Nicola

Age at interview: 24

Age at diagnosis: 7

Brief Outline: Nicola, age 24, was diagnosed with asthma at age 7. She is white British, and lives with other young professionals. She studied journalism and public relations and now works for a PR consultancy. Nicola has moderate asthma and needs to take her inhaler everyday to keep her symptoms under control. In her experience most people know about asthma.

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Nicola first became aware of being asthmatic when she was about seven years old. She had a mild form of asthma and was given an inhaler that she remembers using once every three or so months. Initially she felt breathless when running and doing exercise but it didn’t really bother her that much. It was only later, when she was already at secondary school, that her asthma symptoms began to trouble her and she was prescribed a Becotide inhaler to use twice a day.

Nicola does not get many asthma attacks now, but is prone to develop bronchitis which can last for up to a week. She says that actually, with bronchitis, you are wheezing all the time and it is like having a permanent asthma attack. So it can be a scary experience, particularly if you don’t feel your symptoms are responding to the treatment. She usually gets a course of antibiotics and that clears her bronchitis but for at least the first two days she needs to stay in bed as she feels very uncomfortable and tired.

In her experience asthma has not affected any aspect of her life. She has found that most people know about it because it is a common condition and providing she carries her inhaler with her, she is unlikely to need any help from others. Likewise, she is able to take part in any physical activity provided she uses her inhaler before starting to exercise. On average she tries to go to the gym twice a week.

Recently and for the first time Nicola has seen an asthma nurse and found it most useful. It provided an opportunity to discuss her asthma and treatment in detail. Nicola found out that her asthma wasn’t as well controlled as she had thought and she needed to change the type of her preventative inhaler to improve the control of her symptoms.

Nicola says if you get the right treatment and use the medication correctly asthma need not interfere with your life.

Just that, you know it doesn’t have to take over your life. You can. If you try and see somebody to talk to somebody about it and get all the right information and make sure you’re on the right medication and then you know you can less it, you know not let it affect you day-to-day because it really shouldn’t and it doesn’t need to be a big thing.

Nicola asked the nurse what the outlook for the future might be but was told it’s difficult to predict. ‘You have to deal with it and if it gets worse there’s nothing I can do about it so. There’s probably no point in worrying about it.’

You said that you asked the nurse whether your symptoms or your asthma will get better and of course they couldn’t tell you about it. Did they, do you sometimes think that it might get worse or does that thought scare you or?

I think. I don’t know I don’t really think about it too much but I think it probably.

I should imagine it will stay about the same. It has got worse as time’s gone on but it’s been about the same level for a few years now. I don’t think it will ever go away though because I’ve had it for so long. I don’t know I mean hopefully it won’t get worse and if it does it probably would scare me a bit but, but yeah as I said I don’t, I don’t really think that far ahead about when it comes to asthma.

So you look at it from the perspective of, I have it I have to deal with it?

Yeah exactly. You have to deal with it and if it gets worse there’s nothing I can do about it so [laugh]. There’s probably no point in worrying about it.

Nicola appreciates the fact that the asthma nurse has time to explain things in detail.

I’ve gone to see the nurse. I try and see her every six months so that she can monitor it. Because that was only, I was only told about that about three years ago or something. And so I went to see her the first time and I’d never been monitored in that way before. And so I had the, I was given the peak flow measure and the chart to plot, you know with the graph that you can plot your measurement on. And then yeah I’ve seen her again since. And she, she was really good actually because she explained exactly how it happened. And she had the models of your airways and she could show you what happens when they’re swollen and exactly why people are asthmatic in the first place which was interesting actually to hear.

Did you know that beforehand or not?

I think I did but it was. I’d never been told by a doctor or anybody. I probably read it somewhere but I’d never been told by a professional and been able to talk about it in that way.

So she was the first health professional that

Yeah other than, other than my doctor who had given me the inhalers in the first place and talked to me about that. But she was good ‘cause you know I was solely there to talk about my asthma. And so I was there for about 40 minutes or something.

So and this is what you do every six months?

Yeah, yeah.

You go and she can keep your asthma under check.

Yeah, yeah that, that’s good that they offer that actually.

Nicola has occasionally found it difficult to control her asthma, which was scary. But she has learned that generally she can control her symptoms with medication or by sitting calmly.

The time in France when I woke up in the night and because my medicine wasn’t working it’s scary because you don’t feel in control of your symptoms. When you can just go and take your inhaler and you’re fine and you’re better it’s fine. And I, I sometimes I recognise, I can tell how bad the symptoms are because I’m used to them. So if I’m out in the cold and I’m walking up a hill I’ll probably get wheezy and I’ll know that if I sit down for a bit. I probably don’t even need to take my medication because if I just rest for a bit it will go away. And or if I just took my inhaler it would go away straight away so in that sense I’m. I know that I’m going to be in control my symptoms. I know how to make it better. It’s when it takes me by surprise and when I wake up in the night and I can’t make myself better that’s when it gets scary because I’m completely out of control of it.

I think just because there’s nothing I can do about it so there’s no, no point in having a negative outlook about it. I think you just accept it and move on and get on with things. So just treat it the best you can. And in, you know it doesn’t need to take over your life. You can if you’re treating it as you should then you should be able to do the normal things and go about things in a normal way without it ruining them.