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HindustanTimes Fri,26 Dec 2014

Breathless start

Rhythma Kaul, Hindustan Times  New Delhi, May 12, 2013
First Published: 22:52 IST(12/5/2013) | Last Updated: 01:53 IST(13/5/2013)

Recurrent sinusitis in children and colds that last more than a week can be early warning signs of asthma and allergic reaction to the polluted air that constricts the airways.

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"Most parents take sinusitis casually, but it is found to be a triggering factor for asthma in about 70% of the cases. If you leave it untreated, it's bound to trickle down to the lungs and cause inflammation," said Dr Vivek Nangia, director, department of pulmonology and infectious diseases, Fortis Hospital.

Smoke, including cigarette smoke, dust, allergens like pollens and change in weather, etc, also act as triggers.

"Those prone to allergies must avoid junk food as preservatives used in them trigger asthmatic attacks," said Dr PK Pandey, senior consultant, respiratory department, Max Hospital, Shalimar Bagh.

Even children under the age of five may develop symptoms, making it imperative to get the condition diagnosed at the earliest.

The symptoms could be as mild as chest pain, nausea, prolonged cold and cough to severe ones such as wheezing, shortness of breath and bronchitis.

The symptoms may vary from child to child, and it also depends on the age. In infants, one may notice slow feeding or shortness of breath during feeds.

Toddlers may avoid going out to play as they would get fatigued easily and start coughing when performing any physical activity. In older children, change in weather usually triggers an allergic reaction, which may result in cough that worsens at night.

Sooner the treatment starts the better it is to improve the breathing pattern, to reduce flare-ups and also to control symptoms.

"Treatment occurs in two parts - treating the asthma episode and maintenance therapy, using inhalers and tablets. Once the symptoms get better, the child needs to be put on preventive treatment that requires observing and avoiding triggering factors," said Dr Nangia.

However, doctors warn against misdiagnosis as the symptoms can be similar to certain types of viral infections. Labeling a child asthmatic can be detrimental for his or her growth.

"Unless there are recurrent symptoms -at least three episodes of spasmodic cough  not associated with any viral infection - we don't confirm asthma. We prefer to call it hyperactive airway disease as a lot of them become alright as they grow up," said Dr JS Bhasin, head of paediatric department, BLK Super Specialty Hospital.

While diagnosing the disease, history of the child and family is important such as how does the cough start, when it is worse, exposure to what substance caused the cough and who in the family suffers from asthma.

Before the age of five, doctors prefer clinical examination and observe the child's response to therapy as a means of diagnosis. For older children, there is a pulmonary function test wherein a child gets supposed to blow through a particular machine and readings are recorded.

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The best way to handle asthmatic children is to control the symptoms by avoiding irritants.

"Delhi's air is the biggest irritant and so are the dust mites inside the house. People should take measures such as going for wet-mopping and avoiding carpets. The material for curtains and sofas should be such that doesn't attract dust. Smoking in front of an asthmatic child is an absolute no," said Dr Bhasin.

Though the condition is not curable, once the diagnosis is made it is important to control the symptoms by chalking out a treatment plan in consultation with the doctor.

"Like diabetes or hypertension, asthma symptoms can be controlled by therapy. Inhaler is the first line of treatment. As long as the symptoms stay under control, there is no need to worry," said Dr Nangia.

Is your child suffering from prolonged cold and cough? Take an online quiz here

Second opinion
Readers' queries on autism
My son is autistic and going with the therapies (OT, education and speech) for past over one year but has not shown any improvement. Please advise.

There can be several possible reasons.

Firstly, does your son show signs of difficulty in sustained attention or hyperactivity? If yes, then these need to be taken care of by medication. Many autistic children are unable to benefit from rehabilitation therapies simply due to the lack of sustained attention.

Secondly, is there no improvement at all or has the progress been far below your expectations? There are cases where improvement is slow and insignificant.

Thirdly, do the members of treating team interact and discuss the case at regular intervals? This is extremely important as everyone needs to work in tandem and running into different directions is counterproductive.

I strongly recommend that you discuss these issues openly with the treating team and if necessary take a second opinion.

I suspect my grandson is not mentally sound. Please guide.
Not being mentally sound can be a symptom of cognitive, psychiatric or behavioural disorder. It is a common symptom of several disorders.

It is extremely important to firstly diagnose and understand the exact nature of the problem.

Please consult a mental health professional and give a detailed account of his birth, early childhood, relationship patterns and current difficulties.

My kid is 5. He was diagnosed with PDD ( a form of ASD). His speech therapy and physiotherapy is going on since a year. He has problems in communicating with other kids.
You can arrange for some kids to visit your home regularly and play amongst themselves. Whenever your child takes any kind if interest in the group activity or expresses verbally or non-verbally, reward him.

This gradual shaping of behaviour will improve his communication in the long run.

Pulkit Sharma, Consultant Clinical Psychologist and Psychoanalytical Therapist, VIMHANS


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