October 25, 2019
From Asthma Attacks To Triathlons: Emerson's Healthy Homes Des Moines Story
Kayla Poucher describes her family's life in two categories: Pre-Healthy Homes Des Moines and Post-Healthy Homes Des Moines (HHDSM).
Pre-HHDSM was full of doctors' appointments, emergency room visits and a little boy with severe respiratory illnesses, including asthma.
In their “Post-HHDSM” life, Kayla’s family makes annual doctors’ appointments, hasn't set foot in an ER for nearly three years and their son now participates in triathlons.
"Life before Healthy Homes Des Moines was a ticking time bomb. How long could we go between hospital stays, oral steroids, antibiotics, and 'round-the-clock nebulizer treatments?" Kayla Poucher recalls wondering. "We’d celebrate having no major episodes like these in three months’ time. In fact, I don’t believe we ever made it longer than three months, pre-HHDSM."
Healthy Homes Des Moines
Health Homes Des Moines (HHDSM), which launched in 2015, is an effort to minimize clinic and hospital visits related to pediatric asthma.
The program was previously a collaboration with the following entities: Polk County Housing Trust Fund, Polk County Health Department, Mercy Medical Center, Broadlawns Medical Center, UnityPoint Health, the City of Des Moines, Viva East Bank, the Mid-Iowa Health Foundation, EveryStep, Polk County Public Works, Des Moines Public Schools, Telligen Community Initiative and Rebuilding Together.
While many of these organizations still play a large roll in HHDSM, in October, EveryStep was trusted to assume full management of the program, continuing its important work in the community.
HHDSM serves children who suffer from acute asthmatic symptoms as a result of triggers in their home.
Families with children suffering from asthma are referred by a healthcare provider to HHDSM to receive tailored health education and supplies to help reduce factors that can trigger asthma.
Families can also receive home repairs to remediate asthma triggers and maintain a healthy home. HHDSM serves families with children two to 12 years of age who live in Des Moines proper and earn 80% or less of area median income.
In the first three years of the program, the percentage of children with well-controlled asthma increased to 81%, from 45% pre-intervention. Additionally, asthma-related emergency room visits were reduced by 60%.
The Poucher family is among that statistic.
The family found HHDSM after a frightening hospitalization when their son Emerson was six-and-a-half years old.
Emerson, now nine-and-a-half, and his twin brother, Oakley, were born eight weeks premature. Emerson has had respiratory issues since birth.
After two respiratory stays, necessitating the purchase of a nebulizer before the age of two, Kayla remembers she and her husband were growing even more concerned about this health.
Despite the nebulizer treatments and a daily maintenance steroid, Emerson continued to experience respiratory episodes.
"Over the next four years, we would be making visits to our new pediatrician monthly," Kayla remembers. "It felt like Emerson was constantly battling his own lungs. If not battling, recovering from the battle, and gearing up for the next."
Another four hospital stays followed, bringing the total to seven if you count his time in the neo-natal intensive care unit after birth. Of course, this figure doesn't reflect the dozens of times Emerson visited the emergency room but was sent home cautiously with strict orders to be woken every three to four hours for breathing treatments.
"Dozens of exposures to serious illnesses in waiting rooms," Kayla recalls. "Dozens of weeks where our lives stopped, solely to keep Emerson’s asthma at bay. Dozens of antibiotics, each lasting 10 days and taking a toll on his overall well-being."
When the family moved into their new "old" home, as Kayla calls the 1908 abode, she was at first excited about the solid wood doors that muted noise more effectively than those of their previous home.
That excitement wore away quickly, however, when she realized she couldn't hear the telltale signs if Emerson was in respiratory distress.
"One night, Emerson went to bed coughing, but I couldn’t sleep because I couldn’t hear him," she recalls. "It was too muffled. How in the world was I supposed to know if he was gasping for air, or taking too many breaths per minute or wheezing? I couldn’t know, and therefore, I couldn’t sleep."
The event resulted in a panic attack for Kayla, who then accidentally woke Emerson with her ragged breath as she checked on him that evening.
"I thought I'd never be able to sleep soundly again," she says. "And, I didn't, for a while."
Three weeks later, Kayla recalls her family experienced the most terrifying respiratory issue Emerson had ever had.
The family took Emerson to the ER at 5 p.m. on Sunday, mostly as a precaution before the week started, as he'd been wheezing most of the weekend and his rescue inhaler wasn't helping.
"I thought, 'It’s not that bad this time. They’ll give him a duo-neb and send him home on a steroid. We will be back in a few hours,'" Kayla recounts.
But that wasn't the case. Instead, Emerson's vitals showed his oxygen levels were dangerously low, requiring three hours of continuous oxygen for him to return from a critical to stable state.
Kayla remembers being confused during the visit; Emerson wasn't presenting as badly as he actually was; did she miss a sign?
The ER doctor explained that Emerson was having an asthma attack that wasn't related to a virus or pneumonia as his previous episodes had been.
The doctor told her they were glad she brought Emerson in and they didn't put him to bed, noting that he was in such distress that it would have eventually led to respiratory failure.
"My worst nightmare was almost realized that day. We could have put him to bed, thinking it could wait 'til office hours the next morning, only to find he hadn’t made it through the night," Kayla says.
That was the last time Emerson was hospitalized. During the second day of his hospital stay, a social worker asked if she could talk to the family about an opportunity, introducing them to HHDSM.
"I was surprised that there was such an organization and was eager to learn how Emerson could benefit from it," Kayla says.
Within a few days, HHDSM specialists were inspecting the Poucher's home, trying to detect asthma triggers that could be solved and educating them on asthma and allergens in the home.
"I remember crying with them at my own kitchen table," she says. "I was ashamed that I didn’t know more about how to protect Emerson from his allergens."
The specialists, however, assured her she did nothing wrong and that they were there to help.
For the Poucher's, HHDSM collaborators removed the carpet in the kids’ playroom and refinished the wood floors underneath; gave them an air purifier for Emerson’s bedroom, a hypo-allergenic pillow cover and a hypo-allergenic mattress cover for him; vented the first-floor bathroom and the stove; and gave them a HEPA vacuum.
But the greatest gift, Kayla notes, was the empowerment the family felt to choose what was best for Emerson, starting with a new pulmonologist.
Prior to Emerson's last hospitalization, he began seeing a new pulmonologist who had inaccurately determined that Emerson didn’t actually have asthma, and therefore discontinued his daily medication.
When she told their HHDSM specialist about the issues, she was encouraged to find a pulmonologist who listened to their concerns and took them seriously. And so, the family got a second opinion and a new pulmonologist.
"We felt bound to this pulmonologist, and to his group, but that was an illusion," Kayla says. "Without HHDSM, I do not know how long we would have been tethered to a doctor who neither respected us, nor saw our son’s health for what it actually is and provided the care required to keep him healthy."
Nearly three years later, the daily life for the Poucher family is drastically different.
Emerson has not be on a single oral steroid since the week he was introduced to HHDSM. He hasn't been hospitalized and he hasn't made a visit to the ER or urgent care.
What's more, he competes in triathlons all summer long; swimming, biking and running back to back with a little albuterol to keep him going.
Kayla's sleeping better now, too. She no longer has panic attacks.
And their pediatrician, who knew Kayla's voice the minute she spoke and generously provided the family with his personal number to help mediate between urgent care doctors, only sees Emerson once a year for well-exams. The new pulmonologist is seen every six months for routine checkups.
"Emerson is in good health," Kayla says. "That could not have been said about him, pre-HHDSM. People used to refer to him as 'always sick,' and 'in the hospital more than anyone they know.' Now he’s known as 'the boy who competes in triathlons, and does so with a smile.'"
"The relatively simple and inexpensive means of preventive care that HHDSM provided to us have proven to enhance our family’s quality of life to a degree that we, quite frankly, no longer believed was possible," Kayla says. "We are eternally grateful to HHDSM for helping give Emerson the life we always wanted for him."