Larry LaRue: Just breathe — Health Department home visit can help kids

Staff Writer Staff WriterDecember 16, 2013 

Katherine Brewer is a doctor specializing in allergies and asthma, which means she’s as much a detective as a physician.

“Kids with asthma each have different triggers – anything from cold air to cigarette smoke, pet dander to chlorine in the water,” she said. “We ask questions when we talk to the parents, but sometimes the answer is in a question no one would think to ask.”

Example?

“We always ask about pets, and this family with three asthmatic children said they didn’t have any,” Brewer said. “I referred the family to the ‘Clean Air for Kids’ program, and one of the women in that program visited the home.”

She found a large part of the problem.

“The family did not have pets,” Brewer said, “but there was a feral colony of 13 cats living beneath their trailer. Without a home visit, we’d never have found out about it.”

Given the correct medication, children with asthma can live normally, even participate in sports and other activities. The problem, at times, is finding the precise nature of each child’s problem.

Brewer, the director of the Woodcreek Healthcare Allergy and Asthma Clinic in Puyallup, said she and others have come to rely on the Tacoma-Pierce County Health Department.

In the past 11 years, the department has used the Clean Air for Kids program to reach out to more than 2,000 children in the county. Program director Judy Olsen said that’s from a pool of more than 14,000 children with asthma.

“The family doctor can refer the case to us or the parents can call,” Olsen said.

About half the time, families that have been referred are receptive to a home visit.

“The others won’t allow us to come.”

That doesn’t surprise Olsen or Brewer, who both are working to ease a stigma attached to having a health department representative drop by your home.

“We hear a lot of vacuums running when we get to the door,” Olsen said, laughing. “There’s no white-glove test, we’re not there to fine anyone for anything. We can test walls with mold – it’s not uncommon in the Northwest to find mold – check for dust mites, check on pets.

“We never advise anyone to remove a pet from the home; that’s a family member,” she said. “We brainstorm and try to find ways to separate the triggers from the child’s room, where they’ll sleep and spend most of their time.”

In the past few years, the Health Department has taken an increasingly public stance against indoor smoking, such as in rental houses. It consulted with the Tacoma Housing Authority last year when the authority banned all smoking in public housing units.

But Olsen said the “Clean Air” home visitors will never demand a parent quit smoking.

Brewer understands the initial standoffish reaction of her clients.

“I’d feel anxious about the Health Department coming to inspect my house, too,” she said. “But I’ve met the women involved in this program, and they’re not coming to critique housekeeping.”

In almost every home visit, Brewer said she has learned something she wouldn’t have known otherwise.

Left untreated, asthma is a devastating condition.

“It’s a chronic illness, an inflammatory condition,” Brewer said. “It can cause your airway to constrict to the point you feel you’re breathing through a straw. The symptoms are usually coughing, wheezing, a tightness of breath and a notable decreased quality of life.”

In the first nine years of the health department program, only two women made the visits. Now, there are five, and they come better-armed.

“Dust mites are a common trigger, and they need 50 percent humidity to survive,” Olsen said. “We measure humidity, and if it’s high, we can suggest ways to reduce it. We can give them free allergen-fighting pillow and mattress covers.

“We can measure the moisture in a wall, We have renters who face these problems, and we can work with the landlord to help get them taken care of.”

Olsen is well aware that parents with asthmatic children often lose their jobs because of a child’s frequent hospital visitations. With that in mind, she and others involved will schedule evening visits, Saturday visits, to fit in with a family’s schedule.

The truth is that with asthma, people can live normal lives – even extraordinary lives.

“Olympic swimmer Michael Phelps is asthmatic,” she said.

Larry LaRue: 253-597-8638
larry.larue@thenewstribune.com

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