Former CHOC patient, Brant Whiting Fulfills Dream of Playing Professional Baseball

CHOC Children'sFor Lisa and Mikel Whiting, CHOC Children’s not only saved their son’s life, but solved an eight-year mystery — allowing him to pursue dreams once thought unattainable. From infancy, Brant Whiting suffered severe asthma that caused asthma attacks every single night of his life. Brant describes the experience as trying to breathe through a straw.

One night, at age 8, Brant stopped breathing altogether and was rushed to a local hospital. Doctors said that Brant’s labs “were incompatible with life” and he might not survive the trip to CHOC Children’s in the transport ambulance. But he did, and Dr. Nick Anas, CHOC’s pediatrician-in-chief and his team worked for five hours to keep Brant alive. They succeeded. After six days in a medically induced coma on life support, Brant awoke — and survived. brant dodgers logo

In fact, not only did he survive, CHOC doctors were able to determine the underlying cause of Brant’s asthma — gastric reflux. He underwent a fundoplication procedure at CHOC, eliminating about 85 percent of his asthma symptoms. This correct diagnosis gave Brant the chance to pursue his dreams: playing professional baseball. He played catcher on Stanford University’s baseball team for four years before being drafted by the Los Angeles Dodgers. A precious life saved… and a dream fulfilled.

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Getting Childhood Asthma Under Control

Childhood asthma is a relatively easy disease to control with the right teamwork between a child and his or her family, pediatrician and school. If not managed properly, asthma can negatively affect a child’s quality of life. They may miss a lot of school, be unable to participate in their favorite activities or have frequent visits to the emergency room or hospital.

In episode No. 25 of CHOC Radio, Dr. Stanley Galant, medical director of the CHOC Children’s Breathmobile, explains:

  • How asthma is now seen as a chronic disease rather than an episodic disease, making long-term disease management more important
  • The signs of asthma that parents and school nurses should watch for in a child
  • How parents can partner with their pediatrician to manage a child’s asthma
  • Simple changes to make in the home to prevent asthma attacks
  • The story of the Breathmobile and how it’s making asthma care more accessible for families in Orange County.

CHOC Radio theme music by Pat Jacobs.

The Three Key Asthma Symptoms Every Parent Should Look For

Diagnosing asthma can be tricky. There is no simple test. Instead, evaluating three key symptoms newasthmapic_iStock_000010686472Mediumhelps doctors make a diagnosis, explains Dr. Stanley P. Galant, an asthma, allergy and immunology specialist at CHOC Children’s and the medical director of the CHOC Breathmobile.

Children experiencing cough, shortness of breath – especially during and after exercise or when suffering from a cold, and wheezing should be checked for asthma.

“Asthma is a condition associated with a chronic or intermittent cough that generally comes on in the middle of the night and with exercise,” says Dr. Galant. “One big clue to help diagnose asthma versus another condition or illness has to do with this chronic cough. A diagnosis of asthma is suggested when the cough responds well to medication that opens the airways and dilates the bronchial tubes.”

Asthma symptoms can be triggered by environmental factors, like second-hand smoke, and allergens. In fact, children with asthma—roughly 70 percent—have allergies, which play a big role in diagnosing and controlling the condition.

If a child has persistent asthma – roughly defined as trouble more than twice a week during the day in terms of coughing and wheezing and trouble more than twice a month at night, the child should have skin testing or blood testing for allergies. Allergy testing helps pinpoint triggers for asthma so families can make changes at home to reduce or eliminate them.

Avoiding triggers is a key factor to managing asthma. Second is medication. Allergy shots can also be helpful in certain patients. Parents should discuss the appropriate options with their child’s physician.

Learn more about allergy and immunology services at CHOC.

For more asthma and allergy tips, please go to choc.org/health.

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Protect Children with Asthma from Colds, Flu

Getting a cold or the flu is a bummer for anyone, but these common illnesses can be extra challenging for children with asthma.

Viruses more often than not will worsen asthma, says Dr. Wan-Yin Chan, a CHOC Children’s allergist/immunologist.

Already, people with asthma have inflamed airways to the lungs. Coughing and sneezing prompted by a cold or the flu adds extra stress on these airways, which can trigger an asthma attack.

“Having a cold or flu can result in inflammation of the lung tissues which leads to increased bronchial hyperreactivity, which can result in asthma symptoms such as wheezing, excessive cough, shortness of breath or chest tightness,” Dr. Chan explains.

While asthmatic children are no more susceptible to catching a cold or flu than other people, they are more likely to suffer complications, such as respiratory infections. In general, allergies may predispose a patient to such infections, and most asthmatics are allergic.

In these cases, the same added stress on the airways that triggers asthma attacks can lead to infections like bronchitis or pneumonia.

Because of their added vulnerability, it’s important that children with asthma work to avoid contracting the flu by getting their annual influenza vaccination, Dr. Chan says.

According to the Centers for Disease Control and Prevention, the injection is approved for all people aged 6 months and older. However, children ages 2 to 4 with asthma should avoid the nasal spray vaccine.

In addition to getting vaccinated, asthmatic children during cold and flu season should limit contact with sick people, wash their hands frequently, and avoid touching their eyes, nose and mouth, Dr. Chan advises.

Dr. Chan recommends some of her patients with asthma increase the dose of their daily preventative inhalers for one to two weeks at the first sign of cold or flu. Parents should check with their child’s asthma specialist for dosage instructions, she advises.

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Kids and Asthma

girl with bubbles DIAGNOSING ASTHMA

There’s no single test for asthma, so it can be hard to diagnose the condition in a young child, says Dr. Galant, CHOC’s Asthma, Allergy and Immunology specialist, noting that symptoms are sometimes mistaken for another illness. “The most important diagnostic findings include a chronic or intermittent cough that comes on in the middle of the night and after exercise,” Dr. Galant says. “These kids also have wheezing and they respond to a bronchodilator, which opens the airways and stops the symptoms.” In addition, children with asthma often have allergies, eczema or a family history of asthma, says Dr. Galant.

TREATMENT ACTION PLAN

Effective treatment requires a comprehensive approach and it’s best to have a written treatment action plan, Dr. Galant says.  Treatment can include regular medications and regular checks for lung and breathing function, as well as written instructions for when the child needs “rescue” medications and when to call the doctor. “We want to have few symptoms, no  hospitalizations or emergency room visits and little use of the bronchodilator,” says Dr. Galant. Highly allergic patients may also benefit from allergy shots to help reduce sensitivity to allergens.

AVOIDING ASTHMA TRIGGERS

Since asthma is often due to an allergic response, children with asthma should also be tested for allergies to help identify allergens that can trigger an asthma attack, says Dr. Galant. “There are allergens and non-allergen triggers. Children can be allergic to foods as well as indoor allergens like dust, and cats. Nonallergic triggers include the common cold virus and environmental tobacco smoke,” he says. Knowing a child’s allergic triggers can help the family make changes at home to minimize the child’s exposure to allergens and avoid asthma triggers.

COULD MY CHILD HAVE ASTHMA?

Your child should be checked for  asthma if he or she experiences the  following symptoms:

  • Chronic or persistent coughing at night
  • Coughing, wheezing or shortness of breath during or after exercise
  • Wheezing

FAST FACTS

  • Approximate number of children in the United States who die from asthma each year: 200
  • Percentage of children nationwide with asthma: 10 – 12 %
  • Percentage of underserved, inner-city elementary school-aged children in Orange County with asthma: 20 – 30 %

View the full feature on Kids and Asthma

Dr. Galant
Dr. Stanley Galant
CHOC Asthma, Allergy and Immunology Specialist

PHYSICIAN FOCUS: DR. STANLEY GALANT

Dr. Galant is the medical director of CHOC Children’s Breathmobile, CHOC’s mobile asthma treatment van. He is a clinical professor of pediatrics at UC Irvine and is the former director of pediatric allergy and immunology at UCI.

Dr. Galant did pediatric residencies at Los Angeles Children’s Hospital and the UC San Francisco Medical Center. He had a fellowship in allergy/immunology at UCSF and was a medical fellow with the UCSF Medical Center’s pediatric radiology department and Cardiovascular Research Institute. The Hospital Association of Southern California named Dr. Galant a 2007 “Hospital Hero” for bringing the Breathmobile to Orange County.

Dr. Galant’s philosophy of care: “Our program is unique and provides access to preventative asthma care. To treat our patients satisfactorily and manage a chronic disease like asthma, we build trust and bonds with our patients.”

EDUCATION:
University of California Medical School, San Francisco

BOARD CERTIFICATIONS:
Pediatrics Allergy/Immunology

More about Dr. Galant

This article was featured in the Orange County Register on January 7, 2014 and was written by Amy Bentley.