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:
- 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
- Steam inhalation every night before bed (managed this suprisingly successfully today with some much-needed help from the TV fairy)
- Allergic precautions (though I’m damned if I know how one is supposed to avoid smoke and dust in this crazy city)
- 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…