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Sunday, June 28, 2009

Diagnose Asthma

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Asthma is a difficult illness to diagnose especially in a young child. This is mainly due to three reasons.

The first reason is that in a young child, infection of the lungs like bronchitis can mimic asthmatic attacks. The main difference is the cause � infections are caused by germs (eg. viruses, bacteria), while asthmatic attacks are allergic reactions to a variety of possible triggers. Often, doctors can only diagnose asthma based on the history given by a child's caregiver. For example, if your son gets wheezing attacks very often especially if it is not associated with fever, and if your son responds well to nebulizer therapy, then it is likely he is asthmatic.

The second reason is that an asthmatic child can have a range of different symptoms. Children who are mildly asthmatic may have 1-2 attacks of breathlessness and wheezing a year, and get better with treatment. Some may have persistent symptoms in between attacks that may include chronic cough like your son. Children who are severe asthmatics will have more frequent attacks (eg. monthly) and are often symptomatic even in between attacks. If your child is asthmatic, it is important to profile the severity of his asthma so that your doctor can tailor his treatment accordingly. Children with mild asthma are usually treated with reliever therapy during their acute attacks. Children with severe asthma, or with persistent symptoms in between their attacks have a preventer therapy added to their treatment regime. Preventer therapy needs to be taken daily and used long term usually for months. It is an important component of their therapy as uncontrolled asthma in these children can be life threatening.

The third reason as pointed out by you is that sensitive nose (allergic rhinitis) can often cause persistent coughing, which may mimic asthma. In addition, some children may have both sensitive nose, and asthma.

Both your children have significant risk factors of having asthma � family history, presence of sensitive nose, and eczema. My advice is for you to find a doctor you are comfortable with to follow up with your children in the long term. If your children are indeed asthmatic, their story will unfold as they grow up. Start keeping a diary of your children's hospital admissions, visits to the doctors, and medication history. This will help your doctor diagnose and manage asthma.

Wednesday, June 3, 2009

Best Parenting Advice I Ever Received

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If you are a parent, chances are, you would have experienced a bombardment of parenting advice, whether from parenting books you read, parenting courses you attend, well-meaning friends, relatives, or even strangers on the street.

If you have been a parent for a while, by now, you should know that some advice conflict with others. The truth of the matter is that if you place all the theories side by side, you will realise that they indeed conflict with each other. While some are completely at odds with one another, other theories overlap here and there but yet never seem to agree as well. So we all end up thoroughly confused, like the story of the old man and the donkey.

Among the smorgasbord of parenting advice, there is one which I feel is the best advice I have received. Some parenting advice are like foundational pillars of parenting wisdom, e.g. putting your trust in God and seek Him for wisdom. These are the advice that will apply through all situation, all kinds of parents, all kinds of kids. And if we keep our eyes on them, we will not get lost in the world of parenting confusion.

1. Consider Your Face Already Lost

This particularly applies to our culture where face is important. We do all sorts of things to save face. When we are embarrassed, we lose face.

Think about this : why are we so anxious that our children behave well, do well in school, or go to the best brand name schools, etc. Basically we hope that our children are exemplary in every way. Why?

Firstly, it makes us feel proud. In other words, it give us ‘face’. Secondly, it reflects on us as parents. We must be very good parents to produce such wonderful kids. Something we do must be right. Hey! We are the ultimate experts at raising perfect kids. Thirdly, and sadly, for a lot of us, whether we are conscious of it or not, part of our identity as a person is vested in our children. We are ‘mother/father of so-and-so’. Imagine if your child is, say, President Scholar XYZ. You will probably go round identifying yourself as “I am the mother of President Scholar XYZ.”

Another example : Why do we get angry and frustrated when our children start acting up in public? I suspect it is the same for all of us - we are all embarrassed, and afraid of losing face in public. Therefore, the same tantrum happening at home may not elicit the same kind of reaction from us compared to if it were to happen in a public place, or a friend’s house.

Another example : if you are a high-flyer but unfortunately, your child isn’t the sharpest knife in the drawer, how would you feel, and why?

The bottomline is that for most of us, how we react to our children is very much affected by how much value we place on the issue of ‘face’. This is probably how most us were brought up anyway. The need to save face makes us more anxious, more easily agitated and angered, less patient and less able to think with a clear mind.

So it is best that we recognise that our children are just going to make us ‘lose face’ sooner or later. Probably they have already done so by some mega tantrum in the middle of the shopping mall. So we might as well consider our face already lost, and stop trying to preserve it. With that out of the way, we will be calmer and in a better frame of mind to deal with whatever we need to deal with, be it behavioural issues or performance in school.

We should stop trying to impress or please people :)
 

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