'We don't let asthma define us' say dad and two children with the condition

“It was the middle of the night. She was coughing, wheezing, getting exhausted, struggling to breathe. It’s a very frightening experience to see that. We called Westdoc and they sent an ambulance to the house,” recalls the Galway-based dad who is married to Stephanie.

Yet there is “massive understanding” of asthma in the McDonagh household. This is because Mike has suffered from chronic asthma since childhood. Recalling what it was like for him at a time when the condition was less well understood, the 49-year-old says: “I was tired all the time. I’d sit on the couch and fall asleep. There was no understanding of it. I just continued on, and it didn’t disappear. I’d be out of breath playing football and it was put down to being unfit. 

It’s not that I was unfit — I found it hard to inhale. It escalated and I was diagnosed in my teens.”

Though Mike knew asthma was in his family’s genes, when he and Stephanie were expecting their first baby, they naturally hoped she wouldn’t have the condition. “My father would have been bad with it, my grandfather definitely had a bad chest — it has come the whole way along,” says Mike.

While the couple’s son, Michael, 12, has sports-induced asthma, diagnosed just two years ago (he keeps his blue inhaler in his gear bag), Clodagh’s is more severe. The signs were there from when she was four months old, with night-time coughing. “She was seeing a consultant from an early age. She also has eczema and is on steroids and antibiotics every year,” says Mike.

A student at Coláiste an Eachréidh, Athenry, where she’s in transition year and enjoys science and business, Clodagh describes how asthma impacts her life: “Shortness of breath when trying to run means I don’t do certain sports. Cold weather’s a problem — I can’t go to evening sports during winter.”

Preventing attacks and fitness

It is not just that Mike’s asthma has given him great empathy for his children’s situation, he has also been able to share with them precious, hard-won lessons about how to manage it. He recalls when he had a number of severe asthma attacks that brought him to intensive care. “My big mistake was I’d have an asthma episode, I’d get through it and I’d think everything was fine, but I wouldn’t look after myself. So I’d go from episode to episode. I did that from my teens all the way through my 20s.”

After Michael was born, Mike and Stephanie sat down and had a chat. He realised he couldn’t continue being hospitalised for asthma and that he was not doing his bit to manage it. “I needed something a bit more definite than going from one episode to another.”

Now it is all about prevention, he says. “In our kitchen we have a bowl with various inhalers and medications, and everyone is taking what they are meant to take. Clodagh and I take Singulair [asthma maintenance treatment] every night, we take a preventative inhaler daily and we take anti-histamines as required.”

On this regimen, he says, they hardly need to use the blue inhaler at all — this is a reliever inhaler for quick relief when symptoms come on.

Prevention includes being vigilant for signs of asthma. “With Clodagh, for example, we’d know in the morning how she is, the form she’s in — if she’s tired, lethargic, or has a wheeze like a whistle. You’d know it in your child’s voice — there’s a croak in it.”

Mike and his children know different times of year can be flashpoints for an asthma episode. “I was very bad last winter, now I’m very good. It’s about knowing that there are these different triggers.”

Asthma is always there, he says. “You constantly have to work with it. We’ve massive understanding of it in the house. We know how to deal with it. We don’t fear it. As a family, we live a very normal lifestyle, but we work hard at managing the condition.

“Clodagh performs at a high level sports-wise. She races 1.2km in the sea. She’s very good at school, and at horse riding. She loves swimming.”

Acknowledging there was a time when he let his own asthma be an excuse not to do sport, Mike recalls — about 12 years ago — Stephanie bringing him “kicking and screaming” to Fit4Life (exa.mn/fit4life). “I was only able to do a distance between two telegraph poles. Athenry AC had Fit4Life and I’ve been involved with Athenry AC ever since... I do what I can manage. In the summer, I race in the sea at Salthill, I do 1.2km distance. Everyone in our family rides horses, we do triathlons and go skiing. Both swimming in the sea and skiing are very good for asthma. It all shows that if you manage the condition, anything’s possible.”

Cost of medication

Ireland ranks number four for the highest prevalence of asthma worldwide. More than 400,000 people here have asthma, including one in 10 children. 

“Sadly, we lose one person to asthma every week — 50 to 55 deaths a year, which includes adults with other co-morbidities. Thankfully, we don’t see significant mortality in children, though there are sporadic cases,” says Dr Basil Elnazir, consultant in paediatric respiratory medicine at Children’s Hospital Ireland.

Elnazir has three concerns about child asthma. “A major concern is around adherence to medication, particularly in the teenage group, when they’re very busy with their lifestyle.”

Pointing out that asthma is a chronic, lifelong condition, he is also concerned that — with the increased cost of living expenses — affordability of medication has become a bigger issue. “Some parents might feel they have to reduce the use of medication, or stop it.” He would like the cost of asthma medication to be supported by the long-term illness plan and for everybody with asthma to have a medical card.

Elnazir also believes more work needs to be done with schools in supporting them to support children. “In the absence of the school nurse model, we really need to support SNAs in this task.”

Recommendations for parents:

Adhere to medications. Identify what triggers your child’s asthma — whether viral infections, exposure to irritants or even exercise. “This is by no means a call for young people to stop exercising. If their asthma is well controlled, they’ll be able to enjoy sport. I say to my patients: Having asthma doesn’t mean having less fun.”

Have an asthma action plan, which is individual for each child. Know what to do if your child is coughing, or breathing with difficulty, or
needs a lot of rescue inhalers. “There should be routine follow-up with a healthcare professional every three to six months to check the inhaler, the inhaler technique, and to update the asthma action plan.”

Elnazir’s bottom line? “If asthma is well-controlled, children will grow well.”

Meanwhile, in Galway, Mike celebrates his 50th birthday this weekend — and the Asthma Society of Ireland also marks its 50th anniversary. To celebrate the double milestone, Mike is running a half marathon for the Take a Breath initiative (exa.mn/asthmadonate), the Asthma Society’s biggest community fundraising event. To support him, Clodagh and Michael will do a 5km run.

“We have asthma where it should be,” says Mike. “We don’t let it define us.”

Take a Breath challenge invites people to hike (or ramble) to raise much-needed funds towards the Asthma Society’s mission: To stop asthma deaths in Ireland.

Visit asthma.ie or contact phaedra.vlahos@asthmasociety.ie

The Asthma Society’s webinar, ‘Back 2 School for Teachers and SNAs’, this Thursday, September 28 (7-8pm) via Zoom (Registration link: exa.mn/asthma-webinar) will equip teachers/SNAs with tools to support pupils with asthma throughout school year — in particular through challenging colder months ahead. Worries teachers have around administering medication, responding to asthma attack/asthma emergency, will also be addressed.

If worried about asthma/COPD, speak to asthma/COPD nurse specialist — free phone consultation 1850 445464 (Asthma)/1800 832146 (COPD) or text query to Whatsapp nurse messaging service: 086 0590132.