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Deadly and on the rise, how asthma has changed all our lives forever

New figures show the disease now affects one in 10 here and caused 44 deaths last year. Stephanie Bell reports on how Lurgan teen Elise Smyth nearly died from the condition while Belfast widow Joan Wallace often feels trapped in her home

Published 06/09/2016

Severe symptoms: Carla Smyth with her daughter Elise
Severe symptoms: Carla Smyth with her daughter Elise
Coping better: Joan Wallace has joined a support group
Crucial research: Dr Bettina Schock

An alarming report last week revealed that Northern Ireland was in the grip of an asthma epidemic with one in 10 people now suffering with the condition.

The shocking new statistics also revealed that death rates were soaring with 44 people dying last year from the chronic condition.

The report led to calls for Stormont to take action to ensure that the proper care was in place for everyone living with asthma.

Currently 182,000 people in Northern Ireland suffer from asthma, including 36,000 children.

Asthma is a common long-term condition that can cause coughing, wheezing, chest tightness and breathlessness.

The severity of these symptoms varies from person to person.

While it can be controlled well in most people most of the time, some suffer more persistent problems.

Occasionally, asthma symptoms can get gradually or suddenly worse bringing on an "asthma attack".

Severe attacks may require hospital treatment and can be life threatening.

Asthma is caused by inflammation of the small tubes, called bronchi, which carry air in and out of the lungs and in people with asthma, the bronchi will be inflamed and more sensitive than normal.

When a sufferer comes into contact with something that irritates the lungs, this can trigger the airways to become narrow, the muscles around them tighten, and there is an increase in the production of sticky mucus or phlegm.

Common triggers, which people with asthma live with daily, include house dust mites, animal fur, pollen, cigarette smoke, viral infections and even exercise.

The reason why some people develop asthma is not fully understood, although it is known that you are more likely to develop it if you have a family history of the condition.

Asthma can develop at any age, including in young children and elderly people.

Current statistics reveal just how common it has become with one in every 12 adults and one in every 11 children being treated for the condition.

While there is no cure for asthma, there are a number of treatments that can help control the disease. For many people it is a long-term illness - particularly if it develops in adulthood.

For children diagnosed with asthma, the condition may disappear or improve during the teenage years, although it can return later in life.

Moderate or severe childhood asthma is more likely to persist or return later on.

Research into treatment is ongoing and here the Chest Heart and Stroke Association has been funding studies into respiratory conditions since 1958.

It is hoped that one of the most recent pieces of research being carried out by Dr Bettina Schock at Queen's University, Belfast will help children who are living with asthma.

The research is focused on finding drugs that can increase the amount of the protein A20 in the body. A20 is a protein that reduces the amount of inflammation in the body when someone has an infection.

Children with atopic asthma do not have enough A20, which means that the inflammation in their lungs is not reduced and they suffer from more asthma symptoms.

Dr Schock is testing drugs that are already available and licensed for use in humans to see if any of them can increase the levels of A20 which will help reduce asthma symptoms. As they are already licensed, they will be more quickly available for use.

We talked to two people who are living with the disease - a teenager and an adult - to find out how it affects their everyday lives.

Chronic asthma has robbed teenager Elise Smyth from Lurgan of quality of life for most of her childhood. Now aged 14 and a pupil of Our Lady’s Grammar in Newry, Elise has been enjoying some respite from severe symptoms for the first time in the past two years. Her mum Carla (41), a fundraiser with Guide Dogs for the Blind, explains how traumatic the condition has been for her daughter. Carla is married to Stephen (43), a finance director, and they have a son Lucas (11) who also has asthma although less severe than his sister. Carla says:

Elise has had asthma since she was a toddler. Since then the slightest snuffle has turned into a massive chest infection which causes her to cough so much that she vomits.

She would have been very poorly from September every year right through to April. We lived in fear of the winter months.

Elise would get a cold and then suffer a severe chest infection lasting about three weeks and would get no sleep at all with coughing and vomiting.

Since she was five years old until she was 12, her school attendance was down to about 60% because of her illness.

She was down to the bone with her weight as a result of vomiting and her skin was translucent.

We used to try and feed her up in the summer months to help get her through the winter, but as soon as she went back to school it would start again.

We dreaded the winter and worried about Christmas and her birthday in January and would have been always keeping our fingers crossed that she would be okay.

One Boxing Day she had a strange sounding cough and I thought something wasn’t right so I took her to A&E.

She had developed pneumonia and they told me that in another hour she could have been dead.

I had no idea asthma could be that lethal. Her lungs had started to shut down.

The affects on her are terrible and you are just constantly worrying about her.

Meanwhile seeing her miss so much school and so many fun things in life is just heartbreaking.

It has restricted her so much yet she has done really well at school so it’s just as well she is clever or it would have affected her progress.

Asthma impacts on the whole family. When your child is not getting any sleep, you’re not and are worn out — it puts so much pressure on everyone.

Now that she is growing and getting bigger she seems more able to fight it. She has had two relatively normal winters for the first time which is a massive relief.”

Elise, who wants to be a doctor, says:

I have missed out on a lot of things with my friends, going to school or out to places that I couldn’t go to because I was ill. Because of asthma I even missed out a special Christmas when my whole family were over from England and I had to go to the hospital.

The last two years have been good but I still worry if I get a sniffle or a cough and I’d always think ‘here we go again’.”

Widow and retired administrator from Belfast, Joan Wallace (71), who is a mum of three, has been living with asthma for five years. She says:

My husband died in March 2011 and in June I was upstairs at home one day when I suddenly collapsed. I couldn’t get a breath.

I was taken to hospital and diagnosed with clots on my lungs and that was the start of the asthma.

The doctors couldn’t understand why it had happened. At the time I talked to so many doctors but it was a mystery to them.

I was put on medication to prevent further clots but my lungs didn’t repair fully and I was left with asthma.

Having asthma really does have an effect on what you can and cannot do. I don’t get asthma attacks, I suffer from breathlessness. I take an inhaler in the morning and at night and also if I am going out during the day or have to do anything that may leave me breathless.

I can’t go out on a windy day as it takes my breath away. I live on a steep hill and I can’t walk up it.

Now I have a stair lift at home although I don’t use it all the time. I have difficulty carrying things up the stairs and would have to use the lift for that or if I’m having a particularly bad day.

Recently I did a six-week course with Chest Heart and Stroke on how to cope with a long-term illness which changed everything for me.

When I came out of the hospital I was given a prescription for inhalers but no one showed me how to use them. And I didn’t even know there was a dedicated asthma nurse in my doctor’s surgery.

As a result of the course at Chest Heart and Stroke, though, I joined a support group and we meet once a month and this has been a real lifeline for me.

People come and talk to us about eating well and having a healthy lifestyle and each week you set yourself a goal. I am also part of the first over-65s More Active group at Queen’s University and, as part of this, I go to the gym every Tuesday and Friday. It helps you to set fitness targets and increase the number of steps you take, building it up every day.

Before I went to Chest Heart and Stroke I was trying to cope on my own but now, with the help of others, I am coping with my asthma better.

At the support group meetings we don’t sit around and mope but encourage each other. It is great to be among people who understand and are going through the same thing.

There are days it is hard to be motivated but I am a positive person and you have to adapt your life to asthma.

There is no point me going out on windy day. And, if I am out and there is no lift or escalator I just stay on whatever floor I’m on, so it does restrict me.

My family are very good and do things for me that I can’t. I can’t reach up to high cupboards or climb a ladder to change a lightbulb now.

I’m shocked by the new report and would advise anyone struggling with asthma to get support — it is out there and it does help you to cope.”

The Northern Ireland Chest  Heart and Stroke Association, tel: 028 9032 0184 or visit https://nichs.org.uk/

How asthma affects you and how to treat it. Symptoms include:

  • shortness of breath
  • wheezing
  • tightness in the chest
  • coughing

Your body produces hormones called steroids that help to regulate inflammation, including the inflammation of the airways in asthma. This process tends to switch off when you sleep, so asthma often is often worse at night and first thing in the morning.

Sometimes the airways only narrow a little, resulting in mild symptoms. But some people’s airways can become so narrow that they can’t get enough oxygen into their lungs and their bloodstream. This is a very dangerous situation and requires immediate medical attention.

If you or someone you are with has severe symptoms, call an ambulance straight away.

Treatments

The most common form of treatment is medication taken through an inhaler, also called a pump or a puffer.

Inhalers contain measured doses of medication that you take into your airways when you breathe in, with few or no side effects.

There are many different types of inhalers but the most common types are preventer inhalers, which try to stop asthma symptoms from occurring, and reliever inhalers, which relieve asthma symptoms when they do occur.

Different inhalers work in different ways, and it is very important that your doctor or nurse teaches you how to use your inhaler properly. If you don’t use your inhaler correctly, the medication won’t get into your airways and you won’t get the full benefit of it.

For more information, visit the British Lung Foundation at blf.org.uk/support-for-you/asthma/symptoms or Allergy UK at allergyuk.org/asthma/asthma

Belfast Telegraph

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