Getting in the ring with asthma

Joel110-year-old Joel was diagnosed with asthma at age 2, which was difficult news for his mother Ellis, but not at all surprising. “Joel’s father, aunt and grandmother are all asthmatic,” says Ellis. “His father recently was hospitalized due to his asthma, but thankfully he’s doing better now.”

For years, Joel used an inhaler to increase airflow to his lungs and control his asthma attacks. But as he got older, his symptoms worsened, and the inhaler wasn’t helping. At age 6, a severe asthma attack landed Joel at Boston Children’s Hospital Department of Emergency Medicine with the risk of a collapsed lung. After spending two weeks in the hospital, Joel was released home and referred to Boston Children’s Community Asthma Initiative (CAI)—a free program that helps Boston-area families manage their child’s asthma at home.

Enter Margie Lorenzi, a CAI patient educator with a passion for managing asthma. “When I was 24, my son was diagnosed with asthma,” says Margie. “I wish there was a program like this back then.” She and her son learned to manage his condition, and 20 years later she is helping families like Joel and Ellis through the same process.

A key objective of CAI is to help parents understand there is no cure for asthma, but it can be controlled with regular use of the right medication and avoidance of certain allergens that act as triggers. Margie emphasizes the importance of how she approaches her work— without blame. “I meet people where they’re at. I sit and listen and don’t judge. It’s a conversation, not a lecture.”

Ellis and her son Joel with Margie

First, Margie sits down with the family, listens to their concerns and talks with them about what asthma is and how the medications work. They then review the child’s medications together to make sure everyone is comfortable giving them and using good technique. She answers questions and clears up any misunderstandings the family may have, such as which inhaler to give daily to prevent asthma attacks and which inhaler to use only when the child has asthma symptoms. Finally, Margie does an environmental assessment of the family’s home and then returns twice more to follow up.

Joel3During her three visits with Joel and Ellis, Margie offered tips on reducing triggers and provided anti-allergy bedding, a HEPA vacuum and storage bins at no charge to the family. Ellis feels the changes they’ve made at home combined with a stronger medication have helped. Joel hasn’t been hospitalized in over two years and is more active than he’s ever been. “He’s even taking boxing,” beams Ellis. “He just takes two puffs from his inhaler before class, and he’s all set!”

Although Margie no longer visits with Joel and Ellis, their communication is ongoing. “We created a really nice relationship,” says Ellis. “I’m so grateful that even now if I need anything or have any questions, Margie is there for me.”


Margie’s tips for removing allergens and asthma triggers from your home:

  • Clean naturally. Strong-smelling household products such as bleach, ammonia, Lysol, Fabuloso, air freshener sprays and plug-ins contain chemicals that irritate the airways of people with asthma. Use alternative cleaners instead, such as white vinegar and water (1 cup vinegar to 1 gallon water) for surfaces and floors and baking soda for scouring.
  • Dust weekly. Use a damp cloth or, even better, a dry or damp microfiber cloth that attracts and holds onto dust.
  • Vacuum often. Use a HEPA-filter vacuum on bare floors, carpets and upholstery at least once a week.
  • Reduce dust mites. Use dust mite-proof mattress and pillow encasements to reduce exposure to dust mites, especially if you or your child has tested positive to the dust mite allergen.
  • Keep pollen outside. During pollen season (typically spring), keep windows closed, and use an air conditioner as much as possible to keep pollen out of your home. Leave shoes at the door and, if you or your child has spent time outside, take a shower and change clothes to remove pollen.
  • De-clutter. To reduce household dust, donate items you no longer need such as old clothing, toys and books. Store clothing, toys and other loose items in dressers, closets or covered plastic bins.

Learn more about Boston Children’s Hospital Community Asthma Initiative (CAI).