Co Laois student Rebecca Houlihan has such a severe form of the respiratory illness that she’s barely left the house since the pandemic began. During this Asthma Awareness Week, she tells us about the things she has missed out on, her new treatment plan and why she is staying optimistic for the future
If you think the past year of lockdowns has been tough, for asthma sufferers like 20-year-old Rebecca Houlihan, who has a severe form of the condition, Covid-19 has been like living her own pandemic within a pandemic. The student from Portarlington, Co Laois, was studying social studies before Covid hit. But as news of a pandemic sweeping China reached this country, her doctor advised her to stay home even before the schools closed due to the severity of her condition.
Rebecca’s asthma is so severe that even something like coughing can trigger an attack resulting in her ending up in ICU. And while we’ve all lived with the restrictions lockdown has brought to our lives, Rebecca wants to let people know that Covid-19 has been doubly worrying for asthma sufferers.
As part of Asthma Awareness Week, which runs until May 8, she also wants to highlight just how important it is for asthma sufferers to be in control of their condition especially at this time when the pandemic still poses a significant risk for people like her who are vulnerable.
Asthma is an inflammatory disease of varying severity that affects the airways — the small tubes that carry the air in and out of the lungs. People with asthma have airways that are extra sensitive to substances — or triggers — which irritate them.
When the airways come into contact with an asthma trigger, the muscles around the walls of the airways tighten so that the airways become narrower. The lining of the airways swells and produces sticky mucus. As the airways narrow, it becomes difficult for the air to move in and out. That is why people with asthma wheeze and find breathing difficult.
Rebecca’s illness wasn’t always so severe. While she was diagnosed as a young child, she was what she calls a ‘controlled asthmatic’, although she still had one or two hospital visits a year. Her first half of secondary school was manageable in terms of dealing with her condition and it wasn’t until she was 17 that her asthma became much more severe.
It was only then, in her late teens, that the one or two hospital visits a year became one every month. She ended up in intensive care on many occasions. The karate in which she’d attained a brown belt had to stop because even the warm-up was making her uncomfortable, and she says she had to be aware of the fact there was only so much her lungs could take. Her dreams of becoming a black belt in the discipline were dashed.
She recalls that it was very difficult going from being able to manage her condition to constantly being on steroids and being in and out of hospital. The worsening of her condition also coincided with the two most important school years of her life. Rebecca is grateful that, despite missing huge chunks of time from school, she managed to fly her Leaving Cert and get a place in a post-Leaving Cert course.
But then Covid hit and life as she knew it was even more severely curtailed than it had been. The severity of her condition meant confining herself at times when she became ill. But the threat of Covid was huge. It changed not only her own life, but those of her family members who had to make sure there was as little risk to Rebecca’s health as possible.
“I didn’t leave the house unless I needed to go to hospital. When my little brother went back to school, we wore masks in the house. I still can’t take the risk. Since last August I’ve had 14 Covid tests,” says Rebecca, who is currently on a new pioneering intravenous treatment to treat her condition.
The normal medication — using inhalers and taking steroids — were not enough to help manage her condition. Two-and-a-half years ago Rebecca started going for monthly intravenous antibody medication at St James’s Hospital. She has also just begun treatment on a brand new drug, which is the third intravenous drug she’s taken. She hopes that this medication will bring her condition under control and enable her to re-enter society in a more normal way as the threat of Covid recedes.
Strong smells, pollen, cigarette smoke, dust and animal hair can all lead to her becoming very ill. “With asthma they say when you reach a certain age you can grow out of it. It went to the exact opposite extreme for me. The doctors says there’s still time that I could grow out of it,” she says.
“When Covid first came around it was scary. Even with the easing of restrictions I can’t take that risk, it’s too dangerous. I’ll never get out of that mindset of wrapping myself up. People don’t realise how locked down we’ve been. We didn’t allow anyone into the house and we still don’t leave the house unless necessary.
“When my brothers Ross (17) and Conor (23) come home from school and work they shower immediately and my mother washes the work clothes and school uniform. Covid is a respiratory flu. I have a respiratory illness — when you put two and two together, what could happen?” she asks.
Rebecca acknowledges that it was very difficult for her brothers because they had to give up aspects of their social lives to keep her safe, and she is all too aware of their sacrifices. She keeps a diary of her symptoms to help doctors manage her condition. She begins her day in the morning by taking a note of her peak flow, a measure of her lung function. If she notices it dropping, it’s a sign that she’s becoming unwell.
She believes that asthma as a condition is misunderstood, and says while people may have an idea what it’s like, there are degrees of severity that people live with and not everyone understands the impact it can have on sufferers’ lives. Even though there are things in life that Rebecca feels she’s missed out on a result of asthma, her friends have supported her as best they can through the last year, keeping in touch and making sure she was OK. “I have such a strong bond with my friends. I know they won’t leave me behind,” she says.
But while her friends have all been educated in the effects of asthma, Rebecca says there’s a large part of the population who don’t know what it’s like and how bad it can be. “I would love people to understand what it’s like. It’s not as simple as just taking an inhaler,” she says.
Rebecca says even though she was used to being cooped up at times before Covid when she had spells of severe ill health, she’s still looking forward to embracing the future. “Covid has shown us it’s the little things that are important. My mum would say when you’re healthy you need to live your best life. You also need to have that positive mindset. I am hoping that this new treatment will control things. If it’s under control for a year or two I’m hopeful I’ll be on the inhaler. For now, I have to stay with the injections,” she says.
In the future Rebecca wants to go to college and live the life of an ordinary 20-something. “After the pandemic I just want to be able to go and hang out with my friends and go to the shops. I had my first vaccine at the end of March. The next vaccine would be due at the end of June,” she says.
“When the pandemic is eventually over that doesn’t mean my asthma is gone. I’ll just be less anxious. My asthma won’t go along with it. Yes, it will be great to get back to normal but I still need to take care of myself. I still need to wrap myself up. That’s my own little pandemic,” she adds.
According to the Asthma Society of Ireland, over 380,000 people here have asthma and one in five people — some 890,000 people — are likely to develop the condition at some point in their lifetime. The society’s CEO, Sarah O’Connor, points out that the past year has been a particularly worrying time for those with asthma and their families.
“As Covid-19 is a respiratory illness, it is vital that people with asthma are in control of their condition and so, Asthma Awareness Week 2021’s overarching objective is to focus on the importance of good asthma management to prevent asthma deaths,” she says.
The organisation’s Asthma Adviceline and nurse-led WhatsApp messaging services have been inundated with calls for the past year, with 4,416 appointments with respiratory nurses who have been on hand to support patients and alleviate stress for callers throughout the pandemic.
As part of Asthma Awareness Week, the Asthma Society of Ireland is running a ‘Love your Lungs’ virtual walk fundraiser. Supporters are being asked to step up to the challenge of contributing daily steps in order to fundraise on behalf of the society.
“Depending on your level of fitness, you can contribute your steps each day via your Fitbit tracker or manually via iDonate and help us smash our target. Whether you can stroll 5,000 per day or stride 70,000 steps in the week, we need your help to keep our crucial services open,” Sarah says.
Tomorrow marks World Asthma Day. For more information on Asthma Awareness Week or to register for the challenge, go to asthma.ie