Unconventional Teen Finds Relief From Severe Asthma

Christian’s severe asthma used to land him in the hospital, but now he’s living an active life

Christian, left, with his mother and brother.

Christian Cureton, age 14, is a self-described old man. He finds TikTok dull, and he doesn’t understand the motivation behind getting “likes.” While his classmates are into the latest pop or hip-hop band, he’s drawn to old music, a favorite being Al Green, an American soul singer. His preferred subject at school is history because he likes to learn about “the ups and downs of humanity.”

“Christian is a unique and different kind of guy,” says his mom, Candance. “He has an awareness and maturity about him. He’s always caring and asking others how they are. When he was little and he had to get poked by the nurses, he’d be reassuring them.”

A little of what helped spark Christian’s early old age might have been having to endure severe asthma from such a young age and all the medical emergencies and worries that came with it. Every year, he’d end up in an East Bay hospital emergency room three or four times because he couldn’t breathe. Once, when he was 4 years old, he had a viral and bacterial infection at the same time. He was admitted to the local hospital for two weeks, and he lost seven pounds in 10 days.

“It was all very scary. At one point, he asked me if he was going to die. After that experience, we decided to drive to Stanford Medicine Children’s Health for care,” Candance says.

Asthma exacerbations, also called asthma attacks, are terrifying for kids. A child with asthma might be running along and playing with their friends at recess when they feel their chest get tight, making it hard to get a full breath. Their airways become inflamed, and they start wheezing and coughing. The swelling causes mucus to build up, further narrowing their bronchial (breathing) tubes.

“Doctors at Stanford Medicine Children’s Health immediately knew what to do,” Candance says. “It was a long journey because Christian kept getting worse over time, and they had to keep upping the ante, but today he is doing so well and it’s such a relief.”

Asthma and allergies, a bad combination

When treating asthma, doctors take a step-by-step approach. With mild asthma, sometimes an inhaler is enough to control it. For many children, daily medicines are needed, along with an inhaler and sometimes an add-on quick-relief medicine when an asthma attack is underway. But with moderate to severe asthma, medicines don’t always work. As happened with Christian, sometimes doctors have to resort to oral steroids to stop an active exacerbation. Yet steroids are not healthy for kids in the long term.

“Oral steroids, unlike inhaled steroids, affect the entire body. Side effects over time can include diabetes, lower bone density, glaucoma or increased pressure in the eyes, and stunted growth,” says Rachna Wadia, MD, a pediatric pulmonologist at Stanford Medicine Children’s Health. Dr. Wadia cared for Christian at Stanford Medicine Children’s Walnut Creek location, in partnership with John Muir Health.

Pulmonologists are essential members of a care team for people with asthma. They specialize in the lungs and the upper respiratory system. They often partner with allergists—as in Christian’s case—who help control allergic reactions, which can trigger exacerbations in kids with asthma.

Allergies are asthma’s evil twin. They make double the trouble for kids with asthma, and a large number of children with asthma also have allergies.

“Christian is allergic to a ton of things—horses, trees, certain foods. In the spring, he would have frequent exacerbations. His lungs would fill with fluid and he couldn’t breathe, even with the nebulizer delivering medication day and night,” Candance says.

A rare, severe type of asthma

Around age 10, Christian was diagnosed with eosinophilic asthma, a rare type of asthma that causes severe inflammation in the respiratory system. Candance says that Christian’s immune system was in overdrive, working 10 times harder than normal.

“Eosinophilic asthma is like a superpower that works against me. It doesn’t do anything cool, like shoot flames out of my chest,” Christian jokes.

Christian needed a solution because his medicines were not working well enough to control his asthma, and he needed oral steroids more and more frequently. Plus, he was ending up in the emergency room at least a few times every year.

He needed biologic therapy—medicines made from living organisms, like mice and bacteria, that modify the molecules that lead to inflammation in the human body. The problem was that none were approved for children under 12 years of age. Then, as luck would have it, one became available for kids as young as 6. That was good news for Christian, because biologics have been revolutionary for treating asthma.

“Biologics disrupt the pathway that leads to inflammation in the airways. They are a great solution when daily control medicines are not working for moderate to severe asthma,” Dr. Wadia says. “Since starting a biologic in 2018, Christian has not been back to the hospital. In the last two years, he hasn’t had to take oral steroids. It has really changed his quality of life.”

Through research, Stanford Medicine Children’s Health is helping pave the way to make biologics available for even younger kids. Because the health system is involved in research, it is among the first to learn of new treatment options for kids.

“Today, there are five biologics approved for children,” Dr. Wadia adds.

She encourages parents to talk with a pulmonologist about their child’s asthma, especially if it isn’t well controlled. The last 10 years have brought several new treatments for asthma, allergies, and eczema.

Living an active life, despite asthma

Christian is a great example that people with severe asthma can live an active life. While he prefers reading a good book to a good workout, he’s trying new activities—most recently, martial arts and football.

“Sometimes, it surprises me what I’m able to do. Running was one of the biggest surprises. In the past, I’d always have to stop. It was like there was this invisible limit. Now I can keep going. I have a lot more stamina,” Christian says.

Today, he sometimes forgets to pack his inhaler for school, because he doesn’t need it that often, thanks to the biologic shot that he gets every two weeks. Because she’d been through the wringer with Christian’s asthma in the past, it took a while for Candance to truly believe that he was improved.

“I didn’t trust it right away. I would stay for every football practice, ready with his inhaler. I didn’t want to get a call from the coach that they had to call an ambulance because he had an asthma attack,” Candance says. “But after a few months without problems, it hit me. He was fine. I didn’t have to worry so much. To watch him realize his own physical capabilities has been a real joy.”

“In the past, doctors never would have imagined that someone with severe asthma, like Christian, could be so physically active,” says Dr. Wadia. “We’d tell them not to run too much. But people with asthma should be able to run! Today, some NBA players have asthma. The right treatment plan and keeping asthma well controlled can make all the difference.”

Christian feels like he has a new lease on life. He’s extremely grateful to his mom for always taking care of him and going the extra mile to find the right care. And he’s thankful for his doctors at Stanford Medicine Children’s Health.

“I want parents of children with severe asthma to know that there is hope. Don’t give up. There’s a whole community of people and doctors who can help your child get better,” Candance concludes.

No doubt, Christian has a bright and interesting future ahead of him. Who knows what he will have accomplished by the time he’s actually an old man?

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