Saturday, August 21, 2010

Asthma institutions for asthmatic kids

So I've been studying the history of asthma, and recently I've been reading "Asthma: The Biography," by Mark Jackson. I found it interesting to note that back in the 1940s a "radical" method of removing asthmatic children from the home became a somewhat common treatment for asthma, especially those with difficult to manage asthma.

I find this interesting, because one of the Institutions where asthmatics were sent when separated from their homes was National Jewish Hospital in Denver.

On page 145 he writes the following:
"Others suggested the more radical measure of removing asthmatic children from supposedly emotionally disordered homes. Parentectomy (literally, cutting out the parent), as it became known, was pioneered during the 1940s by the American allergist M. Murray Peshkin, who established the Jewish National Home for Asthmatic Children in Denver (later the Children's Asthma Research Institute and Hospital). in order to treat children with intractable asthma. Separation from the home environment offered both reduced exposure to physical allergens and escape from the 'asthmatogenic emotional climate which existed in the child's own home'. According to Peshkin's reports, residence in the institution at Denver led to substantial or complete relief from asthma in 99% of children."
Of course back in the 1940s asthma experts were split between three basic theories:
  1. Asthma was a disease of inflammation and bronchospasm
  2. Asthma was a psychosomatic disorder
  3. Both 1 and 2 above might be somehow involved in asthma

I have to agree that they were right, that absent the medicines we now have in 2010, removing many asthmatics from the home may have been very beneficial to them. I can completely understand that 99% of these asthmatic children may have benefited from being removed from home allergens and home stress.

When I was a patient at National Jewish in 1985 my asthma was much better controlled in the clean hospital environment as compared to at home, where mom and dad weren't interested in making many changes to my benefit. It's not that they didn't want me to breathe better, but changes come at a cost.

I found later in life that my asthma was much better controlled when I moved away to college. I found my asthma was even better controlled as soon as I stepped foot in an air conditioned building, or even an air conditioned hospital.

I know it must not have been fun to be plucked from your parents. I know personally, because in 1985 I spent six months at National Jewish. Yet that most kids noted improved asthma is in a way proof that controlling your environment, making needed changes to clean your home to get rid of asthma triggers, is an integral part of good asthma control.

And while asthma is no longer believed to be "caused" by emotions, emotions can act as an asthma trigger. And therefore, removal of children from stressful homes, where there is normal anxiety, can be of benefit to the child asthmatic.

In Britain open air schools were set up for asthmatic children "in rural or coastal settings or were temporarily relocated to settlements in mountainous areas of Europe..."

Then Jackson added:

"Although some American asthmatics later denounced parentectomy as 'one of the most shameful treatments foisted on the sufferers of any disease,' life in open-air schools was not universally detested by the children themselves: many of the children sent to schools in the countryside around Birmingham in England during the first half of the twentieth century remember their their time with some affection: '
As a child I suffered from bronchial asthma and was sent to Marsh Hill, which I enjoyed very much.'
"

Interesting hey? Sick kids being plucked from their homes and liking it. Believe it or not I can understand it completely.

I remember being nervous about going to NJH, yet I knew it was going to help me get better. And I was nervous that I was going to 2-May when I thought I would get to go home, yet I later wrote in my journal, "2-May turned out to be a really nice place. I really like it here."

Thus, leaving Denver for me was almost as sad as leaving my family to go to Denver. Those I met in Denver had become my new family, and good friends.

Plus I was able to breathe well while there, and they provided me with the skills to breathe well when I was back at home.

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