When a child comes through the door of a Mobile C.A.R.E. Asthma Van for the first time, the appointment will likely take between 45 minutes and an hour. Our healthcare providers are by no means especially slow about their work—they can pack in more than a dozen appointments each during a typical school day—but because asthma management has a number of moving parts, we must be very thorough before forming a management strategy. A failure to consider even one element can undermine all of our other efforts.
Nowhere is thoroughness more necessary than with allergies. If you look at the CDC’s list of top asthma triggers, you’ll notice that the majority (such as pet dander, cockroaches, dust, mold and pets) are all among the top allergens as well. The Asthma and Allergy Foundation of America estimates that roughly 70% of asthmatics have what’s called “allergic-asthma,” in which a combination of allergies play a dramatic role in closing airways and causing attacks. Substandard housing conditions in low-income areas often hold many such triggers, but most parents don’t know that allergies cause asthma exacerbation.
To give an example, I was diagnosed with asthma when I was very young and have been on some type of medication as long as I can remember. I didn’t, however, know for sure what my allergies were until I was tested later in life. Since being tested and knowing which triggers to get rid of, my asthma has improved significantly. I’m sure many readers have similar stories. Allergies can counteract controller medications, effectively putting your body back where it started and making all that money spent on medication mean a lot less than you thought.
One of the services we provide for kids coming to an Asthma Van is free allergy testing. When a child has an attack and is rushed to an emergency room, they receive care to stabilize their condition, typically not allergy tests that help determine their asthma triggers. Primary care physicians might not bother with them either. If a family lacks comprehensive insurance, as a plurality of our families do, the likelihood is that they will never receive an allergy test. Yet what good is it to recommend that kids take all that expensive medication if there’s a high likelihood that something in their environment is negating its effectiveness?
This was highlighted for me when I had a chance to talk with Ms. Shu, the mother of an Asthma Van patient, a few months ago. Her son, Brian, was diagnosed with asthma in an ER at age 3, but he didn’t receive treatment before coming to an Asthma Van in the second grade. “The Asthma Van made an important difference,” Ms. Shu told me. “I knew that he was allergic to something in the house, but I didn’t know what it was.” Our Asthma Van physician administered an allergy test at no cost, and found that Brian was allergic to cats. And guess who had a cat!
That experience brought home for me why we need to be doing more to emphasize the importance of allergy testing to control asthma (as well as the need for asthma experts to do home environmental inspections, but I’ll have to talk about that another time). It may take a little longer to administer an allergy test, and it may be a little more expensive on the front end, but ensuring that a child’s medication is making the difference it’s supposed to will actually save a great deal of money long-term and will have the added benefit of significantly improving the quality of life for patients. Parents can’t remove allergens they don’t know about. We should give them the resources they need to help their children.
This post originally appeared on the SoundAsthma blog.