[deemash]

Hi Doctors, (Requesting some advise from ENT docs or other fellow members who has experience / had nasal polyps.)

My 9 year old son has nasal polyps. The growth is almost blocking the nasal passage.

Doctor suggested to wait till he turns 10 to see if it goes off naturally.

Couple of my colleagues already had this and as per them cutting the extra growth by undergoing surgery is of no use as it grows up again.

Please let me know if I can go ahead with the surgery to take off the extra growth.

[aadya]

Originally Posted by deemash

My 9 year old son has nasal polyps. The growth is almost blocking the nasal passage.
Please let me know if I can go ahead with the surgery to take off the extra growth.

I am not an ENT expert. Nasal polyps tend to recur for about 60% of patients. But there are 40 % who get relieved permanently. Only way to know whether your son is in which category is to undergo surgery and see the result. But if the ENT surgeon has told to wait for one more year then its fine. The decision should be made on the basis of symptomatology- how severe is the obstruction, whether associated allergies/sinusitis is present etc.. Low dose steroid nasal spray coupled with surgery has shown better results.

[audioholic]

I need some help with the right pillow height/material and setup. I am a side sleeper with slightly wide shoulders. Off late, it has been really annoying for me since I am getting neck and head ache in the morning after waking up. Sometimes I get this headache in the middle of the night and readjusting the pillow will automatically make things better in the morning. But some days I just wake up with a bad neck pain in the side I slept which will extend to that side of the head as the day goes and it ruins the morning quite badly. Two pillows seem too much and one pillow too less. I tried using different pillows based on stiffness and height but it takes just a small change of pillow(sometimes the maid swaps pillow while replacing the covers) and this is enough to spoil a day. Apart from this, I have usually not had neck issues even during prolonged driving, riding or so. Its only when I sleep.

How should I go about selecting the right pillow? I tried getting a memory foam pillow. While it works on the comfort factor, the height is too less and for side sleeping I need more. If I use two pillows, its too much. Should I fine tune the pillow height or is it something else to habituate myself? Strangely, in the pre-covid era, I was always on the move and used to stay in various accomodation both domestic and abroad and never was this a problem for me anywhere in spite of regularly changing pillow and mattress. However this has been more of a problem at home. Does the mattress also have a role to play? Its quite an old mattress made by a local shop but overall it has held up well and isnt hard by any means.

[wildsdi5530]

@audioholic How are you doing? Hope you remember meeting me.
About pillows, my recommendation is that if you sleep on your back or tummy, No pillow is required. If you sleep on your side, the pillow needs to be as high as the width of your shoulder so that your neck is straight. ie. from the tangent of your shoulder to the your ear. What I find most comfortable is to have a regular pillow which I fold in 2 when sleeping on the side. Do regular neck exercises though.
Coming to mattresses, a cotton or down mattress needs to be changed every 6 months at least. The modern foam or spring ones are supposed to last 10 years, but need to be flipped every 3 months.
Thumb rule being that if you feel that the mattress needs to be changed, then it's time to change. You will never sleep peacefully on it again.

[audioholic]

Originally Posted by wildsdi5530

@audioholic How are you doing? Hope you remember meeting me.
About pillows, my recommendation is that if you sleep on your back or tummy, No pillow is required. If you sleep on your side, the pillow needs to be as high as the width of your shoulder so that your neck is straight. ie. from the tangent of your shoulder to the your ear. .

Hi Dr, yes I do remember meeting you . Thanks for the advise. I will try to do this and set the right pillow height. How about the stiffness of the pillow? Say I have very soft pillows set to the width of my shoulder, is it a problem when it sinks in and the effective height is reduced? I prefer medium stiff pillows since if its too soft I dont like the face getting drowned in the pillow to the point I cant breathe and if its too hard thats definitely going to cause issues.

Thanks again for the advise.

[Newpunter]

Hi Doctors,
I need some help with an incident I had in our apartment gym. I usually run for about 30 min at a speed of 10 km/hr and cover 5 kms in a session on the treadmill. Our apartment gym was locked down after they found a Covid case in our layout. So there was a gap of 2 weeks, when I went back to the gym last wednesday.
On this day, I started my usual routine of running at 10 km/hr, but one of my shoe lace came out, so i waited till I completed 2 kms (12 min) and stopped the treadmill. Then I sat down and tied my lace and then got up immediately, to drink some water. I felt that I was losing consciousness and don't remember what happened next.
I woke up 5 min later on the floor and there was blood beside me. I had 3 wounds on the back of my head. There is an exercise bench a little behind the treadmill, so I'm assuming I hit my head on it.
I went to Sakra hospital, where they checked my BP, ECG and a brain CT scan, all of which returned normal. I had 5 stitches on one of the wound and 1 stitch on another.
Now, I am curious, why I lost consciousness. Was it just a one off, or could there be some underlying condition that caused this? The doctor advised me to undergo some cardio tests, but I'm waiting for this Covid situation to improve before I get checked.
Any advice is appreciated.

[wildsdi5530]

@audioholic I'm talking about the compressed height of the pillow. and that depends on the size of your head. So no option but to try a few different ones.
@Newpunter I guess you had what's called postural hypotension, a type of syncope. Will improve with exercise, but do check up with a specialist.

[goandude]

Originally Posted by wildsdi5530

You have not specified which tendon is inflamed. The other options that could be tried are a Local Steroid injection and failing that, surgery. Do share the images.

My wife is suffering from De Quervain's tenosynovitis of the right hand for last 6 months and it is very painful. Have tried Tab Tendocare Forte for a month and immobilisation with spica but the pain and swelling continues. She gets some relief with NSAIDs but we are looking for a more permanent solution. My question is after Local Steroid injections what are the chances of recurrence? Is the injection very painful or is it done under LA? Should we see a reconstructive surgeon or an Ortho surgeon for this treatment?
Thanks in advance.

[vibbs]

Originally Posted by Newpunter

Now, I am curious, why I lost consciousness. Was it just a one off, or could there be some underlying condition that caused this? The doctor advised me to undergo some cardio tests, but I'm waiting for this Covid situation to improve before I get checked.
Any advice is appreciated.

Not a doctor, so this is not a medical opinion. I have at times experienced postural hypotension. But I have never lost consciousness. And I have never experienced in the middle of a workout.

I have experienced this only post workout and only after a prolonged period of lying down followed by a sudden change in posture - ie getting up/standing. It is more like a momentary blackout for upto 5 - 10 secs.

I have found that this tends to happen in my case when I am not optimally hydrated. On days when I workout, I ensure hydration - not just water, but sodium as well. It has rarely occured to me when I have set the hydration part in place.

[wildsdi5530]

Originally Posted by goandude

She gets some relief with NSAIDs but we are looking for a more permanent solution.

A local steroid injection can be just as painful as any other injection, maybe slightly less. If that doesn't help, she may require a minor surgery. Do look at my clinic Facebook page, I think I had written an article a few months back.

@vibbs If I Understand the OPs words, it didn't occur during the workout. After the workout, he has his head at a low level for a few seconds for tying his shoe lace and then suddenly stood up. This can cause a sudden decrease in blood flow to the brain causing the syncope. Or a 'Head rush' in layman's terms. Of course it's always a good idea to get checked if it is anything more serious.

[hondafanboy]

Hi,

Considering that our life is almost behind the closed walls, less exposure to the Sun etc.

What Vitamin D supplements are available in India and which one can we take? Any guidance on this topic from the Bhpian doctors ?

[Geo_Ipe]

Originally Posted by Newpunter

Now, I am curious, why I lost consciousness. Was it just a one off, or could there be some underlying condition that caused this? The doctor advised me to undergo some cardio tests

You losing consciousness could have been a one off event. When you stand up immediately from a sitting position, blood tends to pool in your lower limbs thus compromising blood flow to the brain - thus making you light headed and in an extreme case, faint like you did. During a work out, the general rate of blood flow is high, which may accentuate the said effect.

The issue is that there is no way to prove this is what happened to you. Cardiac problems can also present with sudden fainting, hence your doctor has advised a detailed Cardio evaluation. Please do get it done. If everything turns out normal, then you have nothing to worry about!

[Newpunter]

Originally Posted by Geo_Ipe

You losing consciousness could have been a one off event. When you stand up immediately from a sitting position, blood tends to pool in your lower limbs thus compromising blood flow to the brain - thus making you light headed and in an extreme case, faint like you did. During a work out, the general rate of blood flow is high, which may accentuate the said effect.

The issue is that there is no way to prove this is what happened to you. Cardiac problems can also present with sudden fainting, hence your doctor has advised a detailed Cardio evaluation. Please do get it done. If everything turns out normal, then you have nothing to worry about!

Thanks everyone for your suggestions. I will get myself checked once the situation in Bangalore improves a little bit. For now, I am taking rest and not exerting myself too much. Maybe I will start a little bit of running again in a week or so and see how my body reacts.

[StarryFurry]

Hello Doctors,
Since the last few days, I had a small scab on my chin which was due to some unknown injury. I never remembered any damage to the skin but somehow it occured. Today, out of sheer foolishness, I applied undiluted Dettol with the help of a cotton swab on that scab.

Now, there is a large black patch on my chin and the scab has fallen off with the pale skin visible underneath. Actually, I am very fair so such marks are easily noticeable. Due to the current Covid-19 pandemic, I want to avoid hospital visit. Kindly suggest me some remedies. I am feeling very demotivated because of this and I fear that these marks may be permanent! I will be very grateful if any dermatologist helps me.

[DCEite]

Hello Doctors,

Recently there has been a news report regarding use of Proton Pump Inhibitors (PPIs) - a medicine used to treat GERD/Acid reflux, as having a potential negative impact on the chances of increasing COVID-19 complications.

Would you as a doctor stop prescribing PPIs. Is it still safe to consume PPIs like Pantop 40 or Nexium ?

Or is it better to switch to H2 receptor blockers ?

Link of the news item:
https://www.medscape.com/viewarticle/933645