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Respiratory Therapist/Asthama / Dust Allergy.



Good day to you. The reason of writing you is that today I had been taken to hospital in the morning when I woke up around 11 am and had kind of dust allergic/Asthama attack where I was being treated with below doses in ER.

1- Nebulize with Ventolin alongwith 0.9% Sodium Chloride
2- HY-CORTISONE (Hydrocortisone sodium succinate U.S.P), injection for I.M & I.V use)

My blood pressure was 70/110 in the hospital.

I was having flu since past 2 Weeks but it was not flowing. It was stuck in my chest. My nose was permanently dry. I was having trouble at the time of sleep so I used to put vicks vaporub inside my nose to have a comfort sleep.

When my flu didn't started to flow, I put two drops of mustard oil when I woke up in the morning 5 days earlier. Since then I keep continuing to sneezing with regular intervals. I was convinced to make it flow that it may clear my chest congestion but it didn't worked upto the expectation.

Last night it was unbearable for me to keep continue with sneezing and headache, I took 2 panadols for this, it relieved for half an hour just, then I slept deliberately.

In the morning, I felt alot of chest congestion. Also having sounds of weazing from my mouth and nose. I took hot water steam and again started sneezing but it was unbearable for me when I coughed. I felt that someone has roped my chest from inside.

I am having dust allergy since past 7-8 years and I need to nebulize once or twice every year only in winter or autumn season.

Now a days, there is a dusty season in Karachi, Pakistan. But normally Karachi has moderate climate but due global weather changes, weather has started to change since past few years. The maximum cold this year has been recorded with 2 degree celsius so far.

I have so many pets including Cocktails, Love birds, Budgies, Finches, Dove but they all are located at terrace.  I had birds with at every phase since childhood specially when I was school I mostly had chicks and hen. At that time we used to live in flat and we have budgies as well on the terrace. Now we are in house.

Also have a pair of persian cat which moves around us in our rooms. 2 weeks ago I have bought the female and male is with us since past 4 years. Also have parakeets like ringneck in our corridor.

I used to take MONTIGET or MYTEKA 10 mg (Montelukast Sodium) when I feel that I am going to have the problem in a day. It starts with a bit of congestion and the alarming indication is weazing from nose and mouth specially during sleep or when I wake up in the morning.

I worked in DAMCO (Mearsk line as Sr. Customer service offier) so there is not outdoor job. I have a air condition just planted over my head on my seat with hardly 6 feet height. I can touch its swing blades with my hand.

I am 28 years old married guy. Got married on last Valentine day and just had a baby in NOV, 13. Weight is 73 kgs. As far as my diet is concern, I am an overeater and lover of spicy Asian foods specially rice. I mostly used to travel in a car but sometime I use motor bike as well as Karachi has very high traffic and bike is very convenient as compare to car. Also there is a lot of vehicle in most of the areas.

When I went to ER this morning, I have been advised for a below oral treatment for 15 days.

1- Leflox (Levofloxacin) 500 mg for 5 days (1 + 0)
2- Myteka (Motelukast Sodium) 10 for 5 days (1 + 0)
3- Theograd (Theophylline) 350 mg for 15 days (1/2 + 1/2)
4- Rigix (Cetirizine Dihydrochloride) for 15 days (0+0+1)
5- Panadol (Paracetamol) for 15 days (1 + 1/2 + 1/2)

Need your advised on this to overcome this issue as I am very worried that what will I do if it continues till the rest of my life. Now I am young and can bear this, but when can I do when step into aging phase. If there is anything you would like to ask further in this, please ask.


Jahanzaib Bhatti

Hi Jahanzaib,

I am sorry to hear about your respiratory difficulties.

It sounds like the flu you experienced may have created an imbalance in your immune system and now you are more sensitive to any number of allergens and irritants that may be in your environment from animals, dust, and gereral air pollution. Sometimes, there is a viral component to a respiratory illness as well, which can complicate symptoms, reduce response to medications, and perhaps increase recuperative time; and since you had the flu we already know you had at least one type of virus.

It also seems that your sneezing and congestion increased considerably after you used the mustard oil. Although, it is reported to be used for sinus and respiratory infections by some, in this particular situation,it may have irritated your sinuses further or over-stimulated your immune system. I am not really familiar with the use of mustard oil so I cannot say what effects, positive or negative, could be expected for a particular use.

When we are relatively healthy our immune system is able to handle most situations before they become major health problems; but, if the immune system is already a bit compromised by allergies, frequent contact with irritants, or other conditions that alter the ability to mount an appropriate response, an infection or other adverse response may occur. Sometimes the immune system is overwhelmed, or it overreacts,and the defenses act against the body itself creating even greater problems such as constricted airways and over-production of mucus, congestion, and sneezing. All of these reponses, in appropriate measure, are meant to protect and cleanse the body but in extreme cases they can create debilitating and even life-threatening situations.

From your list of medicines I see that your doctor has prescribed an antibiotic, an analgesic, an anti-histamine and 2 asthma control medicines  to help prevent asthma attacks and to help treat and prevent asthma symptoms like wheezing and tightness in the chest that can cause shortness of breath. All of these take time to work, and work better for some people than others. As usual, antibiotics may be more or less effective depending on the sensitiviy of the organisms causing the problem(s).  The Myteka (Montelukast) prescribed is slow-acting and is not used for emergency treatment of shortness of breath, it is used for asthma control, as is the bronchodilator Theophylline, which is supposed to help especially at night. Since you have already been to the hospital twice you might want ask the doctor to prescribe a fast-acting bronchodilator via inhaler, which is used for quick relief, either albuterol (ventolin) which is what you had in your nebulizer treatment,or Combivent, which is albuterol + atrovent (ipratropium bromide) - these two bronchodilators act together through different mechanisms. When shortness of breath is experienced one or two puffs is used to help open the airways so you can breath easier. This may help to prevent a trip to the hospital when shortness of breath occurs. In some difficult cases short course steroid use (i.e. dexamethasone for a few days) may also be useful. And, it is best to keep the use of panadol to a minimum as it can have adverse effects on the liver which is a very important organ for detoxification and overall good health.

Also, keep in mind that while it is important to cough effectively to remove secretions from your airways, too much forced coughing can further irritate your airways and create more secretions and an exaggerated feeling of a need to cough more.

For now, and in the long term, it is important for you to limit your contact with things that you notice make your symptoms worse. This is not always easy since it is not always obvious but try to keep the air you breathe, at least at home, as clean as possible and avoid, smoke, dust, air fresheners, cleaning chemicals and artificial scents. Avoiding dust and any kind of smoke is especially important because they contain particles that stick in the nasal cavity and can penetrate into the lung and these particles often contain other substances such as chemicals and other agents that have very negative effects on the immune system. Also eat and drink to support your immune system. Drink fresh water and eat plenty of fresh vegetables and fruits. Avoid alcohol, especially while taking medicine, and avoid caffeine and chocolate while taking theophylline. Do not eat sugary foods, highly processed foods or drink soft drinks (which have been associated with worsening of asthma). These are all simple common sense things but they help to boost your immune system and reduce the burden placed upon it. Personally, I always take about 1000mg of vitamin C a day, when experiencing respiratory problems, because I find it really does help. Of course get plenty of sleep, which may not be easy under your circumstances, and drink plenty of water at bedtime and upon waking to stay hydrated and help flush your system and loosen secretions. And, last but not least do plenty of effective, slow, deep breathing through your nose, if possible. Hold each breath a little at the end of inspiration and breathe out completely. Do this several times a day including before sleep and if you wake during the night. This will help to exercise and expand your lungs, break up mucus,expand airways, get more oxygen to your cells and organs, remove waste products and help to balance your immune system so make a habit of doing this. It also helps to use some saline to cleanse your nasal cavity periodically to help prevent nasal conditions that may increase risk of allergic reactions (like the frequent sneezing you are experiencing) and respiratory infections. You can ask your doctor or local pharmacist about this if you are not familiar with it.

It is not possible to know whether a condition will worsen as we age. In some cases asthma, allergies, and other conditions actually improve in time while in other cases they worsen and create more serious chronic conditions. But, generally the more recurrent and severe the problem is the more likely it is to produce chronic effects in the long term. Your daily living habits can have a great affect on the outcome so cultivate healthy habits (as noted above). If you notice something triggers even mild symptoms avoid it as much as possible.

Since you mentioned you have had animals most of your life and you only had to have asthma treatment once a year they may not be a huge factor in the problem but this can change and having them living in closer contact can also make a difference. Sometimes, when living in close contact with some birds, there is the potential for a fungal disease called "histoplasmosis" (fungal spores in bird droppings) that causes flu-like symptoms and can produce lung infection similar to pneumonia which can become more serious.  A blood or urine test can be done to determine the presence of this condition. Many people have no symptoms with this but if the immune function is depressed it may be more likely to be acquired or, reactivated if it is already in the system. It is treated with anti-fungal medicine and can take a month or more to get over. Your symptoms seem more to suggest allergy type reactions but since you mentioned having the flu just prior to the current problem and this disease causes flu-like symptoms and you live closely with birds, this possibility should not be overlooked.

Also, you mentioned having the air-conditioner blowing directly onto you at work. It is best not to have air-conditioned air, hot or cold, blowing directly on you. And, vehicle exhaust is very unhealthy even for the healthiest individuals and also very difficult to avoid so even more important for you to maintain other healty habits. I do not think spicy food is a general problem and can help the immune system just notice if you have an adverse reaction to any particular spices.

Be patient. The worst of your current situation will run its course in due time even though if may feel like it is taking forever. Respiratory problems, especially when complicated by allergy-related symptoms or other factors, can take a while to resolve fully.  And, remember that asthma can be hereditary so be sure to take note if your child displays any symptoms.

One last thing; my sister had developed a severe allergic response to some unknown agent in the air at a school where she worked. It became so serious that she had to quit her job and was debiltated for days after exposure which produced immediate symptoms of coughing, copious secretions, loss of voice, and shortness of breath. Each time it happened more quicky and with greater severity. On researching potential causes and treatment for her condition she learned of a homeopathic medication called Aconitum. She took Aconitum whenever she had an acute attack and was amazed at how well it worked to stop or greatly reduce most of the symptoms. Now she has these attacks far less than previously and  she carries Aconitum with her wherever she goes. You could consult a homeopath in Karachi about this if your symptoms do not clear with your current drug regimen or you experience recurrence - it is not generally a good idea to mix homeopathic medicines with the conventional ones you are taking since the interactions between them are not known. If you are interested, please consult a competent homeopath for advice and presciptive purposes.

You can also pose your questions and concerns to an allexperts physician for more help and information if you have not already.

Best wishes for healing well and completely,

Respiratory Therapist

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Stephanie Tyrrell


Respiratory Therapy is a very diverse field encompassing many specialty areas. I have experience in many of these areas and I am willing to answer any question I feel competent to answer within the scope of my experience in the following areas: neonatal ICU and transport, pulmonary rehabilitation, sleep studies, BiPAP/CPAP therapy, Holter monitoring, EKG, ventilator management, chronic and acute respiratory diseases,(i.e. COPD, asthma, restrictive disease, ARDS (acute respiratory distress syndrome), pneumonia, etc) and therapeutics, arterial blood gases, and others. Please see my profile under Experience for a full listing of areas of experience.


I have worked in respiratory therapy for over 25 years in all facets of patient care including level 4 neonatal ICU and neonatal transport, Director of Cardiopulmonary, community health fairs and networking, staff therapist, pulmonary rehabilitation, sleep studies and BiPAP/CPAP therapy, Holter monitoring, EKG, cardiac clinics, pre and post cardiac surgery education and patient care, emergency and long-term ventilator management, chronic diseases such as COPD, asthma, cystic fibrosis; acute respiratory distress syndrome, emergency room, home and nursing home respiratory care. I also provided temporary staff to area hospitals through an allied health business I owned and managed, while also working as a staff therapist for the business.

Certified Respiratory Therapist, Registered Respiratory Therapist, Licensed RT, NRP ((Neonatal Resuscitation Program) certified, BS Biology/Botany, MS Environmental Sciences - Toxicology

Past/Present Clients
Thousands of in-patient and out-patient clients in the hospitals I was/am employed by as well as a number of local hospitals that utilized the services of my allied health business. I currently work as a respiratory therapist at a general hospital and a rehabilitation hospital.

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