Dealing with breathing difficulties in children

baby

Breathing difficulties in children is caused by enlarged adenoids and tonsils.

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Dear Doc,

My son’s breathing when he is asleep is worrying. He stops and starts breathing again. At times, he wakes up and sits when he is unable to breathe. It is worse with the flu. What could be the problem? He also snores a lot.

Margaret

Dear Margaret,

This is called obstructive sleep apnea, where there is a blockage in the airway that interferes with flow of air, to the extent that the person has to sit up to be able to breath.

The most common cause of this in children is enlarged adenoids and tonsils.

Adenoids are a small mass of tissue at the back of the nose. They usually grow during the first 10 years of life, and then start shrinking.

If they overgrow, what is called adenoid hypertrophy, they cause blockage of the nasal passage.

This causes difficulty in breathing and breathing with the mouth open; snoring, sometimes even when awake, and voice changes.

If the blockage is severe, it interferes with the child’s sleep because they have to keep waking up to breathe. Adenoid hypertrophy can also lead to recurrent infections of the nose, throat and ears, changes in how the face develops and even lung and heart problems.

It can interfere with the child’s taste and smell, affecting appetite. Speech development may also be affected in a very young child.

The child may also have poor growth, poor academic performance due to fatigue, bed wetting, hyperactivity or inattention and behaviour problems.

The problem is best dealt with by an Ear, Nose and Throat specialist. If there is an ongoing infection, antibiotics can be useful.

Nasal drops and nasal sprays may too be used. If the symptoms are severe, then surgery can be done to remove the adenoids.

This is sometimes done together with removal of tonsils if they are enlarged.

Surgery is usually done either because there is no improvement with medication, the child gets sick too frequently or because the symptoms are severe and interfere with his feeding, sleeping, learning and growth.

Severe blockage can lead to right heart failure and lung problems, so if the doctor thinks that the child is at risk of developing these, surgery would be a good option.

Children usually heal within two weeks of having the surgery and breathing normally goes back to normal.


Dear Doc,

I am 22 years old and was born with just one testicle. I have never told anyone my story but I think only my parents know. I have become worried about my sex life. As a devoted Muslim, I have never been involved sexually with any woman or girl. I am deeply worried about my marital life. There is a possibility of not being able to satisfy my wife sexually or worse still, not having children. What should I do? How can I get help? Kindly advise.

Abdi


Dear Abdi,

Having one testicle is called monorchism. During development before birth, the testicles develop in the abdomen then descend into the scrotum. If one of the testicles does not descend, there will only be one in the scrotal sac.

Another possible reason for the condition is the case of “vanishing” testicles before or after birth. This happens where the testicle was damaged due to one reason or another during development, which activates the immune system and the damaged tissue is reabsorbed.

Another cause of monorchism is surgically removal of the testicle.

In most cases, the remaining testicle is healthy and produces enough hormone (testosterone) and sperms to allow for a normal sexual reproductive life with no effect on fertility.

However, it is advisable to see a doctor and have a regional ultrasound scan done, so as to tell if there is an undescended testicle and its location.

If it is present, then it needs to be removed, since it can trigger an immune response that may affect the health of the present testicle.

The undescended testicle itself has a higher risk of developing cancer.

Dear Doc,

Since I gave birth to my second born, I have lost my hairline. I have joined the wig league to hide my hairline. I am struggling and worried that I may lose all the hair.

What could be the reason? Friends and family say it could be because of breastfeeding yet this did not happen with my first born. Any recommendation or advice will be highly appreciated.

Carolyine.

Dear Carolyne,

Hair goes through a growth and a resting phase, after which it falls off and new hair starts to grow.

On a normal day, we lose about 100 hair strands. One of the benefits of pregnancy is that the hair may look fuller, shinier and longer than usual.

This is because of the high levels of oestrogen in the body, which significantly reduces the rate of hair loss and increases the volume of blood in circulation.

After pregnancy, oestrogen levels drop significantly and blood flow goes back to normal.

You end up shedding a lot of hair, about 300 strands per day, including the hair that was in the resting phase not shed during the pregnancy.

This is a normal part of the body recovering from pregnancy.

It is usually at its worst about four months after delivery and the hair should have gone back to normal by the time the baby turns one year.

There is no way to prevent this hair loss, though having a low blood level, or other illnesses like thyroid, can make the hair loss worse and/or last longer.

To manage it, you can use volumising shampoos (e.g. the ones with protein) and light conditioners, reduce heat treatment and any additions or treatment that may further hurt/weaken your hair.

You can also opt to trimming or try styles that make the hair look fuller.

Take healthy balanced meals to facilitate the new growth of hair and treat any underlying illnesses. Be patient, your hair will definitely grow back

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