Thursday, June 06, 2013

1980s: Parentectomy

By 1981 there were 15 hospitals like National Jewish Asthma Center/ National Jewish Hospital for intractile asthmatics, and every one of them ran a program similar to the one suggested by M. Murray Peshkin in the 1940s.  The programs all involved parentectomy, or "separation of asthmatic child from parent as the key to successful treatment," according to a 1981 article in the New York Times.(1)

The idea is that about ten percent of asthmatic do not get better with home treatment no matter what is done, and that removing the patient -- the child --  from the home environment will help them get better.  This "parentectomy" removes both the child from both causes of asthma: parents and allergens. 

Early on this may have been done as an order by the physician, although ultimately I think it was simply another option in the treatment for children with intractile asthma.  In the fall of 1984 my parents were offered this option, and, fearing I might die, decided they had no choice.  So their job became convincing me it was my decision, and at that they succeeded. 

On January 9, 1985 Rick Frea, that's me, was admitted to National Jewish Hospital/ National Asthma Center with what was diagnosed as "High Risk Asthma."  I had been to the emergency room eleven times in the previous year, was admitted twice for about six or seven days, and was on many occasions on systemic corticosteroids.

The week prior to my admission I was in the emergency room every day, and the night before my admission my mom had an epinephrine pen in her purse.  When I started having trouble breathing that night at the hotel across from the asthma hospital, she was afraid to use it.  The next day the nurse told her I should have called them and they would have admitted me.  Yes, I was that bad. 

As soon as I entered the patient lobby of 7-Godman the nurses called a code blue on me, and made me feel a lot worse than I felt. Once they were satisfied I was feeling better the nurses gave me a tour of the boy's dormatory on the eastern side of the building. I barely saw the other kids the first week because I had so many tests to do, and my asthma never got better, so my doctor had me admitted in Pediatric Specialty Center on 8-Goodman. 

I was in PSC for three days, and that was just like a normal hospital.  I had an IV and was injected with systemic steroids.  My face became puffy, and my stomach bloated.  All I wanted to do was eat.  And I was bored out of my mind, and I was anxious and depressed because here I was so far from home, in a hospital, and my parents weren't able to visit.  I was at NJH a week and barely got to meet the other kids.

Yet then I got better.  Gradually I was able to wean into doing physical activity.  Gradually my doctors decided, by trial and error mainly, what medicines worked best for me.  Gradually I met the other kids, and gradually it started to feel more like a camp than just a hospital.  Gradually I was eased into the evening aerobics, and gradually I was able to play with sports by using all my energy, as opposed to just "taking it easy." 

To this day I look back on my experience there and wonder: did I get better because of better treatment, or did I get better because I was removed from my parents?  Or did I get better due to a combination of both?  In all honesty, I'd have to assume it was both. 

Now I don't know if my doctors back then believed asthma was nervous still in 1985, yet even so, it appears quite obvious, especially as I peruse my medical records, that anxiety at home contributed to my asthma.  And I think that even though my parents meant well, I believe to this day I was deathly allergic to the house I grew up in. 

It became evident to me as I grew older my asthma seemed to get better when I left home for college, and it usually got worse when I returned for weekends and for the summer.  Now as an adult I try to avoid my parent's house altogether except for short visits.  I love that house and always have, but it doesn't like me. 

When I was discharged the poeple at National Jewish tried to educate my parents, and even spent time doing a survey of the house for allergens.  The tests came back positive for molds and animal dander that I was allergic too.  Yet all my parents did was get rid of the plants. 

Now I don't mean to disrespect my parents in any way shape or form by writing this, and I don't think in any way shape or form my parents were any different than most asthmatic parents.  I can see no way how my parents really should understand what would trigger my asthma, because neither of them had such a disease. 

Still, I think my parents were a perfect example of why the "parentectomy" was so important.  Regardless of what doctors thought of the whole nervous asthma thing, and to this day I have no idea what my doctors thought about that, I think removing me from my parent's house was key to getting my asthma controlled. 

And they did get it controlled. 

References:
  1. Melvin, Tessa, "For 36 Children, Hope on Asthma," New York Times, September 26, 1982

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