Haiden Holley’s favorite part of school is recess.
“I like to play,” the 7-year-old special needs first grader said.
But his asthma made that difficult for him.
Since Holley first walked into UT Health Northeast's Breath of Life Mobile Clinic in October, his grandmother has seen a marked improvement. And having the mobile clinic come to Dixie Elementary School, where he can walk out for a quick visit, is helpful.
“It does help” his grandmother, Debra Gill, 47, of Swan, said. “That way he doesn’t have to miss that much school.”
Misty Houston, family nurse practitioner, mans the clinic on wheels that visits schools in East Texas so children with asthma can see a medical professional without leaving campus.
Holley has had asthma since he was 3 and was undergoing treatment in the mobile clinic on Feb. 28 for the second time.
“He’s actually one of our success stories,” Ms. Houston said of Holley.
When asked if the treatment has helped his play time, Holley nodded and said he likes running and playing with balls. He said the medication makes him feel better.
“It is just the most rewarding thing I have ever done,” Ms. Houston said while examining him. “Haiden is an example. By being able to ask a few questions and evaluate him we can come up with a (treatment) plan.”
Ms. Houston, 39, was a registered nurse for 15 years before she decided to go back to school to become a nurse practitioner. She wanted to do family medicine to take care of kids throughout their life span, she said. She graduated in August.
“Taking care of people is not what I do, it’s who I am,” she said.
KIDS IN NEED
The mobile asthma clinic was the brainchild of allergist Dr. Paul Sharkey Jr.
Ms. Houston has worked for him since 2010 and finds him to be an inspiration.
“He loves being able to provide care at no cost to kiddos who need it,” she said.
He is involved in every patient’s treatment, even though he can’t be there.
“I’m his eyes and ears in the community,” she said of Sharkey. “I go back and discuss cases with him … I’m very proud to be part of a health care team with a doctor.”
The Breath of Life Mobile Clinic was awarded grant funding and began visiting Tyler schools in September. Now, it visits nine school districts, including elementary and middle schools in Van, Longview, Palestine and Jacksonville. Ms. Houston has also visited Mabank, Martins Mill, Gladewater, Overton and Arp, she said, adding that some of the small communities she goes to don’t have doctor’s offices.
Ms. Houston visits schools four days a week. She said they see about 10 children a day, or up to 50 a week. Each exam takes about 45 minutes.
Stepping outside the school and into the bus is much quicker that having the parents leave work, drive to school, drive to the doctor and back again before they can get back to work.
When she first heard about the grant project, Ms. Houston said she was skeptical about the need for the mobile clinic. “No way there are that many kids in East Texas who have asthma,” she said she believed. “I was wrong.”
Ms. Houston sees a lot of children who are undiagnosed.
They work with school nurses, who work with teachers and coaches to identify which children are missing a lot of school or can’t participate in PE, then examine them to see if it could be asthma.
She said they don’t cure the children but bring their asthma under control. She recently got a hug and a thank you from one of her young patients because he can now play football, she added.
“We make a difference in missed school days,” she said.
When they’re not visiting schools, they take their bus to St. Paul Children’s Clinic twice a month and recently visited St. Vincent de Paul for the second time this year.
“Everybody gets their own asthma plan,” Ms. Houston said, adding that treatments are designed specifically for each patient. “Almost every child we see has been significantly improved by the time we revisit them. In this clinic, we actually make people well.”
Holley has seasonal asthma and has to use his inhaler only when he gets sick. After examining him for the first time in October, they came up with a step-up treatment plan, prescribing certain medications as needed. She said the trick is for him to start taking the medications as soon as the symptoms start, which can keep him sick for only a couple of days instead of weeks.
They reevaluate kids with asthma every six months to see how the treatment plans are working.
During his latest visit, Holley was one of eight children to get examined and allergy tested. Nine numbers were written on each arm, where tiny pricks were made with allergens. Within 15 minutes, she had Holley’s results, showing that he had no allergies for what was tested.
Ms. Houston said unlike Holley’s, asthma is often triggered by allergies and can be prevented if they know what the child is allergic to. “Asthma can be controlled very simply” by knowing what causes it, she added.
They developed a computer program to help keep track of the children’s health. They get an overall picture of the child and how they perceive their illness from the children and their parents, and compare it during the second visit six months later to mark any improvements.
Most children have private insurance or Medicaid but about 20 percent are uninsured. She said they have a community health worker on the bus who helps identify community resources for the kids, such as helping them apply for insurance and knowing the qualifications for Medicaid. They also offer coupons and co-pay cards for people with expensive co-pays for visits and prescriptions.
“I know it will grow in the future,” Ms. Houston said of the program, adding that nearly every week they have been adding a new school district to their list to visit. “It’s insane.”