‘He couldn’t catch his breath.’ Asthma care makes a difference for 5-year-old Malakai
Malakai Wills visited the pediatric emergency department at M Health Fairview Masonic Children’s Hospital multiple times with difficulty breathing in the winter of 2019-2020.
“He would wake up coughing in the middle of the night and it would get to the point where he couldn’t catch his breath and would throw up.” said Mia Wills, Malakai’s mom. She drove him to Masonic Children’s Hospital on multiple occasions to treat his coughing and shortness of breath. Sometimes, Mia would turn around and go back home after arriving at the hospital, because Malakai’s symptoms would mysteriously disappear. Then they would return the next evening.
“It was quite terrifying to see your kiddo struggling,” said Mia.
When Kimara Gustafson, MD, MPH, an M Health Fairview pediatrician working in the emergency department, cared for Malakai in January of 2020, he was 19 months old.
“He was technically too young for an official diagnosis, but I did suspect that asthma was the underlying cause for his symptoms, since he had a strong family history of reactive airway disease,” said Gustafson, who is also an assistant professor at University of Minnesota Medical School. She treated Malakai with a DuoNeb nebulizer and a dose of oral steroids. His breathing improved and he was discharged in a few hours with respiratory medications and steroids for the next day.
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Beginning treatment
After his January emergency visit, Mia brought Malakai to see his primary care doctor, and he was referred to Hiba Bashir, MD, an M Health Fairview allergy and asthma specialist who sees patients in Fridley and Minneapolis.
“It took quite a while to get his asthma under control, as he was initially not responding to common asthma medications as much as I had anticipated,” said Bashir. He was treated with nebulizers and inhalers, and oral steroids were added when Malakai was sick with a cold.
Mia and Philip Wills, his parents, are both nurses, and well-versed in the medical field, but were understandably very concerned during the early months of Malakai’s illness. His symptoms would get worse at night and kept him from sleeping, which added to the stress on Malakai and his family.
Asthma requires personalized care
Asthma symptoms can vary significantly from person to person. Symptoms can come on suddenly and subside quickly or they can continue throughout the day. They may include difficulty breathing, chest tightness or congestion, wheezing, coughing fits, and feeling tired.
In Malakai’s case, he didn’t experience all the usual symptoms, like wheezing, and didn’t immediately respond to treatment. It took a few months to find the right amount, type, and timing of medications to ease his asthma symptoms.
“I worked with Malakai’s parents to understand their concerns and hopes for his care,” said Bashir. “They are the ones caring for him on a daily basis and know his symptoms best. In order to develop a successful treatment plan, I had to rely on their observations, listen to their impressions of how he was responding, or not responding, to medications, and learn what would work best for their family.”
With consistent, personalized treatment, Malakai’s condition improved. By the end of spring 2020, his lung health was better, and they weren’t making frequent trips to the emergency department. But there were new challenges ahead.
Breathing through the pandemic
With the pandemic beginning to unfold, the Wills family decided to “lock down hard.”
One of Malakai’s biggest asthma triggers is upper respiratory infections. Because of this vulnerability, Philip and Mia decided to keep contact outside of their home to a minimum, knowing that COVID-19 can cause severe illness in the lungs. For over two years, they stayed mostly at home to avoid catching the virus.
As a result, the Wills family, which has 3 other boys, experienced very few upper respiratory infections. This gave Malakai’s lungs an opportunity to grow and develop without having to contend with asthma made worse by viral infections.
Malakai’s asthma is under control
Since COVID-19 social distancing has ended, he has had a few colds, which require additional medication. However, with treatment tailored to his needs, Malakai’s asthma is now under control.
Now 5 years old, Malakai is active and enjoying life. He loves cars, riding his bike, and playing sports.
He’s proud to be an older brother to his siblings, and takes care of his young brothers, Ezekiel (2.5 years) and Alijah (12 months). As a kid with a nurturing nature, he gravitates to people who feel left out and helps make them feel included.
For other families who are dealing with asthma, Bashir offers this advice:
“Communicate with your care team and be open and honest. As a physician, I want the best outcome for my patients. I may have the background, knowledge, and medical expertise, but each patient and family is unique. If there are difficulties in obtaining or taking medication or if there are other barriers to implementing the recommended treatment plan, please talk to your care team. Our goal is to work with you to find the best solution for your child.”
