Jan

Age at interview: 46

Age at diagnosis: 4

Brief Outline: Jan, age 46, was diagnosed with asthma at age 4. She is white British, lives with her partner and works as a freelance Business Psychologist. Jan’s childhood was disrupted by regular asthma attacks. As a young adult the symptoms lessened and she thought she had ‘grown out of it’, but in her mid 20’s her asthma flared up again. Nowadays Jan feels able to manage her asthma effectively and although she occasionally has attacks, she feels that the preventative medication she takes regularly helps to keep things under control.

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Jan was diagnosed with asthma at the age of 4. She thinks that the trigger for this at the time was a pet rabbit that she may have been allergic to, but her symptoms also often coincided with the hay fever season. She was also affected by the change in season between autumn and winter when the weather became colder. During her early childhood she experienced asthma attacks regularly and she remembers missing a lot of school because she was often too ill to attend, and that the doctor used to visit sometimes three times a week to administer injections. She recalls that at the time she was the only child in the whole school who had asthma, whereas she says that nowadays there are far more children who are diagnosed with it. Her parents were quite protective and worried about her, and she remembers sometimes her mother having to rush to the local telephone box to call for help when she was unable to get her breath. Sometimes Jan felt left out of things as she wasn’t able to participate in sports or be able to visit friend’s houses where there were pets, but she says her friends and teachers were very supportive and helped her to catch up with schoolwork or visited her at home if she wasn’t able to go out. When she was about 8 she remembers being rushed to hospital in an ambulance and was put on a nebuliser to ease the symptoms, and since then she has been hospitalised with her asthma three times.

As a teenager and in her early 20’s Jan noticed the symptoms much less and she thought that she had ‘grown out of’. During these times she used her inhalers infrequently, and now she looks back and can see that it’s very easy to stop using them when you feel well. However when she began working in a big city on a daily basis she found that the asthma was exacerbated again, which she thinks may be related to the pollution from the heavy traffic around where she worked.

Currently she uses a preventer inhaler (Serotide) which she uses every day - morning and evening, and she also takes her reliever inhaler (Ventolin) twice a day as instructed by her consultant. She also uses the reliever inhaler at times when her breathing becomes difficult. Sometimes if she has a bad cold or chest infection she may take a course of antibiotics which can help to relieve the symptoms more quickly, or if she is having an asthma attack she may increase the dose of the preventer inhaler for a few days until things settle down. Occasionally she has been prescribed a course of steroid tablets if the attack is particularly difficult to control. Recently she has started using the acu-haler which makes it easier to get the medication dosage straight into the lungs.

A few years ago Jan was referred to see a respiratory consultant as the medication she was taking didn’t seem to be controlling her asthma too well (Becotide), and he changed her onto the Serotide that she now takes. Since then she has been for 6 monthly reviews with the consultant, but because her asthma is now fairly well controlled she now only needs to visit her medical centre for an annual review and will only need to see the consultant again if her condition worsens. Jan has the flu jab every year, and was recently given a bone density scan as the regular use of steroids can increase the likelihood of osteoporosis. She has been advised that things are fine, but it would be a good idea to start doing weight bearing exercise of some kind to lessen the risk for the future, and to take a calcium supplement.

As an adult Jan experiences both wheezing and coughing, which can tend to become worse during the night. Her triggers have changed over the years and nowadays she can tolerate being near pets, but finds that the cold weather and having colds and chest infections tend to make her asthma symptoms appear. She also finds that news print will set off the asthma (possibly the chemicals in the ink). She is now able to tolerate flowers, but being near hay bales can set off the asthma. One thing that Jan has found helps is to have a drink of coke when she is feeling wheezy and unable to breath properly, and she has heard that the caffeine content of the drink can act as a decongestant.

Jan finds that she is able to manage her asthma by being careful about avoiding certain situations, but is able to do most things she wants to be able to do. She exercises regularly at the gym, but would avoid taking exercise outside if for instance the grass in the park had just been cut. She would also not be able to exercise during times when she was having an asthma attack which might last a few days or a couple of weeks.

Jan is self employed and is able to manage her asthma without it interfering with her work. Over recent years she has volunteered some of her time to work for Asthma UK as a way of ‘giving something back’ as she feels that without the work of the voluntary sector the improvements in medication and information and support would not have advanced in the way that they have over recent times.

Jan is a volunteer for Asthma UK. ‘I’ve been lucky enough to have benefited from improvements in asthma treatment, so it’s only right that I should try and give something back’.

You do some work with Asthma UK now.

Yes,

What prompted you to get involved in that way?

Well because I’m self employed, I’ve obviously got some control over my time and I made a decision lots of years ago that I wanted to do voluntary work as part of my sort of portfolio of work really

And, work has been quieter in the last few years so I’ve had more time to be able to give to Asthma UK. And I honestly believe, not just for asthma but for a lot of conditions that without the voluntary sector the treatment wouldn’t improve as much as it has done, and therefore you know, I owe, I think as we’ve just talked about, I’ve been lucky enough to have benefited from improvements in asthma treatment, so it’s only right that I should try and give something back.

So when did you first have a connection with Asthma UK then?

It would have been about 1998, around there. Yes, a long while ago.

And so at that time, was that a time when you asthma was worse or at the time …?

Yes, it was probably past its worse, yes, but it was still at a time when I was conscious of having to manage my asthma. So, and I gained a lot of satisfaction from working with the charity because things like giving presentations in schools you can really raise awareness about the condition. And obviously like any charity we rely on fundraising to generate some income so we can encourage fundraising and things like that.

So it’s a bit like putting something back?

Yes, absolutely.

Jan’s message to others is to find out as much information as you can, and take advice from health professionals about how to manage it yourself.

My message would be to understand it and I think things are less frightening if you understand it. To surround yourself with the right tools to try to manage it. So whether that’s the consultant, the right medication and to try and plan for doing what you want to do. So not stopping doing what you want to do, but to try and plan for it.

Jan remembers the doctor visiting frequently at home to administer injections, and feeling quite frightened when she had asthma attacks

My memories are of missing quite a lot of education, in the, in the summer term. And of at that stage I was taking Intel inhalers. They were little sort of, I used to call it my filler, you used to have to pierce them and take the medicine through there.

The doctor came sometimes daily, but certainly I do remember being on injections three times a week, and the doctor would come in and administer … Obviously telephones were different in those days. I remember my Mum having to leave the house and run to the local phone box to get the doctor, so those types of memories were quite frightening.

It must have been quite tricky having medications and injections and things when you were a child?

Well it stops you being bad about injections as an adult, because they were just so much, you know, a part of what I did. I mean I obviously have the flu jab now because of my asthma and it just doesn’t bother me being injected. I suppose you just think you know, it’s what you have to do.

Can you remember how you actually felt during an attack when you were a kid?

Yes, one really, really strong memory comes to mind. We lived in, just like a normal three bed roomed semi, with a, you know, quite a sort of moderate drive where the car used to be parked. And there was a wall. And I remember being sat on that wall and just not being able to physically get as far as the door. And I just sat on that wall. I mean it felt like hours. It was quite a while I think. But it just felt like hours, and I just literally sat there until my Mum noticed me out the window. And it was just very frightening, just not being able to make that, you know, I just literally went out. I was only walking home from a friends. I just ran out of steam. And just couldn’t get my breath and I couldn’t walk.

Jan’s childhood asthma improved when she was a teenager and she thought maybe she was growing out of it, but a few years later symptoms reappeared. Over time she says some of her triggers have changed

As I child, I think I remember about the age of 15, my symptoms got a lot better, and actually optimistically I thought oh I’m growing out of it, and probably for about ten years very few symptoms. And then it came back with a vengeance in my mid twenties.

I personally think the trigger at that stage, I worked on [place name], so lots of smog, bus fumes and I think that was certainly the trigger for my asthma in, in my mid twenties. I had quite a few years of being ill and a few hospital admissions, but pretty much got it under control in my early thirties.

Since then it seems to be this Autumn to Winter that seems to be the trigger. So for instance this weekend hasn’t been a good weekend for me. I was around actually, I went to a party in a farm and there was lots of hay around and I think that was the trigger, but certainly the cold is, isn’t helping as well.

So I think that’s one of the interesting things about my asthma, its different things that trigger it now.

Jan has learned to be practical and plan ahead. ‘The lessons I’ve learned are never to take it for granted’.

I think I understand my asthma now, and it’s like when I was ill on Saturday I knew, you know, how much I could take of that environment before I’d got to remove myself from it. So I think it’s, I think the lessons I’ve learned are never to take it for granted. I mean I’m going to a friend’s house for overnight next weekend and there’s several friends going, and they were talking about sort of who’s going to sleep where, and I knew they’d got cats, so I just said, you know, “I don’t care what I sleep on, but I prefer to sleep in an environment where the cats so don’t spend a lot of time.” So it’s actually just planning. It’s being practical and common sense about what you do and where you go.

I think more people can get it under control. I mean, unfortunately not everyone can keep it under control, but and we all, I don’t worry that there won’t be a situation that I can’t manage, as long as I always have the inhaler, and can always get to a hospital. I mean I know when I need to get to a nebuliser or to, you know, to A & E for help.

And, as long as, and that’s why I left this party early on Saturday because I thought you know, it’s a boring leaving a party early but it would be even more boring if I ended up having to be called an ambulance and everyone’s night gets ruined. So it’s learning to look after yourself really.