PW Health Clinic

[nasirjavaid]

Inhaler should be handy ( in ur car, wifes purse)as it can be used immediately and does not need electricity or an apparatus. Continue with mytika but educate ur kid how to use an inhaler. Does he have difficulty in breathing when he plays, runs about for a few minutes??......

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I already asked his physician last year about inhaler but he stopped me from doing so and said the kid is not at the stage which needs inhaler so I didn't used inhaler. Normally he doesn't feel any breathing difficulty when playing , walking running etc but during these days when allergy season is on peak he is short of breath easily so i have to nablize him.
Last year he didn't felt any symptoms like such but this year i think probably due to climate change and been exposed to some thresher's output (hay /bhoosa) he is feeling like this.

[Glioblastoma]

I already asked his physician last year about inhaler but he stopped me from doing so and said the kid is not at the stage which needs inhaler so I didn't used inhaler. Normally he doesn't feel any breathing difficulty when playing , walking running etc but during these days when allergy season is on peak he is short of breath easily so i have to nablize him.
Last year he didn't felt any symptoms like such but this year i think probably due to climate change and been exposed to some thresher's output (hay /bhoosa) he is feeling like this.

Okay after reading all the previous comments. In my opinion as Xubair also previously mentioned, the doctor gave your child too many syrups, so as he mentioned myteka with nebulizing is enough. Britanyl syrup no way can thin out mucus it is same as ventolin meaning they act similarly that is expanding the airway. But when you are nebulizing then already you are using drugs that expand the airway secondly the normal saline you use in the nebulizer solution thins out mucus and helps to clear it out. So no need for anything extra. If you want a cough syrup then syp. toux can be used. It contains ivy leaf extracts.

Along with IgE levels do get a CBC with differential counts. As I mentioned make your child wear a mask.

[xubair.ashraf]

I already asked his physician last year about inhaler but he stopped me from doing so and said the kid is not at the stage which needs inhaler so I didn't used inhaler. Normally he doesn't feel any breathing difficulty when playing , walking running etc but during these days when allergy season is on peak he is short of breath easily so i have to nablize him.
Last year he didn't felt any symptoms like such but this year i think probably due to climate change and been exposed to some thresher's output (hay /bhoosa) he is feeling like this.

I think in your child case we first need to confirm whether he has asthma or not. In children viral respiratory infections sometime presents with wheeze. And as you have mentioned in normal days he is alright and does not have any symptoms. Even if it is asthma, then most probably it is mild asthma which gets exacerbated in the spring season due to allergen exposure.
My experience is that general physicians and child specialists overuse these syrups which are mostly not needed. Its better to consult a chest physician (pulmonologist ) for proper diagnosis and treatment of asthma.
The other myth regarding asthma is the use of inhalers. People say that inhalers are started when asthma becomes untreatable. On the contrary inhaled treatment is the first line treatment of asthma. And it is also a myth that inhalers once started cannot be stopped. Morever inhalers have fewer side effects as compared to oral treatment.

[nasirjavaid]

Okay after reading all the previous comments. In my opinion as Xubair also previously mentioned, the doctor gave your child too many syrups, so as he mentioned myteka with nebulizing is enough. Britanyl syrup no way can thin out mucus it is same as ventolin meaning they act similarly that is expanding the airway. But when you are nebulizing then already you are using drugs that expand the airway secondly the normal saline you use in the nebulizer solution thins out mucus and helps to clear it out. So no need for anything extra. If you want a cough syrup then syp. toux can be used. It contains ivy leaf extracts.

Along with IgE levels do get a CBC with differential counts. As I mentioned make your child wear a mask.

I agree with Xubair and you and myslef think that this doc gave more than needed and i commented in Xubair's post that the doc must be making pharma companies happy by doing so.... thats why i stopped going to him since 2 years but as my current doc which was very best, left country so i had to go to him for the sake of only finding out if condition is serious or not...

So I can stop other syrups and only give him myteka and nablize him...right?

getting blood test is another funny issue as his veins are so thin to be seen, many guys keep pricking the poor child in try to find vein so I seldom agree for blood test but there are 1-2 docs/lab guys who find it in first try so will get it checked when i go back to my own city where they reside.

What could be the next step after finding IgE and CBC results?

[nasirjavaid]

I think in your child case we first need to confirm whether he has asthma or not. In children viral respiratory infections sometime presents with wheeze. And as you have mentioned in normal days he is alright and does not have any symptoms. Even if it is asthma, then most probably it is mild asthma which gets exacerbated in the spring season due to allergen exposure.
My experience is that general physicians and child specialists overuse these syrups which are mostly not needed. Its better to consult a chest physician (pulmonologist ) for proper diagnosis and treatment of asthma.
The other myth regarding asthma is the use of inhalers. People say that inhalers are started when asthma becomes untreatable. On the contrary inhaled treatment is the first line treatment of asthma. And it is also a myth that inhalers once started cannot be stopped. Morever inhalers have fewer side effects as compared to oral treatment.

I think you are pointing it out 100% as his doc used to say same things that its of mild nature and even there are no single asthma like attack in months while asthmatic patients normally having 1-2 attacks in a month are also considered not dangerous. He also told that it will almost be gone by the age of 13-14 as his lungs develop more and would be strong enough to withstand environmental hazards.

As previously mentioned I went to Lahore Chest Clinic Iqbal town but got bad impression by the chest specialist /pulmonologist as he was just dragging pen over the paper to prescribe medicines and inhaler and pretending as it is very big issue and only inhaler use for the whole life is must. He won't budge even after I asking many questions about what it really is and how to understand symptoms and take necessary action in case of emergency.

However Dr. Waqas Sheikh (my son's only physician since 3-4 years) explained everything really well and educated me what to do in any situation. He never used to give extra medication and if i insisted then he would say its not needed.

There are very few people like him and you guys who really want to help others and not just rip off. Salute you guys.

[Glioblastoma]

If getting blood tests is difficult due to thin veins don't get them done. They are not necessary. Only supplementary in diagnosis of asthma. Best initial test is Peak expiratory flow and most accurate test is pulmonary function test for asthma.

As I said in my first post if you see and now xubair is also saying that most commonly these wheeze in children are due to respiratory infections. And as said inhalers or nebulizers are first line treatment, myteka and all else is secondary try to avoid all oral agents if the symptoms are being controlled on inhaled agents. So as Xubair is also saying show your child to good pulmonologist. Try to find a good one, try Dr. Zubair its his field of expertise. I am also feeling your child doesn't have asthma.

[nasirjavaid]

If getting blood tests is difficult due to thin veins don't get them done. They are not necessary. Only supplementary in diagnosis of asthma. Best initial test is Peak expiratory flow and most accurate test is pulmonary function test for asthma.

As I said in my first post if you see and now xubair is also saying that most commonly these wheeze in children are due to respiratory infections. And as said inhalers or nebulizers are first line treatment, myteka and all else is secondary try to avoid all oral agents if the symptoms are being controlled on inhaled agents. So as Xubair is also saying show your child to good pulmonologist. Try to find a good one, try Dr. Zubair its his field of expertise. I am also feeling your child doesn't have asthma.

Now thats a relief hearing from you experts that its not asthma... this is the thing his first doc used to say and I also feel its sever allergy. I remember when my child was in his first year the doc used to laugh that the kid shouldn't have born in Pakistan as he is very sensitive to dust and allergens.

Yes I am nabulizing him regularly and now I can feel him breathing almost normally as compared to first day when he was breathing with jerks as his chest was not willing to expand to allow air intake. Also as you advised he is using mask when going out of home. The masks pack was already at home as he used them previously.

Please share more info about Dr. Zubair and where can I contact him to get my son checked. Thanks.

[Glioblastoma]

Now thats a relief hearing from you experts that its not asthma... this is the thing his first doc used to say and I also feel its sever allergy. I remember when my child was in his first year the doc used to laugh that the kid shouldn't have born in Pakistan as he is very sensitive to dust and allergens.

Yes I am nabulizing him regularly and now I can feel him breathing almost normally as compared to first day when he was breathing with jerks as his chest was not willing to expand to allow air intake. Also as you advised he is using mask when going out of home. The masks pack was already at home as he used them previously.

Please share more info about Dr. Zubair and where can I contact him to get my son checked. Thanks.

What I meant by Dr. Zubair was @xubair.ashraf ask him. In some previous post he mentioned he is doing his speciality training in chest medicine also called pulmonology.

[nasirjavaid]

What I meant by Dr. Zubair was @xubair.ashraf ask him. In some previous post he mentioned he is doing his speciality training in chest medicine also called pulmonology.

Oh ok... got it..

Dear @xubair.ashraf please pm me your practice location and contact number so i can get an appointment... Thanks

Dear @glioblastoma So you are not practicing ?

[Glioblastoma]

No sorry as I mentioned earlier I am busy with my USMLE exams so not for now.

[nasirjavaid]

No sorry as I mentioned earlier I am busy with my USMLE exams so not for now.

Ok no problem sir.

I am working at mayo hospital. Not doing private practice. Your inbox is full. Could not sent you pm. But here is my no. 03006824725. I shall be happy to help.

Thank you so much sir. Happy to know some really concerned doctors available at mayo hospital otherwise my experience there wasn't so good.

Anyways I will soon contact you before coming there.

[tasawwur]

thanks friends, I went there yesterday. I'll get an appointment on Tuesday.

Dear, i also want to get an appointment for my mother's treatment. Please advise how was you experience with Dr NasarUllah?

[Glioblastoma]

Dear, i also want to get an appointment for my mother's treatment. Please advise how was you experience with Dr NasarUllah?

If you want a good neurophysician in Lahore you can try Dr. amer ikram in doctors hospital or dr. moquit usman in ittefaq hospital.

[nasirjavaid]

Here I come with another issue .. my 4 years boy drank motilium syrup 1/4 bottle (i suspect as only saw empty bottle in his hands so not sure he drained it in flush or drank but want to take precaution) 1 hour ago but still no symptoms. Please let me know what to do or for which symptoms to look for? His doc will be open at 11 so what can we do before that?

Thanks.

[kasaas]

nothing to do. just see if he gets motions or if he feels neck/jaw stiffining

[nasirjavaid]

nothing to do. just see if he gets motions or if he feels neck/jaw stiffining

Thanks sir, He was awake since 2am and playing around so he is sleeping now. Till now no sign of stiffening. What to do if there is any sign of stiffening?

[kasaas]

if he has stiffness just give him 2tsf of syp benadryl otherwise nothing else

[nasirjavaid]

if he has stiffness just give him 2tsf of syp benadryl otherwise nothing else

Ok Thanks. Will keep an eye on him when he wakes up.

[tasawwur]

If you want a good neurophysician in Lahore you can try Dr. amer ikram in doctors hospital or dr. moquit usman in ittefaq hospital.

Thanks for your response. Do you have any contact # of Dr Moquit?

[Glioblastoma]

Thanks for your response. Do you have any contact # of Dr Moquit?

No sorry. You can contact ittefaq hospital only from their website just google it.