Donovan: Everyday Cold to ER Nightmare
“When Donovan gets a simple cold, if it’s not managed properly, it can turn into an ER nightmare,” says Julia, whose five-year-old son was diagnosed with asthma in 2006. “We always dread the cough in the middle of the night. We know we’ll have to start his entire regimen of breathing treatments to preserve the airway.”
As an infant, Donovon was diagnosed with gastroesophageal reflux disease (GERD) and later contracted respiratory syncytial virus (RSV), the chief cause of hospitalization for respiratory illnesses in young children and the leading cause of lower respiratory disease in infants. In the mid-1990s, the virus killed about 5,000 children annually. Thanks to advances in medical care, the RSV mortality rate in America is now less than 1 percent. But children hospitalized for RSV in infancy tend to have abnormal pulmonary function tests or more episodes of wheezing for up to a decade afterwards.
Post-RSV, at the age of two and a half, Donovon was diagnosed with asthma by the Children’s Memorial Hermann pulmonology team of Giuseppe Colasurdo, M.D., Cindy Jon, M.D., and Keely Smith, M.D. Dr. Colasurdo is dean of The University of Texas Medical School at Houston, professor and chair of the Department of Pediatrics and H. Wayne Hightower Distinguished Professor in the Medical Sciences. Dr. Jon and Dr. Smith are assistant professors of pediatrics at the UT Medical School.
Pediatric asthma is a lower airway disease that affects 5 to 15 percent of children – a total of 2.7 million children in the United States alone. It can be triggered by a variety of environmental stimuli that cause an allergen-antibody reaction, resulting in inflammation of the airway. “Donovon’s triggers are upper respiratory infections, irritants like smoke in the air or weather changes like a sudden cold spell. While his symptoms tend to peak during the fall and winter months, we never know when they will hit. Because an attack can be devastating and a cold can easily lead to a more serious secondary infection, we start his treatment protocol after the first cough.”
“Asthma can affect each individual who has it very differently,” says Dr. Smith, who is Donovon’s pediatric pulmonologist. “In some children, it causes occasional mild symptoms. For others, every day can be a struggle just to breathe.”
Today, Donovon plays soccer and leads a normal life thanks to controller therapy that includes Pulmicort and Singulair during the peak season, and bronchodilators as needed throughout the year. “The most important thing for parents to know is where to find help,” Julia says. “If your child catches colds more easily than other children, there may be an underlying cause. If your pediatrician is putting your child on antibiotics and breathing treatments every few weeks, you probably need to see a pediatric pulmonologist.
“We’re very fortunate because when Donovon catches a cold, we’re able to handle it at home,” she says. “Using the combined resources of UT Physicians and Children’s Memorial Hermann – and all the specialists working together – we’ve been able to keep him out of the ER.”