Dealing with Asthma: Denial, Acceptance and Lessons Learned

Over the last couple of months my son Rohaan aged 3 years 10 months, has been showing symptoms of asthma. I have never known anyone in my family to have asthma. My mother in law has asthma. But that’s something I encountered after my marriage. In my understanding, asthma was a disabling thing that usually struck at inconvenient times and prevented you from having any fun. The first indications of Rohaan’s asthma were when he was three. My mother noticed him straining to breathe when he had a cold. She pointed it out to me. I refused to even entertain a thought that he might be asthmatic. I brushed it off saying ‘his chest is congested because of the cold’.

Then when he was about 3½ years, my husband took him to visit his hometown near Thalassery, North Kerala. He ended up with a bad cold and severe wheezing. At my mother in laws insistence, he was admitted in a hospital and given nebulization. I was still in denial and said it’s just because of his bad cold. Asthmatic children have breathing problems even without colds and Rohaan has had a bad cold every time he had to strain to breath.

I finally had to face the truth when we shifted to Cochin and he developed breathing problems. This time, he seemed to have a bad cough, but no congestion. He vomited everything he ate. He wanted to eat, but he vomited even the water he drank. My husband was out of station and I was 6 months pregnant. I also had a two year old daughter to take care of. I wasn't feeling up to travelling to the hospital. I hoped it would be a minor problem and gave him some pediatric anti-vomiting medicine and a cough syrup.The first night, his breathing seemed quite strained and I was really worried. But by morning, he seemed fine. The vomiting had thankfully subsided, though the dry cough lasted a week. He had just about recovered when the same problem recurred and this time, I rushed him to the hospital. His pediatrician confirmed that he was asthmatic and that his cough was not an infection, but part of the breathing problem. It seems, the cough in turn triggers the gag reflex, which is what made him vomit. The doctor assured me that this was just a childhood problem and he would outgrow it by the age of 10. I spent the day in the hospital pediatric ward where they gave him nebulization every hour for up to 6 hours.

His current asthma trigger is the dampness of the house we are living in. It’s a beautiful and spacious sea facing apartment on the 7^th floor. But due to heavy monsoons and some maintenance issues in the apartment, there is water seepage from the ceiling. The dampness gives rise to mold and fungus. 

I researched online to correct my misconceptions about asthma and to learn the real facts of this medical problem. Here is a compilation of my research.

What is Asthma?

Asthma is a chronic disease that causes airways that carry air in and out of the lungs to become inflamed and swollen. Wheezing, coughing, chest tightness and shortness of breath are the common symptoms. It is believed to be caused by a combination of genetic and environmental factors. The diagnosis is usually based on pattern of symptoms and response to therapy over a period of time.

Common Symptoms of Asthma

Common symptoms of asthma are:

• Cough: Coughing due to exposure to cold air, after physical exertion or during night, especially without phlegm can be a symptom of asthma.
• Wheezing: a high pitched whistling sound produced when air breathed out through the obstructed airways during an asthmatic attack.
• Shortness of breath: mild physical exertion may produce breathlessness in asthmatic people and they may have difficulty in recovering from it without medical treatment.
• Tightness in chest: A constricted feeling in the chest as if some pressure is placed on it.

Identifying Asthma Triggers

• Viral Infections can trigger asthma. Respiratory syncytial virus and parainfluenza virus are two common culprits.
• Passive smoking can trigger asthma symptoms in people with the disease.
• Environmental Allergens like smoke, dust, mold, animal hair, pollens, chemicals, preservatives, etc
• Other irritants include paint, smog, air fresheners, perfumes, etc.
• Dietary allergens like dairy products, wheat, eggs, nuts, etc
• Exercise induced asthma is triggered by physical exertion.
• Weather changes, cold air, wind or rain can sometimes trigger asthma.
• Asthmatic triggers maybe allergic or non allergic. 

Diet tips for children with Asthma

• Food allergies can trigger asthma. Common allergens that may affect asthma are milk, cheese, wheat, yeast, preservatives and colorings.
• Fruits and vegetables contain antioxidants that boost the immune system.  So include at least three to four cups servings a day.
• Findings reported in European Respiratory journal quote that children who consume more calcium are less likely to get asthma.
• Magnesium also has anti-asthmatic properties. Just two cups of milk a day provides 75% calcium and 50% magnesium requirements for a child between 4 and 8 years.
• Magnesium is found in cereals, beans, fish, nuts and green leafy vegetables.
• Fishes like salmon, herring, anchovies, etc have high omega 3 content and are helpful in anti asthmatic diets.
• Whole grain cereals, oatmeal, etc are also helpful dietary components against symptoms of asthma.

Natural Remedies for Asthma

• Dietary asthmatic triggers like wheat, chocolate, preservatives, etc should be identified and eliminated from the diet.
• Keep stress and anxiety to minimum.
• Include vitamin C. magnesium and calcium in the diet.
• Drink chlorine free water as chlorine is believed to irritate receptors in the lungs.
• Identify and eliminate contact with environmental triggers such as smoke, pollen, mold, pet dander, etc.
• Invest in air filters and vacuum cleaners at home for efficiently filtering allergens.
• Yoga and other forms of meditation can improve immunity, strengthen the lungs and improve breathing.

Can asthmatic children have ice cream?

Ice cream does not trigger asthma in all children. Some children who maybe allergic to dairy products may have problems with it, but many other asthmatic children seem undisturbed by it. It is definitely not advisable to have ice cream in cold weather or while the child is suffering from a viral infection as this may lead to increase in infection. Cold water or ice cream immediately after physical exercise is also not recommended. Eating ice cream under normal circumstances and in small slightly melted quantities is usually not harmful. 

Here are some useful links:

For controlling asthma triggers

Types of Cough

All You Need To Know About Ear Piercing Infections

What is an ear piercing infection?

Children tend to touch their earlobes with dirty hands which may lead to infection in ear piercings. Yellow or white discharges, swelling, tenderness and pain are the common symptoms of an ear piercing infection. Fever may accompany the infection along with swelling of lymph glands in the neck and along the jaw line. Earrings that are too tight may reduce blood flow to the earlobe and promote the infection. Dirt lodged inside the earring, especially on the backside aggravates the infection. Inserting earrings at the wrong angle may scratch and wound the channel leading to infections. With proper care, the infection clears up in about two weeks.

Causes of pierced ear infections 

• Handling ear piercings with dirty hands. 
• Frequently fiddling with earring using unclean hands. 
• Using un-sterilized equipment for making piercing. 
• Using un-sterilized earring posts during new piercings. 
• Earring that are too tight and don’t allow air circulation. 
• Cheap earring with rough areas that wound the channel and cause infections. 
• Using earrings made of materials like nickel that may cause allergic reactions. 
• Sharing of earrings is not a healthy practice. 

Treatment for Ear Piercing Infections 

• Use an antibiotic cream prescribed by a doctor. 
• Take antibiotic tablets if the problem is severe. 
• Continuing to wear the earring is believed to ensure proper pus drainage and prevent abscess formation. 
• Ensure your earring is of good quality and non allergic if you are not planning on removing it. 
• Clean the earring and piercing with antibacterial soap twice a day. 
• Re-insert the earring or post after applying antibiotic cream on it, to prevent the piercing from closing up. 
• Continue using the antibiotic cream for a few more days even if the infection seems to have cleared up. 
• Keep the area dry as possible. 

Prevention of Ear Piercing Infections 

• It is recommended that the child is at least four years old before the piercing is done, so that she can take better care of the piercing. 
• Prevent touching the piercing or earrings with unwashed hands. 
• Have a doctor or a professional piercer do the ear piercing. 
• Do not attempt to do it yourself. 
• Ensure the ear piercing equipment has been disinfected before usage. 
• Use hypo allergic jewellery like 14 or 18 carat gold, titanium, etc for new piercings. 
• Earrings maybe changed as often as pleased after the initial six weeks of a new piercing. Allow that much time for proper healing. 
• Avoid wearing tight earrings and provide some airspace on both sides of the earlobes. 
• Discard earrings with rough spots that may cause injuries to the channel. 

After care Instructions for newly pierced earrings 

• Do not remove the post for 6 weeks to allow the channel to heal well. 
• Turn the post for around three rotations twice a day. 
• Ensure your hands are clean before touching your piercing. 
• Avoid touching the site unnecessarily to prevent infection. 
• Clean twice a day, removing any crust formation using a cotton swab moistened with antibacterial soap. 
• Clean with clear water and then ensure the area remains dry. 
• Disinfecting with alcohol or peroxide is not recommended as the surrounding skin may dry out. 
• Prevent hair or any clothing from brushing against the pierced site. 
• If an infection occurs, shift to a hypo-allergic earring to ensure the piercing doesn't close up. 
• Vitamin C and multivitamins encourage faster healing 
• Avoid head showers or swimming during the first couple of days, if unavoidable, then ensure the pierced site is cleaned and dried at the earliest. 
• Ensure clean bedding and pillow casing to prevent infecting the piercing.

My Two Year Old Has Ear Piercing Infection!

My experience in dealing with ear piercing infections, its causes, treatments, prevention and after care instructions.

By 5 am, early morning, Tania woke up in tears. She just wouldn't stop crying. I checked her all over to see if something had bit her or to find if there was anything else that could be a problem. I kept asking her whether it hurt anywhere. How does a two year old tell you her problem? I couldn't find any answers. Something seemed to be bothering her and she was really cranky. 

By around 7 am I noticed she seemed to be rubbing her hair. I checked the scalp to ensure there were no wounds or bumps. Nothing! A little later I figured it’s her ear that was the problem, it just that when she was rubbing the ear, the hand kept moving into the hair. Ok! Ear infection, I decided. So off she went to the hospital. The pediatrician after a thorough check up couldn't find anything particularly wrong with her or her ears though she was unusually cranky and fidgety throughout the examination. He finally gave some drops to dissolve excess earwax in case there was any and asked us to show her to an ENT specialist the next day.

Once we were home, I removed her earrings thinking it might make her more comfortable and prevent any chances of injury when she rubbed her ears. Behold! A glistening yellow tinged ring circling the piercing. She had developed an ear piercing infection!
As common to our culture, her ears were pierced when she was around 3 months old. She wore those hypo-allergic studs for 3 months after which she had these lovely little gold earrings. She was nearly two when she managed to lose one of them. My mother-in-law gifted a lovely pair of tiny silver studs with a small white stone in the center. She has been wearing these for the last 6 months or so. I’m not sure what has caused the infection. It maybe allergy to the silver or maybe there are other reasons.

I cleaned up with soapy water. Shaved off some bits from a toothpick to adjust it to the hole size, dipped it in antibiotic cream and put it into the hole to ensure it doesn't seal off while it heals. In my childhood I remember my mom using these tiny bits of sticks from coconut leaves to insert into our infected piercings. We were just supposed to keep them clean and allow exposure to fresh air to heal them.

I spent the afternoon reading up on whatever I could find on ear piercing infections, their causes, their prevention, the treatment, etc. My next submission will be the compilation of my research on ear piercing and its care. I hope others will benefit from a comprehensive article with all necessary information on the topic.