Mary Y
Mary, age 73, was diagnosed with asthma at age 6. She is white British, widowed and lives alone. She has one adult son, and has worked in medical research and counselling. Mary says that asthma medication has improved a lot since she was a child. She finds swimming very helpful and goes twice a week. She feels it is important to focus on what you are able to do, rather than what you cannot.
More about me...
When Mary was 6 she had pneumonia and her Mum asked the doctor whether it might be asthma. The doctor was not very receptive to this and said that Mary would need to stay home from school for six months to recover, but in fact her condition did not improve. Mary had brittle asthma as a child, but now describes it as chronic. She was regularly admitted to hospital due to asthma in her youth, and was not able to keep up with the playing and games that other children did. She often had aminophylline injections at home and hospital which could make her sick. She remembers feeling down about her asthma when she was younger, and wondered why she had asthma when her brothers were in good health. Mary says her brothers have always been very supportive, but she is aware that her asthma dominated her family and took up much of her mother’s time.
Mary had steroid injections and tablets until the introduction of inhalers, when she was in her forties. She finds that Ventolin and steroid inhalers make a big difference to her asthma, and thinks that if such treatment had been available when she was younger, her asthma would not be so chronic now. Mary did worry about the effects of steroids on her baby when she was pregnant. Mary fitted her job as a nurse around her asthma, and recognised that there were some things she was not able to do. Mary is allergic to house dust (and therefore does not have any carpets in the house), tree pollens, nuts, mould spores and nuts, but finds allergic reactions can often be delayed and sometimes don’t appear until the next day.
Mary lives alone and has strategies in place in case she is taken ill and needs help. She has a safe key outside and a telephone by her bed in case of an emergency. Mary takes two puffs of steroid inhaler twice a day and two Phyllocontin tablets every morning, and one Singulair tablet at night. She sees her doctor at least every six months, and knows that if her peak flow reading goes below 200, she needs to alter her medication. Mary is a great believer in the benefits of swimming, and swims twice a week, going at her own pace. She takes Ventolin before she goes swimming. She had a pre-payment prescription for her medication when she was younger, but now she is over 60 she gets her prescriptions for free. She thinks that is unfair that people with chronic asthma are not entitled to free prescriptions.
Mary feels it is important to know your own body and asthma, and respond to symptoms, and to continue to take your medication even if you are feeling better. She also recommends having a ‘flu vaccination. Mary tried hypnosis and acupuncture when she was younger but they were not successful. She suggests that if trying alternative therapies, people should do so in conjunction with their usual medication. Mary feels it is useful to share experiences of asthma with others, and to focus on what you can do rather than what you cannot. She reminds medical professionals to take asthma seriously and to be aware that there are different severities of the condition.
Mary has chronic severe asthma and takes theophylline tablets to help stop her from wheezing.
Mary has chronic severe asthma and takes theophylline tablets to help stop her from wheezing.
Plus I have tablets as well. So I have theophylline tablets. I have two kinds of inhalers. So, and another tablet, Singulair, I take at night. So yes.
Are those the steroid tablets?
No the steroid tablets when, only if I get bad.
If you have an infection or something?
Yes, I’ve always got some, yes.
So what are those other tablets?
Well theophylline, there’s a type of aminophylline used to be injected into the vein 50 years ago, they now have it in tablet form, and it was for a long time, the only real treatment for asthma. Theophylline, aminophylline and adrenaline. Adrenaline has become Ventolin inhaler in the new make up if you like, a form of, and theophylline are kind of the new injection of aminophylline. So it’s changed.
So, why do you take that in combination with the steroid inhalers as well?
Because the theophylline tablets actually open up the lungs, they are called Phyllocontin. They open up the airways, or help to open up the airways, and anything that can make you stop wheezing quite so much is a good thing.
Yes, I’ve heard that said before.
And the Singulair that I take came out as montelukast and that is an anti-allergy thing, because I’m still allergic to a lot of things.
Mary has tried a few different alternative therapies but isn’t convinced they work. She says it can be difficult to participate in some things like relaxation and hypnosis when you are struggling to breathe.
Mary has tried a few different alternative therapies but isn’t convinced they work. She says it can be difficult to participate in some things like relaxation and hypnosis when you are struggling to breathe.
Because you’ve got to concentrate on your breathing to do that haven’t you?
Well you’ve got to have some inhaler before you can start relaxing, yes. Exactly. So I think it depends on the severity of the wheeze and how much puff you’ve got, and things like that.
I also worked in an acupuncture clinic once, so I got free acupuncture…
And how did that …?
Well it didn’t work either.
But you were doing these things in conjunction with also taking your medication?
Yes, yes. I think that’s probably very important. I know people who’ve had children with very mild asthma and they say, “Oh we took them to a homeopathic doctor and they, it’s stopped, or they’ve grown out of it.” But then a lot of children do grow out of asthma. You know, when I was seven they used to say, “Oh well, she’ll grow out of it when she’s 14, or she’ll grow out of it when she’s 21. Or it wears off as you get older.” Doesn’t always. But in some people it stops when they’re 14, 15, in their teens and then comes back again when they’re in their 60s. It comes and goes with some people. So it’s very difficult to actually judge all these therapies.
And have there been any that you’ve found effective?
No.
Or that you’ve wanted to carry on?
No I’ve tried most of them.
Mary has had asthma all her life and it has got progressively worse but she says modern day treatments are much more effective than in the early days.
Mary has had asthma all her life and it has got progressively worse but she says modern day treatments are much more effective than in the early days.
So over the years since the inhalers came into being, you’ve had a variety of different ones I assume?
Yes. Most of them [laughs].
Right and so is that trying out new ones and seeing, or adjusting dosages?
Getting stronger ones, they’re much stronger than they ever were now. They’re about five or six times stronger than when they first came out. And they work in different ways. So get into different parts of the lungs. Some of them you can use in a spacer and some of them are breath activated. So it depends how you are and when you are what kind of ones you need, and nowadays they bring out combination inhalers, which have got the kind of long acting Ventolin in them and steroids. And they have helped quite a lot.
And so I mean, whilst you’re trying out something new, is there a kind of period when you’re sure whether it’s actually going to do the trick or not, or is it a question of putting you on a certain dose and then adjusting it slowly to make…?
It’s more or less putting you onto the new inhaler, which is usually stronger. I’ve never gone backwards as it were, so I don’t really know. I take more or less depending on how I am.
And does it make a difference. Can you tell a difference when you try a different new one?
Oh yes, all my friends can tell the difference, which, what drugs and inhalers I’m on.
Can they? What sort of difference?
Well because I’m breathless most of the time now. If you’ve had asthma for a long time you get, when there weren’t treatments for it, you get chronic changes to the lung, and it’s a bit like chronic lung disease but without the progressive aspect of it. So I’ve got collapse in my lungs, bits of it where I’ve had chest infections over the years, but it doesn’t progress in the same way as somebody who’s got COPD would. So if people nowadays take their inhalers and medications they shouldn’t get to that state. Because the better your lungs are the less infections you get.
So, do you think if you had been born a different time, later on, that you wouldn’t be as chronic as you are now?
Oh I’m sure. Yes.
So it’s more to do with the fact that you had the early days when you were really receiving any treatment?
Well there wasn’t really any treatment, yes.
Right.
Well you know there wasn’t the effective treatments.
Mary has severe chronic asthma but has been swimming with friends twice a week for the last twenty years. She has also recently taken up playing golf, and says her friends have really helped her by encouraging her to get involved.
Mary has severe chronic asthma but has been swimming with friends twice a week for the last twenty years. She has also recently taken up playing golf, and says her friends have really helped her by encouraging her to get involved.
Oh that’s really good.
Which has made an enormous difference.
Because I think people might assume that that wouldn’t be something that you’d be able to do.
Well, you can. You have to learn to do things at your own pace. And everybody else swims up and down, up and down, up and down. I sit up, get my breath back and then swim back again. I can do nearly as much as them, but it takes me longer, because I have to pause.
And what about the chlorine and the chemicals?
Well most swimming pools nowadays haven’t got chlorine in them. I think the chlorine actually now in swimming pool is the top few inches. They put something else, calcium carbonate or something in swimming pools, and it’s that reaction with the air and the top of the swimming pool that causes any chlorine smell.
Are there things that are just totally out of bounds that you really can’t do that you would love to be able to do?
Yes, I would love to be able to dance. I’ve never been able to do that because it takes continued effort. I’ve never been able to run. I’ve never really been able to walk up hills very easily without, you know, dozens of puffs of Ventolin.
But you do still take forms of exercise that you can manage?
Yes, I started to play golf, but now I’ve found that I can only do it if I have a buggy [laughs]. I can do it, because... First I had an electric trolley to pull me up the sliding climbs. You can find things that you can do.
It sounds like quite a good philosophy to focus on what you can do, rather than to worry too much about what things are missing?
Hm. And I think I’ve just been, I’ve been very lucky that I’ve had very good friends that have had the same sort of philosophy, oh well, let’s help Mary do it really.