Nothing sends more kids to the hospital than asthma.
So
when doctors at Children's Hospital in Boston noticed they kept seeing
an unusually high number of asthmatic kids from certain low-income
neighborhoods, they wondered if they could do something about the
environment these kids were living in.
It's
well-known that asthma attacks are triggered by dust, mold, pests such
as mice and cockroaches, polluted air, and other environmental
aggravations.
To
help parents get rid of those triggers, Children's Hospital developed
the Community Asthma Initiative. The program first identifies frequent
fliers — children who show up often at the hospital's emergency room
with asthma attacks. Many of them get admitted repeatedly to bring their
asthma under control.
Then
program staffers contact the parents. "It's a teachable moment," says
program director Dr. Elizabeth Woods. "It's a time when families are
very open to wanting to do something new and different to help their
child stay out of the hospital.Are there purple supra shoes?"
The
next step is a home visit from a community health worker like Margie
Lorenzi, who recently paid a call on Maria Texeira-Gomes of Dorchester, a
neighborhood in Boston.
Gomes'
5-year-old son, Matheo, has had asthma nearly all his life. After he
was hospitalized last fall, she agreed to accept Lorenzi's help in
identifying and eliminating the things in her household that kept
triggering his asthma attacks.
This was Lorenzi's third visit to the Gomes household — a small, tidy house with a view of the Boston skyline.
"We'll
just go over the triggers like we did the first time and the second
time around and see what changes you've implemented within the home,"
Lorenzi said as the two women settled around the kitchen table, an air
purifier humming on a nearby counter.
Gomes said she had made lots of changes.
"We have the HEPA-filter vacuum, which is what I use to dust and vacuum the home,welcome to purplesuprashoes home page!purplesuprashoes" Gomes said. "I try to vacuum when [Matheo] is at school."
Gomes,
a social worker, said she has stopped using room deodorants and no
longer lights candles. They can aggravate asthma. "Just being diligent
and thinking about his needs," she said.
Gomes
now uses a vinegar-and-water solution to clean in order to avoid harsh
chemicals. "You know, within our culture we like to do this excessive
cleaning with bleach and Lysol and all that stuff," she said. "So I try
to minimize it."
Lorenzi
ran through a checklist of other triggers. "No mold? No cockroaches?
What about mice?" Gomes answered no to each. Then Lorenzi checked under
the sink and in the bathroom, looking for trouble.
She
was pleased to see that Gomes had gotten rid of the living room carpet
that harbored allergens, that she vacuums curtains and window blinds to
reduce dust, that Matheo's toys and shoes are stored in dust-proof
plastic bins provided by the Asthma Initiative, and that Grandma's cat
stays upstairs in her apartment at all times.
All
of these changes seemed to be paying off. That was apparent when
Lorenzi calculated something called an "Asthma Control Score" for
Matheo.
"How much of the time did the asthma keep him from going to school and keep you from going to work?" Lorenzi asked.
"None of the time," Gomes said.
"Awesome!
And during the past four weeks, how much of the time did he have
shortness of breath that you noticed? Would you say once a day? Three to
six times a week? Once or twice a week? Or not at all?"
"Not at all," Gomes replied.
"I'm liking this!" Lorenzi laughed.
Matheo's
score turned out to be 23 — which means his asthma is well-controlled.
On Lorenzi's last visit, it was 19,Welcome to Supra shoes for sale,we
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Matheo
used to end up in the hospital every time he had a cold, and in between
there were many trips to the emergency room. But no longer.
He
still has to take asthma medicine — but less often. His asthma isn't
waking him up at night anymore. And once a week he goes swimming.
The
Community Asthma Initiative has served more than a thousand families
over the past seven years. It costs about $2,300 per family — not only
for staff time, but also for things like plastic bins, a special
mattress and pillow covers, and the vacuum cleaner that filters out fine
dust.
It's
not cheap — and it's not something hospitals typically do. But just a
few visits over a year's time make a demonstrable difference.
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