Unconscious in bathroom , worth preventing.

Yesterday I went to a post graduate institute for a clinical meeting where they presented patients who went for a bath , & were recovered from the bathroom in unconscious state sometimes even after three hours. They were investigated for neurological & other causes for this .
Even the MRI showed changes. Some including a doctor were also started on anti epileptic medicines thinking it to be a seizure! It was systematic analysis with high index of suspicion which revealed that it was happening due to Gas Geyser in the bathroom. In winters generally the bathroom windows are closed especially while bathing . This results in accumulation of Carbon monoxide(CO) -a gas which has 250 times more affinity for Hemoglobin in blood than oxygen ( O2). Co typically competes with O2 , not only attaches itself to hemoglobin but also displaces it form hemoglobin. This results into severe oxygen deprivation of brain and unconsciousness.
If at all you must install a gas geyser it should be out side the bathroom.Bathroom windows must be open for ventilation. GO FOR SOLAR ENERGY.!

Quality of life in Asthma and no emergency please.

Emergency room visits can surely be minimized , inspite of increasing incidence of asthma.
The key issues are to accept the diagnosis and follow the methods which can control the disease and improve the quality of life. Often people have the tendency to deny the label of Asthma , they consider inhalers as habit forming , they fear steroids in inhalers and have a myth that this should be the last resort.
Even educated and not so much moneyed have shopping around behavior for the above fears.
They are ready to accept very prolonged and troublesome treatment with hidden salts and unscientific alternate therapies in spite of no definite health benefits , but they fear proven scientific inhalers. The symptom free periods in seasonal asthma are automatic , but they give credit to homeopathy or aurvedic salts.
Health education on continuous basis in friendly way is the only method to keep patients on appropriate scientific treatment.
There is always some amount of ongoing inflammation in the airway even in asymptomatic phase. Doctor , with the help of lung function tests and eosinophil counts etc will decide when to stop and when to restart the inhaler. In seasonal allergies the inhaler may start in preseason even if there are no symptoms.
Patients worry the restart of inhaler as though doctor is useless because she could not stop the inhaler for ever.
The aim of treatment should be good night sleep, being able to do all physical and other activities with pleasure , minimal side effects of medicines , being able to control the attacks oneself with help of rescue inhaler and no emergency room visits. This will improve quality of life and is possible with all the instructions of qualified doctors

Host Factors in pediatric Allergy

Genes no one can change but triggers are very much in ones control.
Right from the newborn age if we modify the host factors Allergy can be prevented.
Mothers milk can help prevent allergies of all kinds and should be continued for longer than a year.
Mothers diet should be healthy but in infant there should be a delay in introduction of salt as well as proteins , these should be postponed till one year of age.
There should be lot of exposure to sunlight throughout life so that vit D is obtained in sufficient amount as vitamin D,s role in Allergy prevention is well established.
Fresh food should be given instead of preserved and processed fancy ready made or precooked packed food. Artificial food colors should be avoided.
Synthetic clothing and toys with cheap paint should be avoided.
Fresh air ,fresh-food, avoidance of smoking in infants room ,avoiding chemical mosquito repellents are some useful host factors.

Do not stop inhaler.

you may be better but do not leave your inhaler.
People often are worried and anxious about using inhaler. They leave it ontheir own , even on feeling slightly better. This results into flaring of inflammation again in the airways and increasing blockage of airways can again triggor asthma attack.
It is safer option to continue inhaler , disease is more harmful than the continued use,
Research has prooved that inhaled steroids are safe in all ages and prolonged use also does not result into growth retardation in children or bone loss in adults.
So why worry and why be anxious to leave them or experiment about leaving.

Inhaled steroids are safe.

She was just a seasonal Asthmatic without any complications when i first diagnosed her and put her on inhaled steroids. Today when she met me after an year she has become a perennial asthma patient , She had not started the inhaler at all because she feared that inhalers would harm her badly , they would make her short stature and fat etc etc.
some of the friends also gave her the advise not to take inhalers but to go on homeopathy and many other modes exept steroids.
She kept on pulling on as her problem was only seasonal. She had the false sense of security that alternate therapies were curing her till she got into severe attack during the season requiring hospitalization. And now she wheezes throughout the year.
Now she has understood that inhaled steroid is the cornerstone of Asthma treatment.
Inhaled steroids do not have side effects if taken in prescribed doses. They do not retard growth , nor do they cause high blood pressure , diabetes or cataract .
Inhaled steroids are the safest and surest method of letting the anti inflammatory medicine reach the airway where the effect is desired.
Regular and systematic use of inhaled steroids would heal the airways , thus emergency visits would be minimised and potentially harmful drugs like Asthalin and steroids by mouth or injections and nubulisations for emergencies would not be required. Be in control of Asthma with inhaled steroids and improve your quality of life!
Seasonal Asthma is treated in pre seasonal period when you are healthy , it can be prevented and cured with proper treatment.

Respiratory allergy April May.

Festival of Baisakhi brings joy to all but misery to the people whose allergy attacks are triggered in this season. They develop asthma attacks severe enough to be hospitalized , thus farmers missing on work in this crucial period of wheat threshing and children missing exams.
The malady is not confined to only farmers or rural background. Its equally prevalent in cities , in adults and children alike. Even for children this period is crucial because of examination period which they are forced to miss because of severe asthma attacks.
It was previously thought that the cause of this allergy is seasonal pollens. but our research has revealed a new allergen for April May respiratory allergy . This is a component of wheat threshing dust and since it is an inhalant allergen it travels far and wide and affects susceptible children and adults in cities and villages alike and not necessarily farmers. It has to be treated very differently.
This problem is best prevented by treatment in preseason period in February March when patients are not suffering. Its a pity that awareness about this prevention is not there even in doctors!

April May respiratory allergy.

Experience with milk allergy contd...

As soon as Rajeev would return home his fatigued limbs would soothe after hugging and keeping little Rohan in his lap. Little Rohan would scream and Rajjev would cuddle and kiss him more to give soothing touch. Problems persisted. Rohan was off milk absolutely in every form as he was a known case os milk allergy.
The problem was serious and could not be solved in spite of several interviews.
Finlay we decided to visit Rajeev,s work place. He was in Nestle milk powder manufacturing unit. of corse he met us after removing his overall.
I was surprised to find his hair and face covered with milk powder inspite of using overall and cap etc.
I advised Rajeev to take bath including the head bath before entering any room in the house or touching little Rohan,
Surprisingly Rohan and Rajeev thereafter played each day without any trouble.
It was hard foe Rajeev to realize that the surface area of little Rohans body was large enough to absorb the micro particles of milk which were on Rajeev while working in milk powder manufacturing unit, and initiate the allergic reaction!
Importance of milk as indirect contact allergen is highlighted in this case.

Experiences with milk allergy contd.

A baby was undergoing misery in the form of unexplained cry most of the time , rash on body and cough off and on. Needless to say that chest x ray, blood tests , even tests for TB did not reveal any diagnosis. Baby was loosing weight in spite of antibiotics , anti asthma medications etc. In desperation even nebulisers were used to comfort the baby. The doctors thought of giving even empiric treatment for tuberculosis.
Some one who had improved after allergy tests suggested to parents to visit us.
It was no surprise that besides many other tests we tested for food allergies. This baby had allergy to milk and also to soya. Baby had to kept away from these articles. it was hard for parents to accept to keep the baby on rice gruel. Every thing else was done to keep the nutrition perfect. Baby would still become worst on every Tuesday!
Details of family activity brought out an interesting fact that this baby every Tuesday was taken to temple and was fed Charnamrut which is a Gods blessed fluid but consists of milk and curd. The puzzle solved. Baby is now a young child absolutely fine.
Thus even a small contact external or internal make the allergy flare!

Experiences with milk allergy.

A new born started rash on face, running of nose and incessant cry.The skin cracked further and became generalized.
Lot of tests and therapies made the problem only worst. The detailed review at medical history and family history led to the suspicion of Allergy. Since the baby was exposed only to milk diet , mothers and lactogen, he was tested for Milk Allergy which was strongly positive.
Milk was stopped, baby was put on soya milk. yet the baby improved only a little.
The interview of granny revealed that baby was being given milk bath. Family members were educated about the strict avoidance of milk in any form.
Baby had steady dramatiic improvement , caught up growth and development and was saved of disease burden and unnecessary antibiotics , sedatives and other mediicines.

Experiences with Milk Allergy.

Vishal was barely out of his diapers when he started recurrent chest infections. Frequent antibiotics and steroids etc became a part of his life, but the problem was getting worst.
He started to bring out blood from mouth which the doctors thought to be from stomach. They investigated him thoroughly for the GI Bleed . Endoscopy and CT abdomen and several other tests could not conclude any thing. The bleeds were severe enough to require frequent blood transfusions. Helpless doctors and parents continued with efforts.
His father was transferred from Mumbai to Cadbury plant near Chandigarh where an intelligent doctor told him to come for a work up to me for Allergies.
Allergy tests were conducted on this child for inhalant , contact and food allergens, which is not a painful procedure at all!
we diagnosed his condition as Pulmonary Hemosiderosis due to milk allergies. That mouth bleed was not from gut it was bleed from lungs due to slightest of contact with milk and its products in any form.
No option exept to stop Milk from all sources includuing his fathers exposure to Bournvita manufacturing site. His father, now is a high official with Pepsi and Vishal is a handsome lad because of keeping away from milk in any form. His mother an intelligent lady is coming up with new and interesting recipes; without milk ,for growing children. She is happy to share her talents with people in trouble like Vishal.
Next blog would contain more experiences of milk allergies.

Asthma and food allergies.

Asthma is essentially a reversible obstruction of airways. Food goes in the food pipe and not in the airways , thus it sounds strange that how can food allergies may result into Asthma.
Food can affect in many ways. It can by itself result into an allergic reaction for eg milk, peanut , egg , fish , even legumes etc can by themselves cause an asthmatic attack in people who are allergic to these articles.
we have had children who have had even lung bleeding (pulmonary hemosiderosis) after milk intake even in minute amount or in hidden form. People who are allergic to Chick pea have got attack even from inhaling the steam from the pressure cooker when chana was being cooked. Attacks of asthma while playing cards where others are eating peanut even thouh the patient was not eating are well recorded. Sea food allergy too is common.
Food can also be a hidded allergen for instance milk in bornvita and layschips. Wheat in malt extracts and honey in certain medicines , puddings etc.
There is yet another method of food allergy that is thru the shared allergen concept. For eg if someone is allergic to latex will also be allergic to banana and if allergic to birch pollen will also be allergic to apples.
moral of story is to get allergy tested rather than guess work , hit and trial.
After allergy test if an allergen is found , one should read labels on food packets to avoid even hidden allergens. Doctor can put you wise on shared allergens. Food allergy is not necessarily a life long problem , Allergy specialist doctor can put you back on these foods by systematic methods. Asthma can be better controlled and medicines and emergencies minimised if food allergy too is taken care of.

April May Asthma and Allergies.

Please , please start your preventive inhalers regularly even if you have not actually started suffering. The key is not to need emergency inhaler that is asthalin.
The idea is to keep the inflammation resulting from seasonal aerobiological changes under control so that emergency does not arise. you will see that by and by the tendency for airways to remain healthy would increase and Quality of life would improve.
Drink more fluids , play sports, swim , be outdoors mostly.
Asthalin inhaler can be taken 15 minutes prior to sports for uninterrupted efficiency.

Winter for Asthmatics.

Its not necessary that winter could be bad for all asthma patients.
Seasonal allergies are worst in April May or September October.
Perennial allergies persist throughout the year with seasonal aggravations.
Asthmatics do fear winters. Indoor allergens like molds , dust mites etc are more prevalent in winters and compulsion of staying indoors due to chill factor increases the exposure to indoor allergen. Dry heat as generated by electric blowers or heaters where humidity can not be adjusted make the atmosphere worst for the constriction of already susceptible airways of asthmatics. Even if heat is generated by burning coal the smoke causes bronco constriction. There are additional factors like more susceptibility to viral infections like that of influenza and others result into pneumonia , sinusitis , bronchitis, ear infections in children etc making the patient miserable.
Asthma patients should take adequate precautions to keep away from such adverse factors.
This can be achieved by keeping good nutrition and hydration. Drink more fluids in spite of no thirst. Take medications regularly. the high risk category patient should take Flu shots in October itself. Avoid exposure to extreme cold , take walks in the afternoon rather than morning or evening. keep ears and head covered which also forms the large surface area of body. Protect with multilayer clothing rather than using equipment generating dry heat. Do not over clothe children , this can result into fever resulting into unnecessary medication. See the doctor early , and always keep the emergency inhaler of salbutamol in pocket for ready use. Do stay outdoors for fresh air and sunlight which are the natural healers and immunity boosters.