Allergy/Immunology

The Severe Asthma Clinic is a multidisciplinary program with specialists in Pulmonology, Allergy/Immunology, Respiratory Therapy, and Nursing, who collaborate to help children with severe asthma. A severe asthma patient is one who experiences pediatric intensive care unit admission, frequent hospitalizations or ER visits, frequent/high doses of systemic steroids and/or one who is symptomatic despite receiving high-dose controller asthma medications.

The mission of this clinic is to provide optimal care to our patients and educate parents and families about asthma to help them improve asthma control and quality of life for themselves and their loved ones.

Children with severe asthma tend to fall into two categories: difficult-to-treat asthma or severe therapy-resistant asthma.

Difficult-to-treat asthma is poor control due to an incorrect diagnosis or comorbidities and poor adherence due to adverse psychological or environmental factors. Evaluating the patient from a 360-degree view, which involves factoring in other medical conditions, addressing home exposures (mold, dust), assessing access to medication and health services, looking at tobacco exposure, and dealing with school issues, are all important and can all contribute to the clinical picture.

Severe therapy-resistant asthmatics are children whose asthma remains uncontrolled despite resolution of any reversible factors. Incorporating a multidisciplinary model that addresses the medical and social needs of children with asthma has shown demonstrable improvement in quality of life and symptom-free days, as well as decreased hospitalizations and ER visits.

We offer a full range of clinical services including:

• Comprehensive evaluation with dedicated physician time from both Pulmonology and Allergy to confirm the diagnosis of asthma
• Identifying and addressing co-existing problems that may be making the asthma worse (i.e. vocal cord dysfunction, sinusitis, GERD, rhinitis, sinusitis)
• Pulmonary function testing with bronchodilator and other tests as deemed appropriate
• Testing for environmental allergen triggers
• Utilizing community resources to perform in-home assessment of potential asthma triggers and providing free products and resources to help reduce the triggers
• Individualized asthma action plan
• Comprehensive patient education with dedicated asthma educators

For patients with refractory asthma, the Severe Asthma Clinic offers innovative diagnostic and treatment services that are at the forefront of asthma care including:

• Measurement of inflammatory biomarkers in exhaled breath for patients not responding to therapies, and requiring high doses of corticosteroids
• Bronchoscopic evaluation to identify potential chronic causes of asthma

Division Manager
Lorraine Esene

Nurse Practitioner
Holly Anderson, CPNP

Registered Nurse & Asthma Educator
Kristel McGuire, RN, AE-C

Research Coordinator
Helena McClenahan

Clinical Secretaries 
Kim Edwards 
Alisa Schwabel