Izaiah Fiedler was outgoing and kind-hearted – he wanted to help people as a doctor and missionary. When he died in May 2017, nothing about it made sense, his mom says.

Izaiah Fiedler grew up in eastern Oklahoma, in the city of Tahlequah, one of about 16,000 living in the heart of Cherokee County. Small in stature compared to others his age, family and friends took to calling him “Itty Bitty,” and eventually just “Itty.” The nickname stuck.

Izaiah made up for his lack of size with a kind heart and big dreams.

When he turned 4 years old, Izaiah announced to his family his chosen career path: he wanted to be a missionary. It was no surprise. “That was his passion,” says Izaiah’s mom, Dru Carey Teehee. “He always wanted to learn more about God. He would carry his Bible and talk to others about God. He was very active in church. He really cared about people.”

Diagnosed with asthma at age 10, Izaiah discovered a new passion – healthcare. As he learned to manage the disease, he coupled his budding interest in medicine with his dream of being a missionary.

“Izaiah wanted to go to other countries, especially third-world countries, and provide medical help. What better way to reach people?” Dru says.

Everything was going according to plan.

But something changed.

On May 6, 2017, Izaiah took his own life, at the age of 17.

Severe Asthma, Suddenly

In the spring of 2016, as Izaiah was finishing his sophomore year at Tahlequah High School, his asthma gradually worsened. He struggled to run cross country and track, and eventually stopped altogether. (“He could hardly run even a little bit without his asthma bothering him,” Dru says.) He stayed indoors most days to avoid outdoor allergens that triggered symptoms.

And when symptoms were at their worst, he made repeat trips to his doctor and the emergency department. At one point, an ER doctor said Izaiah’s lungs were so swollen they were pushing up against his rib cage, causing intense pain.

Izaiah continued to take the daily medication his doctor prescribed – Montelukast (Singulair®), which blocks chemicals called leukotrienes that cause inflammation, swelling and tightening of the airways. They are often prescribed when inhaled corticosteroids alone do not control asthma symptoms.

Montelukast is tolerated well by most asthma patients to whom it’s prescribed, but it has a host of potential side effects – including depression, behavior and mood changes, and suicidal thoughts and actions in some patients.

Dru says doctors never informed her or Izaiah about these potential side effects, never advised her to monitor Izaiah’s behavior or mood. She believes the medication’s side effects caused him to take his own life.

“Nothing about it made sense,” Dru says. “Izaiah was so full of life. He was class president and ranked 15th in his class. He had many friends and family who loved him. He had so many goals. He was planning for the future. He wanted to have kids; he even had names picked out for them.”

She learned about the link between Montelukast and suicide from a support group months after his passing.

“I was floored,” Dru says. “I was the one always making sure he was taking his medication so that he wouldn’t have an asthma attack. It was heartbreaking.”

Advocating in Izaiah’s Name

Since Izaiah’s passing, Dru has become a tireless advocate for improved asthma care and suicide prevention. She has worked to raise awareness of the need for asthma education, especially in underserved areas and high-risk populations such as Native Americans. (Studies show Native American children are at high risk for asthma and are hospitalized or die from the disease more often than almost any other group.)

Last May, Dru and her family – daughters Kieran, Alyssa and Kyla, son Jacob and Kieren’s husband Justin Foster – traveled to Washington, D.C., to attend Allergy & Asthma Day Capitol Hill and share Izaiah’s story. (Daughter Kasha and her husband Tristan Trumbla and Izaiah’s grandparents Dewitt and Anna Teehee were not able to attend.)

They addressed a Congressional Lunch Briefing hosted by Allergy & Asthma Network and met with Oklahoma Sens. James Inhofe and James Lankford and Rep. Markwayne Mullin to urge for better-quality healthcare in Native American communities.

“Growing up, I didn’t have asthma and I didn’t know anyone who had asthma, so when Izaiah was diagnosed with the disease, I expected the doctors to help us through it,” Dru says. “But mostly we were told, ‘It’s just asthma, Izaiah’s fine.’ And then we would be given a prescription and rushed out of the office.”

One time, a doctor referred Izaiah to an asthma specialist, but another doctor at the same practice called the referral unnecessary – adding to the confusion.

“We never had an explanation on what asthma is, or what was happening inside Izaiah’s lungs, until his asthma turned severe,” Dru says. “He was not given a peak flow meter or spirometry to evaluate his breath flow until 2016. When a patient is diagnosed with asthma, all of this needs to be up front. We needed more information and support.

“Healthcare professionals need to take all cases of asthma very seriously, right from the beginning.”

Dru also wants doctors to be more proactive in explaining a medication’s potential side effects. “If patients know what to watch for in terms of side effects, I think they would be more apt to tell the doctor, ‘I’m having a problem, and it could be this medicine. We need to change it,’” she says.

Dream to Reality

The pain of Izaiah’s passing lingers, but Dru finds solace in his legacy. In a way, Izaiah’s dream of being a doctor, a missionary, has become a reality – through Dru’s advocacy, he is helping others.

“No matter who you are or where you live, everyone with asthma deserves equal access to quality healthcare and patient education,” Dru says.