Pulmonologist for Sarjapur Road, Bengaluru

A newer belt, with a recognisable set of lung problems

The Sarjapur Road corridor has grown faster than almost anywhere in Bengaluru, and it is now largely apartment living, young and early middle-aged families, and a workforce that commutes along one of the city's more difficult roads. The respiratory complaints that come out of it are consistent enough to be worth setting out plainly.

Dr. Manjunath M Negigoudara consults at KIMS Hospital, Electronic City, around 30 minutes away. He holds MBBS as a Gold Medalist from Bangalore Medical College, MD in Pulmonary Medicine from JSS Medical College, DNB in Respiratory Medicine and a Fellowship in Interventional Pulmonology from Manipal Hospitals, and has personally managed 250+ lung transplant cases. The transplant work is the specialist end of the practice; most Sarjapur Road consultations are about asthma, allergy, cough and sleep.

Asthma that came back

A large share of patients from this belt had asthma as a child, were told they had grown out of it, and are now in their thirties or forties finding themselves wheezing, coughing at night or getting breathless on stairs again.

The airway sensitivity was generally there the whole time rather than genuinely cured. What changed is usually the environment: a new apartment, a respiratory infection that never fully cleared, a change in work exposure, or pregnancy. The practical problem is that returning asthma is repeatedly treated as a series of chest infections, sometimes for the better part of a year, before anyone performs spirometry.

Two things are worth knowing. If you need a reliever inhaler more than twice a week, your asthma is not controlled, however well you feel in between. And inhaler technique is worth having checked in person, because a substantial proportion of people using inhalers are not getting the drug into their lungs at all, which looks identical to a drug that is not working.

What is in your apartment

Indoor allergens matter more in apartment living than most people expect, and they are identifiable and reducible, which makes them worth pursuing.

• Dust mites in mattresses, pillows, bedding and upholstery. The most common indoor trigger, and the one that responds most reliably to practical changes.
• Mould, around bathrooms, balcony doors and air conditioning units. Relevant particularly in newer buildings where construction damp has not fully dried, which describes a great deal of this corridor.
• Pet allergen, which persists in soft furnishings long after a pet has gone.
• Cockroach allergen, an established and under-recognised asthma trigger in Indian homes.
• Construction dust, which aggravates existing airway disease. Continuous development along this corridor means many residents have lived beside active sites for years.

The pattern that points indoors is symptoms worse at home than at work, worse at night and on waking, and noticeably better when you travel, returning within a day or two of coming back. Mention it, because it changes what gets tested.

One caution about construction dust in particular. It aggravates airway disease but is rarely the whole explanation for a serious lung problem, so it should not be used to dismiss persistent symptoms. Patients here are sometimes told their cough is just the dust when the actual cause is asthma, reflux or early interstitial disease.

Cough, and sleep

Two other complaints come up constantly from this belt, and both are covered in full elsewhere on this site rather than repeated here.

A cough lasting more than eight weeks is very rarely an infection, and repeated antibiotics are the commonest wrong turn in treating it. The HSR Layout page sets out the causes that actually account for most chronic cough and what the assessment involves.

Obstructive sleep apnoea hides inside the ordinary tiredness of long commutes, late working and young children, and it is under-diagnosed in this age group because people expect it in older and heavier patients. Driving drowsy on Sarjapur Road is its own reason to take it seriously. See sleep apnoea assessment and the sleep medicine service.

The conditions that need a specialist rather than reassurance

Most of what this clinic sees from Sarjapur Road is treatable airway disease. A smaller number of patients have something that needs the specialist end of the practice, and the reason to see a pulmonologist rather than wait is that these declare themselves early if anyone looks.

• Interstitial lung disease, which begins as breathlessness attributed to fitness and a dry cough treated as allergy. See interstitial lung disease
• Pulmonary fibrosis, where early antifibrotic treatment changes the trajectory. See pulmonary fibrosis and IPF
• Pulmonary hypertension, which presents as exertional breathlessness and is characteristically diagnosed late. See pulmonary hypertension
• An abnormal finding on a scan done for another reason, which needs comparison against older imaging rather than watchful waiting

The single most useful test for separating deconditioning from disease is a six-minute walk with continuous oximetry. A resting oxygen reading can be entirely normal in someone whose saturation falls sharply on walking, and nothing about sitting still will reveal it.

Getting there, and when to go

By road

KIMS Hospital, Survey No. 37 and 38, PES University EC Campus, Hosur Road, Konappana Agrahara, Bengaluru 560100. From the eastern end of Sarjapur Road, head south through Attibele and up Hosur Road. From the western end nearer Haralur and Bellandur, head toward Silk Board and take the Electronic City elevated expressway south. Around 30 minutes outside peak hours. Parking is on site.

By metro, partway

The Namma Metro Yellow Line runs above Hosur Road rather than along Sarjapur Road, so it does not serve this corridor directly. It is still useful for the second half of the journey: reach Central Silk Board or a station further down Hosur Road, then take the line south to Infosys Foundation Konappana Agrahara for the hospital.

Timing

A mid-morning appointment generally avoids the worst of both journeys. Evening consultations are available by prior arrangement, and video consultations run 9 AM to 9 PM, booked and paid in advance, which suits follow-up visits. Send your reports to +91 79937 41199 on WhatsApp beforehand whichever you choose.

For patients across Bengaluru and beyond

South and east Bengaluru

The clinic serves HSR Layout, Koramangala, Bellandur, Haralur, Kasavanahalli, Bommanahalli, BTM Layout and the Hosur Road corridor south to Attibele, Bommasandra and Anekal.

Across India

This corridor has one of the highest concentrations of recent arrivals to Bengaluru in the city, and respiratory care is frequently transferred in from Hyderabad, Chennai, Pune, Mumbai, Delhi NCR, Kolkata, Bhubaneswar, Guwahati, Chandigarh and Jaipur, and from Kochi, Coimbatore and Visakhapatnam. Bring previous spirometry and allergy testing if you have it. For advanced lung disease, patients also travel from Mysuru, Mangaluru, Hubballi-Dharwad and Belagavi.

International patients

Expatriate residents and returning non-resident Indians consult from Singapore, Malaysia, the UAE, Saudi Arabia, Qatar, Oman, the United Kingdom, the United States, Canada and Australia, frequently scheduling around a visit to India. Patients are also seen from Bangladesh, Nepal, Sri Lanka, the Maldives, Kenya, Tanzania, Uganda and Nigeria. See second opinion.