By Dr. Sergei Shushunov *

All unique and beautiful cities have nicknames. These reflect their essence or aspirations.

New York is the Big Apple, Rome the Eternal City. New Orleans has acquired the monicker "The Big Easy" and Las Vegas, for obvious reasons, "Sin City".

Amsterdam’s essence is The Venice of the North, whereas Russia’s St. Petersburg aspires to be The Venice of the North (the aspiration). Venice is just Venice; Vienna, home to the Austro-Hungarian Empire, the Imperial City.

Then there’s the White City of the North - Helsinki, Paris  - The City of Lights and Bucharest wannabe Little Paris. Cairo – Paris of the Nile (the aspiration). Give it enough time and Paris will be called Cairo of the Seine (the essence).

Hà Nội also has a nickname - The City of Lakes. Indeed, there are many lakes in Hà Nội, probably more than in any other city of comparable population and size. The word “lake” conjures up images of tranquility, but not so in Hà Nội. The traffic congestion, the noise and air pollution, require a fertile imagination or a very thick skin to give off a sense of peace and tranquility.

After spending a few months here and getting a taste of the city, I thought of a different nickname, but before sharing my idea I would like to take a step back into my pediatric practice at Family Medical Practice Hà Nội (FMP).

One relatively common condition pediatricians see in their offices is called posterior nasal drip, or postnasal drip. This is how it goes: your child develops something which looks like a common cold - a runny nose and a cough. A week goes by with no improvement, then another week, then it becomes a month. You try a cough syrup of one kind, then of another, then you begin to worry and take your child to a doctor who prescribes antibiotics. But a week later your worries mount because the cough continues.

At FMP one of the first questions we ask is whether this cough is worse at night or in the morning. Invariably the answer is "yes." Typically, the only finding will be nasal congestion and mucus in the back of the throat. Now we have a diagnosis: postnasal drip. Post - from the word "posterior", behind.

This is what happened: Your child developed a persistent runny nose. When awake and upright, his or her nasal secretions tended to drip out or be swallowed. But when lying down in bed, nasal secretions pool at the back of the throat where they try to sneak into the windpipe, activating a natural defense mechanism: a cough. There is actually nothing wrong with your child’s lungs and no antibiotics can help. Once the diagnosis is made, the treatment is simple - administering oral and topical anti-inflammatory medication - and the result visible within days.

Before coming to Hà Nội I would usually see one case of postnasal drip in a week or two. But Hà Nội is unique, not only because of its lakes. It also stands out as a very polluted city. Breathing Hà Nội air is often dangerous. Constant chemical irritation of the airways leads, among other things, to chronic inflammation, which subsequently leads to postnasal drip. I usually see two to four children with postnasal drip a day, making it about 15-20 times more than I was accustomed to.

This is what in my professional experience makes Hà Nội so unique and for this reason I propose to nickname it the City of Postnasal Drip.— Family Medical Practice Hanoi

*Dr. Sergei Shushunov came to FMP Hanoi with over 30 years of experience in pediatrics in the United States. He received training in General Pediatrics and in Pediatric Critical Training at Universities of Illinois and Minnesota. He was board certified in General Pediatrics in 1989 and in Pediatric Critical Care in 1990.

Dr. Shushunov had the opportunity to open two Pediatric Intensive Care Units in the US, while caring for patients ranging from newborns to adults.  He served as a faculty member at the Universities of Illinois and Kansas. In addition to his training in conventional medicine he was trained in Medical Acupuncture and Pharmacognosy at UCLA and University of Illinois.  For more advice on medical topics, visit FMP Hanoi at 298 Kim Mã Street, Ba Đình. Tel: (04) 3843 0748. E: hanoi@vietnammedicalpractice.com.