Mobile clinic brings healthcare information to children BALTIMORE, MD (wypr) - In Baltimore, asthma is a leading cause of school absenteeism, and at some schools as many as 20 percent of the students have the chronic lung disease. That's more than twice the national average for school-age children.

WYPR's Taunya English reports on a traveling effort to keep city students in the classroom - and out of the emergency room:





In Baltimore, an asthma and allergy clinic on wheels shuttles from one elementary school to the next helping families manage their children's asthma.

IC: "Every child should be able to take gym everyday, be able to run around with their friends every day and have a normal life."

Michelle Foster is a registered nurse on the Breathmobile:

IC: "Our goal is definitely to keep the kids out of the ER, and that can only happen with their asthma being controlled."

Foster and the staff from the University of Maryland Medical Center teach children - and their moms and dads - to make asthma care a part of everyday life. When patients climb on the 34-foot bus, first, there's an ear, nose and throat exam. Then, a nurse checks each child's lungs to make sure he's breathing easy:

IC: "It's important to do pulmonary function testing on every visit to determine whether or not the child's quality of life has gotten better, through the teaching and the medications that have been provided."

IC: "(checking lungs) Now when I do your back, I want you to pretend you're blowing out all your birthday candles at your next birthday. Now I want you to take a deep breath and blow... Good ... Good."

With asthma, three things work together to make breathing difficult. Redness and swelling of the lungs, muscle tightness and mucus buildup, all combine to nearly close down the airways.

Asthma is a chronic condition that has to be managed at home, every day. So, nurse practitioner Melissa Streett prompts even her youngest patients to keep tabs on their own symptoms:

Streett IC: "How 'bout your eyes, were they itchy? ..."
Child: "Yes, just sometimes, they are itchy, and my mom gave me some eye drops."

Streett conspires with her kids to help them avoid the triggers that can set off a sudden attack of coughing and wheezing:

IC: "This boy is allergic to everything, foods, chocolate, dairy, dust, grass, lemons, egg shell powder, oat... He's a walking booger. Did I miss anything, what else are you allergic to? Your brother? (laughs)"

Children with asthma, who have access to management medication, are sidelined less often than kids who have no preventive care.

So, onboard the Breathmobile, the nurses spend lots of time teaching families the difference between maintenance medication and rescue drugs.

Rescue drugs are a temporary fix to open the lungs during an acute asthma attack. But over the long haul, Streett said, those quick-relief medications do little to hold back asthma complications:

IC: "The controller is the everyday medication and that is to prevent asthma and asthma attacks."

Streett says tricks, like keeping the controller meds right next to the toothbrush, remind children to take their maintenance medication, even when they feel perfectly fine. Every visit to the Breathmobile is free to patients. The program can even provide a temporary supply of medication.

But Nurse Michelle Foster says sometimes the best asthma treatment is helping a mom work through situations that distract from a child's health care:

IC: "I'm a certified case manager, so I can help with other things that can help her focus on getting her children medical care."

Foster helps families sign up for Maryland's health program for children. She also directs them to outside services that can pay the BG&E bill or keep groceries on the shelf.

I'm Taunya English, reporting from southwest Baltimore, for 88.1, WYPR.
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