Swollen tonsils turn into an emergency procedure

When 7-year-old Cole woke up at 2:30 am on May 8 with a croup-like cough, his mom Donna Johnson wasn’t all that worried. After all, her son had experienced croup – an upper airway infection that is often accompanied by a barking cough like Cole had – in the past and cold air allayed his symptoms then.

She took her son outside to get some fresh air to see if that would help, but it didn’t. “I gave him some cough medicine and had him sitting up and taking deep breaths to get him settled down,” Johnson, of Hahira, Ga., remembered. “He was just a little short of breath at first, but 30 minutes later, he started coughing again. I knew he needed to go to the emergency room, but when I saw blood on the edge of his mouth, I immediately called 911.”

Johnson took Cole back outside to wait for the ambulance. “His breathing was becoming very hard and he was no longer coughing,” she said. “I had my arm around his waist and put my hand under his chin, holding him up so he could breathe. He was sweating and he looked like he about to pass out. He was turning a washed-out, gray color and he was so scared, so I started singing his favorite song to him, ‘Joy to the World.’ But I was getting really, really scared.”

What seemed routine became life-threatening

The ambulance arrived, and paramedics gave him an oxygen treatment.

“When we got to South Georgia Medical Center [in Valdosta], they thought Cole had pneumonia in both lungs, but his breathing was getting worse and worse and worse,” said Johnson. “The ER doctor said, ‘I don’t like to do this with anyone but an adult, but I have to intubate your son. It is so hard for him to breathe that if we don’t do it now, we won’t have a choice but to do it later.’”

Donna and her husband, Mark Johnson, agreed to the procedure, and the doctor sedated Cole. “They started pumping blood and stuff out of his lung,” she said. “The doctor said, ‘We don’t know what’s going on, and there is no Pediatric Intensive Care Unit at South Georgia Medical Center, so we have to get him somewhere else.’”

South Georgia Medical Center contacted Wolfson Children’s Hospital of Jacksonville, which sent a team to transport Cole from Valdosta to Jacksonville, Fla.

The Kids Kare Mobile ICU transport team with Wolfson Children’s Hospital was dispatched, flying in on the LifeFlight air ambulance.

“That’s when it got real,” said Johnson, who took photos and video with her phone of her son being loaded up. “We watched until we couldn’t see the helicopter anymore, and then my husband and I drove to Jacksonville.”

Trying to find answers

Cole was admitted directly to the Pediatric ICU at Wolfson Children’s Hospital, which is where he was when the Johnsons arrived.

“They tested for everything under the sun,” Johnson said. “They did blood cultures, viral and bacterial, for 24 hours but we still had no idea what was going on. Dr. [Karen] Lidksy [medical director over Pediatric Neurointensive Care at Wolfson Children’s], consulted with a pediatric ear, nose and throat physician, Dr. [Angela] Black, who said she wanted to do an exploratory scope in the OR to look for airway abnormalities or injury.”

During the endoscopic procedure, Dr. Black found that Cole’s tonsils were so swollen that the only thing that had kept the boy’s trachea open was being intubated.

The ER doctor’s decision back in Valdosta may have saved Cole’s life. 

“Dr. Black said she wanted to take his tonsils out right away. She told us he had the largest tonsils she had ever seen on a child,” Johnson remembered.

After removing Cole’s tonsils, doctors decided to keep him intubated and sedated for 24 hours after surgery, checking his blood gas levels and making sure everything was alright.

Soon, Cole required only nasal oxygen and then was soon breathing on his own. He was discharged from Wolfson Children’s on a Saturday, and was back to school that following Thursday.

“They weren’t able to find a reason why his tonsils were so swollen,” Johnson said. “We don’t know if he was allergic to something or what. He was diagnosed with negative-pressure pulmonary edema [where the lungs fill up with fluid when they are trying to expand against an obstruction (tonsils)].”

Despite not having clear-cut answers about what led to Cole’s severe case of tonsillitis, Johnson knows one thing to be true. “It wasn’t his time to go.”

Reunited, and it feels so good!

Although Cole doesn’t remember his helicopter ride because he was sedated, he was very interested in seeing the helicopter that transported him from Valdosta to Jacksonville. He also asked his mom if he could meet the people who saved his life. The reunion, held on June 28, 2018, was arranged by Wolfson Children’s Hospital and Air Methods, which owns the LifeFlight helicopter that was used for transport.

Cole's family couldn't be more grateful for the care he received, and for the opportunity to meet the crews and take tours of the helicopter and the Kids Kare unit. "It's a day we'll never forget!" said Johnson before the family headed back to Hahira.