She suddenly realized her inhaler was at home.
"I felt like I could die and nobody would be able to look at me and tell that I had asthma," said Maes, a 14-year-old sophomore at Piedra Vista High School. "Every day I carry it now. That was pretty much the turning point."
The change in seasons means a heightened risk for people, particularly children, who are living with asthma, said Cathy McDonald, the nursing coordinator for Farmington Municipal Schools.
With asthma rates in northwest New Mexico significantly higher than the rest of the country, the schools are preparing employees, from P.E. teachers to bus drivers, to be on the lookout for signs that a student is having an asthma attack, she said.
Cold weather, being sick, allergies, aerobic activity or even anxiety can trigger an attack, she said.
The percentage of people with asthma in New Mexico is about 1 percent greater than the national average, according to 2009 asthma report by the New Mexico Department of Health.
Asthma rates among children in northwest New Mexico dropped from 16 percent to 13 percent in the last five years, but the northwest corner still has the second most cases of children under the age of 15 being hospitalized with asthmatic symptoms in the state, according to last year's report.
Those numbers may not tell the whole story because children who were treated by Indian Health Services are not included in the data, said Dr. Elizabeth Matthews, the medical director of the family health bureau for the New Mexico Department of Health.
"We don't know what the impact (of asthma) is among Navajo kids, so that sort of skews the numbers," Matthews said. "We can speculate that if we added in Indian Health Services data we would have higher rates."
The department of health is calculating how many children on the Navajo Nation suffer from asthma. The department suspects when those results are calculated the Four Corners region will be considered one of the most asthma-prevalent areas in New Mexico.
Asthma rates increase in low income and rural areas. Many Navajo traditions, such as using wood-burning stoves, also increase the chances a child will develop asthma, Matthews said.
Local doctors also suspect power plants in the region increase a person's odds of developing the disease, Matthews said.
Last school year, 1,250 of about 10,600 students in Farmington schools — almost 12 percent — had asthma, McDonald said.
Less than 200 of those students provided school nurses with inhalers. Some students with asthma don't use inhalers, and other students carry inhalers, but don't check it in with the school, McDonald said.
When Maes had an attack at school and didn't know where her inhaler was, the school nurse had Maes' medication and administered it, Maes said.
Every person with asthma has different triggers, and it's vital the school has information on each asthmatic student's medical history so the school nurse can create action plans for students with a history of asthma attacks, McDonald said.
The school district has action plans for about 200 students.
The action plan "is so that they can tell us specifically how often (asthma) is a problem for your child. Is this something that is in control or is it not in control," McDonald said. "It actually has symptoms for moderate reaction and symptoms for when the child needs to be transported by emergency services."
San Juan Regional Medical Center started seeing an increase in the number of children hospitalized because of severe asthma attacks at the start of the school year, said Mark Harrington, the respiratory care manager at the hospital.
"Kids start coming in because they are exposed to so many different bugs. That's just the nature of the beast of being back in school," he said. "As the weather changes and gets more severe, we see more."
Teachers, coaches and anyone else who works in the schools should be on the lookout for any behavior out of a student's norm, he said.
"The whole teaching staff should be on alert (for asthma attacks) to help these kids," Harrington said. "It's very important that kids get help right away."
Ryan Boetel: firstname.lastname@example.org