And The Cough Goes On

Do you have an untreated cough that has lasted for several weeks? If so, you are not alone. Many patients in my practice have been complaining about a cough that does not seem to go away. I have seen more of it this year than in other years, and it started back in November of last year.

Typically, one would have an episode of bronchitis, sinusitis, or the common cold, which may have been treated with a course of antibiotics. The initial symptoms then partially or fully resolve. A few days or a week later, the nagging cough develops, and is commonly referred to as “post infectious cough.”

The cough may be “productive” (producing mucus), or it may be “dry.” It can occur during the day, when you’re lying down at night, or throughout the night. In more severe cases, the cough will come in “volleys” (paroxysms), and will awaken you, or even frighten you. It may be associated with a post nasal drip or gastric acid reflux. Some medications, particularly some of the medication used for the treatment of high blood pressure, can cause a persistent, dry cough.

The underlying reason for the cough is an inflammatory process which affects the linings of the bronchial tree leading to the lungs. It’s similar to the process responsible for bronchial asthma. It is thought by some authorities that, when left untreated, this condition can leave you predisposed to a recurrence, or even trigger the new onset of asthma.

When the cough lingers, you should be examined by a physician. This is especially important if you have a chronic condition such as asthma, chronic bronchitis or heart disease, and even more so if you have an impaired immunity, take immune suppressing medications, or are a smoker.

In treating the persistent cough, the physician must make sure that conditions other than post infectious cough are ruled out, such as pneumonia, asthmatic bronchitis and the whooping cough (pertussis).

Once other causes have been ruled out or treated, the post infectious cough will resolve on its own. But it may take weeks, and I have seen it last for months. Treating it will generally shorten the duration and severity of the post infectious cough, and should make you feel better much faster.

So, when you develop a lingering cough, don’t just tough it out, have it evaluated medically, and treated if necessary. See your primary care physician or pulmonary specialist!

Homeopathic Treatment for Asthma – The Safer and Smarter Alternative

With rapidly increasing air pollution across the globe, especially in urban and industrial hubs, there has been an alarming rise in the incidence of asthma and other respiratory illnesses all around the world. According to conservative estimates, at present around 300 million people in the world are in need of asthma treatment, and this number is expected to rise by another 100 million by 2025.

The characteristic feature of Asthma is an excessive reactivity of the respiratory system (main wind pipe and its numerous branches) to a variety of external stimuli resulting in their narrowing and constriction along with increased secretions. These changes result in the following typical symptoms:

Breathlessness
Cough
Wheezing

There may be an initial constriction feeling in the chest prior to the actual onset of symptoms. The common allergens that provoke an asthma attack include dust, pollen, moulds, change of weather, pet animals, chemicals in air or food, tobacco smoke, stress, etc.

Traditionally, asthma treatment involves the use of bronchodilators, steroids, and nebulising agents (in oral, inhaler or injectable forms) to relieve the constriction and narrowing. These asthma treatments help in achieving a certain degree of control over the symptoms. However, there is no conventional asthma treatment to reduce the excessive reactivity or sensitivity of the airways.

Thus, it is a well recognized fact that despite spending billions of dollars on asthma research worldwide, Asthma treatment remains one of the toughest challenges for the medical fraternity. An attack can be easily precipitated by the presence of triggering factors.

The world today is shifting its focus towards homeopathic treatment for asthma which aims at reducing the excessive reactivity or sensitivity of the airways towards harmless environmental factors.

Homeopathic treatment for Asthma reduces the hypersensitive response by modifying the patient’s immune system. This causes marked reduction in severity of the attacks. Homeopathic treatment for asthma focuses on treating the patient rather than merely treating the symptoms of the disease. Thus, homeopathic treatment for asthma helps in regulating the immune system of the patient rather than suppressing it.

Homeopathic treatment for Asthma includes a detailed study of the patient’s case history in order to find out the patient’s individuality that distinguishes him/her from others. Once the patient’s unique portrait has been painted in minute detail, then the remedy that closely matches is selected as the right remedy.

Asthma treatment with such a remedy then gradually brings about a marked improvement in the patient’s symptoms providing him with initial relief. However, more importantly, such a well selected remedy then begins changing the patient’s immune response and reduces the oversensitivity or reactivity over a period of time. Thus homeopathic treatment for asthma brings about a rapid, gentle and permanent cure in the patient’s asthma.

Apprehending Asthma

“We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right – one after the other, no slipups, no goofs, everyone pitching in.” – Atul Gawande, surgeon and journalist

Since I have talked of colds and allergies I guess it is natural to feel compelled to discuss the challenges a paediatrician faces with managing asthma. My moment of truth came when a close friend of mine broke down as I was nebulizing her nephew. I knew that she had outgrown wheezing episodes as a child and I expected her to be reassuring by virtue of her experience. When I asked her to explain herself she said, “The fear you feel when it becomes increasingly difficult to breathe, it’s horrible… I know what the child must be going through, can’t help feeling bad for him.” That’s when I guessed that it’s this panic that actuates so much of absurd behaviour and decision making. So let me share some facts to allay some of it.

First of all being asthmatic means you have airways that are hypersensitive and prone to becoming narrowed because the surrounding tissues get bloated as a part of the rabble rousing response of the immune system when it encounters some triggers. Asthma attacks come and go, with wide variation in the symptoms at different times. Many people with asthma have problems only occasionally but others struggle with it every day. There is no cure, the focus should be on control, and it can be achieved. What we aim for when we say control, is generally

An ability to live an active, normal life (which means performing daily activities, play, and participation in sports without difficulty)

Prevention of chronic and troublesome symptoms

Zero school absenteeism because of asthma related symptoms

Avoidance of symptoms during the night

Stopping the need for urgent visits to the doctor, emergency department, or hospital

Prescription and adjustment of medications to control asthma with little or no side effects

Secondly, not all wheezing is asthma. About half of infants and toddlers with repeated episodes of wheezing with shortness of breath or cough (even though these illnesses usually respond to asthma medications) will not have asthma by the age of six. Because of this, many paediatricians use terms like “reactive airways disease” or “bronchiolitis” when describing such children instead of labelling them as asthmatic.

No one really knows the exact reasons why more and more children are developing asthma in recent times. Some experts suggest that children spend too much time indoors and are exposed to more and more dust, air pollution, and second-hand smoke. Some suspect that children are not exposed to enough childhood illnesses to direct the attention of their immune system to bacteria and viruses and therefore, develop allergies (the so called “hygiene hypothesis”).

We also find many parents hesitant to give inhaled asthma drugs or liquid medications delivered with an asthma nebulizer, also known as a breathing machine. I wish parents would take the time to educate themselves (the resources being so accessible) and have clear concepts in their minds because only then can they motivate children to be regular with medications and not feel self-conscious while taking them. This is very crucial.

Asthma in children is handled using very specific guidelines, depending on the severity and duration of symptoms. The medications given fall into two categories. One category includes drugs taken daily that are meant to control asthma in the long term and reduce the frequency of asthma attacks (controller or maintenance medications). The other category is medications that provide instant relief from symptoms (rescue medications). Steroids are a vital part of the list too. Very short oral courses (three or five days) or long term inhaled preparations seldom cause alarming side effects and there is no need for trepidation. In general, doctors start with a high level of therapy during an asthma attack and then decrease treatment to the lowest possible level that still prevents asthma flare-ups and allows your child to have a normal life. Every child needs to follow a customized asthma management plan based on the severity and triggering factors so do not compare it with another.

So the essential parts to managing your child’s asthma are Identifying and Controlling Asthma Triggers, knowing when to anticipate flare ups and having a clear plan of action to handle it, being regular with medicines and periodically updating your knowledge with your doctor.