Thorough & Expert Care: Family Twice Blessed

Soon after 8-year-old Remy Escal began having terrible episodes of breathlessness and coughing up “stones,” his mother, Angela Lujan, knew what she had to do.

“We’re not messing around. We are going to the best,” she told her family. To Angela Lujan, the best meant National Jewish Health, which had already saved the life of one family member.

Several years before, Lujan’s partner, David Espinosa, had been suffering mysterious symptoms that several physicians could not diagnose. His skin had changed color in places and had become stiff and tight. He had an intense cough, trouble breathing, stiffness in his hands and severe fatigue, among other problems. A dermatologist told him it was nothing to worry about, but Angela and David’s mother kept after him until he made an appointment at National Jewish Health. Rheumatologist Mehrnaz Maleki, MD, and pulmonologist Amy Olson, MD, evaluated David thoroughly and settled on a diagnosis of scleroderma.

“Drs. Maleki and Olson were so thorough,” said Espinosa. “They did a full-blown array of tests that allowed them to really understand what was going on in my body.”

Drs. Maleki and Olson then prescribed an intense treatment regimen, including chemotherapy, that now has Espinosa’s life-threatening condition in remission.

One night soon after David’s scleroderma went into remission, Remy rushed out of a restaurant in terror, panicked and crying, “I can’t breathe.

I need to go to the hospital.” He had several more sudden attacks of breathlessness over the next two weeks and then began coughing up what seemed like small stones — hard BB-sized balls of an unknown substance. The attacks were becoming more and more frequent.

With one lifesaving experience behind them, they turned once again to National Jewish Health. This time, Pamela Zeitlin, MD, chair of the Silverstein Department of Pediatrics, saw Remy.

“We will get to the bottom of this,” Dr. Zeitlin assured Remy and his mother during their first visit. “We are going to figure this out.”

They ran extensive tests of lung function, allergies and anything else that might shed light on Remy’s breathing problems. Dr. Zeitlin sent one of the stones off to the laboratory for analysis.

“You guys were phenomenal,” said Lujan. “She really checked him out.”

In the end, the stone was the key to a diagnosis. The laboratory reported that it was actually a small bit of bacteria surrounded by mucus that had dried out and become very hard. That confirmed Dr. Zeitlin’s suspicion that Remy was suffering from a specific form of asthma in which the mucus blocking his smallest airways was plastic-like and contributing to his chest pains.

Dr. Zeitlin prescribed an inhaled steroid used for asthma and his attacks stopped completely.

“Twice your doctors have gotten to the bottom of mysteries others could not solve,” said Lujan. “We are twice blessed and thankful to National Jewish Health every day.“