‘I don’t think asthma is taken as seriously as it should be’ – The Irish Times

Ireland has one of the highest prevalences of asthma in the world, with around 380,000 people officially diagnosed with the condition, according to the Asthma Society of Ireland.

The country also records the second highest rate of hospital admissions for asthma among all EU countries and is around 50 percent above the EU average. One in ten Irish children live with asthma, while one in five will experience the disease in their lifetime.

Tuesday, May 7 is World Asthma Day, an annual event organized by the Global Initiative for Asthma to improve asthma awareness and care around the world. And knowing how to manage asthma is crucial, because taking medications correctly is key to managing symptoms.

Edel Abberton can attest to this, as she was diagnosed as a teenager, but because the condition was not properly treated, she has required many interventions over the years. “I was diagnosed at the age of 19, but always had a cough as a child,” she says. “Growing up, not much was known about the different types of asthma, but by the time I was in my late teens I started having shortness of breath and coughing a lot, and that’s when I got my diagnosis.

“Then, in my mid-20s, my flare-ups started to become more frequent, but these were generally manageable with treatment from my GP. But I have been to the emergency department a few times over the years with my asthma and until recently I had the type of asthma that worsened over a short period of time, rather than the classic asthma attacks.”

The mother of four, two of whom have autism, was able to manage her symptoms with medication, but things took a turn for the worse just over a decade ago.

“In 2011, my condition became much more difficult to manage and as a result I developed respiratory infections much more frequently,” she says. “I ended up in the emergency department feeling very unwell and out of breath so I was admitted to hospital as I needed oxygen treatment, steroids, antibiotics and nebulisers. I was there for about a week and couldn’t get out of bed for a few days because I was so out of breath.

“I really missed the children when I was there, especially because my youngest was so small at the time. When I was discharged I still hadn’t fully recovered, but there is always a balance and it was better to be at home because I could sleep better and recover faster because I felt comfortable in my own environment.

“Because I’ve had asthma for so long, the whole experience didn’t really scare me, or maybe it was because I was so sick that I didn’t think about it that way at the time. I just tried to focus on getting through it. I think it was scarier for my family since my youngest was only two years old at the time. Strangely enough, I think I was more concerned about how we would manage caring for the four children. My adoptive parents, who are now deceased, were themselves in poor health and were unable to help, but I was fortunate to have a very close relationship with my birth mother, who came to our rescue and helped us.

“If you have a chronic condition and are an informal caregiver, things become complicated. It also means that if you are sick, you should continue anyway. So you may not get the rest you need or the time to recover.”

Although she got better, the 52-year-old mother, who lives in Galway, developed Covid in 2022, which affected her very badly. Previously she used to run 10km straight, but since then she finds it difficult to even go for a walk, has had several asthma attacks and has had a number of outpatient visits to her local hospital in recent years.

“Our whole family, except the youngest, had Covid in March 2022, and initially I had the usual flare-up of asthma symptoms in the first week, so although I felt quite unwell I was able to manage,” she says. “But in the second week it went downhill and I got a bit scared. It’s hard to explain the full effect, but trying to breathe makes you so exhausted, and that’s always the danger for asthmatics.

I would advise anyone who has asthma to contact the Asthma Society of Ireland Nurseline as they are so helpful

— Noble Abberton

“I had great support from my GP and after trying to manage the symptoms for a few days I started having problems with my oxygen saturation so I was sent to University Hospital Galway A&E for assessment. I couldn’t breathe properly and they were so overwhelmed with the admissions at the time that I was sent home later that day, but was advised to come back if things got worse or didn’t get better. I was able to manage at home because I’m lucky enough to have a home nebulizer, which is a big setback when your rescue inhalers aren’t working so well.”

Abberton, who works as a nurse, may know better than most how to manage her symptoms and she also has a very good relationship with her GP, who knows her condition well and monitors her treatment closely. But her asthma is severe and often uncontrolled, and she believes that not enough attention is paid to the condition as a whole by healthcare professionals.

“I don’t think asthma is taken as seriously as it should be, or perhaps there is a lack of public awareness because people still think of someone with asthma as someone who is wheezing and looking for their inhaler,” she says. “But it varies so much between people, and sometimes in the emergency department, that some doctors in training didn’t know enough about the different ways it can manifest in people.

“I’m lucky to have a great GP who knows my asthma very well and has helped me manage it, as has my respiratory consultant. Ciara, one of the nurses from the Asthma Association, has also helped me a lot, because although I have had asthma for a long time, I was quite bad at standing up for myself, even though I am good at standing up for my boys with their disabilities to do. With Ciara I was able to have a conversation about my asthma, how to deal with it and what questions to ask during my outpatient appointments.

“It’s great that you have this resource to help you advocate for yourself, but also become a more active member of your own asthma care. I would advise anyone who has asthma to contact the Asthma Society of Ireland Nurseline as they are so helpful. Every phone appointment I have had with Ciara has been so helpful in helping me better manage my asthma and advocate for myself at outpatient appointments. They also have fantastic resources on their website for anyone wanting to learn more about the condition.

Having this kind of support is crucial for good asthma management and Edel would advise others to take all help offered and seek additional advice if necessary. “I would encourage you to value your relationship with your GP and have them as your first point of contact if you have any concerns about your asthma,” she says. “GPs do a lot of great work that isn’t often talked about, and most of them are well informed about asthma.

“But if you want better health as an asthmatic, you also have to keep an eye on your own asthma. Keeping a diary of your symptoms and peak flows can be a great help in monitoring the condition over a long period of time. The Asthma Society of Ireland has peak flow booklets available and there are also some phone apps available to help keep an eye on things.

“It is still difficult to manage my asthma today as since having Covid the frequency of flare-ups has increased. I see outpatients under the direction of a respiratory consultant at University Hospital Galway who monitors my asthma condition as I have what one of the doctors there called ‘difficult asthma’ so I take quite a lot of preventive medication to to keep it under control.

“If you’re not sure what questions to ask, ask your doctor to speak to the Asthma Association nurses, who will provide you with guidance and support.”

• Asthma is an inflammatory disease of varying severity that affects the airways.
• People with asthma have airways that are extra sensitive to substances (or triggers) that irritate them.
• Common symptoms include coughing, wheezing, shortness of breath and chest tightness.
• Ireland has one of the highest asthma rates in the world.
• Asthma often starts in childhood, but can start at any age and often runs in families.
• Smoking during pregnancy or exposing a child to tobacco smoke increases the risk of developing asthma.
• Being overweight increases the risk of developing asthma.
• Some children lose their symptoms as they get older, but asthma is a chronic disease, so it never goes away and symptoms can return later in life.
• For more information, see asthma.ie