Dr. Utkarsh Sharma
Pathology
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Patient's Query
Hi doctor,
A patient with diabetes (ten years), BP (26 years) and 26 years before the paralytic attack in the left side, and dementia (he cannot recollect the person, object, day or night) is not bedridden. He will do his routine based on the repeated commands that are given. For the last three years, he is locomoting in a wheelchair. In recent times (six months), he has asthma. For which Duolin and Budecort have been given via nebulizer. Upon the previous consultation with homeopathy, we have given Arsenicum 30 for two days, five drops each twice a day. SpO2 is 96 to 97. However, if we make him walk for urination or shifting him to bed, he starts with wheezing. We give Asthalin inhaler (three times a day) or Foracort 400 inhaler (twice a day). There is no history of the corona. There is no cough, but phlegm is there in the chest. Also, he has constipation (every two days once he is passing motion with so much difficulty). We also give Cremaffin two days once if he struggles so much and feels bloating. His BP is 120/80, post-prandial sugar is 105, and fasting sugar level is 95. He is under the following medications: Envas 5 mg, one in the morning, Dianorm-OD 30 mg, one in the morning, Tonact-ASP 75 mg, one in the morning, Renosave, one in the morning, Gasex, two tablets in the morning. Please advise if we can continue the medicine for wheezing, or do you recommend any other medicine for the same. Also, suggest medicine for constipation. We are planning for the COVID vaccine. Do you recommend the same for him? What are clinical tests (like antibodies) that you recommend before having the corona vaccine? Which Vaccine do you recommend (live or non-live)? Kindly give your opinion.
Hello,
Welcome to icliniq.com.
I understand your concern and will help you regarding it. I appreciate you for explaining everything in detail. This helps in proper assessment. I will answer the queries you asked in the same sequence. Please share the diagnosis of asthma. There are different severity levels of asthma. Different drugs are of choice for different severity levels. However, you can continue Duolin (Ipratropium and Salbutamol) and Foracort (Formoterol) 400 if the doctor has prescribed them after the examination. Both drugs are helpful in an asthmatic wheeze. For constipation, try Naturolax (Isapgol), one teaspoon mixed in one cup water after dinner (drink immediately after mixing). I recommend the COVID-19 vaccine as he comes in a high-risk category. No tests are required before taking the vaccine. Both vaccines are good, and if you have to choose one, I will recommend Covishield. I hope this was helpful. Thank you.
Patient's Query
Hi doctor,
Thank you for the reply. Do you suggest any test for asthma so that we can take and share for further medications? Also, noted that a vaccine to be taken. In my place only Covaxin is available. Is there any issue if he takes Covaxin? Or shall we wait until Covishield is available in the city? Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
The diagnosis of asthma will require proper history, physical examination, and pulmonary function tests, mainly spirometry. Is not he already a diagnosed case of asthma? Once the diagnosis is established, the severity is adjudged depending on the frequency, duration, and severity of asthma attacks. If the diagnosis is not already established, I suggest visiting pulmonary medicine OPD (outpatient department). You can go with Covaxin. As I already said, both vaccines are effective against new variants. At this point of time, waiting is not a good idea. I hope this was helpful. Thank you.
Patient's Query
Hello doctor,
Thank you.
Should we stop any of the above medicine before or after taking the corona vaccine? Kindly give your opinion.
Hello,
Welcome back to iclinq.com.
You can continue all of the above medications. They will not interfere with the immune response of the vaccine. Stay safe and stay healthy.
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Pathology
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