. XXXXXXXX told me if nasal spay is not helping much then instead give budacor nebulization as both are steroids and inhallation will help more
Doctor :   Yes in case when there is difficulty breathing severe cough and cold
User :   from yesterday I am giving asthaline 4 hourly and not twice a day but still she is coughing and puking
Doctor :   In Post nasal drip of less use
Doctor :   You should not give it more than three times a day max
Doctor :   'Then she will probably require antibiotics too
Doctor :   Plz get her examined by a doctor again
User :   we actually gave her budacort and she is not coughing now
User :   u mean to say asthaline I shouldnt give more than three times?
Doctor :   Its a steroid it will mask the defect and produce a feeling of well being
Doctor :   Yes asthalin only thrice
Doctor :   And budecort should be used wisely along with medication
User :   when we started giving her asthaline doctor here had asked to give 4 hourly
Doctor :   Not individually as it will mask the condition misleading
User :   and when she was ok then they said twice daily
Doctor :   Can you breif the dosae
Doctor :   * dose
User :   I am scared now...I hope thiis will not have a very bad side effect ?
User :   OK i counted...I gave her asthaline 4 times today
Doctor :   Dont have to worry increased dose will clear all secretions and result in puking and cough clearing expectoration making it difficult for child
User :   didnt get
Doctor :   The dose ( strength)
Doctor :   Is it a vial or repsule or tablet
User :   respule
Doctor :   Ok plz restrict to three only when severe attacks or discomfort consult and then administer
Doctor :   Better get her administerd neubulasation in an clinic or hospital
Doctor :   Do you give the full repsule or is it diluted
User :   ok...sure but is there any bad effect or something to worry ?
Doctor :   No
Doctor :   Just excess secretions
Doctor :   Which makes it uneasy for child
Doctor :   Prefer steam inhaltions alternatively to astahlin
Doctor :   * astahlin
User :   yes I used to always give steam inhallation only
User :   i was very much against giving nebulization but doctor told so I gave
Doctor :   Thats is fine and safe at home
Doctor :   But you will require when there is severe difficulty or excess cold which requires clearing the nasal pathway
User :   i gave her budacort only now as she was coughing so much that she was crying and was not able to sleep...hope thats fine...and do u suggest not to give her budacort anymore now?
Doctor :   Along with steam inhaltion is severe cough is present
Doctor :   When you have such difficulties plz dont hesitate to visit a doctor near bye
Doctor :   So that can avoid overdosage
User :   day time she is Ok..playing and all...coughs but managable only when she sleeps its kind of unmanagable...she screems, cries and whatever she eats she throws up
Doctor :   Considering your child age plz be cautious till they settle down
Doctor :   Get an second opnion from a peadtrician so that issue is orted
Doctor :   * sorted
User :   what are the side effects? is it that she will get used to these?
User :   what about the steroidal nasal spray? that is also not asked her to give twice a day for 2 weeks and then once a day for one week...
Doctor :   Yes you should taper the dose and withdraw the drugs
Doctor :   Because they will get adapted and have dependence to it
User :   I never gave her spray or asthaline earlier its only from 23rs sept 2010....hope thats fine?
Doctor :   Yes
Doctor :   Its fine
User :   asthaline is not a steroid so that I can stop without tapering right?
Doctor :   But dont overdose her
Doctor :   any difficulties consult a doctor before administering the drug
Doctor :   Yes
User :   overdose will make her puke ?
User :   what is the indication that she is overdosed?
Doctor :   Yes
Doctor :   They puke and have excess secretions
Doctor :   Dont use the older prescribed medicines
User :   Does ACE level shows that she is allergic?
Doctor :   Get her examined before giving her the same drug too
Doctor :   Yes and also an prevailing infection
Doctor :   Hi
Doctor :   Proceed
User :   sorry recharged
Doctor :   I am Dr here
User :   so Doctor please suggest what should I do?
Doctor :   Just avoid giving self medication by phone orders
Doctor :   And get her examined before administering any drug further
User :   sorry doctor...but I only increased teh dosasge from twice to four times of asthaline rest...whatever was told by doctor I gave
User :   Dr XXXXXXXX told me first to get teh blood test done shows some irregularity then go for allergy test
User :   and PFT for her
User :   but will she be able to bear >?
Doctor :   You dont require an allergy test
Doctor :   But will require examination
Doctor :   No
Doctor :   Not required
User :   now what tests are pending....we did eray - 2 xrays, boold test...ENT say her...Pulmo doc saw her...pediatric saw her... and gave her this treatment of Nasal spray and asthaline and when severity budacort....
Doctor :   Ok
User :   in between 1 week antibiotics was also given
Doctor :   This was done 2 weeks ago
Doctor :   When symptoms reoccured you shouldmeet the pulmonologist for the same
User :   but didnt help....
Doctor :   Thats why i am suggesting an second opnion
User : u r suggesting to meet Pulmonogist again and tell her
Doctor :   Yes
Doctor :   Say her the symtpoms did not improve
User :   sure....I will take her to anothe doctor this week...
User :   are you from
Doctor :   Yes
User :   when she is coughing and puking she throws up PHLEGM...thick and whitish...
Doctor :   That is collection of cough and sputum
Doctor :   She will require an higher antibiotic and extyra care
User :   so u suggest that higher antibiotic is better than asthaline or nasal sprays?
Doctor :   Along with asthalin and steroid
User :   increased AEC suggest that she has some infection or allergy ?
Doctor :   Antibiotic will control the infection and asthalinand stroid will ease the child from symptoms
Doctor :   Allergy Mostly
User :   is it good for such a small child for antibiotics/steroids etc ?
User :   ESR is normal
Doctor :   As in your case it also suggests infection
Doctor :   Esr is not an accurate marrker for infection
User :   is it common with kids in bangalore
Doctor :   yes especially during the rainy seasons and winter
Doctor :   Did you follow?
User :   I asked here in bangalore doctor said local steroids are not harmful and when required it should be given and there is no harm...actually I am very very scared with steroids
User :   yes I will t ake her to her pediatric tomorrow
Doctor :   steroids should be used wisely
Doctor :   And appropriate way
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