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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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14 Year Old Suffering From Shortness Of Breath, Wheezing, Not Able To Distinguish Smells. Adenoid Is Swollen. Need Removal?

Hi, My son is 14 and a half years old. He is suffering from shortness of breath (may be Asthma, doctors say it's asthmatic cough) since the time he was 6 or 7. Whenever he suffers an attack it is with cough and wheezing sound with shortness of breath. Till 6 or 7 his complexion was quite fair but he is getting darker day be day. We have given him Alopathic, Homeopathic, Ayurvedic and Unani treatment for long durations at a stretch but there is just a small bit of relief. This means the number of attacks per year has decreased. We have kept a very close watch to ascertain the triggers but could not actually figure out. Recently, we feagured out that whenever he has a choked nose, he is short of breath and has to take Inhalers and even Nebulizers. He is unable to identify different smells and tastes too. He snores a lot during sleep. The cough happens anytime during the day, not specifically during the night.Its not necessary that the attack would happen at any specific point of time during the day. It can happen anytime. He can't even do cycling or swimming or even climb stairs of 2 floors. He gasps for breath after these. Am deeply concerned. At some point of time his doctor said that his adenoid gland is enlarged somewhat. Would removing the gland help him out?
He also suffers from pigeon chest.
Mon, 22 Apr 2013
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Pediatrician 's  Response
Hi,

Thank you for your query.

Reviewing the details provided by you, I have to give one of the following diagnosis to your son:
1. Asthma
2. Rhinitis
3. Enlarged adenoids with or without rhinitis
Since you mention that your son does not have night cough but a blocked nose which makes him breathless I am more inclined to think on the lines of rhinitis. I suggest that you the following investigations done, if not already done, and discuss with the doctor:
1. Peakflowmetry.
2. CT scan of sinuses.
It is only after these investigations can a call be taken on removal of the adenoids.

I hope I have answered your query to your satisfaction.

Wishing your son all the best.

Regards,

Rajiv K Khandelwal
http://goo.gl/SuCjl
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General & Family Physician Dr. Het Ram Bishnoi 's  Response
Hello, thanks for the query to H.C.M.C.
In asthmatic attacks usually cough occurs more in the night and in your's son case it is more in day time so pl be sure that this is not an ordinary asthma ( allergic).
Pigeon chest is the root cause of all evils of your's child.
Pigeon chest seems to be in the 12-15 yrs old boys.
In these cases chest wall is rigidly held in an outward position.
due to this outward position respirations are inefficient. When respiration is inefficient an individual needs to use accessory muscles ( muscles between ribs)for respiration.
Normally a person use chest muscles during cycling or swimming but in pigeon chest's patients use accessory muscles and that's why there is decrease in stamina of an individual as in your's son case.
Adenoids are nothing to do with this case so in my opinion pl don't agree for operation of adenoids.
So pigeon chest disease consult a pulmonologist and have a best treatment for your child.
Good luck and best wishes for your son as he will get relief soon.
Regards Dr. HET
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General & Family Physician Dr. S. Jegadeesan's  Response
Hi.
Your son is 14 old, suffering from Shortness of breath, associated with cough and wheezing from the age from the age 6. You have tried all treatment with minimum improvement. He has become little darker after this attacks. As per your observation the attack is initiated by Choking of nose. The cough and wheezing comes any time of the day and he is not able to do cycling, swimming and climb the stairs up to second floor. Your drs have told you it is asthmatic cough. Recently your dr has told you that your son's adenoid gland is enlarged.
The breath hunger - dyspnoea - air hunger are all same. It is due to so many reasons and important are asthma and pneumonia for children. Asthma has interconnection with nasal congestion which may be due to any etiology, for eq. nasal polyp, sinusitis, allergic rhinitis etc.,
Treat the cause your son will be alright - If nasal congestion is the cause - investigate the cause for nasal congestion and treat it. In that way adenoid gland (may not be the direct cause) removal may help your son. Medically treatment with steroids, antibiotics and nasal decongestants may give relief. Once his shortness of breath is relived every thing will be alright.
Blood investigation are needed to find out other cause/result - like anemia. ECG and X-Ray chest is a must. Asthma is not the cause for pigeon chest, where as pigeon chest may prevent full expiration.
Conclusion: Assure yourself and your son - asthma is 100% curable provided Nasal congestion and pneumonia like infection are the cause. Investigate and treat the cause your son will become alright
Best wishes

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14 Year Old Suffering From Shortness Of Breath, Wheezing, Not Able To Distinguish Smells. Adenoid Is Swollen. Need Removal?

Hi, Thank you for your query. Reviewing the details provided by you, I have to give one of the following diagnosis to your son: 1. Asthma 2. Rhinitis 3. Enlarged adenoids with or without rhinitis Since you mention that your son does not have night cough but a blocked nose which makes him breathless I am more inclined to think on the lines of rhinitis. I suggest that you the following investigations done, if not already done, and discuss with the doctor: 1. Peakflowmetry. 2. CT scan of sinuses. It is only after these investigations can a call be taken on removal of the adenoids. I hope I have answered your query to your satisfaction. Wishing your son all the best. Regards, Rajiv K Khandelwal http://goo.gl/SuCjl