Asthma

Airways that narrow and inflame. Very treatable, and it still kills around three people a day in the UK.

What it is

Asthma has an image problem. It is so common that people treat it as trivial, and that assumption is precisely what makes it dangerous.

Roughly 5.4 million people in the UK have asthma. Around 1,200 die of it every year, and the National Review of Asthma Deaths found that most of those deaths had warning signs that were missed, and that many involved people who were over-using their reliever inhaler and under-using their preventer.

The airways are inflamed and twitchy. Triggers make them tighten and fill with mucus. The preventer inhaler treats the inflammation, quietly, every day. The blue reliever only opens the airway for a few hours and treats nothing.

Signs you might notice

Wheeze, cough, chest tightness, breathlessness. Worse at night and in the early hours, which is a useful clue.

Coughing after exercise, laughing or cold air.

In children, a cough that keeps returning without a cold, and getting tired before their friends do.

The warning signs that matter most: needing the blue inhaler more than three times a week, or waking at night with symptoms. Both mean the asthma is not controlled, whatever anybody says about coping fine.

How it can affect day-to-day life

The daily cost of poorly controlled asthma is broken sleep, missed school and a slow withdrawal from sport that nobody quite decides on.

The acute cost is an attack. Attacks build over hours or days far more often than they arrive out of nowhere, which is exactly why the warning signs matter.

And there is a pattern worth naming plainly: people who have had asthma for years become the least likely to take it seriously, because they have got used to symptoms that a doctor would treat as an emergency.

Supporting someone well

Take the preventer every single day, including on good days. Especially on good days. It works by keeping inflammation down over weeks, so stopping when you feel well is how the next attack gets built.

Check the inhaler technique. Studies repeatedly find that a large share of people use theirs wrongly, which means the drug lands in the mouth rather than the lungs. Ask a pharmacist to watch you do it. It takes two minutes.

Use a spacer with any aerosol inhaler. Adults too, not just children.

Get a written asthma action plan and keep it where others can see it. Have the annual review. Take up the flu vaccination.

For a supported person or a child in a care setting, Fiducia Guardian keeps the action plan, the inhalers and the reliever count in one record, so a pattern of increasing use is visible before it becomes an admission rather than after.

Where to get help

An asthma nurse at the GP surgery does the annual review and the technique check. Book it rather than waiting to be called.

Call 999 if the reliever is not helping, if speaking full sentences is hard, if lips or fingers look blue, or if a child's stomach sucks in under their ribs. Do not wait to see whether it settles.

Asthma + Lung UK have a helpline on 0300 222 5800.