Asthma attacks, or flare-ups as they are called more recently, can be frightening. Sufferers cough, experience shortness of breath, hear whistling or wheezing sounds coming from their lungs, feel tightness in their chest, lips may turn blue and they can have trouble talking.
“Winter, with its cold weather, can make a flare-up like this more likely,” says Ruth Morrow, specialist asthma nurse with the Asthma Society of Ireland.
“That’s why it is so important to keep your symptoms under control.”
Ruth explains why winter weather is a trigger for asthma.
“If you have asthma, your airways are more sensitive to temperature changes. Cold air causes your airways to produce a substance called histamine, which triggers wheezing,” she says.
“It can also make your bronchial tubes (airways) swell up. This means you can’t take in enough air so you have trouble breathing.
“More mucus is produced in your lungs and nasal cavity too, and this leads to phlegm being produced so you cough to try clear it.”
Tip 1 – Emergency
The first and most important tip to remember in winter is what to do when you have an acute asthma attack.
“We call it the five-step rule,” says Ruth. “We advise sitting down, staying calm and upright, and taking slow, steady, deep breaths. Take one puff of your reliever (blue) inhaler every minute for 10 minutes.
“If a child is having an attack, get them to take six puffs over 10 minutes. Use the piece of equipment known as a spacer with the inhaler, if available, as it makes it easier to use and the medication gets into your lungs quicker.”
“Call 999 or 112 for an ambulance if this hasn’t worked and repeat those steps while you are waiting. Be sure to tell the switchboard operator that it is an acute asthma attack – it is important they know that. If you are assisting someone who is having an attack, stay with them the whole time.
“Don’t be afraid to use the blue inhaler again if it is an acute attack,” she says.
Tip 2 – Medications
Take your medications correctly.
“It is important to take your controller inhaler (orange or brown) twice a day,” says Ruth. “Some people may have to increase this during winter months – the important thing is to keep taking it. Put a reminder on your phone to take it at 8am and 8pm each day, for example, as, when you are well, it can be hard to remember.”
Tip 3 – Action plan
Ruth advises having a written action plan.
“You should have this regardless of what age you are. You can download a template plan from our website, or discuss it with us on our telephone support line.
“There are two kinds of plans – a regular one and one for those on Maintenance and Reliever Therapy (MART). This involves a combination controller and reliever inhaler,” she says.
Tip 4 – Medical review
Get a medical review during the winter months.
“If you have no flare-ups and your asthma is well controlled, a review once a year is fine. However, if you find yourself using your blue inhaler more than twice a week you should be booking an appointment with your doctor, because something is not right.
“Your blue inhaler is not the most important, your (orange/brown) controller inhaler is. If you use your blue one too much, your airways become desensitised and they no longer work very well.”
Tip 5 – Flu vaccination
Get a flu vaccination.
“Not everyone with asthma needs one,” Ruth says. “But talk to your GP.”
Tip 6 – Stay warm
“Cold air is a trigger. As mentioned, whenever someone inhales cold air, it can cause the airways to tighten up and make people wheezy and short of breath. If you warm the air as it goes in, it will be easier, however. We advise breathing through your nose rather than your mouth and also wearing a snood over your mouth and nose.
“Don’t use one that is fluffy or woolly, though, as it could irritate the airways.”
Tip 6 – Eat well
“Getting all your vitamins is important for staying well in winter, particularly vitamin D. Low vitamin D levels can affect our immune systems and make us more prone to infection, so it’s a good idea to eat foods that are rich in this.
"Taking a supplement over the winter months can also help, because we don’t have enough sunshine during the winter here. Taking exercise is also important for general wellness. You need 30 minutes of physical activity a day – walking, gardening is fine. You don’t need to go to a gym.”
Tip 7 – Don’t vape
Ruth is adamant that asthma sufferers should never smoke or vape.
“Secondhand smoke is just as harmful as smoking. This is particularly true for children with still-developing lungs and airways. Children are more vulnerable to respiratory illnesses.
“Passive smoking is dangerous too, so avoid smoky environments.
Tip 8 – See your GP
“There are signs that you should pay heed to,” Ruth says. “If asthma symptoms are waking you up at night, say, one night this week, that could be a warning that something is going to happen in three weeks’ time. Do not ignore this. Contact your doctor, because it can indicate that your asthma is not well-controlled.
“The other sign that your asthma is getting worse is that you are using your blue inhaler more than twice a week.”
Tip 9 – Call the helpline
Call the Asthma Society of Ireland’s free advice line. You can arrange to speak with an asthma nurse, or send the nurse a message via WhatsApp.
The Asthma Adviceline is 1800 445464 and the Beating Breathlessness WhatsApp number is 086 0590132.
Case study: Edel Abberton
Edel Abberton attends a severe asthma clinic.
Edel Abberton (52) from Galway was diagnosed with asthma when she was 19, but her condition worsened in her 30s and she has been prescribed stronger medication since then. She now attends a severe asthma clinic to help control her symptoms.
A mum of four and a qualified nurse, she was first hospitalised in 2010. Since then she has been under the care of a respiratory specialist team.
“The hospitalisation was the best thing that could have happened,” says Edel. “While it took some time for them to get my asthma under control, I started feeling much better and got back running, something I love to do.”
However, contracting Covid in 2022 proved to be a setback, .
“I was hospitalised and spent six weeks in bed at home also. Covid is dangerous territory for me. It triggered my body into inflammation and took me months to recover.”
Edel now takes a number of medications for her asthma, including preventer and controller inhalers, a nasal inhaler and several tablets.
“My asthma can be unpredictable in terms of control, which means my quality of life is unpredictable, but right now I’m doing well,” she says.
Winter can be a worrying time for Edel because of asthma, however.
“I am always wary of Covid. Also, I understand that one of the medications that I’m on for asthma, that is suiting me well, is in short supply nationally, so that is a concern looking ahead, but I try to help myself as best I can.”
She has had her flu and Covid vaccinations, as have her family members, and she advises staying active and taking your medications as prescribed.
“The Asthma Society specialist nurse is also very helpful,” she says. “Over the phone, you get lots of advice about things like recording peak flow meter readings and inhaler techniques, and you can learn to be fully prepared for medical appointments and advocate for yourself when you see the doctors. It’s a great service for parents, or carers of people with asthma also.”
See asthma.ie
One in 13 adults and one in 10 children in Ireland are affected by asthma.The main treatment is inhaled corticosteroids (controller inhaler). Taken as prescribed, this can reduce excess mucus and prevent swelling of the airways. There are 8,000 asthma admissions to hospitals in Ireland every year, with someone visiting an emergency department every four minutes because of this condition. Farmers should be mindful of asthma triggers, regardless of the time of year. These can include strong smells like silage, slurry and chemicals, and dust risks – like opening bales of hay or straw and being near sheep wool. Wearing a mask and working in a well-ventilated area is advised. Read more
Healthbytes: the latest in the world of healthcare
Health: it's either go - or go blind
Asthma attacks, or flare-ups as they are called more recently, can be frightening. Sufferers cough, experience shortness of breath, hear whistling or wheezing sounds coming from their lungs, feel tightness in their chest, lips may turn blue and they can have trouble talking.
“Winter, with its cold weather, can make a flare-up like this more likely,” says Ruth Morrow, specialist asthma nurse with the Asthma Society of Ireland.
“That’s why it is so important to keep your symptoms under control.”
Ruth explains why winter weather is a trigger for asthma.
“If you have asthma, your airways are more sensitive to temperature changes. Cold air causes your airways to produce a substance called histamine, which triggers wheezing,” she says.
“It can also make your bronchial tubes (airways) swell up. This means you can’t take in enough air so you have trouble breathing.
“More mucus is produced in your lungs and nasal cavity too, and this leads to phlegm being produced so you cough to try clear it.”
Tip 1 – Emergency
The first and most important tip to remember in winter is what to do when you have an acute asthma attack.
“We call it the five-step rule,” says Ruth. “We advise sitting down, staying calm and upright, and taking slow, steady, deep breaths. Take one puff of your reliever (blue) inhaler every minute for 10 minutes.
“If a child is having an attack, get them to take six puffs over 10 minutes. Use the piece of equipment known as a spacer with the inhaler, if available, as it makes it easier to use and the medication gets into your lungs quicker.”
“Call 999 or 112 for an ambulance if this hasn’t worked and repeat those steps while you are waiting. Be sure to tell the switchboard operator that it is an acute asthma attack – it is important they know that. If you are assisting someone who is having an attack, stay with them the whole time.
“Don’t be afraid to use the blue inhaler again if it is an acute attack,” she says.
Tip 2 – Medications
Take your medications correctly.
“It is important to take your controller inhaler (orange or brown) twice a day,” says Ruth. “Some people may have to increase this during winter months – the important thing is to keep taking it. Put a reminder on your phone to take it at 8am and 8pm each day, for example, as, when you are well, it can be hard to remember.”
Tip 3 – Action plan
Ruth advises having a written action plan.
“You should have this regardless of what age you are. You can download a template plan from our website, or discuss it with us on our telephone support line.
“There are two kinds of plans – a regular one and one for those on Maintenance and Reliever Therapy (MART). This involves a combination controller and reliever inhaler,” she says.
Tip 4 – Medical review
Get a medical review during the winter months.
“If you have no flare-ups and your asthma is well controlled, a review once a year is fine. However, if you find yourself using your blue inhaler more than twice a week you should be booking an appointment with your doctor, because something is not right.
“Your blue inhaler is not the most important, your (orange/brown) controller inhaler is. If you use your blue one too much, your airways become desensitised and they no longer work very well.”
Tip 5 – Flu vaccination
Get a flu vaccination.
“Not everyone with asthma needs one,” Ruth says. “But talk to your GP.”
Tip 6 – Stay warm
“Cold air is a trigger. As mentioned, whenever someone inhales cold air, it can cause the airways to tighten up and make people wheezy and short of breath. If you warm the air as it goes in, it will be easier, however. We advise breathing through your nose rather than your mouth and also wearing a snood over your mouth and nose.
“Don’t use one that is fluffy or woolly, though, as it could irritate the airways.”
Tip 6 – Eat well
“Getting all your vitamins is important for staying well in winter, particularly vitamin D. Low vitamin D levels can affect our immune systems and make us more prone to infection, so it’s a good idea to eat foods that are rich in this.
"Taking a supplement over the winter months can also help, because we don’t have enough sunshine during the winter here. Taking exercise is also important for general wellness. You need 30 minutes of physical activity a day – walking, gardening is fine. You don’t need to go to a gym.”
Tip 7 – Don’t vape
Ruth is adamant that asthma sufferers should never smoke or vape.
“Secondhand smoke is just as harmful as smoking. This is particularly true for children with still-developing lungs and airways. Children are more vulnerable to respiratory illnesses.
“Passive smoking is dangerous too, so avoid smoky environments.
Tip 8 – See your GP
“There are signs that you should pay heed to,” Ruth says. “If asthma symptoms are waking you up at night, say, one night this week, that could be a warning that something is going to happen in three weeks’ time. Do not ignore this. Contact your doctor, because it can indicate that your asthma is not well-controlled.
“The other sign that your asthma is getting worse is that you are using your blue inhaler more than twice a week.”
Tip 9 – Call the helpline
Call the Asthma Society of Ireland’s free advice line. You can arrange to speak with an asthma nurse, or send the nurse a message via WhatsApp.
The Asthma Adviceline is 1800 445464 and the Beating Breathlessness WhatsApp number is 086 0590132.
Case study: Edel Abberton
Edel Abberton attends a severe asthma clinic.
Edel Abberton (52) from Galway was diagnosed with asthma when she was 19, but her condition worsened in her 30s and she has been prescribed stronger medication since then. She now attends a severe asthma clinic to help control her symptoms.
A mum of four and a qualified nurse, she was first hospitalised in 2010. Since then she has been under the care of a respiratory specialist team.
“The hospitalisation was the best thing that could have happened,” says Edel. “While it took some time for them to get my asthma under control, I started feeling much better and got back running, something I love to do.”
However, contracting Covid in 2022 proved to be a setback, .
“I was hospitalised and spent six weeks in bed at home also. Covid is dangerous territory for me. It triggered my body into inflammation and took me months to recover.”
Edel now takes a number of medications for her asthma, including preventer and controller inhalers, a nasal inhaler and several tablets.
“My asthma can be unpredictable in terms of control, which means my quality of life is unpredictable, but right now I’m doing well,” she says.
Winter can be a worrying time for Edel because of asthma, however.
“I am always wary of Covid. Also, I understand that one of the medications that I’m on for asthma, that is suiting me well, is in short supply nationally, so that is a concern looking ahead, but I try to help myself as best I can.”
She has had her flu and Covid vaccinations, as have her family members, and she advises staying active and taking your medications as prescribed.
“The Asthma Society specialist nurse is also very helpful,” she says. “Over the phone, you get lots of advice about things like recording peak flow meter readings and inhaler techniques, and you can learn to be fully prepared for medical appointments and advocate for yourself when you see the doctors. It’s a great service for parents, or carers of people with asthma also.”
See asthma.ie
One in 13 adults and one in 10 children in Ireland are affected by asthma.The main treatment is inhaled corticosteroids (controller inhaler). Taken as prescribed, this can reduce excess mucus and prevent swelling of the airways. There are 8,000 asthma admissions to hospitals in Ireland every year, with someone visiting an emergency department every four minutes because of this condition. Farmers should be mindful of asthma triggers, regardless of the time of year. These can include strong smells like silage, slurry and chemicals, and dust risks – like opening bales of hay or straw and being near sheep wool. Wearing a mask and working in a well-ventilated area is advised. Read more
Healthbytes: the latest in the world of healthcare
Health: it's either go - or go blind
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