Dear Mrs. XXXX,

Thank you for using the services of XXXXXXX I am Dr. Taher.

Having read your question, it is my belief that the doctor has diagnosed allergic bronchial asthma as the underlying cause of your daughter's recurrent attacks of cough and cold. While he may be right in his diagnosis, I think there is no need to treat her repeatedly with antibiotics unless she has definite evidence of infection.

The best way of treating asthma and similar illnesses is with inhaled drugs like levolin. The nebulised route is one such method, and is appropriate for her illness. I think you already purchased a nebulising machine; if not, please consider doing so, as you can then carry out the treatment at home with as much frequency of use as may be needed. The frequency of Levolin will depend on the severity of her symptoms; it is safe even if used 6-8 times in 24 hours.

Singulair is a preventive medicine for asthma, but the success rate of this medicine is variable. While some children experience a good effect, with reduction in the frequency of attacks, others fail to show such a response, and may need to be shifted to other forms of preventive medication. Use of Singulair for 2-3 months is reasonable, and you should continue its use.

In my opinion, expensive products like Laktrum have no role to play in asthma, and you can safely discontinue this medicine after your present bottle has been consumed. I suggest that you DO complete the present bottle because not only is it expensive, it may improve her immunity by a fraction or two.

It is premature for the doctor to suggest that the symptoms will go by the age of 5/6 years, as this varies from one individual to another. There is a 33-40% probability of the symptoms disappearing by this age, and every passing year would see about 5-10% more patients getting "cured". However, a significant proportion of children DO NOT outgrow the illness, and they continue to suffer throughout their youth.

Use of the preventive medicine helps to push back the disease, and so, for this reason, too, please continue giving her "Singulair".

I hope I have answered all your concerns. Please revert to me if you need more clarity or more knowledge. If not, please do stop by to rate my answer and review it.

Thank you.

With regards and good wishes for your daughter,

Dr. Taher, M.D. (Pediatrics)

http://drtaherforkids.in

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Dear Mrs. XXXX,

Thank you for reverting and for your appreciation.

Allergic bronchial asthma is a globally common disorder in these troubled times, where we consume so many ready-to-eat pesticide and insecticide-ridden foods, artificially boosted and genetically modified crop and items with colouring agents, preservatives, chemical additives and what not.

There is a ball-park figure of nearly 15-20% of all children being affected with
some form of allergy - e.g. allergy of the nose, eyes, skin, or asthma, as in your daughter's case.

Prevention of attacks is only documented with medicines. Usually, no dietary restrictions work. Some children drink tons of cold water and never get a cold, others go out in a windy climate for ten minutes and get affected with an acute attack of breathing difficulty! Some children tolerate all fruits, others come down with cough and cold as soon as they are fed oranges and sweet lime.

You, as a mother, are the best person to try out different food eliminations and see what works for her. At the same time, I will be honest with you: I have never advocated blind restrictions. My asthmatics are asked merely to avoid artificial foods, cold drinks, close contact with children in play groups and nursery (as a simple viral cold can bring on an acute attack) and assiduous hand-washing and personal and clothes hygiene.

There is a list of things that asthmatics' homes should avoid: I had published a Child Care book some years ago. The book is not available any more, but here is an extract from the book on things parents must do to avoid trigger factors that may cause an acute attack:

Prevention of trigger factors: To this end, the house is subjected to many changes. Rugs and carpets are thrown out if possible; if not, they should be vacuum-cleaned everyday. The vacuum cleaner is also used to clean nooks and crannies in the house, and to disinfest pillows, rugs and carpets with an eye to remove the microscopic but XXXXXXX house dust-mite. Pillow stuffing is changed if it was originally made from bird-feathers or cotton; long curtains and other cloth material are washed weekly and vacuumed daily; no pets are allowed to be kept; adults who smoke are allowed to do so when they are outside the house; if the house is small, lacks ventilation or is too crowded, attempts are made to relocate the child to where these problems are absent; house-plants and gardens around the house are NOT encouraged.

Early treatment is sought for the most minor cold as it can trigger an acute attack of wheezing; the child is trained to use a preventer inhaler before embarking on a stint of exercise like a game of football or a race in a sports event; baths with cold water are discouraged if the child has reacted to it in the past with an attack. The child is moved away from all smoke-causing devices like incense sticks, cooking stoves, barbecue parties etc. No perfumed sprays or similar cosmetics are to be used where the child is present. During the pollen season, the child is not taken out to gardens and open spaces where he may develop an acute attack. Liquid mosquito repellants are relatively safer than coils, but their use should be permitted only if the child can withstand them. If possible, herbal methods of pest-control (which are now available commercially) should be resorted to.

I hope this answers your question.

With best wishes,

Dr. Taher

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