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Child with cough, cold, - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Child Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User :   Hi, may I answer your health queries right now ? Please ty
Doctor :   hi
User :   Hi doctor my name
User :   we have a problem.
Doctor :   Dr. XXXXXXXX here
User :   Till 1.5 years she was health issues at all..
User :   Hi Dr. AAAAAAA
Doctor :   please proceed with your health query
User :   nice to meet u
User :   in her second year she started with cold and cough....once a month she used to get....but this time it started on 14th August 2010 and
User :   as usual it started as a cycle...few days running nose then nose blocked and then converted to cough and difficulty in sleeping...only when she used tp lie down she coughs
Doctor :   ok
Doctor :   what symptoms does she have at present?
User :   then finally on 23rd her pediatric told us to do her x-rays ans other tests...they found she is an allergic child and has sinus and enlarged tonsils and adrenoids
Doctor :   is she on any medications for her symptoms?
Doctor :   ok
User :   so she is on Prophylactic inhaler treatment is steroids inhaler and asthaline nebulization twice a day for 1 month
User :   she was OK for 1.5 weeks and now again she got little cold and cough last night
Doctor :   ok. is the child better on these medications?
User :   yes she was better and totally fine
User :   but again she got it
Doctor :   ok. what is the frequency of using eh inhalers?
User :   she never has fever
User :   we have tried so many cough syrups, antibiotics but nothing helped
User :   nasal spray twice a day and asthaline nebulization twice a day
User :   we have started this treatment from 23rd Spet 2010
Doctor :   since the problem is allergic, she will have her bronchus and airways reacting so, simple cough syrups will not help
User :   how do we know that she is allergic when from birth till 1.5 years she never had any issues
Doctor :   i would recommend you to be calm, continue on teh medications as prescribed, maintain her diet, and consider getting consultation with a pulmonologist
Doctor :   also proceed with getting these stests done
User :   yes we met a pulmonologist
Doctor :   1) allergen patch test to identify the allergen causing reactions.
User :   and she only put her to these medicines
User :   ok
Doctor :   2) a blood test called hemogram along with peripheral smear and AEC (absolute eosinophil counts)
Doctor :   these test will help to fine out if she is allergic child
Doctor :   and to what she is alergic to
User :   ok thanks doctor
User :   also I would request you to answer my last 4 queries
Doctor :   in the meantime change her clothes 2-3 times a day
Doctor :   change bedsheets daily. it will help in minimizing attacks
Doctor :   I have just answered your 1 query of how to know she is allergic
User :   ok doctor thanks
Doctor :   please proceed with your other queries
User :   1. Are the nasal spray (Steroidal) and Asthaline Nebulization is safe and will they have any long lasting side effect?
Doctor :   the medications are safe to use for long term, do not worry about side effects, her symptoms need to be controlled.
Doctor :   use of steroids make sure that there is no stiffening of airways due to inflammation
Doctor :   such that long term complications are avoided, hence for acute attacks steroids are advised to be used
Doctor :   going ahead with the tests recommended will help to know her alergy status
User :   2. This treatment now is only for a month, so what after that?
Doctor :   and if found to be allergic, then alternate medications might need to be started to control symptoms better
Doctor :   the treatment shul dbe continued until teh child is completely beter
Doctor :   the steroid can be stopped, rather tapered off slowly over few days time once she is better
Doctor :   but the asthalin might need to be continued over longer time period
User :   3 The treatment is on but she has caught a cold again during the treatment that normal ?
Doctor :   yes it is normal. waxing and waning of symptoms are common during such attacks. be strict on her diet
Doctor :   strat on home remedies and precautionary mesaures too
Doctor :   to avoid relapses
Doctor :   home remedies include: Doctor :   1) honey with tulsi leaf juice, ginger juice and peper 2-3 times a day
Doctor :   2) changing of clothes and bedsheets daily, preferbly each time she is put to sleep
Doctor :   3) miniaml handlingof child
Doctor :   4) avoiding of smoke and dust and pets around
Doctor :   5) avoiding foods consdered as cold, like citrus fruits, cud and curd products, rice, etc
Doctor :   was the consultation with pulmonologist involve PFT (pulmonary function test)?
Doctor :   if not, then consider getting one done, it will help n further guidance of treatment.
User :   no it was not done only...x-rays as she is 26 months old thats what they said
User :   Steroidal nasal spray has been given for 2 weeks twice a day and then once a day for another 1 week. so is this OK? I mean the tapering
Doctor :   a simple spirometry can be done by asking child to blow into the apparatus
Doctor :   to see if there is any airway problem and to decide on continued use of asthalin
Doctor :   the tapering should be decided based on the child's response
Doctor :   not on duration of use
User :   ok doctor
Doctor :   to make sue that the child is comfortable and does not have relapse.
User :   my last question: User :   4. Here in Bangalore Doctor has asked not to send her to her play school for a month. But is there any guarantee that she will not get it during this one month or after 1 month when she again start going to the school?
Doctor :   sure, please proceed

Doctor :   thee is no guarantee that she will not get it again. if there is dust involved, then there might be relapse. hence i suggested the allergen patch test such that the causative allergen can be identified to be able to avoid it completely.
Doctor :   and avoid the relapse
User :   is it a blood test?
Doctor :   plus she should not stop the asthalin use
Doctor :   it is not a complete blood test. it is more a skin test
Doctor :   where reaction to allergens are monitored from day to day life
User : will it pain and will the child be able t o bear ?
Doctor :   the child should be able to bear it. it will cause some discomfort
Doctor :   you can atleast proceed with tehblood test advised
Doctor :   the hemogram, peripheral smear and the AEC counts
User :   someone suggested to give budacort nebulization at night....ya sure doctor I will get it done today for that only once the blood will be taken isn't it ?
Doctor :   these will show if allergy is he cause, but these cannot identify the cause exactly (the allergen causing the reaction)
Doctor :   yes it will be 1 time sample
Doctor :   budacort is a steroid again in form of inhaler
User :   so for that allergen patch test is mandatory? I will try to get it done after the blood test hope that's fine ?
Doctor :   it can be given as nebulisation, it will work better than the spray
Doctor :   yes, you can decide on it later
Doctor :   that is if blood test identifies her to be allergic to something
Doctor :   have you followed all that I have said?
User :   she has been given duonase so can I instead give her budacort nebulization ?
User :   yes i HAVE
Doctor :   is there anything else you would like to ask me?
User :   thank u so much time is getting over.....
Doctor :   consult her pediatrician abut giving her budacort instead of spray
User :   she has been given duonase so can I instead give her budacort nebulization ?
User :   ok
User :   thank u so much
User :   bye
Doctor :   by reporting lack of complete relief with duonase
Doctor :   thanks for consulting me,. bye for now.
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