Two members of Children’s Home Care knock on the door of an apartment near the Fresno Fairgrounds in southeast Fresno, where a posted sign reads: “Oxygen in Use.”
Tristan Yang, a respiratory therapist, and Karen Camoroda, a registered nurse, don’t have to be reminded. Inside, there’s the constant hum of a primary ventilator.
Timmy Thao, who will celebrate his first birthday on March 19, rests in his crib, which is set up in the living room, along with the ventilator, a back-up ventilator and other hospital equipment and supplies. There’s room for a couch, and very little else.
This living room resembles a hospital room for a reason.
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Timmy can’t come off the ventilator. Rather than having Timmy’s parents, Tony Thao and See Chang, bring their son to Valley Children’s Hospital, the Children’s Home Care unit regularly drops off equipment and supplies at their home and sends hospital medical staff to do regular procedures.
Children’s Home Care, which has offices and a warehouse near River Park Shopping Center, provides an array of nursing, respiratory care and infusion equipment in the homes of children with chronic illnesses. It serves 11 counties and offers cost-effective and convenient programs featuring the latest technology for patients, caregivers and physicians.
Children’s Home Care is staffed by a team of nurses, respiratory care practitioners, pharmacists and pharmacy technicians. It supports and services all of its equipment, offers free delivery and set-up, 24-hour on-call clinical assistance and billing of all third-party reimbursements.
Each year, the department serves about 2,000 patients in the 45,000-square-mile area Valley Children’s covers. Many are low-income families.
“It’s all about family,” said Lisa Helms, manager of clinical services for Children’s Home Care.
Timmy has had open-heart surgery three times. He also had a tracheotomy in October. After he improved, Timmy was discharged on Jan. 14, and his parents were sent home with all the equipment and supplies that he needs.
Since then, Children’s Home Care has conducted two consecutive follow-ups at Timmy’s home, a five-day follow-up and a seven-day follow-up. On Feb. 11, Yang and Camoroda visited for a 14-day follow-up.
Yang’s task was to supervise Timmy’s parents as they put their son on the back-up ventilator so they could change a circuit on the primary ventilator, a procedure that needs to be done every two weeks. Camoroda conducted a general assessment of Timmy’s medical status, medications and a wound on his left ankle. Camoroda also checked Timmy’s weight, which was 19.84 pounds.
Yang spoke in Hmong with Tony Thao as he worked with Chang to put their son on back-up, then change the circuit in the primary ventilator. Everything went well.
However, there was a slight hitch as Thao and Chang removed the tracheotomy tube to clean it — a slight leak. Timmy whimpered in discomfort. The parents eventually completed the job, earning Yang’s approval.
“It’s OK,” Yang told Timmy. “We’re not going to touch you anymore.”
Thao and Chang said they are grateful Children’s Home Care visits their home and supervises their jobs. They are on their own for the next circuit change. Yang and a nurse aren’t scheduled for another home visit until about mid-March.
“I’m so happy they help us out because of the stuff we need,” Tony Thao said. “Sometimes, they tell us stuff we need to know. It’s good they help us. Without their support, we couldn’t take care of him.”
Chang agreed, saying, “It’s scary; it’s hard.”
There is hope Timmy eventually can be taken off the ventilator.
“He’s a survivor,” Yang said.
After the visit, Yang returned to Children’s Home Care offices. After a break for lunch, Camoroda continued on by herself to a home visit near Fresno’s Tower District.
There, 6-year-old Lilly Fairbanks-Miller requires total parenteral nutrition, which is intravenous feeding, a method of getting nutrition into the body through the veins.
Lilly’s gastrointestinal tract, an organ system responsible for consuming and digesting foodstuffs, absorbing nutrients and expelling waste, isn’t functioning properly. Because of her metabolic disorder, she can’t break down fats. Her body builds up toxins, resulting in acidosis. She ends up in intensive care units because her body shuts down.
In the back of the family’s home is a room full of medications for Lilly. In the kitchen, she has her own refrigerator. Children’s Home Care regularly drops off Lilly’s medications and supplies.
On this day, Lilly sat in a customized wheelchair in the living room, watching the children’s television show “Wonder Pets.” Unable to speak much, she tapped the top of her head when she wanted the channel changed and stepped out of her wheelchair to play on the floor with a dollhouse.
Camoroda’s visit mainly was to draw blood for lab work, which is required twice monthly. Hinds Hospice workers come weekly, managing Lilly’s care, including equipment.
Camoroda, who has worked for Children’s Home Care since September, talked with Lilly’s mother, Amber Fairbanks, who says one of Lilly’s tubes has been draining more.
“I noticed her lips; she is dehydrated,” Camoroda said.
Fairbanks said she is grateful that Children’s Home Care provides services in their home.
“It means the world to us,” she said. “It helps us to keep her home. She has good days and bad days, and I worry when she has bad days. She’s a happy girl. When she isn’t happy, you know something is wrong.”
Lilly’s father, John Miller, said: “This is a lifeline for my daughter. This helps her to be on this planet to be alive.”
Camoroda said it is important that Children’s Home Care provide services at patients’ homes.
“It’s about being there to support the families, caregivers and patients, like Lilly and Timmy, where there are so many medical needs,” she said. “They need someone to say, ‘You’re doing well.’ People feel when they leave the hospital, they’re alone.”
Children’s Home Care makes sure they are not alone.