Tuesday, November 20, 2007

About a Sick Little Boy

It’s been a tough three weeks health-wise over here in Chez Ayaan. There’ve been two distinct health issues, one chronic and one acute.

It all started just before we left for Delhi. Actually it started sometime in August, with a cough and a cold that refused to completely go away, especially acting up during the night. Sure, there were times when they subsided somewhat but I cannot remember a cough-free day since August. We tried all of the following:

  • One bout of antibiotics when the cough got really bad. The cough got better but never went away entirely
  • Three rounds of a cough syrup when the cough got bad enough to take him to the doctor
  • Daily doses of a home remedy recommended by the paediatrician in Jaipur – three parts honey and one part ginger juice sprinkled with powdered clove. While this didn’t banish the damned thing either, it was great at soothing the cough and generally helping the little fellow to feel better.
  • Vicks Vaporub on the chest and back before sleeping

Actually, it was not as much a consolidated attack on the infection as this probably sounds. I have to admit that I realised that this had become a chronic issue only just before I took him to the doctor – time just seemed to pass by and there were periods of minimal coughing in between so it really seemed more like 5-6 bouts of cough/ cold that had to be treated in one of the ways mentioned above. But then before we left for Delhi, the cough got bad again and since Ayaan was going to be away for over two weeks, I thought to consult our regular doctor before leaving and that’s when the tubelight in my brain lit up to the fact that this had been going on for an inordinately long time.

When I told the doctor the whole deal, he immediately suggested that I get him x-rayed for adenoids and sure enough the report came back positive for enlarged adenoids. The doctor told me that this was nothing to worry about and that we should follow the following sequence of events:

  • A 4-week course of antibiotics to treat the infection that was causing the adenoids to swell up
  • This was to be followed by a 6-week course of medicated nasal drops
  • If at the end of the ten weeks, the adenoids were still enlarged, he said that we would have to surgically remove them. I almost fell off my chair at this drastic recommendation but he assured me that it was a simple surgery and was only needed in 20% of the cases as the rest of the kids responded well to the earlier two steps of the program.

Now, I did balk at the 4-week course of antibiotics but decided to trust the doctor (who has never shown any previous tendency to over-medicate Ayaan) and in any case, I felt the pressure to DO SOMETHING since we were travelling the next day.

Two weeks later found us in Jaipur for Diwali. The cough had improved but still showed no signs of going away. We would probably have kept going had the acute (unrelated) problem I mentioned earlier not reared its ugly head, forcing us to pay a visit to the Jaipur paediatrician (of the home remedy fame). Obviously, we had to first tell him about the ongoing treatment and he was really surprised at what had been prescribed. His view was:

  • Enlarged adenoids are very common in young children and tend to shrink on their own as they approach 5-6 years of age. And one should wait and watch before going for something as drastic as surgery, especially since adenoids also act as a defense against infections.
  • When kids have enlarged adenoids, this prevents the nasal secretions from draining out and hence causing the perennially stuffy nose. This was compounded by the fact that he had an allergic cough – an explanation for the persistent cough inspite of clear lungs. And the reason why the cough sounded chesty was because of the post-nasal drip thanks to the adenoids.
  • The extended course of antibiotics was not only unnecessary but most likely useless since two weeks of the treatment had still not vanquished the cough. And sincce there was no lung or ear infection present, he recommended we stop the antibiotics right away since they would not in themselves shrink the adenoids. The acute problem (will explain in a bit) made it necessary to stop anyway and so we did
  • He also said the nasal drops were bad idea as well as they were likely to disturb the nose lining and cause it to get inflamed, which along with the adenoids would only compound the problem.

He has suggested we do the following:

  1. Give him an anti-allergic syrup, along with a another one to dilate his airways for a few days every time the cough and cold get bad
  2. Steam inhalation every night before bed (managed this suprisingly successfully today with some much-needed help from the TV fairy)
  3. Allergic precautions (though I’m damned if I know how one is supposed to avoid smoke and dust in this crazy city)
  4. Immediate response to a fever or an ear ache, implying an ear infection, which could be potentially dangerous.

The research on the net kind of supports what he said too. Surgery is recommended only in cases where some of the following symptoms exist:

  • Excessive snoring, which might indicate a blocked airway
  • Trouble breathing through the nose/ noisy breathing
  • Episodes of not breathing during sleep (sleep apnea)
  • Chronic ear infections that persist despite antibiotics

Ayaan is clear of all these symptoms, though he does have a tendency to breathe through the mouth, especially when he has a cold (who can blame him?).

So we are sticking to the Jaipur doctor’s plan for the time being. But this also raises another problem – I need to change my doctor in Mumbai. Other than the fact that I am unhappy with his prescription, I would also find it tough to go back to him having disregarded his advice. And I don’t know where to find another paediatrician who I cam trust. Most of the parents I know in my part of town either go to the current doctor or to another high profile doctor whose appointment book is super-blocked and usually you get to meet one of his junior assistants. I am paralysed into inaction because I don’t know where to start and it’s stressing me out because I don’t want to wait till he gets sick again to begin a desperate doctor hunt.

Now, moving on to the oft-mentioned acute problem. Ayaan got a bad case of food poisoning when we were in Jaipur. Obviously I can’t say for certain what caused it but I’m willing to bet it was the bite of Diwali sweet he had just hours before he started throwing up. It was pretty bad – he threw up almost everything we fed him for two and a half days, got diarrhoea and notched up a fever of 102oF. We finally had to give him an antibiotic and he slowly got better. But even after he got okay, he rejected food for another couple days, even throwing up on purpose when we pushed him too hard. I got worried that he had become a fussy eater and, in my less rational moments, wondered whether it was the JMonster getting me for writing this post.

But thankfully, his good eating habits are back. In fact, he’s eating more than before. I think it helped that I got him back to his schedule and eating habits as soon as he showed signs of returning to normalcy. Even the dreaded TV was used only twice as I realised it only distracted him and made him eat stuff that his body wasn’t ready to take in, and which he threw up anyway.

So all’s well that ends well except Mama’s poor heart that breaks afresh every time she looks at the skinny little bag of bones her son has become and how his clothes fit looser than before. He was never what you would have called plump but over the last few months, I had stopped getting the ‘He’s so skinny’ comments but I guess they will be back to haunt me as soon as I run into a supposedly well-meaning relative or an ill-mannered aunty.

Belated Diwali wishes to you all - hope it was happy. Ours was somewhat less happy – as they say, a picture is worth a thousand words…

45 comments:

  1. Hugs to you and aayan. Call me crazy, but when I read the first few lines of your post when you described aayan's cough, asthama/allergic cough was what jumped to mind. Also, AFAIK adenoids enlargement is VERY common in young kids and they generally do outgrow it. Surgical intervention is required only in case of acute sleep apnea and suchlike. I think a bronchodialator (like albuterol) - Chip is on it as an MDI or nebulizer should help with the symptoms. Asthamatic Cough has triggers, but it not always dust and smoke. It may take a lil investigating to what triggers these coughs. With Chip, his asthama is triggered by a bout of cold or exposure to intense cold. Albuterol does the trick, but if the wheezing continues, he inhales corticosteroids to reduce inflamation of the airways. But don't worry about Aayan.. most kids will outgrow these prblems by the time they are 8-10. Also, there are great homeopathic remedies (Hydra) for post nasal drip.

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  2. Big hugs Ayaan. He looks so very tired in that photo.....I am glad that you put him right back on track with the eating. Some docs kind of jump the gun thinking prevention is better than cure.

    Belated diwali wishes to you too. Pray next yrs would be all funfilled.

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  3. Oh poor Ayaan. Hope he gets better soon. Don't worry about the weight gain, he will be normal soon. Hugs to the poor thing.

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  4. I was going to say it is most definitely allergic cough and I see that dotmom has already given you the low down on allergic cough and treatment options..i did some of that with Li'l A as well when he was younger... it will get better as they grow older.
    So, is Ayaan completely symptom free now?

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  5. He looks so haggard, poor li'l man. Do not worry about the weight, he will gain weight once he gets over all this. Here is wishing him well and you peace. Hugs!!!

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  6. Oh dear, poor baby! He does look quite exhuausted. Hope he's better now.

    I had an adenoids problem as a kid - and the advice even back then was the same - to wait it out. It did get better, but mine didn't quite go away, so I had them surgically removed when I was about 12.

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  7. aw! i feel for you and for ayaan. K has also been having a chronic cold, and one bout of antibiotics didn't make it go either. these kids dont know how to cough out phlegm and i think that's probably the reason why it takes donkey's years for a ENT problem to go away. my hubby is currently in kerala with K and mentioned that K (and he in the process) hardly slept last night due to K's cold disturbing him..anyway robi's dad is taking K to a homeopathy doctor today. will let you know how that goes.....if succesful you could consider that as well!

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  8. Oh my god ! I can't believe you're not me . My son's been having cough since Aug himself. We've done antibiotics, ayurvedic stuff and I've even fought with my MIL on trying homeopathy medicines and how he needs to get out more often to build up resistance. Would love to know what other traditional cures your Jaipur doc suggested. Have you tried ayurvedic or homeo medicines ? I do think surgery should be the last resort.

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  9. Poor guy! Yuck!

    Check with Jaipur doctor (not that other guy), but adding Eucalyptus oil into the steam will help open the airways even further, as well as adding a natural anti-biotic resistance to the regimen. (Use a child-friendly strain of eucalyptus, such as Eucalyptus radiata.)

    I hope you are having Ayaan eat lots of yogurt or curds now that he's been on all those antibiotics? A good probiotic supplement might be good, too, to replenish all the good gut bacteria that got killed off with the bad. It will help him get back to normal better, and not leave him as open to other infections. (If you can get him to eat some lacto-fermented chutneys or something, too, that would help.)

    It's so hard when they're sick, and there seems to be so little you can do about it. Good luck in finding a wiser doctor in Mumbai!

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  10. ooh, poor dear. take care. why don't u try homeopathy for a while/ biochemic.. slow but steady

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  11. [Dotmom] Thanks for all the advice. One of the syrups I mentioned is a bronchodialator. He was much better after that but I stopped it day before yesterday and he's back to coughing. I can't keep giving him the medicine endlessly. You are right about the homeopathy - I am on the lookout for a good homeopath.

    [Shobhana] Well, the tiredness is definitely not a problem anymore. He is back to his usual hyperactive self...

    [Chickoo/ Anitha] I know but at some irrational level, I feel like a bad mother when he's thin :(

    [Orchid] Unfortunately, no. As soon as I stopped the syrups, the cough has started creeping back in

    [Moppet's Mom] 12 is a much more acceptable age for surgery than 2.5 and I would be much more comfortable doing it at a later age, when all other options have been exhausted.

    [Lawyermama/Minka/Itchy] I am looking at homeopathy as well but need to find a really good doctor as a wrong diagnosis/ treatment could actually worsen things.

    [Talena] Will check out about the eucalyptus oil and the probiotics. We are giving him. Thanks. And what are lacto-fermented chutneys?

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  12. poor thing....somethings in the air and Kaju is recovering from Pneumonia...and scared like hell now that past 2 days it has been pouring cats and dogs in madras and kaju is back on her respiratory issues.....

    god bless Ayaan and man it breaks our heart to see our kids go through such pain when they cant even explain it clearly....:(


    i guess let us start a mutual prayer club...

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  13. Oh poor dear! I do hope you get another--more old-fashioned maybe--doc for Ayaan in Bombay soon. Allergies are apparently very common now among children, more so in cities. I'm told that there really is no problem having anti-histamine medicine for quite a while. Hope he gets well soon

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  14. Anonymous3:34 pm

    try dr aspi irani --his clinic is in lokhandwala. he was my paedritician and now my son's...very dependable and well-known.

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  15. rohini......
    ayaan looks so weak and tired....last weekend A was down with ear infection. he woke up in the mid of the night and cried his lungs out. he would pull his ears, look into my eyes and say mamma, mamma, as if asking me to cure his prob....but mommy cldnt do anything. it literally breakas your heart to see the lil one in such pain. took him to the doctors on sat morning and het got a shot of antibiotic. he is fine now.......
    i wish aayan a quick recovery....
    hugs

    J

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  16. A big hug to you and Ayaan. It's good to know that he's slowly trudging towards normalcy.

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  17. Poor Ayaan! Good to hear that he's feeling better. Sometimes simple remedies work the best.

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  18. oh dear. its totally awful when kids fall ill. just yesterday a friedn was telling me how her 6 mo old is constantly coughing and she is at her wit's end as to what to do. phew.

    adenoid enlargement is indeed very common - my nephew and two kids of friends here have them. all 3 moms swear by a homeopathic remedy - helps alleviate symptoms plus apparently cures it in the long-term.

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  19. Ayaan looks very dull in the pic. Hugs to him

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  20. Hi

    Delurking for the first time here. Had t tell u this that my son (now 5) was also suffering from this cough which persisted for 3 months on & off...But our doc didn't prescribe any antibiotics for him as his chest was clear..it was purely allegic cough. We finally literally ordered the doc to have my Son's blood test done as he had become very scrawny by then (inspite of him eating quite ok)...which turned out to be normal othr than the high level of easnophils...which clearly showed that it was allergic....Yr jaipur doc is absolutely right & those were the points our doc said too....Also asked us to completely avoid woollen clothes & blankets for the kids esp the allergic kids. Instead if very cold he suggested using 2 or 3 layers of clothing.
    Pray Ayaan recovers soon.....
    Sinu

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  21. [IBH] Oh poor Kaju... hope she's better now?

    [Hillgrandmom] The search is on...

    [Anon] Thanks for the lead. Could you give me his clinic number?

    [Jayashri] Glad A is better. Ayaan is better but the cough is starting to creep back in

    [Megha] Thanks :)

    [Naina] Yeah, hoping the steam will have some effect

    [Choxbox] Agree but need to find a good homeopath

    [Timepass] He looks better (though thinner) now - I should do an after picture :)

    [Sinu] Thanks for delurking to share that... we don't use woolens thanks to the equitable Mumbai weather. I guess I have to keep looking for what causes it

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  22. some one said eucalyptus and I second that. its quite amazing what a few sniffs can do. Also of he eats fruit at night after say 7:700 pm, try eliminating that. When my mom told me this, I resisted, but I thought, why not give it a try and it works!!!

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  23. Awwww! LOTS of get well hugs to lil Ayaan! hope he's better now and the medicines are working fine. it's terrible when the lil ones fall sick.

    And wish y a happy belated diwali!

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  24. Anonymous1:31 pm

    hey rohini, is there an email id i could reach you at for dr irani's number? i am uncomfortable putting it up online. or try justdial.com for the numbers -- you should be able to get it.

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  25. he looks so dull- hope he is better now.

    did the diwali crackers aggravate it?

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  26. Oh no. Glad to hear he's better and got his apetite back.

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  27. glad to hear he's doing better. he does look exhausted in that picture. poor baby.

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  28. Oh poor little man! I agree with DotMom, as soon as I read the first few lines I thought of allergic asthma. See, in Cal the pollution is so nasty, all kids (and adults) cough all winter.

    I'm glad you guys found a doctor who took the time to figure out what was really going on.

    My two cents (based on the many chronic illnesses on my side of the family) -- honey, ginger, tulsi, neem etc. are best used as relief, better than allopathy (so long as you think they are working) because kids don't become immune to their effects. Also, I'm becoming a great believer in homoeopathy.

    Poor man. Do give him a cuddle from me.

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  29. Oh dear he looks really tired after all that. I'm glad you found a sensible doctor. He'll be back to his usual self shortly.

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  30. That's quite a rough ride for him, poor little guy. He does look tired in that picture. Trust that he would have regained a lot of his energy by this time. Glad you are considering homeopathy. Its the best alternative, really.

    Btw, wanted to wish you a very happy anniversary. Hope it was a good day for you and J. Youguys share an anniversary with Poppins too. :) Have fun.

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  31. Hope Ayaan is better now. He looks so paavam in that photo. Give him an extra hug today from me.

    Wishing you a happy Anniversary!

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  32. late to this post...believe it or not, K recently went through a very very similar set of chronic-acute infections. he was coughing endlessly, and suddenly in the middle of nowhere had a diaherrea, then went back to coughing. we are on homeo, and it helps somewhat.

    hope you find a good doctor soon and glad he's eating more...he'll fill in those skinny clothes soon.

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  33. Hi Rohini,
    I hope Ayaan is much better now..all the little ones i know alongwith mine keep having these bouts on and off and it really breaks ur heart to see them suffer :-(
    Hugs and Best Wishes :-))

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  34. Poor baby! Hope he's a little better now. My friend's son had his adenoids removed. He's a lot better now.

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  35. hi rohini, hope ayaan is better now.

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  36. [Dotmom] Am trying to figure out a reliable source for the eucalyptus oil. And the only time Ayaan has fruits is in the mid-morning.

    [Aqua/ Squiggles Mom/ Kodi's Mom/ Anu/ Big Zed/ Ranjit] He got better but the cough and cold have sruck back in the last couple of days... :(

    [Artnavy] The problem has been on since August, much before the Diwali crackers raised their ugly head

    [Anon] Hi. My mail ID is up on my profile page

    [Mumbaigirl/ Mona] Thanks

    [Sue] Thanks for your two cents. The honey-ginger-clove thingy that I give him really does help soothe him

    [Itching/ Sue] Oh no, not again!\

    [Tharini/ Boo] Thanks for the wishes

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  37. I came across your blog from some other Mommy Blogger and I really like the idea of Mommy Blogging. Its so much fun and informative to read about growing kids and the issues that moms face. Do keep up the good work.

    -Tarun

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  38. Anonymous10:50 pm

    I just read this post and I just wanted to tell you that I had the same problems as a kid ..and 7 out of 8 doctors in Calcutta recommended surgery. One doctor recommended some homeopathy and said that I would outgrow it and by the time I was around 10....I was fine. So ...hang in there :) !

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  39. hey Ro, hope Ayaan is feeling better now...

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  40. Rohini - just read this post. I was nearly in tears - I have such low tolerance when it comes to seeing kids in pain - esp ones I know...and that picture just broke my heart - he looks so tired. Enough advice has been given in a lot of comments here and am sure you are doing everything you can to make the situation get better. My niece/nephew all used Albutrol for allergic/asthma cough. It feels soo bad to see your child coughing - I went through it when KB coughed non stop when he got a respiratory infection when I was visiting Chennai.
    I hope Ayaan gets better soon - I know it's not fun dealing with the comments on top of all this - oh my god, he looks so thin, oh my God, is he really 2 etc etc! I hate those comments!
    Anyway - good luck!
    Here KB is saying "Computer Vendam" (no comp)- so I better log out!

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  41. Sorry for not check on the follow-up comment for so long! It's probably too late now. But anyway, lacto-fermentation is a method of preservation using "good" bacteria. Usually you use whey (strained from curds or yogurt) and mix it in and leave on the counter for 2-3 days. With this method, you do not want to use tons of sugar in the chutney, as it will simply ferment alcoholically. Ditto on a very sweet fruit chutney. (I made a pineapple chutney this way once--I think it may have been too warm in my house, or something, 'cause there was definitely more than one kind of fermentation going on!) Lacto-fermented fruits and vegetables tend to be a little bit sour, like sauerkraut (which was originally a lacto-fermented dish). Also, you do not need to use vinegar because the preservation and sourness both come during the lacto-fermentation process.

    For an article about lacto-fermentation and how it works (with chutneys specifically mentioned), check this out.

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  42. May he be healthy very soon.

    -Tarun

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  43. This really briught back memories of S' problems with Adenoids when she was about Ayaan's age. I thought I had left a comment here but it seems like I didn't (I blame it on sleep deprivation!). I am going ot email you.

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