STRUGGLING TO BREATHE VALLEY KIDS TRY TO CONTROL THEIR ASTHMA.

Byline: Jennifer Radcliffe Staff Writer

PACOIMA - Wendy Valenzuela raises six children in a federally subsidized apartment in the East San Fernando Valley, working two part-time jobs to supplement her husband's income as a house painter.

But even on their shoestring budget, the couple scrimped to buy a $1,300 vacuum cleaner and $595 breathing machine to stave off their 5-year-old son's asthma attacks - fits of coughing and wheezing that have landed Johnny in the emergency room several times.

Johnny's asthma has turned the family's life upside down. It costs them extra money, keeps them awake at night and forces them to rethink even simple trips.

``It affects everything. I don't sleep at night. I get up every day wondering whether my son will have an asthma attack,'' Valenzuela said.

The family is not alone. Asthma is the most common chronic childhood disease, affecting roughly 6 million U.S. youngsters and costing taxpayers $12.7 billion a year.

An estimated 63,000 Los Angeles Unified School District students have asthma - prompting the nation's second-largest district to create a $400,000-a-year program to try to keep youngsters healthy.

Grass-roots efforts paint an even bleaker picture in the East San Fernando Valley. In a pocket of Pacoima, for example, 28 percent of residents report having asthma, and, in a nearby Sun Valley school, about 14 percent of children have been diagnosed.

Surrounded by landfills, highways and other pollutants, many of Valenzuela's East Valley neighbors are plagued by a condition that steals their babies' breath and can turn their children shades of blue.

``We're the trash can for L.A. County,'' said Maria Sesma Sooy, outreach consultant for Fernangeles Elementary School in Sun Valley. ``This is landfill heaven.''

While the actual causes of asthma are unknown, studies show that genetics, lung development and the environment can lead to its development. Triggers found in sub-par, overcrowded housing exacerbate the symptoms.

``Asthma is an epidemic. We know the (triggers) and we have to eradicate them,'' said Jim Mangia, CEO of St. John's Well Child and Family Center in Los Angeles.

Even though asthma is a manageable condition, children of the area's mostly poor and immigrant population usually are not properly diagnosed or treated. They're also often uninsured or lack access to quality health care, experts said.

``Although it is a chronic illness, you can manage it and can have a completely normal life,'' said Roberta Villanueva, an LAUSD nurse practitioner. ``There's just tons of kids out there that are completely mismanaged.''

Mismanaged asthma

After a few frightening visits to the emergency room, 13-year-old Demi Williams was diagnosed with asthma.

Her mother, North Hollywood resident Shari Holiday, left the hospital unsure of what the condition meant and how to help her daughter.

``It's so sad. She was uncomfortable and it seemed like there was nothing we could do,'' said Holiday, who was staying in a homeless shelter with three of her children.

Children in the United States miss more than 10 million days of school a year because of asthma. Disrupted sleep leaves them with poor memory recall, problems concentrating and mood swings.

After Demi was flagged for missing too many classes at Sun Valley Middle School, LAUSD's Villanueva came to Holiday's dormitory-style room to explain the condition.

Holiday also learned that her daughter's moderate asthma requires two medications - a daily treatment, such as a steroid, to keep the airways from becoming inflamed, and a quick-relief medicine to relax the muscles in an emergency.

Only 55 percent of children in California with moderate or severe asthma regularly take the much-needed medicine for maintenance, according to a 2004 study, Children and Asthma in America.

It's among the mounting evidence that many asthma cases are mishandled. Some families - many of whom are poor, uneducated and speak a language other than English - also confuse the medicines or overuse the emergency formula.

``These families require a lot more than just `here's a prescription' and send them out the door,'' Villanueva said.

But because the East Valley is considered ``medically underserved,'' hospitals and clinics are often overcrowded. Caregivers have little time to properly advise patients on how to use the medicines or how to asthma-proof their homes.

Others lack current information on the condition or aren't familiar with modern treatment goals.

Some doctors are still reluctant to call it asthma, relying instead on more generic labels like ``bronchitis'' or ``restrictive airway disease,'' which don't require the same level of treatment.

``There's some people, because of fear of asthma and what it meant in the past, they don't want to call it asthma,'' said Ana Saravia, a pediatrician at the Northeast Valley Health Corp. ``People used to die from asthma.''

Finding triggers

When Kevin Ayelan, 10, was diagnosed with asthma, he had to throw out his stuffed animals - sparing only a favorite bunny.

The confident, athletic boy, who dreams of being president - or maybe just a lawyer - blames garbage for his asthma.

``It's the dump over there,'' he said, pointing from his house in Sun Valley. ``A lot of people in my school have asthma too because of the dump.''

On top of throwing out dust-attracting toys, the Ayelans spent $10,000 tearing out their carpet, repainting their house and cutting back flowers in their yard to help calm Kevin's condition.

``The minute we changed everything, he got better,'' Kevin's mom, Alma Ayelan said, adding that he's down to one or two attacks a year.

Many families like the Ayelans are at the mercy of social workers who are trying to spread the word about controlling asthma one East Valley house at a time.

The workers explain how families can clean their house and change their lifestyles to reduce triggers.

Doctors may diagnose the problem, but ``they never go to the source and find out what's causing it,'' said Liseth Romero-Martinez, director of programs for Pacoima Beautiful.

Still, many renters have a tough time convincing their landlords to make even basic repairs, such as fixing leaky plumbing that can cause mold or attract cockroaches.

Property owners need to be held responsible for meeting city and state codes. In addition, penalties need to be stiffer for companies that violate air quality laws, especially near schools, advocates said.

``Kids need to be protected,'' said Martha Dina Arguello, director of health and environmental programs for Physicians for Social Responsibility in Los Angeles.

The Asthma Collaborative, a collection of 40 groups from across the county, is supporting legislation that would tighten laws and drafting an asthma action plan that will address the area's growing health problem.

But even when asthma is seemingly under control, it still weighs heavily on parents' minds.

Ayelan was initially so concerned about Kevin's well-being that she decided to study to become a certified nursing assistant and now works at the pediatric unit of All Saint's Health Care.

With her newfound education, she's confident that Kevin's asthma will not keep him from being an active little boy who plays sports, swims and studies hard enough in school to become an attorney.

``He's going to get better,'' she said. ``He's going to have a normal life. We don't have to be scared all the time.''

Jennifer Radcliffe, [phone]

jennifer.radcliffe(at)dailynews.com

CAPTION(S):

3 photos, box, map

Photo:

(1 -- 2 -- color) Asthma sufferer Jorge Vela, above, demonstrates how he uses an air chamber that dispenses medication as Rosa Garcia, asthma case manager for the Northeast Valley Health Corp., checks his technique. At left, Norwood Street School student Jonathan Gonzalez, 8, blows bubbles while walking for World Asthma Day.

Evan Yee/Staff Photographer

Tina Burch/Staff Photographer

(3) Nancy Halpern Ibrahim, with the Esperanza Community Housing Corporation, walks with kids during the ``Catch Your Breath'' community event to mark World Asthma Day May 3.

Tina Burch/Staff Photographer

Box:

ASTHMA AT A GLANCE

SOURCES: American Lung Association of California, Los Angeles Controlling Asthma by Stopping Allergens, Centers for Disease Control.

Map:

ASSEMBLY DISTRICTS

Gregg Miller/Staff Artist