asthma

March 30, 2005

Tanisha Ammons lives on the west side of Chicago in a rentedfour-bedroom apartment. The neighborhood is working-class. The street isreasonably quiet. The apartment's not far from the local elementaryschool, and it's an easy drive to Midway Airport, where Cornelius Cook,Ammons' husband, works the night shift. When he leaves for the airport,Ammons—who works by day as a nursing-home aide—lies in bed,listening for the sound of her four sons sleeping. http://news.bbc.co.uk/1/hi/health/1099418.stmFor many parents, this is the day's most peaceful time—a hard-wonsilence in which you can hear yourself think again. But for Ammons,bedtime is often its own harrowing beginning.Sometimes it's Jacquez who starts. He's the oldest at eight, a devoteeof Spider-Man and Harry Potter, a sensitive kid who writes poetry. Inthe hours after midnight, Jacquez begins coughing. It's slow at firstand then revs up, until the boy is sputtering in machine-gun intervals. Then it's Marcus, who is seven, chiming in with his own cough—a raspyhack that can go on for hours. Ammons listens to it almost nightly now,this haunting call and response between the two brothers. Marcus' coughhas grown especially scary in the last year. "It sounds like he'schoking," Ammons says. "He barely sleeps."Nor does Ammons, who gets up and gives the boys cough syrup or a puff ofAlbuterol, or occasionally just stands in their doorway to make surethey're all right. On a bad night, her other kids join in. Semaj, thefour-year-old, coughs so violently that she doesn't even bother puttinghim in his own bed much anymore, preferring to keep him next to her, tomake sure he doesn't turn blue. Omarion, who is two, has a chronic coughas well. And then there are the really bad nights, when the Albuterol doesn'thelp and one of the boys—usually Marcus—starts struggling tobreathe. This is when he has to be raced to Cook County Hospital'semergency room, where he's given drugs to release the invisiblestranglehold on his airways. When it's over, and the boy is breathingnormally again, Ammons relaxes—but only for a while: Marcus' symptomsusually return within days. "I never stop worrying about it," she says.On a late fall Thursday, the streets slick in a light drizzle and thelast of the season's leaves dropping wetly from the trees, Ammons andCook have brought the two oldest boys for a doctor's appointment in anunlikely spot—a 35-foot-long recreational vehicle parked outside theboys' school, Webster Elementary. In appearance, the RV is not muchdifferent from what a pair of footloose retirees might drive toYellowstone but for the words "Asthma Van" emblazoned emphatically inblack on each side.All four of the Ammons boys have been diagnosed with asthma , which is tosay that their airways are chronically inflamed. When an asthma patient is exposed to certain "triggers"—like changesin air temperature, dust mites, or smoke, among a host of otherthings—the lining of those airways produces extra mucus, causing themto constrict, which in turn can lead to coughing, wheezing, anddifficulty breathing. The feeling is sometimes compared to breathingthrough a straw. A severe asthma attack can quickly starve the lungs ofoxygen. According to the National Institutes of Health, more than 5,000Americans die this way every year. In Chicago, where the condition isparticularly rampant, rates of hospitalization for asthma are twice thenational average. http://www.motherjones.com/news/feature/2005/03/asthma.html

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