The Story of Caleb Mahan

Family Health Partners (Kansas City, Mo.)

Caleb Mahan was 6 years old when he had his first asthma attack. It came without warning and was severe. "He was literally gasping for air," says his mother, Sharon Blanton. It took the intensive care unit staff at Kansas City's Children's Mercy Hospital several hours to stabilize Caleb with drug and breathing treatments. He then spent three days in inpatient care.

"We had no idea that anything this serious was about to happen," says his mother. "He had a little bit of a runny nose that day, but otherwise seemed fine when he went to school."

Unfortunately, that was only the beginning. Over the next several months, Caleb had frequent recurring attacks, emergency room visits and hospitalizations. "It seemed like we would just get over one attack, and he'd have another," says Blanton.

After the second hospitalization, however, Caleb and his family began getting help from an asthma control program developed by Children's Mercy Hospital and its subsidiary HMO, Family Health Partners, which provided health care coverage to Caleb and his family.

In addition to doctors and nurses, the program—called KC CAMP for the Kansas City Children's Asthma Management Program—provided a case manager, Colleen Pleiss, who taught the family about the unpredictability of asthma and the tools available to help control the disease.

Pleiss helped draft an asthma action plan for Caleb and showed the family how to use Asthma Action Cards™, a patented color-coded tool that can help determine the risk of an asthma attack and provides steps to prevent an attack from occurring.

Caleb's asthma was unusual in the severity of the attacks and intensity of the treatment approach. For many asthma patients, the primary care physician provides the main defense against the need for emergency and inpatient care. A major component of the Kansas City asthma program was placing asthma educators in physician offices to train the doctors and their staffs in effective asthma management measures.

For Caleb, there was no magic bullet. Even after KC CAMP got involved, he experienced several attacks serious enough to require hospital care. Life, however, definitely improved. At the time his mother was interviewed, almost a year had passed since Caleb's last trip to the emergency room-a record she attributes largely to Pleiss's intensive management of her son's case. If "he experiences any asthma warning signs, he knows to tell me how he's feeling so we can follow our plan to prevent an asthma attack," she says.

Best of all, Caleb, now 9, can do what most boys his age do: go to school, play with friends and ride his bike.

(Based on information and quotations reported to RWJF by the grantee organization and also included in material disseminated by the Center for Health Care Strategies.)

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