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Late autumn is the worst time of year for a lot of people with asthma. That’s primarily because of the change in weather.
“It’s cooler, there is fog around – these are all big triggers for asthma,” says Ruth Morrow, a respiratory nurse specialist with the Asthma Society’s WhatsApp messaging service.
She is used to dealing with people’s queries and sending on information and links to those who contact the service and top of her list is protecting yourself if going outdoors.
“Exercising in the cold air is a huge trigger for many people, but we want people to exercise,” she says.
“We suggest wearing a snood or light scarf over your nose and mouth as this will warm the air going into your lungs and help alleviate the symptoms. If this is still a problem we would advise you to exercise at home where you’re warm.
“Breathing through your nose can also help as the nose has an air filter and does warm the air up. If cold air is a trigger, it can definitely help.”
Most people know when their bad times of the year are
Having your asthma as well controlled as possible is important too.
“Some people may need to increase their prevention medication at this time of year, some don’t,” she says. “Most people know when their bad times of the year are (with asthma). It can be spring or summer for some people when pollen counts are high but it’s very individual.”
She stresses the important of taking the prescribed prevention medication (brown/orange inhaler).
“Some people are over-reliant on their blue inhaler (for emergencies) and that’s actually quite dangerous,” she continues.
“Your preventer inhaler is the one you need to take every day, as prescribed by your doctor.
“The majority of people have to use this (brown/orange) inhaler twice a day.”
Overuse of blue inhaler signals danger
Using your blue inhaler more than twice a week indicates that your asthma is not well controlled and you need to have your medication reviewed by a doctor.
If you are getting more than three blue inhalers a year, you are at risk of an acute asthma event. If you are using more than 12 blue inhalers a year, you are at risk of an asthma-related death.
“Blue inhalers are only used for emergencies,” Ruth says. “You might have to use it when you get a cold or a chest infection but once that time is past you should be coming off it again.”
Get the flu vaccine- and the pneumo one
Getting the flu vaccination each winter is really important, she states.
“This is standard guidance for those with asthma. All children in Ireland are being given a nasal flu vaccine this year and this would be particularly important for those children who have asthma. A few children can’t get it, but your doctor will advise you. For adults with asthma, getting the flu vaccination every year is essential.”
Getting the extra pneumococcal disease vaccine is also important.
“You need to talk to your GP about this vaccination because you don’t have to get it every year.”
1 Keep your house heated
Houses can be damp during the winter and mould growth during wet weather can be another trigger at this time of year, so it is important to have heating on and keep warm and wear a coat when you go out.
2 Minimise dust
Dust is always a big trigger so it pays to minimise it in the home.
3 Open fires
Open fires can be a problem too so we recommend not to be burning smoky fuels. If people can use stoves, it helps significantly.
4 Unscented candles
Strong odours can trigger an asthma attack also, so it’s best not to use scented candles in the home as the smell can be overpowering. We suggest unscented ones or LED candles.
5 Check inhaler technique
While you should always use your brown inhaler and carry your blue one with you for emergencies, you should also refresh your knowledge of inhaler technique. This is important in order to get the medication into your lungs correctly. There are videos you can watch on asthma.ie that illustrate the technique. Remember also that if you are using the ordinary inhaler, (the one you press down on), it’s important to use a spacer device with it, so the medicine gets into the lungs. Some inhalers don’t require spacers, but it is worth asking your GP if a spacer is needed as it makes the process easier. Using the inhaler directly into your mouth means less medication gets into lungs. Spacers are not just for children with asthma.
This is important in case you have an acute asthma attack.
“You may never have one but there is no guarantee you won’t get one,” says Ruth. “You need to know how to deal with the risk. We have wallet cards that can be sent out if you ring the Asthma Society also.”
Have action plan in place
“This will tell you what to do when you’re well and when you’re unwell and when you’re having an acute asthma attack. People can download those plans from our website and fill them in for regular reference. You then have a step-by-step guide to help you manage your asthma and that you can discuss with your doctor and that is tailored to your own situation.”
What you should do to avoid COVID-19 stress
There is additional stress this year for those with asthma because of the COVID-19 pandemic.
“This is causing a lot of anxiety and anxiety can trigger asthma also,” Ruth adds.
“Just because you have asthma doesn’t mean that you’re more at risk of getting COVID-19, however.”
Hospital
“In research people with asthma who have COVID-19 are not ending up in hospital as often as people with cardiovascular disease, for example.
“The most important thing is for you to have your asthma well-controlled. Even though your brown or orange inhaler has a little bit of steroid in it, all the recommendations are that you can continue your inhaler steroid regardless of COVID-19.”
Enquiries related to COVID-19
The pandemic has been the topic of 95% of queries to the Asthma Society’s WhatsApp messaging service since it started in May, Ruth says.
“People were worried about going back to work, going back to school, about face mask wearing. We do advise that you wear your mask, there is no medical reason why you can’t. Obviously if you’ve difficulty breathing in, it’s not going to help you, but generally people with asthma can wear masks.”
Mike McDonagh, 46, is married to Stephanie and they have two children, Clodagh and Michael.
Asthma is part of his family, he says. This is his story of asthma and how he has come to manage it successfully: “We’re all asthmatics, myself and my two children. I would have had fairly acute asthma episodes over the years. I would cough a lot, every night. I would wheeze. It wouldn’t take a lot to bring on the wheeze. Relievers – they were everywhere – I’d be hospitalised, you’d be looked after and when you came out you’d be good, but it would go downhill again. Asthma was something I had to live with, and keep at bay. As far as I was concerned sport was for people that didn’t have asthma. If I ran any distance or was under any sort of pressure I would start to wheeze.”
Several years ago, he decided to follow an asthma management action plan, however.
“I had to put a plan in place to manage my asthma better. It involved going to the respiratory clinic in the hospital and reviewing the medication I was on and looking at our lifestyle – what would improve it and what we could do in daily life to manage the asthma better.
“Since that, life has changed a lot. I used to be only able to run the distance between two telegraph poles, that became a hundred yards, that became a couple of kilometres… it reached its highest point when I ran the Dublin marathon last year in 2018. It (following the action plan) lets me cycle, swim, ride horses… we do things as a family unit that wouldn’t be part of our lifestyle if we hadn’t taken control of my asthma.”
Challenge
Mike continues to challenge himself and sticks rigidly to his action plan.
“It works for me and lets us live the life we want to live. I am currently training for a half Iron Man event.”
His wife Stephanie says: “If you’ve asthma contact the Asthma Society – you’ll have an extra line of support there. Our two children have asthma and they take their medication morning and evening. If you have asthma go to the GP in time and don’t be passive about it,” she says.
Download your action plan at asthma.ie or ring the adviceline 1800 44 54 64.
People who have questions about managing their asthma/Chronic Obstructive Pulmonary Disease (COPD) during the winter months are encouraged to freephone the Asthma Society’s HSE-funded Asthma and COPD Adviceline on 1800 44 54 64 or send a WhatsApp message to their Sláintecare-funded Asthma and COPD WhatsApp service on 086 059 0132.
Both services are free and allow users to communicate directly with an asthma/COPD nurse specialist.
Available to members and non-members.
Each week in Ireland, a family is devastated by the death of a loved one from asthma. Sadly, the vast majority of these deaths are preventable.
The Asthma Society’s fundraising has been impacted due to COVID-19. Please give what you can by going to asthma.ie. Every little helps.
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