Asthma
Adult onset of asthma
Here we discuss people’s experience of being diagnosed as an adult.
Often people who were diagnosed with asthma as adults said they hadn’t realised it can develop at any time of life. It could be difficult to accept to begin with, especially as it may take a while to find the right medication to control it. Eileen said, ‘I just couldn’t understand why I suddenly had asthma. I’d had nothing before’. Val was shocked to be told she had asthma, even though other people in her family had it -‘how can someone as fit as me get asthma?’
Julie’s asthma was diagnosed in her 40s after a persistent cough. Until then she had thought of asthma as something children had and could grow out of.
Julie’s asthma was diagnosed in her 40s after a persistent cough. Until then she had thought of asthma as something children had and could grow out of.
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How long ago was that?
This was 1982… and asthma wasn’t in my consciousness because I thought it was something children had and grew out of at that stage, I’d never heard of asthma appearing in your life when you were 40.
The next time I got a cold, similar coughing. I thought, “Oh dear, this is sort of with me,” you know. Not knowing anything about asthma I didn’t know it was a condition that was there for good. I didn’t know what was going to happen. So I think we moved that year, was it that year? It was either that year or the next year, we moved to [place] so change of doctor’s, change of lifestyle slightly because I was starting to commute and working in London. And I got very bad cold and I was given, I think, antibiotics for the cough and that didn’t really get rid of it.
Val had led a fit and active life until she got asthma in her 50s; the diagnosis shocked her.
Val had led a fit and active life until she got asthma in her 50s; the diagnosis shocked her.
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No. Well I should have, because again looking back now, my grandmother had it and my mother’s sister had it very, very, very severely and in fact died of an asthma attack - but in her seventies, you know, and she was always in and out of hospital with it. So I should have realised that you could get it, but no, just wasn’t sure… I might get it as an adult. I just assumed people got it as young children and kept it or got rid of it, ‘cause I know children now can reduce or get rid of their symptoms, but I hadn’t realised that you could be diagnosed as an adult with it.
I mean how did you actually feel yourself about your diagnosis?
I was really shocked, ‘cause I just thought ‘how can someone as fit as me get asthma?’ [laughs]. You know, I was just, but again looking back when I was in my forties I used to do a lot of rock climbing, mountain climbing, and I used to be able to climb some of the highest mountains in Europe and I think one of the first attacks I got, I’d done this mountain two or three years previously, this was some kind of organised group trips. And then I tried to do it again three years later and I thought I was going to die, honestly I just couldn’t breathe and I thought ‘this isn’t right, I can’t be that much less fit than I was three years ago’, and I suppose I should have realised then really that there was something wrong.
It can be hard to tell the difference between asthma and other conditions causing similar symptoms, such as bronchitis or other chest infections, emphysema (chronic obstructive pulmonary disease or COPD), and heart disease, so sometimes it may take a while to diagnose asthma in older adults.
Ann’s first experience of asthma was a severe episode of difficulty breathing. Her GP sent her to the hospital for a chest x ray, but when the junior doctor at the hospital looked at the x ray he said he thought she had a problem with her heart and did not immediately diagnose asthma. It took several months for Ann to get the right diagnosis which made her anxious and upset, which in turn made her asthma worse.
Ann was going through the menopause when she first experienced asthma. She later discovered through Asthma UK that a drop in hormone levels can trigger asthma in some women.
Ann was going through the menopause when she first experienced asthma. She later discovered through Asthma UK that a drop in hormone levels can trigger asthma in some women.
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But it certainly explains my personal experience.
Looking back, some people like Val who had a family history said they later realised that they had experienced other signs and symptoms of asthma in the past, but it had not occurred to them it might be asthma. Others asked the doctor if it could be asthma, as their symptoms were similar to those of other family members. Alice only discovered after she was diagnosed that there was asthma on both sides of her family.
Often people said it took a while to accept the diagnosis and its implications such as having to be more careful about activities and their environment, as well as using medication, particularly learning to use inhalers. Some were shocked to have a potentially life threatening condition.
When he was first diagnosed as an adult Peter didn’t know what to expect or how it might affect his life. Some people are much worse affected than he is.
When he was first diagnosed as an adult Peter didn’t know what to expect or how it might affect his life. Some people are much worse affected than he is.
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To be honest I didn’t know what to expect. I certainly had no idea that it could be as severe as it is for some people. I mean I have it kind of moderately badly, but there are plenty of people who have it, you know, very, very much worse than what I do, and the symptoms are much worse. I’ve never been admitted to hospital. Quite a lot of people I meet have been. Some are admitted fairly regularly. And I’d no idea it could be fatal. Its relatively sort of low numbers of people a year, around 1100 or that kind of number anyway, so compared to some of the conditions it’s not that high, but I’d no idea at all that it could be the primary cause of death for well infants, children, teenagers and people of any age. So I’d no idea how widespread it was or how serious it could be. So that just something that you learn as you go on.
Catherine has had asthma since early childhood but can understand that for people diagnosed as adults it can be life changing.
Catherine has had asthma since early childhood but can understand that for people diagnosed as adults it can be life changing.
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That’s a whole different ball game.
And it’s a whole different ball game.
There are going to be anger management issues there and resentment that I don’t so much have because... I’ve not known life without it.
Once people with adult onset asthma have learnt to manage their symptoms, they may find their asthma remains stable. Stephen had recently been diagnosed and hopes to live as normal a life as possible:
Stephen is 25 and thinks his asthma might have to do with smoking while living abroad. He is optimistic and hopes that asthma won’t disrupt his life.
Stephen is 25 and thinks his asthma might have to do with smoking while living abroad. He is optimistic and hopes that asthma won’t disrupt his life.
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There was a say five minutes after I’d actually left the GP, after the chat with the doctor, there was five minutes before I went and collected my prescription where I was kind of depressed. You know, there was a there was a slump but then I decided, you know, “This isn’t going to be a big thing and I’m going to get out. I’m going to train harder. It’s not going to affect my lifestyle.” I’d listened to the story the doctor told me in terms of how his life has continued with it and I just thought, there’s no reason why that can’t be me.
Since I came out of the appointment with my GP that particular day, I thought about my lifestyle over the past couple of years.
I thought, you know, “How has my body changed from two or three years ago until now. You know, what have I done in that space of time that’s having such an effect on my lifestyle.”
I became a regular smoker. There was about a ten month period I was smoking between about fifteen cigarettes a day in Australia. Since I’ve come home I’ve quit that out since January I haven’t smoked at all. It’s now June.
How do you feel about having to see a nurse, say, maybe every three months or twice a year, something like that, about asthma?
I wouldn’t want to do it, to be honest. At the moment, I’d go and see her, you know, as I say, early days, just diagnosed. I’d perhaps go and see her in three month’s time and I wouldn’t want to be scheduled in for another appointment. If I could go and see her the once. That would be that would be great [laughs]. You know, if I was told I had to go every three months it would it would be depressing. It would be a dampener. I’d be extremely de-motivated coming out of the appointment.
Why’s that?
Because it would feel like it’s getting a grasp on my life, you know. It would feel like it’s controlling me whenever I should be controlling it.
Peter said that for the first couple of years having asthma didn’t affect him too much, but over time it has got worse and over the last 15 years he’s tried various medications. David did not worry when diagnosed because his children had asthma and could control it well, but over time he has got worse. Esther had always strongly opposed any medication and took a while to accept using her inhaler:
Esther disliked the thought of using any kind of medication.
Esther disliked the thought of using any kind of medication.
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But I did have to. And then I realise now if I’m wheezy I have my puffer straight away. But I think I’ve, I resisted it for ages and didn’t like the idea of being dependent on drugs. I was quite a natural woman in those days. I was going through my really Earth Mother phase.
Eileen felt almost suicidal at the beginning because she was so unwell, but over time she has worked out her triggers and strategies to manage her asthma, and now finds she rarely has to use her inhalers at all.
Eileen felt almost suicidal at the beginning because she was so unwell, but over time she has worked out her triggers and strategies to manage her asthma, and now finds she rarely has to use her inhalers at all.
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It was terrible. I, I could not walk across a normal living space. I would have to sit down half way and recover before I could go on. I would get into bed and I would have a coughing fit. Couldn’t breathe because of the coughing fit, would get back control, which would be just about getting my breathing into control when I’d have another coughing fit and the whole thing would start all over again. And it really was just, just terrible. I couldn’t really live a normal life. I mean, when my asthma was bad it was just so bad I really, I, actually I didn’t want to live because I just couldn’t do anything.
But gradually over time I’ve looked at it I’ve analysed where my problems are because everybody has a different trigger. I know that certain types of stress will bring it on. I also know that if I have a really bad cold my nose gets stuffed up, my breathing then becomes difficult. I know the kinds of foods that make me worse.
So that if I feel an attack is coming on I will go backwards on these foods, wheat-based products I know make me really bad. I eat wheat-based products but if I feel I’m getting to the stage where my asthma’s getting bad I will cut them out. And also dairy based products, if I have a bad cold so that I don’t make too much mucus and, and try and alleviate some of the problems there. I also then start taking calcium too make sure that I’m not losing the calcium I’m getting from the dairy products.
Over time this, this has helped it, it has worked greatly. And I would have to say that I feel my asthma is well under control. I don’t have to use my medication very much. And it generally doesn’t impinge upon my, my life at all. If it does get bad I will go and get steroids to get rid of that particular bout of it, if it’s really bad but most of the time it’s well under control and I’m having minimal use of my inhalers.
Jane spent months trying out different inhalers to get things under control.
Jane spent months trying out different inhalers to get things under control.
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So I started with a brown inhaler morning and evening and my blue inhaler. And I then developed what I call my rainbow collection. These inhalers as I understand it have steroids in them and so you have to take them for three or four weeks before they know whether they’re having any effect or not.
So I had my brown inhaler, three or four weeks later I was still not better so I then had a, a pale purple inhaler with a dark purple cap. And the same thing happened. So three or four weeks later I then had a dark purple inhaler with a light purple cap. And three or four weeks later it was still no better. So I then had something that my son always said looked like an ocarina. It was kind of round rather than a long thin inhaler. And that didn’t make any difference either.
So by the autumn I was beginning to feel that I was, I would never be well. I felt like I could never, I, my, I could never breathe properly. And when my asthma was bad it was particularly difficult. I was having time off work and this wasn’t what my perception of asthma had been. My perception of asthma had been that people managed fairly well and then if they have an asthma attack they used a blue inhaler, I’d seen people doing that, and five or ten minutes later they were fine again and they carried on with life. And that’s not how it was for me, I was just having difficulty breathing at some point every day.
Had a very busy lifestyle. Travelled round the country a lot and travelled up to London a lot. And I knew that the air pollution in London was not helping me.
And I knew that at time the, things like the diesel fumes from the trains weren’t, not helping me. And I did go through a point where I wondered whether I ought to give up work because this, this was clearly not doing me any good. And my GP was really helpful. He said, you know, “No, absolutely, we’ve got to get on top of this. And you don’t have to give up work, we have to find a way of controlling your asthma so it fits in with your lifestyle. You don’t have to change your lifestyle, we have to be able to treat this asthma so that you can manage the lifestyle that you’ve always had”. And that was really helpful.
(Also see ‘Being diagnosed with asthma’, ‘Early signs and symptoms’, ‘Medication and treatment – inhalers’, ‘Managing asthma – reviews and action plans’, ‘Exercise, diet, weight and lifestyle issues’, ‘Coping and emotions’ and ‘Triggers’).
Last reviewed August 2017.
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