Hello,
Thank you for asking at HCM.
I went through your son's history and would like to know more about him as follows:
a. He has asthma since childhood. How it was treated? What were the medications used? What are the medications he is currently using?
b. Regarding 3 episodes of fainting, what were his symptoms? How did he lose balance? Did he have black out? Was his blood pressure measured at that time? How much time it took to completely recover? I want to know this as such things could be due to
postural hypotension or
anaphylaxis, a more serious form of allergy.
c. As all 3 episodes of fainting occurred in washroom, is there anything special about washroom? Is there mold inside washroom? (mold is a very common allergen) Does it contain fumes of acids/cleaners, etc?
d. How are his asthma symptoms in between? Does he have breathing difficulty, cough or wheezing?
e. Are there any seasonal variations?
f. Does he have any other medical conditions? Does he take any other medications regularly/frequently?
g. Does he have nose symptoms? - nose congestion, sneezing, running nose, etc?
h. Does he have any digestive problems?
constipation, acidity, heart burn, etc?
i. Does he smoke? any other exposure to dusts, smokes or air pollution?
j. Is stress an important factor in his life? Does stress worsen his symptoms?
Above details would help me to know more about his health and therefore to make more specific suggestions for him.
At present, from your provided information, I would like to make more specific suggestions for him as follows:
1. I would suggest him
spirometry with post-
bronchodilator reversibility testing. This will help to know his lung capacity, status of his asthma as well as it will also help to better choose his medications.
2. I would also suggest him allergy testing for common allergens. In addition, I would also suggest him serum total IgE and baseline serum tryptase levels. (serum tryptase levels are done only at a few centers in India at present)
3. If such further episode occurs, I would also suggest you to get him examined by a doctor as soon as possible, get his blood sugar and blood pressure measured.
4. As he has
severe asthma, I usually suggest my such patients regular use of inhalers like inhaled
corticosteroids. For in-between asthma symptoms, I would suggest him to use salbutamol inhaler on as-and-when-needed basis. Further medications can be suggested only after detailed information.
5. In general, I would suggest him plenty of fluids during day to maintain hydration. I would also suggest him to not immediately stand up after awakening in the morning. He should sit upright in the bed for a few minutes and then slowly stand up and go to washroom. This may help if he has postural hypotension.
Hope above suggestions will be helpful to you.
Should you have any further query, please feel free to ask at HCM.
Wish your son the best of the health ahead.
Thank you & Regards.