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Law helps kids with asthma
By JON HOORNSTRA
Imagine being awakened suddenly in the middle of the night by "some kind of sound" that you soon realize is your young son or daughter gasping for air in the face of a severe asthma attack. From personal experience many years ago, I know few things in life are as frightening to a parent or child as that kind of attack, even when all the medications needed are immediately athand.
Of course, not all asthmas are that severe. Most, in fact, are classified "moderate." But even a moderate condition can become severe if not properly managed, per "doctor's orders."
Following the doctor's orders, however, can be tricky for kids in school or day-care facilities. There are more than 5 million children under the age of 18 in the U.S. with asthma. The number in Santa Clara County, consistent with national trends, has been growing, and asthmatics are the single largest diagnosed group requiring medication in the Cupertino Union School District, according to the district's head nurse, Katy Waugh. The district dispensed more than 400 medicines in the 1997-98 school year, Waugh said, and a major concern always is getting the kids to remember to take their medications on time.
"On time," however, isn't a simple matter with asthma. Albuterol, a primary asthma medication, is typically prescribed to be taken "as needed." Who decides when it's needed? Who decides if it's to be taken right now or 15 minutes from now? In the case of asthma, these are not trivial questions. Waugh encourages parents to talk with her about particular situations to make sure the kids get what they need on time.
Still, many schools in California and nationwide keep asthma medications locked up and stored in school offices, often at considerable distance from the child who might need it. This issue prompted a paper published April 9 in the Journal of the American Medical Association, calling on schools to make some changes.
In "Asthma Management in Schools: Call to Action," author Marilyn Larkin says, "Locking medications away in a nurse's office or health room can deter children from taking proper care of their asthma." Larkin calls on parents and school officials to work out individualized action plans and to take several other steps to make school campuses "asthma friendly."
In many parts of the country, many elementary school children spend time in licensed daycare facilities after school. Only recently, however, have the state's day-care centers been told to train their staffs to deal with asthma. Last October, former Gov. Pete Wilson signed Senate Bill 1663, authored principally by state Sen. Jack O'Connell. Implemented under emergency status, it went into effect immediately. The new law removed all the legal roadblocks that kept day-care staffs from helping kids with asthma medication. It further mandated that by Jan. 1, 2000, first-aid training for day-care personnel include asthma medications and equipment, such as nebulizers.
The YMCA of Santa Clara Valley, which provides after-school care to about 400 kids in the Cupertino-Sunnyvale area, already accepts kids with asthma medications and nebulizers. According to Bernice Alaniz, the YMCA programs only require instructions from a physician and parental consent.
A lot of free help is available to schools and other groups. The American Lung Association offers free training and other help. Just call 408/998-5864. And Dr. Alan Goldsobel of San Jose's Asthma & Allergy Associates, says a new chapter of the Asthma & Allergy Foundation of America has just opened for northern California. That number is 415/339-8880.
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Sunnyvale, California Since 1994
