Has your asthma affected your mental health and is this ever considered by the professionals who look after you?
This is a new area for me. Until last year I always said asthma was all about my lungs, not my head but after my long stay in the hospital and subsequent discharge, I found the whole thing difficult to compute. I had nightmares, that’s when I could sleep. Every time I had an asthma attack I wasn’t sure if I’d end up in the hospital again or worse still what if they can’t get me breathing again.
When I was discharged after the month in the hospital I was sent back to see my GP and referred to the local acute asthma clinic. The hospital consultant didn’t want to see me again. I think I asked too many difficult questions for her liking. Unfortunately, there was a 3 -6 month wait to be seen, which was ridiculous. More worrying was my GP who openly admitted that my level of asthma was way above her knowledge level. This definitely didn’t help my anxiety levels.
In May this year, my mental state actually affected my asthma in a way that has totally transformed my thinking. It was my current last visit to A&E. I’d gone to hospital by ambulance with a severe asthma attack given prednisolone and several nebulisers. The A&E doctor had managed to get my breathing and oxygen sats to a reasonable level when he started to discuss admitting me. He then noticed, as did I, that my breathing changed quite dramatically to such an extent that it triggered another asthma attack. The doctor, my wife and I were gobsmacked at the realisation. The anxiety of being re-admitted had fundamentally changed my breathing. The doctor said he’d read about it and assumed it was a small factor in asthma attacks but this was solid confirmation for me that mental health is a factor in asthma. It is probably different for different people but it can’t be ignored especially if you are treating asthma. You have to treat the whole condition, not just the wheeze, tight chest, high heart rate. Treat also the anxiety and mental health issues that come with living with a life-threatening long-term chronic condition.
Luckily for me, I was already in the early stages of talking to the local wellbeing service about what they could do to try and keep me out of the hospital. The clinical lead is a well-renowned psychologist and I have to say her input is helping me mentally get past the anxiety and fear of my asthma was superb. In my opinion, severe or difficult asthmatics should be offered psychological help as part of their treatment plan. Tablets and inhalers are important but so equally is the mental well-being of the patient.
Are you happy to tell us about your worst asthma experience? What happened and how did it feel?
I woke one morning slightly tight chested no wheeze which was unusual for me especially after having a six month period without a serious attack. In fact, my asthma was quite good. I got ready still a bit chesty and went to work. As the morning went on my chest got a bit worse but there still no wheeze. I repeatedly took my reliever really for the first time in several weeks to no avail. At about 10.30 I noticed my hands had gone blue and I felt extremely short of breath but still no wheeze. I was rushed to the hospital and I was told I was having a silent asthma attack. Nothing was going in or out of my lungs. I’d never heard of this “silent asthma attack” before and it scared me to death. They managed to stabilise me and then sent home (which my consultant nor I can believe to this day) only to have another similar life threatening attack which resulted in me spending the next month in the hospital.
The lack of information and engagement with me as the patient was as worrying as the asthma attack. My asthma literally changed overnight and not for the better but I didn’t know why or how or what had caused it, and no one was talking to me.
Do you have good inhaler technique?
Yes, I have been checked on so many occasions by consultants GPs and asthma nurses but unfortunately never by a pharmacist sorry.
Do you attend your annual asthma review?
No, as I’m currently under the Acute Asthma Clinic they are in charge of my reviews usually every 6 weeks or so
Do you feel these reviews improve your asthma control?
To be honest, I generally thought they seemed to be a tick box exercise, they would occasionally change the medication but without any reasonable follow-up.