Hunched over my dining table and gasping for air, feeling as though an invisible person was squeezing my chest while I tried to breathe through a straw, I somehow didn’t realise I was having an asthma attack.
At 31 years old I was operating under the mistaken belief that, having never had an asthma attack before, I would never get one.
I was diagnosed with asthma as a child, but up until this moment I had thought it didn’t affect my life at all.
I apparently wasn’t the only one who was thinking along the same lines. The paramedic I spoke to on the phone after calling 111 told me he didn’t think I was having an asthma attack, as I didn’t have a history of asthma attacks. He said an ambulance could be anywhere from 20 minutes to an hour away, and I might consider finding my own way to the hospital if I didn’t want to wait.
I now know asthma attacks are considered an emergency well before they reach the level of severity mine was at. I also now know how serious asthma attacks are, with one or two asthma-related deaths happening in New Zealand every week on average.
In the days leading up to the peak of my asthma attack, I could feel my chest getting tighter, my breathing wheezy and strained. I could barely sleep, finding the only position I could breathe properly was propped upright, leaning my face on a stack of pillows. I attributed my violent coughing fits to the daycare bug I’d caught from my toddler.
My inhaler was doing little to help me breathe, which I now know is a sign of an asthma emergency. Photo / NZME
If I’d known then that my symptoms weren’t simply a bad bug I needed to power through, I would have sought medical help before it became so dire.
Respiratory viruses are one of the most common triggers for asthma attacks, so as we navigate the full force of winter illnesses, the Herald spoke to respiratory specialist and Asthma and Respiratory Foundation’s medical director Professor Bob Hancox to answer everything you need to know about this underestimated disease.
What is an asthma attack and what does it feel like?
An asthma attack is a worsening of symptoms caused by the airways becoming tight and inflamed.
Asthma symptoms include:
Shortness of breath
Wheezing
Coughing
Chest tightness or pain
Severe symptoms include:
Gasping for air
Difficulty speaking
Blueness around the mouth or fingers
Excessive sweating
Straining chest muscles
When I had my asthma attack, the best way I could describe the elasticity of my lungs compared to when I was healthy, was as if I was trying to blow air into a water balloon. It felt like a fight to inflate my lungs – and keep the air in them – with each breath. Now, when I’m not experiencing symptoms, filling my lungs feels as easy as blowing a bubble.
Asthma symptoms can be triggered by illness, particularly respiratory viruses, as well as allergies, animal dander, mould and dust, certain temperatures, and even stress.
When is it an emergency and when should you seek help?
Hancox recommended every person with asthma put together an asthma action plan with their doctor. This tells you how to respond when you are having a flare-up of your symptoms.
Most asthma attacks can be dealt with by using an action plan, but in severe cases you may need to contact your doctor or call 111.
“If you are really finding it hard to speak or breathe, if you’re finding your inhaler’s not helping at all or you’re using it every one to two hours, you should be dialling 111,” Hancox said.
Using an inhaler should alleviate or make a substantial difference to symptoms. If that’s not happening, you should seek help. The medicine in an inhaler works to relax the muscles in your airways.
Image / Asthma and Respiratory Foundation
It was “very important to understand when to trigger an emergency”.
“People often underestimate an asthma attack,” Hancox said.
There are many treatments that can be given in hospital in an emergency, including higher doses of medication than can be given at home, he said.
“Lots of paramedics can start these treatments on the way to hospital, so getting the ambulance in a life-threatening situation is important. These treatments work – it is rare for someone to die from acute asthma in hospital. Sadly, most deaths happen before people get there and often the delay is because they didn’t realise how unwell they were.”
One helpful tool to use is a peak flow meter, a handheld device that measures how fast you can blow air out of your lungs. You should be able to determine your maximum capacity when your lungs are healthy.
During an asthma attack, you can use your peak flow meter to determine how diminished your capacity is.
A peak flow reading between 50 and 80% of your maximum indicates your airways are starting to narrow and you should begin to follow your asthma action plan. A reading below 50% is severe – you should take your reliever medication and call 111 if symptoms don’t improve.
These meters are free for people with asthma. I used one during a second attack a week after my first and discovered my capacity was just 33% of what it should be.
Is asthma genetic and can I grow out of it?
Some people appear to grow out of asthma, but sometimes the symptoms can return later in life, Hancox said.
Figures also show more boys have asthma in childhood, but more women have it in adulthood, possibly indicating males are more likely to grow out of asthma.
“Nobody knows what we can do to encourage people to grow out of asthma.
People can grow out of asthma, though it's more likely for boys to grow out of it than girls. Photo / 123rf
“Asthma does tend to run in families, and there is a strong genetic component, but there is no single gene that causes it. It seems that there are lots of different genes that increase the risk by a small amount. These genes interact with the environment in ways that we don’t yet understand to cause asthma.”
My asthma is mild, can I even get an asthma attack?
Yes. Don’t fall into the same trap I did, believing you’re immune to asthma attacks.
Hancox said people can develop asthma at any age and that anybody with asthma can have an attack, even if their condition is mild.
“Probably you are similar to a lot of people with asthma in that you get used to the symptoms,” he told me. “They’re having symptoms all the time, they’re just so used to it they don’t even think about it. It’s just their normal.”
He has a good point. After my attack I started researching my condition, realising how the symptoms I’d experienced my whole life were from my asthma. Coughing in cold weather, a knives-in-my-chest feeling when I try to do cardio. I had assumed it was just because I was unfit, but it was actually a case of asthma not being fully under control.
Taking a daily inhaler is a worthwhile trade if it means potentially avoiding another asthma attack. Photo / Kenny Rodger
After my second attack, my GP prescribed a daily preventive inhaler.
I questioned whether it was necessary to start taking lifelong medication for something that had never really bothered me before.
“I hear you,” my GP said, “but that’s how people die of asthma attacks.”
A couple of months on and I’m using my new inhaler religiously, twice a day. I don’t know yet if I can notice a difference, but if I can avoid ever feeling the panic and fear of another life-threatening asthma attack again, it’ll be worth it.
Melissa Nightingale is a Wellington-based reporter who covers crime, justice and news in the capital. She joined the Herald in 2016 and has worked as a journalist for 10 years.
