Breathing Lessons, Part III

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The six-week course will teach the students the basics of asthma: how to know when an attack is coming on, how to control the disease with proper medication, how to avoid allergens that can bring on an attack.

Alma Brown, principal of Dr. Bernard Harris Elementary School, one of the four participating schools, is a fan of the program. "Children here used to be absent a lot because of asthma," she says. "But once the program started, attendance for those students increased. Also, a sense of security increased for those students because it's pretty scary when they have an attack and they don't feel in control. This program has given them a sense of security because they know what to do. They're better able to manage their symptoms before they get to a critical stage."

The program, Brown adds, has also helped improve the historically rocky relationship between Johns Hopkins Hospital and the Oliver community. "There was the sense," she says, "and probably still is the sense, that Hopkins does a lot of research but they don't give a lot to the community. This program certainly dispels that theory."

Today, Daphne Morgan is scheduled to begin one of the A+ Asthma Club courses at Johnston Square Elementary School, a 30-year-old red-brick building that houses 575 students. The nurse, who is wearing a Yoruba tribal outfit called a buba and made of indigo cloth, rings the buzzer at the school's entrance, but it doesn't seem to be working, so she knocks on the door until someone lets her in. Inside, she meets Vera Moore, a community health care worker who will help her set up for the presentation.

On the floor of the stage in the school's auditorium, the two women spread out a large comforter for the kids to sit on. A few minutes later, 10 students--seven boys and three girls--amble in and plop down. Morgan passes out booklets to each kid and says, "Everybody listen up. My name is Daphne, and I'm the asthma nurse. I want you to open your folders and look for the page that looks like this." She holds up her own booklet to the first lesson, which is called, "So You Have Asthma, Too."

During the six-week course, the students will learn the basics of asthma: how to know when an attack is coming on, how to control the disease with proper medication, how to avoid allergens that can bring on an attack, and the like. Today, however, Morgan spends most of her time going over the rules of behavior. She gives each student a "passport" and tells them that they will get stickers if they behave well during the classes. If each student has six stickers by the end of the course, the kids will be treated to a pizza party, and the student with the most stickers will get a prize. Naturally, the kids are dying to find out what the prize is, but Morgan tells them it's a surprise. The carrot-and-stick approach seems crude, but Morgan insists that it's necessary in order to get their full attention. Asthma, after all, is serious stuff.

One of the boys in the course is a 10-year-old named Jeffrey Allen. He had his first asthma attack back in September. "I was wheezing," he says. "It felt like something was pounding into my chest. My mother took me to the hospital, and they put me on the asthma machine"--a nebulizer--"three times." He missed three days of school, and when he came back his teacher told him about the A+ Asthma Club. His younger brother, who also has asthma, is attending the course, as well.

Mary McCrea has been principal of Johnston Square Elementary, where 95 percent of the students qualify for free lunches, for about a year and a half. "I was surprised when I got here," she says, "because I've never been around so many people with asthma, and I've been in the school system for a long time. I think we have at least 50 or so, out of 575 students. A little less than 10 percent. And those are the ones I know about. There may be a few others that we don't know about."

Like Alma Brown, she gushes about the asthma program. "Oh, it's wonderful," she says. "It's helping the students cope better. The majority of our children who are involved with the program have found that they have a little buddy system, a real support system, with the other students in the program. They see that they're not alone, that there are many others who have asthma."

It's dark outside when Lorraine Matthews, one of the asthma program's community health care workers, pulls up in front of a two-story, red-brick row house on North Avenue, a few blocks from Harford Heights Elementary. Matthews, accompanied by Daphne Morgan, has arranged to meet with Rosalind Benston and her son, Shawn Moore, a 5th grader at the school. Shawn, 10, was first diagnosed with asthma when he was 5 months old. He enrolled in the Oliver Community asthma program three years ago.

Benston, a 30-year-old single mother who works as an office manager at an apartment management company, welcomes Matthews and Morgan into her living room. Shawn, wearing a white T-shirt, green jeans, and black sneakers, is sitting on a couch, clutching a Nintendo Game Boy. The house is clean but cluttered. On one wall is a large black-velvet painting of Jesus walking on water.

Recently, Shawn had an asthma attack. He ended up at the emergency room, where he spent half the night hooked up to a nebulizer. He missed three days of school.

Matthews has visited the house before, so she knows that Benston has taken steps to keep the dwelling free of dust and insects. So for tonight's session, she intends to quiz Shawn to find out if he's doing all the right things to keep his asthma under control.

"Do you have a peak-flow meter?" she asks the boy.

"Yes," he says.

"Do you know how to use it?"


"Go get it."

Shawn runs upstairs and returns a few minutes later with the device.

"It looks brand-new!" Matthews says. "Show me how to use it."

Shawn takes a deep breath and then blows hard into the meter. He's supposed to keep a daily diary of his peak-flow readings, but he hasn't been doing this lately, so Matthews gives him a calendar and urges him to use it. Shawn promises to do a better job monitoring his breathing.

Matthews asks the boy if he knows how to tell if his inhaler is full, half empty, or empty. "I don't know," he says, grinning.

"Go get a pan of water," Matthews says. Shawn goes to the kitchen and returns with a water-filled glass bowl, which he places on the coffee table. Matthews tells him to put the inhaler cartridge in the water. It sinks.

"What's that mean?" she asks.

"I don't know," Shawn says, smiling.

"He knows," his mother says.

Shawn plays dumb, but eventually he gives the correct answer: "It's full."

"Are you sure?" Matthews asks.


Recently, Shawn was at his grandmother's house when he had an asthma attack. He ended up at the emergency room at Johns Hopkins, where he spent half the night hooked up to a nebulizer. He missed three days of school.

"I wish I would outgrow it," he says.

"We have to deal with managing it now," Matthews tells him.

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