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Ask Dr. Craig!: Pulmonary Embolism & Bronchiolitis

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BellaNaija is pleased to announce a new column for our special readers – ‘Ask Dr. Craig!Dr. Craig is a BellaNaija columnist and one of the doctors who writes for BN Doctors’ Lounge {Get familiar here}. The idea behind ‘Ask Dr. Craig!’ is for BN readers to get quick sharp answers to niggling medical issues that they have. This does not in anyway mean that readers should not go to their doctors. However, sometimes you just need a human face to give answers to those fast, burning medical concerns our readers have.

Send your questions for Dr. Craig to features(at)bellanaija(dot)com stating your full name and where you are writing from. (Your name will never be published) The editor reserves the right to edit submissions for content brevity and clarity. We regret that we cannot provide individual answers to questions sent in and cannot state at which exact date answers would be published.
We hope that people will find help by reading and sharing. We look forward to reading your emails and tweets with questions for Dr. Craig.

Please enjoy the first edition and let us know what you think!

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Dear Dr. Craig,
One of my very close friends died suddenly recently. She was only 26. She was a paragon of health, had no illnesses whatsoever and we her friends used to call her ‘queen fit-fam’. So you can imagine how devastated we were on her passing. She had just returned that morning from a holiday in America and was hale and hearty. A few hours later she started complaining of pain in her chest and by that evening she was dead. The doctors mentioned something about a blood clot but I don’t understand- Aren’t those only in old people?
I thought you doctors said we should eat right and exercise to live longer. She did all that, and for what? No benefit at all! If she could die so suddenly what would happen to those of us who have a few extra pounds? Would we just drop dead like flies?
Not-so-fit-fam. Trans-Amadi, P.H

Dear Not-so fit-fam,

Please accept my deepest condolences on the passing of your friend. May her soul rest in perfect peace. Even though the details you have given are broad and non specific, It seems to me that your friend most likely suffered what we call a Pulmonary Embolism or PE.

Blood is a complex fluid that is alive with billions of cells flowing at high speed in our blood vessels. If for any reason, the flow of blood is obstructed or the speed at which it flows is reduced significantly, then there is an increased tendency for the blood to clot just as it would if it were outside the body. When blood clots within the vessels it is called a thrombus. Most thrombi are small and may cause no problems but if the thrombus is large, it can detach and get carried by the blood to distant sites and is now called an embolus. Emboli formed in large vessels are particularly dangerous because they can potentially get stuck in smaller vessels in virtually any part of the body and block its blood supply.

In Pulmonary embolism, a variety of risk factors cause a thrombus to form in the leg and is subsequently carried away in the blood to the chest where it blocks the blood supply to the lungs and if not treated can rapidly lead to death. One of the most significant risk factors for the possible development of PE in your friend is her having returned from a long haul flight. The prolonged immobility occasioned by flying long distances causes blood to pool in the calves and this predisposes to clot formation. Other risk factors are oral contraceptive pills, Pregnancy, pervious history of blood clots (deep vein thrombosis) and other causes of prolonged immobility.

Blood stasis can easily be prevented on long haul flights by doing the simple lower limb exercises and stretches found in the wellbeing section of most in-flight magazines.

Exercise and healthy eating are VERY important and do help keep the body healthy and boost immunity. PLEASE don’t give up either because of this unfortunate turn of events. Studies have proven that you can add decades to your life by taking good care of your health and maintaining a healthy diet and body weight.

Warm regards,
Dr. Craig

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Dear Dr. Craig,
My 7month old son has been coughing, wheezing and finding it difficult to breathe.
His father used to be asthmatic as a child but has outgrown it and I was wondering if maybe my son could be asthmatic too? A friend told me that weaning him early and feeding him with infant formula can reduce the likelihood of him having asthma. Is this true?
Asthma Worries. Lekki, Lagos

Dear Asthma Worries,
I understand your concern about asthma in your son, especially seeing that your husband had it as a child. However, 7 months is a bit too early to diagnose asthma in a child even with a positive family history of asthma or atopy in the father. The reason why I say this is because many other conditions can mimic asthma in the under-fives and these are more common than confirmed asthma cases in early childhood. One of the more common cases is called Bronchiolitis and this is usually a viral infection of the lower respiratory tract and can give the same symptoms as asthma. Also, a simple case of nasal congestion caused by catarrh or foreing bodies like beads placed in the nose by the child,can cause difficulty in breathing and produce whistle-like noises from the nose that can be mistaken for a wheeze. This is not to say, however, that younger children cannot have asthma.

Your friend is terribly wrong. On the contrary, staying on breast milk longer is actually better for preventing asthma because it contains important antibodies that are passed on from mother to child and studies have shown that infant formula made from cow’s milk is highly allergenic and can actually predispose susceptible infants to asthma.

If you can, have your son seen by a Respiratory Paediatrician and they can then decide if he will benefit from allergen testing to determine what his risks are and may also give a trial of asthma medication to measure his response to treament. In the meantime, keep him warm and avoid exposure to dust, pollen, pet dander (ie. Cats, dogs) and other known triggers.

I hope he feels better soon.
Warm regards,
Dr. Craig

Disclaimer: This column is written for patient education. It is not intended to diagnose or prescribe treatment and does not replace the advice of your physician. It in no means attempts to cover the full medical scope of this condition.

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David Olamide Craig is a Physician, Pastor, Photographer, Poet and Playwright. He graduated Bachelor of Medicine and Bachelor of Surgery from the University of Ibadan and holds a Masters in Occupational Health from the Institute of Occupational and Environmental Medicine, University of Birmingham. He is passionate about healthy living and sustainable energy.
When he is not seeing patients, Dr. Craig spends his time stretched out on his favourite couch, reading books, magazines, and blogs.
Find him on twitter @RevDrCraig

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