Severe Asthma and Allergies: Mena's Story

Mena, 17, is breathing easy and thriving after several years of struggling with severe asthma and food allergy symptoms. She is being treated with a biologic therapy at the Allergic Asthma Program at Children's Hospital of Philadelphia (CHOP).

Mena was a freshman in high school when the asthma symptoms she had been dealing with for years escalated sharply.

Mena's asthma was manageable when she was in the second grade and the family moved to Philadelphia. But in middle and high school, her symptoms grew worse and included frequent wheezing and difficulty breathing. By the time Mena had reached ninth grade, asthma was taking over her life.

“Anytime she went on a field trip to a camp ground, she’d be sick for almost a week,” explains her mother, Madhavi, who's a primary physician. For Mena, almost anything could trigger her symptoms including environmental allergens like dust and mold, and food allergens like nuts.

"She couldn’t travel anywhere or volunteer anywhere without coming back congested," Madhavi said.

A common cold could turn into a serious chest infection for Mena. “She would end up with difficulty breathing and congested chest and airways," says Mena's dad, Srinivas. To treat her symptoms, Mena received regular oral steroids, but it often would take time to bring her relief, says Srinivas.

Mena missed 5½ weeks of school her freshman year due to her asthma and ended up in the Emergency Room after a particularly severe asthma attack.

Initially, her doctors prescribed high-dose steroids to calm the inflammation, but the steroids weren’t as effective as doctors had hoped. Searching for answers, Mena's family sought out other experts including a local pediatric pulmonologist. Unfortunately, Mena’s asthma did not respond to standard treatments.

Allergy history

When Mena was a baby, she was diagnosed with several IgE-mediated food allergies and asthma. Her parents, both of whom are medical doctors, grew accustomed to managing her allergies.

More About IgE-mediated food allergies

“She’s had reactions to every nut and legume you can think of,” explains her dad. “She would break out into a rash, hives, have difficulty breathing, and could have an anaphylactic reaction. That’s why we have to watch like hawks and make sure when we are in a restaurant that the food is safe for her.”

While Mena and her family could manage her food allergies with extra caution and care with her diet, Mena’s asthma quickly became a force of its own. Over the years, it increased with such severity and frequency that it was tough to control the symptoms.

Turning to CHOP

It wasn’t long before the family turned to Children’s Hospital of Philadelphia (CHOP) for an evaluation of Mena’s complex and multifaceted condition. Mena was already seeing Anne Rosato, MD, FAAP, a pediatrician at CHOP Primary Care Center in Paoli, PA.

Madhavi says:

We realized, why not go through CHOP because it has the best doctors in the world?

"We went online and researched and found Sigrid DaVeiga, MD, Co-director of the Pulmonary Allergy Personalized Asthma Clinic, an attending physician with the Allergic Asthma Program and The Allergy Program at CHOP," says Madhavi.

Dr. DaVeiga was the third specialist the family consulted over the course of Mena’s freshman year of high school, and she and her staff would become, as Mena’s father explains, “a godsend.”

Mena and her family visit Dr. DaVeiga at CHOP’s Specialty Care & Surgery Center in Exton, PA. Mena’s mother had heard of a relatively new biologic treatment for severe asthma. She discussed with Dr. DaVeiga whether Mena would be a good candidate for the medication and Dr. DaVeiga agreed.

A blood test measuring the amount of IgE in Mena’s blood — an antibody the immune system creates in response to allergens — confirmed that Mena would respond well to the biologic medication. The test also helped determine how much of the medication she would needed and how often she should take it. Mena began injections of the biologic therapy in August 2016, and continues to receive the medication every three to four weeks.

“I can tell a big difference," Mena's mom says. "Mena used to get sick as soon as school started and then miss a week. Now, even if she does get sick, we noticed she’s only out of school for a day or two and she doesn’t have to rely on oral steroids nearly as much. She gets better on her own and we don’t have to rely on constant antibiotics,” explains Madhavi.

“The therapy has had an incredible effect in Mena,” added Srinivas.

“It helped get my asthma under control,” Mena says. “When it was out of control, I was missing birthday parties and going out with friends.”

Biologic therapy

Biologics agents for asthma provide targeted therapy for patients with specific types of asthma when a patient is not responding to conventional therapy. Mena's biologic therapy reduces inflammation in the lungs of patients who suffer with severe asthma by targeting and blocking receptors in the body that cause the inflammation that triggers an asthma attack.

“It reduces the time of the chest inflammation, and it has reduced the number of days Mena has been sick,” explains Srinivas. “She hasn’t missed as much school and we feel like we finally have it under control.

For parents who have children with chronic conditions that can't be "cured," management and control of the condition is the optimal. "We feel like we are able to manage the allergy and asthma in a much better manner now,” Srinivas says.

Mena's breathing has improved, as well as her ability to manage her asthma. She still has occasional flare-ups — notably one during her sophomore year of high school that brought her to the emergency department at CHOP. But for the most part, Mena’s asthma has stabilized and she has a plan, developed with the help of Dr. DaVeiga, to manage future symptoms or flare ups.

Bright future

Mena is now a senior at a private prep school for girls in Philadelphia. This year, she's only missed three or four days of school. Her treatments have allowed her to flourish and she's planning to live away from home at college. She wants to study International Relations and Foreign Service and will be attending the University of St. Andrews in Scotland.

Mena and her family are already researching local allergists near her school so her condition can continue to be monitored and she can keep receiving the biologic therapy while she’s away.

The family credits Mena's 180-turn around to the top-notch care they've received from Dr. DaVeiga and her staff, especially administrative coordinator Christina Johnson, who has helped wrangle complicated family schedules for appointments every 3-4 weeks at CHOP Exton.

Madhavi says:

We are just very happy with the treatment and the staff has been amazing.