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Peyton, 5

| Services: Pulmonary Medicine

Before coming to Children’s Hospital of Richmond at VCU’s (CHoR) Division of Pulmonary Medicine in May 2014, Peyton Taylor’s asthma attacks were so frequent that she was in the emergency room or doctor’s office at least once a month. Her mom, Linda Bradshaw, said her daughter “would cough a lot and gasp for breath” and was frequently prescribed oral steroid medications to reduce the inflammation in her airways. But within a week of meeting Michael S. Schechter, MD, MPH, Professor and Chief, Division of Pulmonary Medicine, CHoR, and changing asthma medications, Linda said 5-year-old Peyton “has been great ever since.”

Asthma, one of the most prevalent chronic childhood diseases, affects an average of one in 10 school-aged children and is characterized by wheezing, coughing, shortness of breath and other breathing difficulties. It is one of the most common causes of hospitalization in children and accounts for more than 10.5 million missed school days a year, according to the Asthma and Allergy Foundation. Asthma runs in families, and although it does not have a cure, it can be managed with proper prevention and treatment.

Diagnosing the Problem

“Peyton came to me because she’d been having problems with asthma and recurrent wheezing,” said Dr. Schechter, “and had been in and out of emergency departments and the hospital. She had been treating her asthma with rescue and controller medication, but to get better control of her asthma, we needed to step up her therapy and make some other adjustments.”

While most of Peyton’s asthma attacks were brought on by cold viruses, Dr. Schechter also suspected allergies played a role and ordered a blood test to identify her allergens. He found significant reactions to dust, dogs and cats and suggested strategies to reduce Peyton’s exposure including switching the type of sheets on her bed, eliminating objects in her bedroom that increased dust, vacuuming daily and using a dehumidifier. Dr. Schechter also prescribed a daily nasal spray and antihistamine to control her nasal allergy symptoms.

“When caring for a child with a chronic disease, the key to doing well is educating and empowering the family and making them an integral part of the care team,” said Dr. Schechter.

Although Peyton does not have pets at home, when she’s around her grandparents’ animals, Linda has taught her to wash her hands before touching her face or eyes. Peyton also knows how to use her rescue inhaler, which Linda is proud that Peyton hasn’t needed in almost six months.

For three of the last four years, Richmond has been listed as the most challenging place to live with asthma on the Asthma and Allergy Foundation of America’s Asthma Capitals report. Richmond’s ranking, which examines 13 factors relating to asthma prevalence, environmental conditions and healthcare utilization, was based on the area’s higher than average emergency room visits and death rates in children with asthma. In addition, Richmond’s mild climate and humidity increase the amount of pollen, mold, dust and other common airborne irritants that can trigger allergies and asthma.

“Peyton is a ball of energy and loves being outside,” said Linda, who lives about 60 miles south of Richmond in Jarratt, Va. “She loves to dance, played t-ball this summer and wants to be a cheerleader.”

Pulmonary Partnerships

Before Dr. Schechter got Peyton’s asthma and allergies under control, Linda said Peyton would cough so much at night that her daughter couldn’t sleep. Although her nighttime coughs have disappeared, because Peyton continues to experience habitual snoring, Dr. Schechter has recommended a sleep study. For the study, he will partner with Justin Brockbank, MD, the newest physician to join CHoR’s team of pulmonary medicine specialists.

CHoR’s Division of Pulmonary Medicine treated 1,955 children during the 2014-15 fiscal year with a variety of acute and chronic problems including asthma, cystic fibrosis, and aerodigestive problems like aspiration and reflux. The team’s six physicians treat patients, conduct research and collaborate with other CHoR specialists as needed for patients with more complex conditions such as sickle cell disease, muscular dystrophy and cancer.

While many children outgrow asthma, Dr. Schechter said there are many others who don’t, as well as others who outgrow the disease only to have it reappear in adulthood.

“Peyton’s prognosis is unpredictable in terms of when or if she’ll outgrow her disease,” said Dr. Schechter, who sees Peyton every three to four months. “But she’s doing very well and has not had any further hospitalizations or emergency room visits since I met her. While getting a cold is her most common asthma trigger, this past winter she had a couple of colds that caused only mild symptoms and were not major ssues the way they had previously been.”

Asthma Facts & Figures

  • The prevalence of asthma has been increasing since the early 1980s across all age, gender and racial groups. The increase can be attributed to a variety of environmental, social and economic factors.
  • Asthma is more common among children than adults.
  • Nearly 7.1 million asthma sufferers in the U.S. are under the age of 18.
  • Asthma in children is the cause of almost five million physician visits and more than 200,000 hospitalizations per year, which makes asthma the third-ranking cause of hospitalization for children under 15 years of age.
  • The estimated annual cost for treating asthma in children younger than 18 is $3.2 billion.
  • More than two million children who suffer from asthma attacks live in areas of the United States that received a failing grade for ozone levels by the American Lung Association.
  • * According to the Asthma and Allergy Foundation of America and PediatricAsthma.org

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