Thursday, May 23, 2013

1950s: Asthma at national Jewish Hospital

Figure 1 -- National Jewish Hospital today.  You can see the Goodman bulding
on the right.  It was there, on the 7th floor, where I was a patient in 1985.
The boy's ward looked out in this direction.  On the 7th floor was where kids
12-18 lived, and on the 8th floor was home to younger kids.  I stayed
on 7 Goodman for 3 months, andthen I was a patient of 2-May for 3 months
(another building not seen here).  The treatment greatly helped me.
So by the 1880s about 1 in 4 residents of Denver were patients with lung diseases, and many of them were literally dying in the streets.  It was for this reason the Jewish community came together and donated money to open the doors of National Jewish Hospital for the Treatment of Consumptives.  

It was not the only such sanatorium in the area, nor was it the only one in the United States.  In fact, many had opened both in the U.S. and in Europe, and all had about equal success.  What made National Jewish stand out over time was it's effort in 1914 to open the first building outside of a university with the specific goal of researching a cure for a disease.  

It also became the first such institution to open a ward specifically to treat children with a disease in the 1920s.  So by the 1930s National Jewish had the capacity to take care of hundreds of tuberculosis patients of all ages, plus it was a leader in the attempt to find a better treatment and a possible cure.  

And partially through the efforts of this hospital, the number of people getting tuberculosis saw a steady decline beginning at the turn of the 20th century, and then a steep drop off after the discovery of an effective treatment in the 1940s and 1950s.  So while the goal of the hospital was to treat consumptives, consumptive patients were slowly disappearing.

When the hospital was opened in 1899 the president of the institution said, "that its doors may never close again until the terrible scourge is driven from the earth."  It probably appeared that was exactly what was going to happen.  The disease was never driven from the earth, although it's one that is readily controlled, for the most part, in modernized nations of the world, particularly in the United States and Europe.  

Yet there were other respiratory disease that continued to plague the west, and we must not forget that these patients were also welcome at National Jewish.  So as tuberculosis declined as a leading cause of death, and is now at the bottom of the yearly list, other disease saw a steady rise and deserved the attention of the world's leading lung experts, particularly those at National Jewish Hospital.  

Due the the rise of people smoking cigarettes following WWI the incidence of chronic bronchitis and emphysema was on the rise.  Likewise, with the modernization of the west, asthma was also on the rise.  These folks, mainly adults with COPD and children with asthma, needed a place where they could find help.  And that place was National Jewish.

During the 1940s various centers for asthma were opened in the United States, yet National Jewish was already an option for them.  Yet the 1940s saw a rise in the number of asthma patients at the hospital.  Many asthmatics were taken away from the stress of their home lives, with their parents and doctors that had little knowledge of the disease, and admitting them to these asthma and research centers.  (2, page 29)

During the 1960s various discoveries, such as the IgE antibody and cortisone, allowed for better methods of treating asthmatics.  Although cortisone worked to trmeat asthma, there were some pretty significant side effects to taking it long term.  So this brought about the corticosteroid inhaler, although the fear of side effects prevented physicians from using it as a daily preventative medicine.    This fear persisted until the 1980s when studies proved the benefits far outweighed the side effects.

When I was a child in the 1970s with asthma my physicians treated me only when I was symptomatic with rescue medicine like Alupent solution via a nebulizer or epinephrine or susphrine, both when I was admitted to the emergency room.  I have discharge papers telling me to use my inhaled corticosteroid inhaler (Vanceril) only until I felt better, and then to only use it when I was having trouble.

But this was the normal accepted means of treating asthmatics back then, so it wasn't that my doctors were not good doctors.  Yet the physicians at hospitals like National Jewish were participating in the research, and were privy to the latest techniques in treating the disease.  And it's for this reason kids like me with "high risk" asthma were being admitted for long-term treatment, control, and education to hospitals like National Asthma Center/ National Jewish Hospital.

So as the medical needs of society changed through the years, so to did the name of the hospital.  
  • 1899 — National Jewish Hospital for Consumptives
  • 1925 — National Jewish Hospital at Denver
  • 1965 — National Jewish Hospital and Research Center
  • 1978 — National Jewish Hospital / National Asthma Center
  • 1985 — National Jewish Center for Immunology and Respiratory Medicine
  • 1997 — National Jewish Medical and Research Center
  • 2008 — National Jewish Health
I was a patient of the hospital in 1985, and was there when the name was changed.  That was also the year the address was changed from Kolfax Avenue to Jackson Street. I think the main reason for the name change at that time was to show that the hospital wasn't just for asthma and COPD patients.  

In 1990 it was proven that inhaled corticosteroids were safe for asthmatics, or at least the benefits outweighed the side effects.  It was also proven that all asthmatics have a certain degree of inflammation always in their lungs.  This proved that asthma was a chronic disease that should be treated on a daily basis to prevent symptoms, as opposed to treating only acute symptoms.  

By 1997 the children's wards that I lived in were closed mainly because asthma had run its course. Surely there still exists the disease, although back in 1985 regional doctors weren't privy to the latest asthma treatment and the physicians at National Jewish were.  

Today, however, partially thanks to the various asthma guidelines, and even while asthma rates continue to rise, asthma is much easier to control.  Part of the reason is better medicine, but another reason is the efforts of National Jewish Health physicians making an effort to better educate regional physicians.  

Today, under the name National Jewish Health, the hospital's doors are still open.  I would imagine COPD patients are still treated on the 2nd or 3rd floors of the Goodman Building as they were back in 1985.  Yet asthmatics are no longer living there. 

Floors like 7-Goodman, where I stayed for three months, and 2-May, where I stayed for 3 months, and 8 Goodman, where younger kids stayed, are now closed.  Replacing this type of long term treatment are very effective outpatient programs.  
Why did the hospital wards end?  Well, I would imagine homesickness and dealing with teenage boys was a major problem.  Yet I think another main reason was that physicians at National Jewish Health, along with other asthma experts, made a major initiative to educate regional doctors to focus on asthma control and prevention, as opposed to simply treating acute symptoms.  

Another major reason for the change was the initiative to create asthma guidelines in the late 1990s.  These guidelines are created by the worlds most prolific asthma physicians and experts.  The goal is to provide a guide for asthmatics all over the world, and the physicians treating them.  

So the need to use a hospital like National Jewish Health has greatly diminished for both the tuberculosis and asthmatic patient.  However, both those diseases are still present, asthma more so than tuberculosis. 

And, when needed, the hospital is still around, and still looking for better ways of treating, and, perhaps more important, curing these disease.  Plus, when needed, hospitals like National Jewish provide a way to help hardluck asthmatics gain better control of their disease, so that they can live life more like a normal person.  (3)

References:
  1. Dobozin, Bruce S, Stuart H. Young, "Allergies: The complete Guide to Diagnosis, Treatment, and Daily Management," 2011
  2. Bjorklund, Ruth, "Asthma," 2005, China, Marshall Cavendish Corporation0
  3. In 2008 I interviewed the Public Relations Representative for National Jewish Health and she provided me with an interview where I obtained up to date information about the NJH children's asthma program.  

3 comments:

  1. Asthma is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm.Common symptoms include wheezing, coughing, chest tightness, and shortness of breath.Asthma

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  2. I too was at the hospital both in the Goodman and May buildings back in 1980-1982 on two occasions. I did benefit from the treatment and medications. It was not easy emotionally however.

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  3. Hi Amanda. I was there in 1985 for 6 months, and I would agree it was very difficult emotionally too. I would imagine this was one of the reasons they got rid of that asthma program in favor of an outpatient program. If you want to share NJH stories in private you can contact me by clicking the contact icon in the right column. I have lost contact with all the kids I met while there. Thanks.

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