Allergic rhinitis?

[babybubot]

hi doc leletmd, kagagaling lang namin sa dermatologist para sa impetigo nya sa batok, binigyan sya ng ointment yung mupirocin then allergologist for his allergic rhinitis. 3 months continous medication sya ng montelukast and allerkid plus meron pa syang muconase. Impress ako sa allergologist na tumingin sa kanya lahat pinaliliwanag at tinatanong ako kung may concern pa ko (actually di ko talaga alam kung ano itatanong ko bukod sa nasabi nya na lahat). Thank you so much sa mga advice mo Doc.

[Mommy P]

 
  @ thank you doc leletmd

           I was kinda hesistant to give the antibiotics at first considering, di naman masyadong na explain yun assessment ni dr canlas. I only told him na Baka nahawa ang baby ko saakin kaya nagkaroon ubo't sipon, he check my baby's breathing via stethoscope, then bigay na nang reseta, not sure Kung nagmamadali siya since Marami siyang pasyente.

        Honestly, I trust him considering maraming good feedback sa kanya at Marami talaga siyang pasyente but with my baby not really sure if Mali ba na pinAtingin ko siya na dapat sa " pedia-pulmo" ko siya pina check up so maybe the pro biotics would be discussed. I understand dr. canlas lacked of explanation with regard to the reasons behind the meds given to my baby considering Hindi naman siya pediatrician na na dun yun parang caring aurA with regard to a baby patient.

       I' m a first time mom kaya I have my missed then, but given a chance and next time, I will go see a pediA-pulmo na Lang for my baby...

     The reason for the slimy stools is because, he is swallowing his mucus and  Baka sa Monday, will go to a pedia to check my baby!

    Thank you doc leletmd for the advise, you are an angel to us "first time moms".

[leletmd]

@babybubot:
I am glad that you were able to bring your baby to an allergy specialist already. I hope he responds to the medications.

@Mommy P:
I do not think you were wrong in bringing your baby to an allergologist, instead of pedia pulmo (no offense meant to pedia pulmonologists).
Dr. Canlas is an excellent allergologist and well respected in our field. Maybe nagkulang lang ng explanation due to the bulk of patients.
There are pedia allergologists in Makati Med, si Dr. Tiza Santos - Abes and si Dr. Marysia Recto (at medical plaza makati naman). Both are excellent allergologists as well.
In my opinion, it is best for your baby to be evaluated first by an allergy specialist to rule in/rule out allergic rhinitis at this point.

[artemis26]

I was kind of disappointed when I brought my kid to be checked by Dr. Danilo Alcantara at Healthway SM North. Siguro the timing must have been "wrong" (about a few minutes before the end of his clinic sked). I made kwento about the frequent bouts with sipon/ubo na per her regular pedia is allergic in nature. then I asked if, at her age of 3.5 years old, she can be considered at risk for asthma. He mentioned that asthma testing is for 4-5 years old. And went on to discuss about the possible factors of allergic rhinitis, ie triggers such as weather, dust, etc. Gave us some advise (which I already read about her thanks to sis leletmd). Tapos nagreseta ng Zyrtec, without even CHECKING OUT MY KID, yun bang usual na routine ng mga pedia? Like he never touched my kid at all the whole time we were at his clinic. Maybe he was bored. Sayang, waste of money lang And lahat naman ng sinabi nya, nothing new at all since sis leletmd has already discussed here.

pasensya na for my rant.

[leletmd]

@artemis26:
I am sorry to hear about your experience with Dr. Alcantara. I know him to be a very good allergologist, but clarify ko lang, he is not a pedia allergologist kasi. He is an IM allergologist, but as an allergologist, we are trained to see/diagnose/treat adult and pedia patients.

[agape]

@artemis,
Same, same Lang naman halos ang nirereseta for allergies.
Kasi konti Lang naman ang derivatives/ gamot sa allergies. Memorize ko na nga e.

[artemis26]

Yes, i knew before hand na hindi sya pedia allergologist, sis leletmd Yun lang nakakaturnoff was that he only assessed my kid thru our narrative, wala man lang yung usual na check-up? ganun ba talaga? even though that time may sipon rin yung anak ko. Oh well, siguro next time agahan na lang namin ang punta, kasi baka gusto na rin nyang umuwi that time.

@agape. Yes sis, I am also familiar with the meds for allergies, so I did not have a question with his prescription. The only think I found off was yun nga, wala man lang examination muna nun bata before mag-prescribe.

[leletmd]

@artemis26:
Sorry, I thought that you thought he was a pedia allergologist since you said: "yun bang usual na routine ng mga pedia? "
Anyway, medications should be given based on a good history and a thorough physical examination so meds should not be prescribed based on a narrative alone.

[Aleph120112]

Hi.. Bago po ako sa site na to.. My son is turning 4 months this april 1, 2013 and he's with my mom sa province.. less than a month pa lang sya ng ngkacough and colds, yung resita sa kanya was ambroxol and antibiotic after siguro two weeks naging ok sya.. Mga 3rd week of january nagkaubo nanaman sya pero salbutamol nebule lang ang nireseta ng pedia.Mga mid of FEB nagkaubo na naman sya as per my mom cefaclor resita and ambroxol medyo naging ok sya..pero last March 12  sa ibang pedia sya dinala ang nireseta is Cefixime Triocef 10 days and Citirizine for 1 month tapos nebulize ng salbutamol...naging ok yung ubo and colds ng konti but according to my mom as of today meron nanaman syang ubo at sipon... May history din kasi ng asthma and allergic rhinitis.. Worry [textspeak!] kasi ako kasi na dedelay vaccine ng baby and also bakit hindi gumagaling.. I'm planning na dalhin sya dito ulit here in Manila kasi wala akong kilala na pedia allergologist sa albay..So need ko your suggestion..hindi na ako makatulog kasi worried talaga ako sa baby..And I remembered also sabi ni mom mas lalong inubo ng inihiga sa foam.. I'm thinking na possible may allergy sya.. So inask ko  sila na palitan yung beddings pati mismo yung higaan and clean up the house..

[leletmd]

@Aleph120112:
It is quite early for your baby to be diagnosed with either Allergic rhinitis or asthma. However, your baby already has 2 main risk factors (early introduction of antibiotics and your family history of asthma and allergic rhinitis) so kailangan talaga siyang bantayan dahil there is a likely chance he will develop allergic diseases early on.
As far as I know, there is only 1 allergologist practicing in Albay: Dr. Edmund Wong. Not sure though if he is a pedia or IM allergologist.

[jess_121009]

Hi Doc Lelet! I hope it's not OT. My son who is currently 16 months is frequently coughing at night (it started nung sobrang uminit na yung panahon, around last week of Mar). Wala siyang cough throughout the day pero pagnagstart na yung hapon and habang natutulog siya sa gabi nagigising siya dahil inuubo siya. We were in montelukast (singulair) for more than 3 months na pero it seems na hindi rin nawawala yung attacks niya. He was diagnosed of allergic rhinitis na rin since at night naririnig namin yung pagsinghot niya na parang may sipon na wala naman kapag araw. He was checked by a pedia-pulmo yesterday and we were told to manage it with seretide for 3 months since montelukast is not enough. While backreading, I read that asthma can't be diagnosed this early. If that's the case po, pwede ko lang po mahingi yung opinion ninyo if tama na po ba talaga na magseretide siya at this early given his symptoms, or should we still get a second opinion? Meron din po siyang pedia-allergologist (kung sino po ang available yun po ang pinupuntahan namin) pero maski rin po siya she diagnosed my son having allergic rhinitis before and prescribed montelukast. Do you think po we should also see her to also know if they have the same assessment? Thank you po..

[leletmd]

@jess_121009:
There are special situations where we diagnose asthma early in life and classify it as infantile asthma.
Example would be a child with a very strong family history of allergy/asthma who has episodic cough (usually morning and night time) which is recurrent and usually related to exposure to allergens such as house dust mites. The rest of the day, kapag di exposed sa allergens, the patient is usually fine.
Based on your post, your son sounds like he has an allergic cough that may really be asthma or related to allergic rhinitis. Why? Cough is episodic and he is ok the rest of the day which means he is ok when he is not exposed to his allergic triggers.
Since he has already been on montelukast for 3 months and yet, he is still coughing, then that means there is a need to add/revise his medications. I suggest you bring him back also to the pedia allergologist for re-assessment.

[jess_121009]

thank you very much doclelet.. at least i know now what will be my next step.. laking tulong ninyo po..

[sleepless]

hello mga sis!

yung baby ko kasi nagmumuta :-( mga 1 month  na, I dont know if may nasal congestion sya, .. symptoms ba yun ng AR? my baby is 3month old .

[break_free]

Also, may marerecommend ba kayo na good Allergologist for adults? And contact info na rin po... TIA!

[leletmd]

@sleepless:
If it has been going on for more than a month now then it is best that you bring your baby na to the pedia for check up. Allergic rhinitis is unlikely at that age.

@break_free:
You can check the website of the Philippine Society of Allergy, Asthma and Immunology so you can find an allergologist near your location.
By the way, allergologists see both pedia and adult patients.

[sleepless]

^ okay po dr let. pero ano po yung mga possible reasons pag ganyan na nagmumuta c baby?

[leletmd]

^ It could be due to a clogged lacrimal duct (problem with the eye drainage in itself) or due to nasal congestion caused by an infection. Either way, it needs to be checked up so that proper meds can be given.

[lindseigh]

hi doc lelet, i have 2 kids na may ubo for a couple of weeks now, we've visited out pedia and andami ng binigay na gamot sa knila, but their cough usually s gabi lang and pag natutulog sila..ang sabi ng pedia wala nman syang naririnig s dibdib nila, cough nila is sobrang dry talaga then pag nag ubo sila s gabi sumusuka parang may gusto silang ilabas na wala nman, we've visited pedia pulmo nagreseta sya ng meptin and kung di p rin nagbago pa xray n raw nmin..sa tingin nyo po doc should we visit an allergologist? kase dry cough lang and wala naman halak, almost ilang weeks n rin akong di makatulog bec of their cough hope you could advise me, thank you!

[leletmd]

@lindseigh
If cough occurs only at night, most likely it is not infectious.
What was your pedia pulmo's assessment? Did the pulmo tell you why meptin was given?
If no improvement with Meptin, then I suggest a consult with an allergologist.