Israel Westbrook, age 10, is an active kid who likes playing outside. He loves school and is an honor roll student who this year tested out of fifth grade and advanced to sixth. He’s also a child with asthma and allergies that, if left untreated, would greatly hinder his ability to play and go to school—and even land him in the Emergency Room.
“Israel’s 14-year-old sister was born premature and had breathing problems. So when Israel started showing signs of allergy and asthma at age 2, I knew I needed to take him to see Lila at Children’s Hospital,” says his mom, Charlotte Small.
Lila Kertz, MSN, RN, CPNP, AE-C, is a certified pediatric nurse practitioner specializing in allergy and asthma at St. Louis Children’s Hospital. She is one of the hospital’s asthma experts who develop Asthma Action Plans for patients like Israel.
“The plans are set up in zones and designed specifically for each individual patient,” she says. “The green zone means a child with asthma is feeling fine and just needs to take his or her daily medications. Yellow means asthma symptoms are present, and there are instructions about identifying triggers and what medicines to use. Red is when a child is having real difficulty breathing and decisions have to be made—do you start a different medication, do you call and talk to us, do you call 911?”
The goal of each plan is to ensure a child does not experience periods of uncontrolled asthma. “A child or adolescent doesn’t have to have a major attack to experience uncontrolled asthma,” says Lila. “Having restrictions in activity, coughing more than two days a week on a regular basis, awakening at night with cough more than two times a month—those are all signs of uncontrolled asthma.
When Israel is doing well, he sees Lila every four to six months for checkups. If his medications need to be changed, his follow up is every one to two months.
“If either of my children have a breathing issue and I can’t get into my pediatrician quickly, I know I can always call and talk to Lila or one of the other nurses,” says Charlotte. “When you have children with a chronic condition like asthma, being able to talk to someone immediately and having the option of having your children seen quickly by someone familiar with their past history is comforting.”
Israel has specific triggers for his asthma—changing seasons, elevated mold counts, common illnesses like viral and upper respiratory tract infections. It’s a chronic condition, one he has dealt with it his whole life by following his Asthma Action Plan. For him, the plan is not just a piece of paper—it’s his ticket to the park.
