Alex and the inhaler

Alex

Alex was then the infant child of my friend Ann, who lived about an hour away.  One day I was talking with her.  She was very worried about Alex.  He kept getting sick.  With what?  Chest colds.  He’d been to the ER, and he was breathing so fast he scared her.  I listened.  Ann, take him into your family doc down there and tell him Alex has asthma, and get an inhaler with a mask attachment, and try that next time before you go to the ER.

She did.  He got sick.  She tried it.  It worked, for a while, but he got worse, and she made another ER visit.  We talked.  Ann, he needs a daily steroid inhaler.  Go back to the doc and tell him.  She did.  He agreed.  Alex never had another ER visit.

That could be the end of the story, except that I married her and acquired him!  While his sister went with Dad, Alex came with Mom, and we became a recombined family in 2005, when Alex was 8.  He still had asthma.  It was not in control.  I brought home a free peak flow meter from work, and taught him how to blow it until he was good at it.  Then we determined his personal best between attacks, and set a green zone above 90% of that and a red zone at 50% of normal.  Next I taught him to measure his peak flow every night.  I would read to him nightly, and randomly ask, did you measure your peak flow?  What was it?  If he said no or said yes but couldn’t report the number, I made him go do it and interrupt our reading.  Random reinforcement schedule!  He learned quickly to measure every night.  Then I taught him to take a second dose of the steroid if he dropped below 90%.....

Alex took up soccer with a friend, and sometimes would use his quick relief albuterol inhaler before a game.  Then one day we were at the Green Lake soccer fields in a big game, and the clay surface was blowing dust everywhere on a dry summer day.  The assistant coach came running over to me:  Alex said he didn’t use his inhaler!  Is he going to be OK?  I thought just a fraction of a second.  He was independent, but trustworthy.  (Later, he became an Eagle Scout!).  I was sure he was still measuring nightly and adjusting.  He’ll be fine.  And he was.

There are national guidelines for how to treat asthma.  What I did with Alex is fully in compliance with those, except for diagnosing him from 60 miles without meeting him.  Oops!  Sadly, not every child gets good care.  Another boy on another team kept missing practice due to his recurrent asthma and trips to ER.  I offered help to his father.  He was defensive and insulted, saying his son had perfectly good doctors.  The coach kicked the boy off the team for recurrently not showing up.  Fathers can be fools.  Momma taught me never to look a gift horse in the mouth.  I’ve been a rejected gift horse many times!