‘It wasn’t “just asthma” – it was fatal asthma in the end’

Sociable and sporty, 11-year-old Conor Callaghan was excited about the prospect of starting sixth class at Dromin National School, Co Louth in August, 2017. He had his brand new Lionel Messi schoolbag all packed, with one more week of the summer holidays to go.

His mother, Selina, had made sure the new bits of uniform, runners and anything else needed were bought in good time. “We wanted the last week of the school holidays to be fun.”

Friday, August 18th, 2017 “was like every other day”, she recalls. That afternoon Con (as she always called him) spent a few hours outside in the back garden of their home in Cappogue, Dunleer, contentedly kicking a ball around.

“Small but mighty”, as his mother describes him, Con had to cope with asthma but it seemed to be under control. A keen player of soccer with Dromin Utd and Gaelic football with St Kevin’s, he was physically fit but knew to take an inhaler with him wherever he went.

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“He was obviously aware of it but he lived his life. I wouldn’t say asthma impaired it in any way,” says Selina. He had even had a whole year without any episodes whatsoever but then it “started to creep in again”.

There was a family party nearby that Friday evening, at which “Con had a fantastic time”, she says, but they didn’t stay late as her husband, Justin, had work the next day in his butcher’s shop on West Street in Drogheda. “Coming home in the car, Con felt a little bit wheezy, nothing major. He always had an inhaler in the car and took a little puff.”

He walked from the car to the house and they asked him if he thought he also needed the nebuliser. “No harm,” he replied and started to use that. “A minute or two into the nebs, he just didn’t seem right so we took the mask off and he just wasn’t right,” says Selina. With Con slipping out of consciousness, his nana, a nurse who lives across the road, was called and she started giving him cardiopulmonary resuscitation (CPR). An ambulance was there within six minutes.

“They worked on Con a good bit and did everything in their power but nothing was working. He wasn’t responding. They took Con in the ambulance and we followed.”

Medical staff were with Con in a room when the couple arrived. “They said we could go and talk to him, which we did. And they were working on him and working on him. “But nothing would work. Con was gone. It was extremely sudden. You have no time to register. Everything just changed in minutes.”

Selina and Justin have asked themselves could they have done anything different that night but, looking back, they know everything possible was done in a very short space of time.

‘Shockingly quickly’

“It happened shockingly quickly and the outcome for Con was not going to be any different,” says Selina. “That is the hard part to comprehend.”

More than one person a week in Ireland dies of an asthma attack. The Callaghan family want others to be aware of just how unpredictable an illness it can be. "You don't really hear stories like that and after Con passed, I hear more and more of them. It is not highlighted enough that asthma can be fatal," says Selina.

With about 20 per cent of children here suffering from asthma at some stage in their lives, Ireland has the fourth-highest incidence out of 90 countries worldwide, according to an International Study of Asthma and Allergies in Childhood. "We're not really sure why we see these differences in prevalence," says respiratory consultant Dr Marcus Butler, the medical director of the Asthma Society. "But the majority of asthma in childhood is allergic in basis.

“We just happen to have a rich array of allergens in this part of the world. Our temperate climate suits allergens,” he says. The pollen season is kicking off right now, but the most significant all-year-round, indoor allergens include the dust mite and cats and dogs

The high prevalence can lead to complacency. “People tend to say ‘it’s just asthma’ but there are some kids, and my Con was one of them, where it wasn’t ‘just asthma’, it was fatal asthma in the end,” says Selina.

“Asthma is notoriously variable,” says Butler, “that’s how we separate it from other chronic respiratory diseases. People can be feeling perfectly normal for long periods of time and then have really debilitating spells, going on for weeks or months of being chesty.”

The treatments are very effective in keeping symptoms away, once they are adhered to, he says. However, “even with the best asthma care, some asthma deaths are unavoidable”.

Internationally, the asthma death rate has come down dramatically over recent decades, he reports. Ireland’s rate of fatalities is down too compared to 40 years ago, thanks to better awareness, improved medication and greater understanding of the dangers in treating asthma.

“But there is still a long way to go,” Butler warns. Our annual asthma death rate, based on 2019 data, is approximately 1.4 deaths per 100,000 of the population, compared to 2.2 per 100,000 in the UK but just 0.6 in Canada or 0.4 in Italy per 100,000.

Plunged into grief

Behind those statistics are individual families and communities who are plunged into grief with no warning. “When Con died, that little part of all of us died,” says Selina. “In the space of minutes, your whole future with Con is gone. As much as you try to get your head around it, you cannot do it.”

Selina and Justin talk about Con constantly and include him in everything, "keeping his memory alive in so many ways", both within the family and the community. The league in which Con's soccer team played now has the under-12s competing for the Conor Callaghan Cup and he is also remembered in local fundraising for the Asthma Society of Ireland.

It is in support of the society’s recent Asthma Awareness Week (May 1st-8th) that Selina is giving this her first media interview. She has always loved talking about Con but, for a long time after his death, she couldn’t bring herself to look at a photo of him. In conversation, she would picture him in her head but to see an actual photo “was like a knife to the heart”.

The Callaghans did everything they could to keep Con’s asthma under control ever since the day Selina noticed, when getting him dressed, that “he was breathing slightly heavy and his stomach muscles seemed to be going a bit too fast”. She took him to the GP, who referred him to A&E to be on the safe side.

They had more incidents like that before he was definitively diagnosed and prescribed medication. “We had good months and bad months, that’s the way asthma goes. We managed it.

“Con was very aware of his asthma; he would always come to me if he didn’t feel well.” Giving him the medication at home was usually enough; if not, they would be off to the GP.

Most times the use of steroids and nebuliser there would work but sometimes they would be referred to the emergency department of Our Lady of Lourdes Hospital in Drogheda, where he might have to be given oxygen and was admitted on a few occasions.

A five-night stay was the longest but she thinks that was down to a chest infection, for which they were administering and monitoring antibiotics. Aside from the fatal asthma attack, she can remember only one previous alarming episode, which had been managed speedily.

Idolised Messi

A Chelsea fan, who also idolised Messi and Barcelona, Con would come off the pitch if he didn’t feel good. “He would know himself, if he carried on it could develop into something else.”

His sister, Clodagh, was 14 when she lost her only sibling. “They were little buddies, very close,” says their mother. She was due to start her Junior Cert year that September, “which was important to her, she likes school”.

Although very nervous, she went back on the first day of term, “took it in her stride and never missed a day,” says Selina. Now Clodagh (18) is doing her Leaving Certificate having had to cope, like all those in the class of 2020 and now 2021, with the pandemic disruptions.

“We are so proud of Clodagh and everything she does,” says Selina.

It was very quiet in the house after Con’s death, so Selina and Justin decided they would try for another baby “and see if it happens”. In September 2018, just after Con’s first anniversary, their third child arrived.

“Little Tristan helps a lot,” she says. “He keeps us busy.” While he looks quite like Con, “they are nothing alike in personalities,” she laughs. Right now, he’s a typical “rough and ready” two-year-old boy. Con was bit more laid back and easy going.

Nearly four years on, Selina still plans things for Con, “even though I know I shouldn’t”. Like what sort of party he might have had when turning 15 this August. “We’d love to see Con as a 15-year-old boy and what he would do now in his life,” she muses. “His personality would carry him through anything.

“He was very outgoing, very social and would put his hand up for anything. I knew Con’s future was going to be amazing.”

But it wasn’t to be. Con was buried in Dromin cemetery, dressed in half Chelsea kit and half Barcelona kit – “we knew he would never have been able to choose between the two” – with the unused school bag by his side.

Read: What is asthma and how is it diagnosed in children?