‘I don’t think asthma is taken as seriously as it should be’

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

The country also records the second-highest hospitalisation rate for asthma across EU countries and is about 50 per cent above the EU average. One in 10 Irish children live with asthma, while one in five will experience the disease in their lifetimes.

Tuesday, May 7th is World Asthma Day, an annual event organised 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 medication correctly is key to managing the symptoms.

Edel Abberton can attest to this as she was diagnosed with the condition as a teenager, but due to it not being managed properly, has required much intervention over the years. “I was diagnosed at age 19, but always had a cough as a child,” she says. “When I was growing up, there was not much known about the different types of asthma, but by the time I was in my late teens, I was getting shortness of breath and was coughing a lot and that is when I got my diagnosis.

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

The mother of four, two of whom have autism, was able to control her symptoms with medication but just over 10 years ago, things took a turn for the worse.

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

“I really missed the kids while I was in there, particularly as my youngest was so little at the time. When I was discharged, I still wasn’t fully recovered, but there is always a balance in this and it was better to be at home because I was able to sleep better and recover quicker as I was comfortable in my own surroundings.

“Because I have had asthma so long I wasn’t really frightened by the whole experience, or maybe it was because I was so sick that I didn’t think along those lines at the time. I was just trying to focus on getting through it. I think it was more scary for my family as my youngest was only around two at the time. Weirdly I think I was more worried how we were going to manage with minding the four kids. My adoptive parents, who are now deceased, were experiencing their own ill health and were not able to help, but I was very lucky that I have a very close relationship with my birth mother who came to the rescue and helped us out.

“When you have a chronic condition and are a family carer, it complicates things. It also means that when you are sick you still have to keep going. So you may not get the rest you need or the time to recover.”

Although she did get better, the 52-year-old mother, who lives in Galway, developed Covid in 2022 which affected her very badly. Before this, she was running 10km at a time, but since, she finds it difficult to even go for a walk, has experienced several asthma attacks and been an outpatient at her local hospital on a number of occasions over the past few years.

“All our 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 was quite unwell, I was able to manage,” she says. “But in the second week, things started to go downhill and I became a bit frightened. It’s hard to explain the full effect, but when you are trying to breathe, you get so exhausted from it, and that is always the danger for asthmatics.

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

—  Edel Abberton

“I had great support from my GP and, after trying to address symptoms for a couple of days, my oxygen saturations were struggling, so I was sent for assessment to the ED in University Hospital Galway. I couldn’t get a full breath and they were so overwhelmed with admissions at that time, that I was sent home later that day, but advised to come back in if I got worse or didn’t improve. I was able to manage at home as I am lucky that I have a home nebuliser which is a great fallback when your rescue inhalers are not working as well.”

Abberton, who works as a nurse, is possibly more aware than most of how to look after her symptoms and she also has a very good relationship with her GP, who knows her condition well and keeps on top of her treatment. But her asthma is severe and often uncontrolled and she feels that the condition as a whole isn’t given enough consideration by healthcare professionals.

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

“I am lucky to have a great GP who knows my asthma very well and helped me manage it, as has my respiratory consultant. Also, Ciara, one of the Asthma Society nurses, has been a great help because although I have asthma a long time, I was pretty poor at advocating for myself, even though I am great at doing it for my boys with their disability needs. With Ciara I was able to have a discussion about my asthma, how to manage it and what questions to ask at my outpatient appointments.

“Having that resource is fantastic for helping you to advocate for yourself but also to become a more active member of your own asthma care. I would advise anyone who has asthma to contact the Nurseline at the Asthma Society of Ireland as they are so helpful. Each phone appointment I have had with Ciara has been so useful in helping me to manage my asthma better 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 sort of support is crucial to proper management of asthma and Edel would advise others to take all the help which is offered and seek out extra 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 are concerned 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 on asthma.

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

“Managing my asthma today is still tricky as since I had Covid, the frequency of flare-ups has increased. I attend outpatients under a respiratory consultant in University Hospital Galway who monitors my asthma condition as I have, what one of the doctors there called, ‘a difficult asthma’, so I am on quite a lot of preventive medication to control it.

“Ultimately, if you’re unsure what questions to ask, ask your doctor to speak to the Asthma Society nurses, who will provide you with guidance and support.”

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