Alex Hall, 4, and his 1-year-old brother, Shade, are playing on the patio of ISU student Michelle Hall’s off-campus house. Hall’s two sons are enjoying the sunny April afternoon, along with four children from her daycare service.

Although no external differences can be detected between the children, Alex and Shade are working five times harder than the others to keep up with the pace of the games.

At all times, the Hall brothers experience a pressure on their chests equivalent to the weight of a brick. This extra strain makes it more difficult for them to breathe.

Hall and her husband, Steve, are parents of two boys who both have cystic fibrosis, a genetic disease that affects the respiratory and digestive systems and requires up to four hours of treatment each day.

“Sometimes maintaining health care is a full-time job,” said Hall, graduate student in educational leadership and policy studies.

Hall is not only occupied with the health of her sons and her at-home business; she is also working to graduate as a certified education counselor. She is currently taking night classes and working at home in order to take care of Alex and Shade while Steve is at work, she said.

Although Hall’s demanding schedule limits her spare time, she manages to fit in time for studying.

“If school is your priority, then you make it work,” Hall said.

Between medications and treatment, Hall and her husband work to combat the disease around the clock. Just measuring out medications consumes 20 to 30 minutes each day, she said.

The purpose of the time-consuming medications and treatment is to break up the thick mucus that attaches itself to the organs.

“Their mucus is thick and sticky like gum that sticks to your shoe,” Hall said.

The mucus prevents digestive enzymes from breaking up food, which keeps their bodies from receiving nutrition, she said.

“The worry is starvation because no nutrients can get through,” she said. “To combat that, we give them synthetic enzymes with every meal or snack.”

Alex and Shade also undergo physical therapy on a daily basis. Alex has a “ThAIRapy Vest” intended to create vibrations that loosen the mucus from his lungs. Alex has had this vest since he was 2 1/2 years old, Hall said.

“The vest takes the place of the manual physical therapy … it frees up to two hours,” she said.

Hall performs manual physical therapy on Shade because of his age. She vibrates all sides of his upper body with her hands and a cup-like device, she said.

In addition to the vibration treatment, Alex and Shade receive therapy through nebulizer masks — one to four times each day at half-hour increments. The masks get moisture to the lungs, which loosens mucus, she said.

“The more mucus we get up and out, the less likely they are to get lung infections,” Hall said.

The risk of passing infections from one son to the other is a constant concern, she said.

“We want them to be able to be brothers, to hug and kiss, but it is not feasible at times,” Hall said.

The fact that both brothers have contracted the disease is unusual. In order for a child to be born with cystic fibrosis, both parents must be carriers, she said.

“One out of every 20 people are unknowingly a carrier,” Hall said. “Between two people that are carriers, there’s a 25 percent chance of C.F. — the odds are not high.”

When Hall was pregnant for the second time, she reminded herself that there was a 75 percent chance her child would not have the disease, she said.

When Shade was born, he began to show the same symptoms Alex had when he was diagnosed at 2 1/2, Steve Hall said.

“We were devastated,” he said.

Another challenge is the financial aspect of caring for two children with cystic fibrosis. Paying ISU tuition is a struggle and would not be possible without accessibility of student loans, Michelle Hall said.

“The monetary impact is phenomenal,” Hall said. “The therapy vest was $16,000.”

The Hall family has taken an active role in raising money to support this research by becoming involved in the Cystic Fibrosis Foundation, she said. Hall and her husband chair a committee of 20 Ames residents in charge of the Ames Great Strides Walk to Cure Cystic Fibrosis.

The event will be May 6 in Brookside Park. The Halls are making an effort to include businesses and groups around Ames, she said.

“We are hoping for 500 walkers. We had 370 last year,” Hall said.

Renea Gross, junior in English, is serving as a liaison between Hall and ISU students. She is working to publicize the walk in ISU residence halls.

Gross said fund-raising packets were delivered to residence halls last week.

“I hope the residence halls will really begin to get involved with Great Strides, and that in years to come, their participation at the actual walk will grow,” she said.

As a family, “Team Hall” drew more than 100 walkers and raised more than $9,000 last year, Hall said.

“It is a very emotional day. You see how many people care about the cause,” she said.

Hall keeps a positive attitude about the future of her boys. Doctors are continually coming out with more efficient treatments, and the life expectancy has risen to 31 years, she said.

“Our goal is to maintain their healthy lungs until there is a cure,” Hall said. “It will be within their lifetime