Seasonal changes can be very exciting for most people. Each season brings with it a new set of colours and nature takes a new turn. However, for people with seasonal allergies, a seasonal change also comes with a set of allergies. From skin rashes to wheezing to breathing difficulties, the list of symptoms can be quite long. Asthma is the most common problem, and the attacks can be quite bothersome with wheezing attacks and breathing troubles.

With advancements in the field of medicine, there is a lot of relief for asthma patients. A little understanding on how asthma attacks happen will help in understanding how to control it. Asthma is an allergic reaction caused by narrowing of the airway with thick mucus, which makes breathing difficult. During an attack, the person can have a dry cough, face shortness of breath and wheezing.

Asthma is often triggered or worsened by some factors, and being aware of these can help prevent or manage an attack:

Common allergens like pollen, mites, ticks, furs of animals, bird feathers, specific foods (peanuts, milk products, eggs, etc.) and mold spores appear during change of season.
Environmental chemicals like cigarette smoke, car fumes, dust, etc., can also trigger an attack.
Attacks of cold or flu can lead to an asthma attack.
Workout during cold weather can be problematic, but exercise can also help control asthma attacks. Lung function improves sufficiently, but an exercise regime should be drawn up for the patient based on his condition.
Stressful emotions like anger and anxiety can also lead to an attack or make it worse.
Some medications like aspirin, beta blockers, glaucoma drops can aggravate attacks of asthma.
Once you know the triggers, here are some common measures that can help prevent and relieve the wheezing.

The preventers reduce the inflammation in the airway tube and the swelling. While they do not provide immediate relief during an attack, using these in the long term helps avoid attacks. These are low-dose inhaled corticosteroids such as beclomethasone, fluticasone, and budesonide. Doctors would advise their usage even when there are no symptoms, as asthma attacks can be triggered when they are not taking these medications for a while. Newer drugs include leukotriene antagonists like montelukast and zafirlukast. Relievers are used for symptom relief and include Salbutamol (short acting) and Salmeterol/Formoterol (long acting). Peak flow meter may be useful in acute attacks, wherein the peak flow rates can be reduced.
A good strategy is to use preventers regularly and rely on relievers during an attack. The first one helps build resistance and so reduces the incidence of attacks. Reach out to a doctor if a severe attack ensues (lasts more than 3 hours).


Tips to Control Allergy Driven Wheezing this Season

Coughing of blood is a serious problem in comparison to normal coghing. The coughing up of blood that originates from below the level of the larynx is known as hemoptysis. This can vary in terms of severity depending on the amount of blood being expelled. This disease is a common condition, but on an average, less than 5% of hemoptysis cases are life-threatening.

Oral antibiotics are usually the first stage of treatment for this condition. Smokers will also be urged to quit cigarettes as this can worsen their condition. Treatment for minor hemoptysis may also include:

Oral hemostatics
Cough suppressants
Anticoagulants
Radiation of laser treatment
Therapeutic bronchoscopy
In its later stages, hemoptysis can be treated with a minimally invasive procedure known as endovascular embolization or with surgery. In some cases, endovascular embolization may also be sued to stabilise the patient before surgery. This procedure reduces the pressure in the hypertrophic arterial blood vessels and decreases the risk of perioperative bleeding.

Hemoptysis is also one of the most common complaints of lung cancer patients. Depending on the stage of cancer and the amount of blood expectorated, treatment in some cases may not be possible. In such cases, a parenteral opioid and fast-acting benzodiazepine may be administered.

Hemoptysis rarely affects children. The symptoms of this condition include:
Sudden onset of a cough with bloody phlegm

Fever
Anorexia and weight loss
Dyspnoea
Paroxysmal nocturnal dyspnoea
Fatigue
What should you follow in following situations?

Chest pain: Medical attention should be sought in cases where this condition recurs often, if it lasts for longer than a fortnight or if the volume of blood expectorated is more than 30ml per day. The various tools that help in the diagnosis of this condition are:
Chest radiography: This imaging modality helps lateralize bleeding and understand the amount of lung involvement. It is quick, inexpensive and can also help detect other underlying abnormalities.
Bronchoscopy: This involves the insertions of a rigid or flexible endoscope into the bronchial passages to check the airways and determines active bleeding sites.
MDCT: A multidetector CT is a non-invasive imaging tool that provides a comprehensive evaluation of airways, lung parenchyma, and thoracic vessels. It can also be used to uncover potential causes of bleeding such as bronchiectasis, pulmonary infections and lung cancer. In some cases, a multidetector CT angiography may also be used.
In case you have a concern or query you can always consult an expert & get answers to your questions!

Coughing Up Blood: Know The Causes Of It! 

Fever in children is a very common phenomenon, but still parents absolutely dread it. It can completely break your heart to suddenly see a happy, healthy child not getting up from the bed. Your first instinct when that thermometer crosses that dreaded 100 degrees F is to rush to the doctor for an immediate cure. That is probably the best remedy as a doctor can often catch additional signs of any disease that you may miss out on. Beyond that, here is how you can understand about fever in children better and how you can help. Technically, your child has fever when the body temperature crosses 100.4 degrees F.
 
Some children manage to stay active even then, but slowly get bogged down with muscle pain or other accompanying symptoms like cold, diarrhea, vomiting etc.
 
Causes: Fever is normally caused by the body's reaction to fighting an infection. (That is why most doctors say it's a sign of a robust immune system). When the body's natural defense system is stimulated, the core inner temperature rises, thereby making it harder for the bacteria and viruses that caused the infection to survive. Most fever subside on their own but that's a tough thing to accept as a parent who only wants to see their child up and running as soon as possible.
 
What you can do: Keep an eye on that temperature obviously. You need to find a doctor the moment the fever crosses the threshold temperature (101+ for less than three months olds, 102+ for 3-6 month olds and over 102 for older children). You should also see a doctor if there are accompanying symptoms or if you've given a dose of Paracetamol but the fever shows no sign of subsiding. It might happen at midnight and beyond, when no regular pediatrician is unavailable. So it is best to find out which hospital has an emergency center capable of handling such eventualities near your home.
 
Fever medications: It is super important for parents to know that fever medications must be given in the correct dose at the right times based on a child's weight, age, and overall health. An overdose can lead you straight to the emergency room. Don't mix a cold/cough medication that also has a fever medication in it.
 
Home remedies: Encourage your child to drink as much fluids as possible to prevent dehydration. Some doctors advise complete body sponging to bring down the temperature and this can be done as long as it doesn't cool the body too suddenly (there are contradictory notes on this practice, so do consult you doctor before your do this).
 
As parent, it is important you equip yourself with the right knowledge before you provide treatment to your child. 

Parenting Tips for Fever in Children

Influenza is more commonly known as the flu. It is an infection that affects the respiratory system and is caused by the influenza virus. This injection is recommended for kids who are under the age of 6 months. It ensures that the baby is safeguarded from the virus during an influenza outbreak. Since the nature of virus changes year on year, the immunity doesn t last for more than 1 year. This vaccination is ideally taken during the month of October and November. The effect of the vaccination typically lasts for 6-8 months.

Ideally, kids who have never had a flu vaccination should take 2 vaccinations within 4 weeks. Kids who have received a shot of flu should undertake this vaccination once in a year. This arrangement is ideal up to 9 years of age. Flu shot is extremely important for a kid due to the following reasons:

It saves a kid from chronic lung and heart disorders such as asthma and cystic fibrosis
Kids suffering from immune deficiency, cancer, and HIV should take this vaccination to avoid further complication of the existing disease
Kids suffering from diabetes, kidney diseases, and metabolic disorders should go for this vaccination without a second thought
Kids suffering from a neurological disorder, haemoglobin deficiency, and anaemia should take this vaccination to refrain from the risk of aggravation of the present disease
Pregnant women should ideally take it for the safeguarding the fetus
Flu shot should not be taken be taken if:
1. A baby is under the age of 6 months.
2. The baby has thimerosal allergy.

Is flu shot safe?
The flu shot is considered to be very safe. It does not result in flu. Few side effects include:
a. Soreness of the place where the needle is injected. This doesn t last for more than a couple of day.
b. Body ache and mild fever for the first couple of days after the vaccination is done.
c. There is little to no pain in the place where the injection is injected by the doctor.

What is nasal flu vaccine?
This is an influenza dose that is not injected into the body but given in the form of nasal spray. Healthy kids above the age of 2 years are fit to get this injection. For those kids who have a history of chronic illness should check with their doctor to go ahead with nasal spray. Each dose is given in each nostril. Like the influenza vaccine, nasal flu vaccine should be undertaken once for those who have already taken this dose once. Kids who have not undergone this vaccination are eligible for 2 dosages each 4 weeks apart from each other.

Influenza Vaccine - Why is it Important for Kids?

A cough is not necessarily to be worried about always. It is the natural response of our body to throw out harmful particles which somehow managed to enter our respiratory tract. There is sticky mucus situated in the pathway to lungs which plays a major role in trapping harmful particles. Coughing once or twice is generally a natural phenomenon but if it s persistent it is called the chronic cough, and there is a reason to worry.

Is your cough chronic?
An acute cough aggravates within a very short span of time, maybe 2-3 days. There are situations when coughing doesn t hinder your day to day activities and are easily neglected. Sometimes these infrequent bouts of a cough can persist for long and continue for more than 2 months, which has been characterized as a chronic cough.

A chronic cough is sometimes found associated with blocked or running nose. Persons suffering from a chronic cough feel very exhaustive and suffer from a headache, dizziness along with excessive sweating. Under such situations, you must consult a pulmonologist.

Know the causes of a chronic cough
There are several causes for persistent coughing, and the following are the common causes of a chronic cough and medication is taken in consultation with a trained medical practitioner only.

Infections: Bacterial or viral infection in lungs can be one of the causes of a chronic cough. Tuberculosis is one of them which initiates as a chronic cough and is later characterized by emitting blood after cough bouts.
Drug Interactions: Antihypertensive drugs have been found to be responsible for a chronic cough in some people. Hypersensitivity to the prescribed drugs is found to responsible for the cough bouts, and change in medication takes care of the issue.
Asthma: It s a situation characterized by blockages in the bronchi which disallows the normal air flow during inhalation and exhalation. Due to inadequate oxygen, brain assumes that there is a blockage which needs to be expelled and coughing pattern starts. However, asthma has to be treated, and the bronchi have to be brought back to normal with the help of medication by an expert medical practitioner.
COPD: The most common cause of a chronic cough nowadays is COPD, better known as Chronic Obstructive Pulmonary Disease. This is one of the progressive diseases which means it deteriorates with time. Active smokers are the biggest victims of it. Persons exposed to high degree of pollution or similar occupational hazards are also at high risk. Exposure to these pollutants causes inflammatory responses in lungs resulting in the tapering of the airways and destruction of lung tissues. These can be measured by lung function tests. In asthma, the narrow airways can be broadened by external medication, but in case of COPD, it s not possible.
To conclude, chronic cough is a preventable disease by reducing the exposure to risk factors as mentioned above. Quitting smoking, improving the indoor air quality with the use of solar cooking and moving on battery run vehicles can prevent COPD from further worsening. You can also undergo pulmonary rehabilitation program which is being counseled and coordinated by many physicians to benefit the individual suffering from the issue.

Chronic Cough - Why It Happens?


Lung cancer may not always give out noticeable symptoms in the early stages. Most cases get diagnosed in later stages. It can happen to anybody irrespective of age or geographical location although smokers fall under high risk groups. Prevention and awareness can help. Check these lung cancer symptoms as early screening/diagnosis may help people fight the disease.

1) Unstopable Cough: Be cautious if your cough lingers. While a cough associated with a cold or respiratory infection will go away in a week or two, a persistent cough that lingers can be a possible sign of lung cancer. Don't dismiss a stubborn cough, whether it is dry or mucus-producing, as "just a cough."  See your doctor right away.

2) Disrupted Chronic Cough: Pay attention to any changes in a chronic cough, esp. if you smoke. If you are coughing more often and it has gone deeper or hoarse, or you are coughing up blood or more mucus than usual, it’s time to make a doctor’s appointment.

3) Short breath: Shortness of breath or becoming easily winded is also a possible symptom of lung cancer. This symptom occurs if lung cancer blocks or narrows an airway, or if fluid from a lung tumor builds up in the chest. Keep a track of how quickly you go short on breath. Does it happen while taking stairs or doing routine jobs is a question to answer.

4) Wheezing: When air passages of the body become blocked, constricted, or inflamed, the lungs produce a wheezing  or whistling sound as you breathe. While it can be due to other causes, wheezing is also a lung cancer symptom, which is why it demands your doctor’s attention. If wheezing continues, don’t assume it’s asthma or an allergy. Let your doctor find out what's causing it.

5) Chest Pain: Lung cancer may cause pain in the chest, shoulder, or back area. These aches may not be associated with coughing. Consult a doctor if you notice any type of chest pain, whether it is sharp, dull, constant, or twitching.

6) Hoarse Voice: If there is a noticeable change in your voice that stays for more than 2 weeks, or if someone else points out that your voice sounds hoarse or deeper, get it checked out by your doctor.

7) Loss of  weight: A sudden and unexplained loss of weight can be associated with lung cancer or another type of cancer. Cancer cells use energy in the body. Do not ignore it.

8) Painful Bones: If it gets spread to the bones, lung cancer may produce pain in the back or in other areas of the body. This pain may get worsen at night while resting on the back. Notice your aches and pains, and discuss them with your doctor.

Click on Consult Privately to ask me a private question on this topic or a related one.

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