Long-ago asthma diagnosis didn’t explain boy’s difficulty breathing

It was early May, a hot and humid Friday night for the under-11 boys soccer game. My 10-year-old son collapsed on the field, unable to breathe. The coach grabbed another child’s inhaler and administered it to Ian, who, after six puffs (instead of the usual two) was able to catch his breath and stand.

I wasn’t at the game, so I heard about the incident from my husband, who is unruffled at even the most dramatic moments. “Oh, yeah,” he said that night as we were headed to bed. “Ian had an asthma attack during the game, but he was fine.” It was only later that I heard the full, scary story from the coach.

(JAVIER JAEN BENAVIDES FOR THE WASHINGTON POST) - Mother’s frightening episode trying to find out why her 10 year old couldn’t breathe.

A few years earlier, on the heels of an upper-respiratory infection, Ian had been given a diagnosis of asthma. For a few months, he occasionally used an inhaler, but then the attacks stopped and we eventually stopped carrying it with us. Now, we were afraid, we were back to the asthma diagnosis.

On Saturday morning, we took him to the nurse practitioner at the pediatrician’s office. She diagnosed a sports-induced bronchiospasm and sent Ian on his way with an inhaler (two puffs before every practice and game) along with antihistamines to counter any allergies he might be experiencing. She didn’t think it was anything serious — it seemed like a situation that millions of children and adults live with each day.

So I was unprepared for what happened Wednesday night. Ian had played soccer without incident. He stayed up late watching “The Miracle” on my laptop while I dozed on the couch. Around 10:30 p.m. (way past bedtime, but my husband was out of town and we were living loose), Ian woke me.

“I can’t breathe,” he croaked, clutching his throat. “Can’t breathe.”

I grabbed the inhaler and administered the prescribed two puffs. No relief. Two more puffs. Tears streamed down his cheeks as he whispered, “Can’t breathe.” The fact that he could whisper indicated that he could breathe — but his lips were turning blue. I called 911.

To the hospital

The EMTs were at the house within minutes. They administered oxygen and a nebulizer, packed him up on the gurney and rushed us to the hospital. There, a physician listened closely to his lungs but could hear no telltale wheezing, the signature sound of an asthma attack. Still, his other symptoms seemed to indicate that he had experienced one and that his panic had worsened the symptoms. The ER doctor prescribed a large dose of oral steroids and another nebulizer.

A second doctor later listened to Ian’s lungs and his comments that he was still having trouble breathing, that his throat felt tight and his chest hurt. A chest X-ray revealed clear lungs. The doctor noted that Ian seemed a little anxious and suggested that this was contributing to the breathing trouble, so she administered half a milligram of an anti-anxiety drug to calm him down. Around 4 a.m., they sent us home.

I kept Ian home from school on Thursday, and we saw our pediatrician. Midday, just after he’d had a drink of water, he began to complain again that he could not breathe. Two puffs on the inhaler gave no relief. Another call to 911.