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Child Has Pediatric Asthma. Not Cured By Asthalin Inhaler. How To Get Rid Of This?

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Posted on Sat, 6 Apr 2013
Question: Hi, My son is 4 yrs& 10 months old. He came to Bangalore on XXXXXXX For past 4 months he was suffering from cough in the night. In XXXXXXX he has been hospitalized as he got little wheeze, the doc has given asthalin inhaler after first nabulization itself he came out of that wheeze. He was given augmentin injection when he was hospitalized. There is no history of asthma/wheezing for any of our family members. Last week we consulted one more doc, he told my son is suffering from peadatric asthma.. so he has given asthalin inhaler for every 4 to 6 hrs 4 puffs,seroflo inhaler 125 -night & morning 1 puff. But now also I am able to hear his breathing sound from his nose when I am sitting next to my son. I am feeling he is having cold but when i ask him to throughout from his nose nothing is coming. His cough is reduced but its still there. so i have a doubt whether i can continue using asthalin. Whether he can come out of this asthma. whether there is any food restriction for him. can you please suggest how to get rid of this
doctor
Answered by Dr. Hema Yadav (52 minutes later)
Hello,
Thanks for posting your query .
I assume your doctor has carried out a formal diagnostic work up for pediatric asthma including detailed history and examination , X-ray chest , respiratory tests like spirometry or peak flow metry.
Also if the wheeze and cough improve drastically with asthalin then it's definitely more likely to be asthma.
Hearing a wheezing sound when your child breathes can be a symptom of asthma.
However most asthmatics do have some family history of allergies or them self are allergic to dust smoke or foods like nuts, eggs , dairy product , shrimps etc.
Please provide me a detailed history of the onset duration and progress of your child's symptoms and upload ( if any) reports so that I can guide you in the best possible manner .As of now you need to continue asthalin if that improves his cough and breathing significantly.
Awaiting your response ,
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hema Yadav (5 days later)
Hi, I have attached the details of the reports of my son when he was admitted in hospital in XXXXXXX He was prescribed T-,minic,cheston syrub when was discharged. But Now the current doctor has prescribed Asthalin6 hrs inhaler 4-for 3-5 days ,serflo 125 inhaler for 3 months. But after giving asthalin inhaler his cough got reduced after 8-9 days. But its not completely gone. So can u suggest what i have to do whether to continue the astahlin inhaler or to stop the inhaler. what is the remedy for this symptom. Whether he can recover from this symptom completely...
doctor
Answered by Dr. Hema Yadav (5 hours later)
Hello,
Thanks for the details.
After going through his reports it doesn't seem that he had asthma since the chest X-ray was normal and treatment was given for a lung infection( pneumonitis).
However if child has persistent wheeze ( sound heard during respiration) as well as cough for more than two weeks now then he needs to repeat certain investigations like CBC , ESR , X-ray and mantoux test + pulmonary function test( not done yet).Depending on the reports one can label it as asthma or lower respiratory infection and treatment can proceed accordingly.
At present asthalin inhaler can just provide temporary relief in breathing ( bronchodilator) and seroflo is an inhaled steroid which should only be given once the diagnosis is confirmed.
I would request you to get your child evaluated by a chest physician (specialist or pulmonologist ) and get him reinvestigated . With the last investigations the child doesn't seem to have pediatric asthma and more likely a chest infection which should have resolved by now.
Kindly let me know his present symptoms severity ie 1.cough ( occasional , nighttime or throughout day , severe enough to disrupt feeding and playing?)
2.breathlessness or wheezing sound wether present or absent , at rest or on exertion.
3. Any weight loss or low grade fever or any other symptom?
If the child has mild cough and nothing else I would recommend you give him an antihistamine like syp zyrcold or relent twice daily along with zinc and multivitamin supplement like zinconia and Ato Z syrup once daily . Sometimes azithromycin an antibiotic might be effective in treating respiratory infection ( if present reports suggestive. All these for a course of five days should cause resolution of his symptoms in a week . If symptoms persist , a formal assessment for asthma is mandatory.If he has any additional symptoms do let me know.

Hope I have answered your query.
Awaiting your response.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hema Yadav (27 minutes later)
Thanks for your reply. Please find the answer below:
1.cough ( occasional , nighttime or throughout day , severe enough to disrupt feeding and playing?)---Ans::::: occasional
2.breathlessness or wheezing sound wether present or absent , at rest or on exertion.---Ans::::: no wheezing
3. Any weight loss or low grade fever or any other symptom?--no fever and no weight loss.
Can you please suggest which medicine to be given how much ml to be given for how many days... and stop the inhaler which the current doctor has suggested. Can you tell me whether its an infection or any other causes this symptom
doctor
Answered by Dr. Hema Yadav (19 minutes later)
Hello,
Thanks for the follow up.
Please do not worry .
I have already recommended some course of treatment in my previous answer however please note that it's not advisable to stop the inhaler or start any medicine without the advice or prescription of your child's chest physician or pediatrician .
Yes, it could be a infection or allergic cough the confirmation as I already mentioned requires further investigation .
The next best step would be to discuss his condition with the treating doctor who can withhold the inhalers and carry out further investigations if necessary .He can give a 5 day trial of antibiotic ( azithromycin usually 5 ml once daily ) and antihistamine ( Like relent 5 ml twice daily ) and a once daily multivitamin and zinc supplement.Please do not hesitate to discuss your doubts with the childs doctor and make sure you give a detailed and specific(not exaggerated )history of the childs symptoms.I understand your concern as a parent and the hesitation to give prolonged treatment ( 3 months) . I am sure that your discussion with the treating doctor can help him understand your child's condition better and allay your fears as well. Alternatively you can take a second opinion from a chest physician who are more experienced in diagnosing asthma and lung infections after careful examination ( auscultation ) of patient.
Meanwhile you can give him warm steam inhalations and throat gargles twice daily to cause faster relief.
Make sure to give him plenty of fluids and Vit c XXXXXXX fruits like amla , citrus fruits etc
Hope that answers your query.
Wishing your child a speedy recovery.
Regards

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Hema Yadav

Pediatrician, Infectious Diseases

Practicing since :2005

Answered : 1528 Questions

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Child Has Pediatric Asthma. Not Cured By Asthalin Inhaler. How To Get Rid Of This?

Hello,
Thanks for posting your query .
I assume your doctor has carried out a formal diagnostic work up for pediatric asthma including detailed history and examination , X-ray chest , respiratory tests like spirometry or peak flow metry.
Also if the wheeze and cough improve drastically with asthalin then it's definitely more likely to be asthma.
Hearing a wheezing sound when your child breathes can be a symptom of asthma.
However most asthmatics do have some family history of allergies or them self are allergic to dust smoke or foods like nuts, eggs , dairy product , shrimps etc.
Please provide me a detailed history of the onset duration and progress of your child's symptoms and upload ( if any) reports so that I can guide you in the best possible manner .As of now you need to continue asthalin if that improves his cough and breathing significantly.
Awaiting your response ,
Regards