Eve

Eve, age 54, was diagnosed with asthma at age 36. She is white and originally from the United States but has lived in the UK for many years. She lives with her husband, and has one adult child, and also lost a child to cancer several years ago. Eve lost her sight as a very young child through a rare form of cancer. Eve experiences symptoms intermittently, but generally has her asthma well controlled using preventer and reliever inhalers. Triggers can include getting a cold, weather conditions, pollen, over exertion, and smoke or fumes.

Eve was 36 when she was diagnosed with asthma. During a day out walking in the countryside with friends one day she found herself feeling very breathless and unable to manage the walk. On that occasion she dropped out of the walk, which was unusual for her as she had never had problems like that before. Prior to this she remembers that she had become more sensitive to being around dogs and people who smoked on several occasions she had found herself coughing. She visited the GP and asked whether it could be asthma, and the GP thought that was probably the case and gave her an inhaler to use, which worked the next time she went walking with friends after using the inhaler she was able to go all the way. Looking back Eve thinks she may have had mild asthma as a child. She grew up in the states and went to a school in Los Angeles which at the time was heavily polluted, and she remembers that on some days her mother wouldn’t let her go to school because her chest was feeling tight. She also recalls an occasion when she was staying with a relative who smoked where she couldn’t stop coughing and wheezing and realises now that she had an asthma attack at that time, but this was a few years before she was diagnosed with asthma.

Initially she was given a preventer inhaler to use and this seemed to work to alleviate symptoms. About a year later when she saw another GP her peak flow reading was quite low and she was then given a reliever inhaler to use in addition to the preventer at times when she was struggling with her breathing. Typically she became breathless when she walked to the shops or took any form of exercise, so she began to use the reliever before leaving the house and sometimes she would also use it when she was out. Symptoms would be worse in summer as she has hay fever and this exacerbates her asthmatic symptoms. Over the years Eve says she has become allergic to more things which trigger her asthma.

It wasn’t until sometime after her diagnosis that she was given her own peak flow meter to enable her to monitor her own condition. As Eve is visually impaired, it was a problem to be able to read the peak flow meter but her husband made some markings on the side using clear nail varnish to enable her to be able to use it for herself.

Normally Eve’s asthma symptoms are coughing, a tight chest and feels breathless, and she only gets wheezy in hot steamy conditions for example in a hot steamy shower or if the heater in the car is on high. She also finds that her asthma symptoms will flare up if she has a cold, or if someone she is in close contact has one.

Eve recalls when her son was about 11 that he wanted to have a pet and she agreed he could have a guinea pig and a rabbit, however being close to the pets exacerbated her asthma and she needed to take steroid tablets to help overcome the symptoms. She was also given a long acting bronchodilator to use in addition to her two inhalers, however eventually the pets had to be given away as they were clearly making her feel very unwell. Eve herself doesn’t have a guide dog and never wanted one as she manages very well with her cane, however she does find that she is allergic to friends guide dogs.

A few years ago Eve’s symptoms were particularly bad during the summer. She kept having asthma attacks, and her regular medication wasn’t working to alleviate things. She was prescribed a tablet called Singulair, to take in addition to her other medication (Singulair is a leukotriene receptor antagonist). That year she had been due to go to Italy for her silver wedding anniversary but had to cancel the trip because her asthma was so bad, and she was advised that flying was not a good idea due to the lower oxygen levels in the air cabin. She recalls that year was one of the worst she has experienced she was taking antibiotics, steroid tablets, the Singulair tablets and using inhalers but she kept having bad asthma attacks nonetheless.

Eve sometimes gets acid reflux which can exacerbate a coughing spell, so she takes medication to help with that. It took a while to get the dosage right but now it is under control.

Eve has kept her symptoms well managed over the years but this year she had a particularly bad attack and had to be taken to hospital where her conditioned was monitored and stabilised, and she was then discharged back home. Generally though, Eve says that she can go for several months sometimes without having any symptoms of asthma, so it doesn’t always impact on her life, however it can be difficult to predict when her symptoms will flare up so there is an element of uncertainly involved in not knowing when she will feel well or being able to plan to do certain things.

Eve says that asthma doesn’t prevent her doing most things. There are some activities that she would like to be able to participate in, such as singing in a choir, or cycling but she has come to terms with the fact that she can’t do that, mainly because she would feel she could be unreliable and have to stop when it might be inconvenient for other participants.

Eve has been blind since she was born and so is accustomed to running her life without sight. In terms of her asthma she says that generally she manages very well and her visual impairment doesn’t make a lot of difference in the way she can manage things. She doesn’t have a written care plan for managing her asthma, but has had discussions with her asthma nurse about what to do when her peak flow measurement is low, and she says she keeps that in her head remembering it rather than having it written down. She is able to recognise her different inhalers because the turbo inhalers that she uses have braille numbers on them. She keeps them in certain places around the house so that she can find them easily.

Eve sees her asthma nurse about every 6 months and finds it useful to have somebody else helping her to evaluate her progress in self managing her asthma. She has occasionally been referred to see the hospital consultant if her asthma is very bad, and she has also recently been seeing another respiratory specialist who is looking into the possibility that she may have sleep apnoea (where the airways close up when you are sleeping).

Eve says she has no qualms about using her inhalers when other people are around and she thinks it’s important not to hide away and do it in private. She thinks that generally people can be unaware of the symptoms and triggers of asthma and she works with Asthma UK as a volunteer giving talks to groups of people about asthma to raise awareness.

Eve sees the asthma nurse about every six months, or more if she needs to. She appreciates having someone else looking at it and giving me her opinion. [AUDIO ONLY]

Age at interview 54

Gender Female

Age at diagnosis 36

How often do you go to see the asthma nurse?

At least every six months, depending on if I need to see her more often I can. I’ll be seeing her in about a month’s time actually.

Is it useful to go and see her inter

Yes.

now and again?

Yes. She knows what shes doing. I like the asthma nurse. She knows what shes doing.

And what kind of help have you had from her?

Well how can I put it… shes… supportive of what I’m trying to do if nothing else.

What you’re trying to do in terms of?

Working with the asthma. You know, shell get me to the specialist if she thinks, if between us we think I need to see the specialist, but she knows I’m trying to manage it myself and she sort of, she just sort of, as well somebody else is kind of outside me as it were, looking, looking at it and giving me her opinion of what she thinks it’s doing.

So what would make her refer you to see the specialist, the consultant?

If I was having too many flare-ups and it wasn’t we couldn’t control it really I think.

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As an adult Eve started getting breathless when walking and was also reacting to a friend’s dog and to cigarette smoke. Shed had hay fever for 20 years but started to realise this was something else. [AUDIO ONLY]

Age at interview 54

Gender Female

Age at diagnosis 36

We were going up this hill, and I was getting more and more breathless. And I was, I knew I wasn’t super unfit or anything. And I got to the point, I was getting so breathless I thought, I cannot do this. And I actually had to drop out of the walk.

And I had been having troubles with breathing before, I had been troubled, I had recently become allergic to dogs and I was coughing a lot when I was near this friend’s guide dog. And, I thought why, you know, this, with this reaction to the dog and also similar reaction when I was around a couple of people who had been smoking. They weren’t smoking at the time but there was smoke on their clothes. And I was coughing and coughing, and I took my hay fever medication, but that didn’t do it.

Then I had this problem getting up the hill and getting so breathless I couldn’t do it, I couldn’t get up the hill, and I had to stop, literally, wait for everybody else to go back up and then come back down and get me half way, half way there.

I thought wait a second, something’s wrong here. And I said to my GP what the problem was and I said, This isn’t asthma is it? Because I’d had hay fever for over twenty years by then, and she said, Well it kind of sounds like it is. And she gave me at the time, just a steroid inhaler. She said, take, you know, told me to take it, two puffs in the morning, two at night and see what happened.

And it eased off the symptoms, and the next walk I went on with my friends, I could go all the way. And that sort of told me something [laughs].

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Eve can go for several months without her asthma bothering her and then she may get several flare up’s’ especially if she gets a cold or chest infection. [AUDIO ONLY]

Age at interview 54

Gender Female

Age at diagnosis 36

So on a day to day basis, how much does your asthma impact on your life would you say?

When I’m not having a flare up it doesn’t a lot.

So how often would you say you have even if it was a more minor flare up say?

Well I can go through several months without a flare-up and then I can have two or three within a couple of months It just, you just never know when it’s going to do that. I think that’s the problem you don’t know, you don’t. It catches you out.

I would love to sing in a choir. I used to sing when I was younger and I can’t because I don’t know from one, you know, one month to the next whether my breathing’s going to behave or not. I don’t feel I would be reliable enough, if that makes sense.

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Eve has noticed that her asthma has become worse over the years. [AUDIO ONLY]

Age at interview 54

Gender Female

Age at diagnosis 36

Overall would you say, how would you describe how, how well you manage your own asthma symptoms?

I think I manage them pretty well. I just get frustrated sometimes when, when theres a lot of flare-ups. I get frustrated. But theres not always anything I can do about that. It’s just… more things get added to the allergy list. And…

And that puts more limitations on your

Sorry.

That puts more limitations on your lifestyle I suppose?

Yes. I mean I remember hearing that if you become a, if you’re like diagnosed as an adult, if you pick up, if you become asthmatic as an adult, you tend, your asthma tends to get worse over the years, and I’ve noticed that with mine. It is getting worse over the years. And I keep hoping it won’t do that, but it is doing that.

So what do you feel about your future with asthma? Have you got any kind of feelings about it?

Well I’m just going to have to keep fighting it or working with it, or whatever I’m doing. I it’s not going to go away, but I am going to do the best I can to control it. Keep it under control and I know you have to take your medication.

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Eve remembers when she was a child living in Los Angeles that she would often feel tightness in the chest when the air was polluted. [AUDIO ONLY]

Age at interview 54

Gender Female

Age at diagnosis 36

But the thing is, when I look back now, I think I may have had mild asthma before then, because when I was a young child I went to a school for. Okay I lived in Southern California and I went to a school for the blind in Hollywood of all places, and of course LA which we had to go through, was very smoggy at the time. It probably still is. And sometimes the inversion layer, how far the stuff in the air could rise to where it could get away from, get away was so low [musical noise] that my Mother wouldn’t even let me go to school.

And even on days when it was a bit higher and I could go to school, there were days I came back and my chest was tight. But I didn’t know that that was what, what the feeling was until now when, now that I have asthma and I know a tight chest feels like, I know that’s what I was feeling as a child, but I didn’t know what that was then. I just remember feeling it. And I recognised that’s what it was.

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