Remembering Carson: Parents of Woodbrook student urge calm
News that a local boy died after a bout with H1N1 has made headlines, but the father of Carson Raymond, the Woodbrook Elementary School third-grader who died October 10, says he and his wife do not want what happened to their son to incite panic.
"Parents should not be freaked out that their kid is going to die from this," says John Raymond, noting that H1N1, commonly known as swine flu, is usually no more serious than regular seasonal flu for the average child.
"Carson," his father explains, "just had the wrong body for this illness."
Since it first emerged last spring in Mexico, H1N1 has spread around the globe, and its potential severity has been the subject of constant prognosticating–- particularly as some experts invoke the "Spanish Flu" pandemic of 1918, which killed half a million Americans and at least 50 million people worldwide.
Most of those 89-years-ago deaths occurred in the fall and winter, when a mutated and deadlier version of the spring strain emerged. So far, according to the CDC, this time around, H1N1 has not mutated into something more deadly– though there have been fatalities, just as there are each year with seasonal flu. And it is possible H1N1 will prove more deadly as flu season progresses.
The most recent data released by the Centers for Disease Control indicate 76 laboratory confirmed pediatric deaths from H1N1 since April (There have been 830 deaths including both children and adults). Over the last three years, the number of pediatric deaths from seasonal flu has ranged from 46 to 88 per year. Of this year's H1N1 victims, an estimated 70 percent had a known underlying condition.
On September 28, a 47-year-old man died of suspected complications from H1N1 at UVA hospital. According to UVA Medical Center spokesperson Sally Jones, the man was more susceptible to the virus due to an underlying health condition. And Carson Raymond, his father says, also falls into that category.
Carson, the oldest of the Raymonds' three boys, was born more than two months premature. Arriving at just 30 weeks and weighing just 3 pounds six ounces, the first 51 days of his infancy were spent in a hospital. While Raymond says doctors haven't suggested that Carson's difficult start contributed to his later health problem, his heart condition rendered him particularly vulnerable to any strain of influenza.
Two and a half years ago, when Carson was six, Raymond says, he contracted a common seasonal strain of Type B flu and nearly died after suffering viral myocarditis, a potentially fatal inflammation of the heart muscle. The condition lasted six months, says Raymond, during which time Carson had regular appointments with both a cardiologist and his pediatrician.
By this past February, however, approximately a year and a half after Carson's heart had returned to normal, doctors assured his parents their sports-loving son was well. This fall, he was playing in the Northside Cal Ripken Baseball League, as he had every year since he was four, and was thriving at school and at home, where his father described him as "a great big brother" to six-year-old Tucker and four-year-old Wyatt.
"He was always taking care of them," Raymond says, "letting them win."
In addition to sports, Carson–- who turned 9 September 25–- enjoyed Pokemon and video games. The blond boy with a dusting of freckles across his nose was "one of those kids who never had an enemy," says his mom. "He was just a nice boy who was a friend to all."
Despite doctors' assurances, when their son fell ill with flu-like symptoms earlier this month, his parents immediately took him to a pediatrician, where on Monday, October 5, he tested positive for Type A flu. According to CDC spokesperson Amanda Aldridge, "almost all" of the influenza viruses identified so far in 2009 are Type A H1N1 and are responsive to antiviral drugs including Tamiflu.
After two days on Tamiflu, however, Carson seemed lethargic, his father says, and his mother, Jennifer Raymond, took him back to the doctor to have him checked on Wednesday morning, October 7. His heart function appeared to be normal, but by that evening, concerned that he was dehydrated–- and recalling the terrifying ordeal the last time he'd had a flu–- the Raymonds took Carson to UVA hospital, where doctors assessed his heart function.
By stethoscope and EKG, his heart seemed to be functioning normally, his father recalls, but in an echocardiogram less than an hour later, doctors discovered his heart was, in fact, enlarged. With both parents present, his father says, Carson suddenly went into cardiac arrest.
Because he was already in the hospital, doctors were able to revive and stabilize him by Thursday morning, but the inflammation meant he was unable to his maintain blood pressure. By Friday, Carson was placed on life support. He died on Saturday.
Even amid fresh grief, John Raymond says he is grateful to the team of doctors and nurses who stayed with them during the ordeal.
"They worked incredibly hard and were so compassionate," says Raymond. "I don't know how they do that job every day."
Raymond says he's also grateful for the time he and his wife were able to share with Carson in the hospital. Despite being heavily sedated, Carson opened his eyes several times and looked at his parents as they spoke to him.
"As horrible as it all is," says an emotional Raymond, "my wife and I were able to have a few moments at the end to say goodbye."
Raymond says Carson was part of a "very small" percentage of children who will have an "over-the-top" reaction to flu. Because of his earlier heart problems, he was already participating in a study being overseen at UVA by Dr. Doug Willson in UVA's Pediatric Intensive Care Unit investigating why certain children have such severe flu responses. As part of that study, Carson's parents have submitted DNA samples so researchers can attempt to determine if there is genetic component.
According to Willson, pediatric viral myocarditis is "rare," although its exact prevalence is unknown–- in part because many times a child recovers without it being diagnosed. Of those children suffering severe enough myocarditis to require hospitalization, 25 percent will die, says Willson.
Still, despite the potential for the H1N1 flu season to prove more deadly than seasonal flu, "parents don't need to panic," says Dr. Greg Gelburd, a family practitioner who, in addition to prescribing Tamiflu for patients with underlying conditions, regularly recommends the over-the-counter homeopathic flu remedy Oscillococcinum. Although little research has been conducted on the remedy, Gelburd says he believes it lessens the flu's effects in his otherwise healthy patients.
And what of the H1N1 vaccine? Albemarle County and Charlottesville public schools have announced H1N1 vaccinations to students over the next several weeks, and most pediatricians are urging parents to vaccinate their children, despite some parents' concerns over safety.
"We have had literally hundreds of millions of people vaccinated against flu with flu vaccine made in this way," says CDC Director Thomas Frieden in an October 6 teleconference. "That enables us to have a high degree of confidence in the safety of the vaccine."
Frieden further notes that vaccination is important not only in preventing individuals from getting sick themselves and missing work or school; it also prevents the spread of the disease, a critical piece in public health management.
In the same week that they are planning a funeral for their first-born, John Raymond says that while he and wife Jennifer are planning to vaccinate their two younger children, they want to make sure Carson's legacy isn't one of irrational fear.
"There's no evidence to support that the swine flu is worse than the regular flu," says Raymond, expressing concern that if everyone rushes children to the emergency room at the first signs of illness, hospitals will become overwhelmed and "the people who really need the help won't get it."
"Carson just had the wrong tools to fight this fight," says his dad, who has already begun organizing a foundation to give young children access to a sport that Carson loved through improvements to the Woodbrook T-ball program including helping fund involvement by children who can't afford to pay. In lieu of flowers, the Raymonds ask that donations be sent to The Carson Raymond Woodbrook T-Ball Foundation, P.O. Box 6551 Charlottesville, 22906 or be made through the website, carsonraymondfoundation.com.
A viewing will take place Wednesday at Teague Funeral Home from 7-9pm, and Carson's funeral will be held on Thursday, October 15 at 3pm at the First Baptist Church on Park Street.
–last updated Tuesday, October 13 at 2:29 pm