rhinitis in children
DESCRIPTION
Rhinitis in children. Jacqueline M Mardon. A collaborative model. retrospective review 47 children referred by ENT allergic or non-specific rhinitis ineffective conventional therapy assessed by homeopathic practitioner treated with homeopathy ± isopathy follow-up and outcomes. - PowerPoint PPT PresentationTRANSCRIPT
Rhinitis in childrenRhinitis in children
Jacqueline M MardonJacqueline M Mardon
A collaborative modelA collaborative model
retrospective review47 children referred by ENTallergic or non-specific rhinitisineffective conventional therapyassessed by homeopathic practitioner
treated with homeopathy ± isopathyfollow-up and outcomes
retrospective review47 children referred by ENTallergic or non-specific rhinitisineffective conventional therapyassessed by homeopathic practitioner
treated with homeopathy ± isopathyfollow-up and outcomes
The integrity of the child
The integrity of the child
What is rhinitis and what is it an expression of in the child’s being?
What is the significance?(different levels this can be approached)
What is rhinitis and what is it an expression of in the child’s being?
What is the significance?(different levels this can be approached)
A very visible manifestation:flowing, stickylurid green, yellow, clear
burnyblood
Face full, tender, squeaky, stuffed-up
Unseen pain, itch - nose rub, palate scratch
A very visible manifestation:flowing, stickylurid green, yellow, clear
burnyblood
Face full, tender, squeaky, stuffed-up
Unseen pain, itch - nose rub, palate scratch
Eyes water, stick, searing tears
Ears fuzzy, bubbleSkin prickles and flakesHard to breathe - the night is not peaceful, disturbed with grunts, snorts and gasps
Eyes water, stick, searing tears
Ears fuzzy, bubbleSkin prickles and flakesHard to breathe - the night is not peaceful, disturbed with grunts, snorts and gasps
An assault to the dignity of the young individual and their integrity
Affects concentration, distorts the face. Hard to gaze outwardly.
There may be shame, mute miseryCan experience being shunned, bullied
An assault to the dignity of the young individual and their integrity
Affects concentration, distorts the face. Hard to gaze outwardly.
There may be shame, mute miseryCan experience being shunned, bullied
Conventional approaches
Conventional approaches
History, examination ± investigation (skin prick tests, RAST)
Associated asthma, eczema, foods?
Treatment nasal corticosteroids, anti-histamines
History, examination ± investigation (skin prick tests, RAST)
Associated asthma, eczema, foods?
Treatment nasal corticosteroids, anti-histamines
Self-help approachesSelf-help approaches
Allergen avoidance/reductionSaline nasal washesLight impulse probes?
Allergen avoidance/reductionSaline nasal washesLight impulse probes?
Homeopathic “holistic” approach
Homeopathic “holistic” approach
The child first and always Welcome the family Symptoms Maternal history, birth Early life, breathing, feeding and weaning
FHxOnset allergy - eczema,asthma, rashes, food
The child first and always Welcome the family Symptoms Maternal history, birth Early life, breathing, feeding and weaning
FHxOnset allergy - eczema,asthma, rashes, food
Homeopathic “holistic” approach (2)
Homeopathic “holistic” approach (2)
Movement Physical, social and emotional development
Sleeping Day rhythms TemperatureObservations; significance of ages
Movement Physical, social and emotional development
Sleeping Day rhythms TemperatureObservations; significance of ages
Review of cases(1)
Review of cases(1)
47 children: 18 girls, 29 boys
Age range: 1 - 16 years
47 children: 18 girls, 29 boys
Age range: 1 - 16 years
Review of cases (2)ENT referral/diagnosisReview of cases (2)
ENT referral/diagnosisNon-specific rhinitis - 8 children
Allergic rhinitis/multiple allergies - 37
Other - 2 children
Non-specific rhinitis - 8 children
Allergic rhinitis/multiple allergies - 37
Other - 2 children
Review of cases (3)other medical problems/Hx
Review of cases (3)other medical problems/Hx
A hetereogeneous groupCongenital heart diseaseTonsils, adenoidsCleft lip and palateNasal intubations/feeding, surgery
Grommet insertions, ear problems
A hetereogeneous groupCongenital heart diseaseTonsils, adenoidsCleft lip and palateNasal intubations/feeding, surgery
Grommet insertions, ear problems
Review of cases (4)medical hx cont
Review of cases (4)medical hx cont
Asthma (11 children)Eczema (13 children), 5 with both“ALLERGY MARCH”Urticaria/rashesFood allergies: milk protein, fish, egg, dairy
Chest and respiratory tract infections - multiple antibiotics
Asthma (11 children)Eczema (13 children), 5 with both“ALLERGY MARCH”Urticaria/rashesFood allergies: milk protein, fish, egg, dairy
Chest and respiratory tract infections - multiple antibiotics
Review of cases (5)Review of cases (5)
Allergy tests
RAST - 2 children
Skin prick tests - 39 children(9 negative results; 30 positive for one or more allergen)
Allergy tests
RAST - 2 children
Skin prick tests - 39 children(9 negative results; 30 positive for one or more allergen)
Review of cases (6)Family history
Review of cases (6)Family history
Siblings with congenital heart disease (2)
30 children with family hx of atopy
Siblings with congenital heart disease (2)
30 children with family hx of atopy
Review of cases (7)Maternal hx/birth
Review of cases (7)Maternal hx/birth
33 children recorded details
7 Caesarean Section births5 births by Forceps delivery - SCBU with bruising to head/face in 2 babies
Individual experiences eg “stuck”, purple large baby with excess mucus, lasted several months
33 children recorded details
7 Caesarean Section births5 births by Forceps delivery - SCBU with bruising to head/face in 2 babies
Individual experiences eg “stuck”, purple large baby with excess mucus, lasted several months
Review of cases (8)Review of cases (8)
Conventional medication:- one child parents declined nasal spray
- one child spray effective but parents concerned re side-effects
- In most cases the tx (steroids,antihistamines) ineffective or limited effect
- Also bronchoinhalers and antibiotics
Conventional medication:- one child parents declined nasal spray
- one child spray effective but parents concerned re side-effects
- In most cases the tx (steroids,antihistamines) ineffective or limited effect
- Also bronchoinhalers and antibiotics
Review of cases (9)Review of cases (9)
Previous homeopathy - one patient visited homeopath in Pakistan; another previous patient GHH
Previous homeopathy - one patient visited homeopath in Pakistan; another previous patient GHH
Review of cases (10)Homeopathy/Isopathy Tx Review of cases (10)
Homeopathy/Isopathy Tx Many different remedies, first consultation and beyond
No treatment (1)Single (constitutional) remedy (17)
Single (local)remedy (1)Miasmatic nosode and constitutional (3)
Isopathy and constitutional (23)
Many different remedies, first consultation and beyond
No treatment (1)Single (constitutional) remedy (17)
Single (local)remedy (1)Miasmatic nosode and constitutional (3)
Isopathy and constitutional (23)
Review of cases (11)Follow-up
Review of cases (11)Follow-up
11 children attended one appointment only- 1 was planned
Further ENT assessment/treatment?(10/46 is DNA rate of 21.7%)
36 children attended at least one follow-up (range 1 to 14 months from first seen - patient-led!)
11 children attended one appointment only- 1 was planned
Further ENT assessment/treatment?(10/46 is DNA rate of 21.7%)
36 children attended at least one follow-up (range 1 to 14 months from first seen - patient-led!)
Review of cases (12)- Outcome
Review of cases (12)- Outcome
Reduction/cessation conventional Tx No response at follow-up - 5 children (1 did not like powders): 5/36 (14%)
Partial response - 9/39 (25%) Good response with significant improvement - 22/36 (61%)
31/36 children (86%) of those seen more than once have either partial or good response - some follow-up and Tx ongoing
Reduction/cessation conventional Tx No response at follow-up - 5 children (1 did not like powders): 5/36 (14%)
Partial response - 9/39 (25%) Good response with significant improvement - 22/36 (61%)
31/36 children (86%) of those seen more than once have either partial or good response - some follow-up and Tx ongoing
Review of cases (13)Discussion
Review of cases (13)Discussion
Rhinitis is a symptom - complexity of individual’s history and circumstances
Many of these children had heavy load of interventions and Tx
Allergies on many levels Can treating early in holistic way affect longer-term outcome?
Rhinitis is a symptom - complexity of individual’s history and circumstances
Many of these children had heavy load of interventions and Tx
Allergies on many levels Can treating early in holistic way affect longer-term outcome?
Collaborative modelCollaborative model
Child at centreFamilyGeneral PractitionerSpecialists - ENT surgeon, Homeopathic/holistic practitioner
Community/environment
Child at centreFamilyGeneral PractitionerSpecialists - ENT surgeon, Homeopathic/holistic practitioner
Community/environment
ThanksThanks
Mr HA Sadiq ENT Surgeon, Royal Hospital for Sick Children, Glasgow
Elaine Hamilton, Nadja Gunneburg, Kamal Ohri, Bridie O’Dowd, Robert Leckridge
Linda and administrative staffBetty and pharmacy staff
Mr HA Sadiq ENT Surgeon, Royal Hospital for Sick Children, Glasgow
Elaine Hamilton, Nadja Gunneburg, Kamal Ohri, Bridie O’Dowd, Robert Leckridge
Linda and administrative staffBetty and pharmacy staff