The Little Girl and Her Couch

© 2008 Jeffrey C. May

A concerned father called me because his four-year old daughter was suffering from chronic asthma. He described his disappointment at being unable to alleviate her symptoms, despite all the heroic efforts the family had put into changing their lifestyle. They had torn out wall-to-wall carpeting and installed hardwood floors, replaced the playroom couch with a leather one, put allergen mattress and pillow covers on their daughter's bed, and taken away all of her favorite dolls and stuffed animals from her bedroom. They washed her bedding every week and kept the whole house immaculate.

The strangest part of all of this was that whenever they stayed in their summer cabin, which was carpeted wall-to-wall and was dusty, their daughter was fine. As soon as they returned home, she began to have problems with her asthma.

The little girl hadn't slept through the night at home for years. Twice a night, the parents took turns placing their daughter on a nebulizer, to administer inhaled medication in order to ease her breathing problems.

As I drove down the street to the home, I was struck by the diversity in the styles of the houses on the street. Each home was different from the next, and snow and ice covered the street and walkways. The family's house was a well-maintained single family with a steep gable roof. The ground was frozen, and there had been a recent, heavy snow. When I parked the car, the father came out to greet me to be sure I didn't slip on the icy driveway. I was struck by his quiet kindness, and from the moment I met him, I could feel his concern over his daughter and his frustration at not being able to do anything to improve the situation.

What worried me when I entered the house was that the space was so clean and well-maintained that I wouldn't find any potential indoor sources of allergens and so wouldn't be able to help the family. Luckily, I was wrong.

The father led me to the basement and then through every room in the house, explaining how they had cleaned things and the items they had replaced. I could see with a mirror and flashlight, though, that the only areas in the house that hadn't been cleaned of all dust were the bottoms of the heat convectors in the walls.

When he was through, I began collecting my air and dust samples. The couch in the playroom was the new leather one, but the couch and the easy chairs in the living room, where his daughter also played, were older. I took samples of the dust from these older pieces of furniture and found that they were infested with dust mites. One of them also contained some mold and bacteria.

Back at my lab, as soon as I examined the slides, I called the father and suggested that they remove all the dust from all the convectors (using a HEPA vacuum) and replace the living room furniture. In the meantime, I recommended that they cover the couch and easy chairs with plastic, to seal in the allergens. Later, I found out that as soon as we hung up, he went out and bought heavy plastic drop clothes and duct tape to accomplish the "re-upholstering."  He carefully wrapped each piece of contaminated furniture in plastic and sealed the seams as if he were wrapping a gift. The next day, they cleaned the convectors as instructed.

Even though they continued to use the somewhat uncomfortable furniture, the daughter began to sleep through the night. He reported to me that within days, she was off the nebulizer, and her symptoms had been reduced by 80%.

This story proved to me once again, that despite our best efforts, one or two omissions in our war against an unseen enemy can still leave us vulnerable.