Adult onset

Here we discuss people’s experience of being diagnosed as an adult.

Often people who were diagnosed with asthma as adults said they hadn’t realised it can develop at any time of life. It could be difficult to accept to begin with, especially as it may take a while to find the right medication to control it. Eileen said, ‘I just couldn’t understand why I suddenly had asthma. I’d had nothing before’. Val was shocked to be told she had asthma, even though other people in her family had it -‘how can someone as fit as me get asthma?’
In older people, asthma symptoms are more likely to be triggered by colds and chest infections, exercise, stress or environmental triggers such as cigarette smoke, rather than allergy. 

It can be hard to tell the difference between asthma and other conditions causing similar symptoms, such as bronchitis or other chest infections, emphysema (chronic obstructive pulmonary disease or COPD), and heart disease, so sometimes it may take a while to diagnose asthma in older adults.

Ann’s first experience of asthma was a severe episode of difficulty breathing. Her GP sent her to the hospital for a chest x ray, but when the junior doctor at the hospital looked at the x ray he said he thought she had a problem with her heart and did not immediately diagnose asthma. It took several months for Ann to get the right diagnosis which made her anxious and upset, which in turn made her asthma worse.
Many people talked about adult onset asthma being diagnosed after they had been out walking, cycling or taking some form of exercise and had suddenly felt unusually breathless or wheezy. Others, like Peter and Charles were diagnosed after finding it difficult to shake off a cough or chest infection.

Looking back, some people like Val who had a family history said they later realised that they had experienced other signs and symptoms of asthma in the past, but it had not occurred to them it might be asthma. Others asked the doctor if it could be asthma, as their symptoms were similar to those of other family members. Alice only discovered after she was diagnosed that there was asthma on both sides of her family.

Often people said it took a while to accept the diagnosis and its implications such as having to be more careful about activities and their environment, as well as using medication, particularly learning to use inhalers. Some were shocked to have a potentially life threatening condition.
Catherine, who has had asthma all her life, reflected on how different the experience must be for people who develop it later in life.
Whereas some young people ‘grow out of’ childhood onset asthma as they get older, adult onset asthma is likely to be lifelong, but many people did not realise this. Jane, for example, was quite shocked that she had a condition which would not go away. "I suppose I’d seen myself as invincible but I’d never been ill. I’m not somebody who even gets colds very often. And suddenly I got this condition that wasn’t going to go away"

Once people with adult onset asthma have learnt to manage their symptoms, they may find their asthma remains stable. Stephen had recently been diagnosed and hopes to live as normal a life as possible:
Most people can almost completely control their symptoms with medication. But in some, symptoms may change or get worse over time, and that can be difficult to face.

Peter said that for the first couple of years having asthma didn’t affect him too much, but over time it has got worse and over the last 15 years he’s tried various medications. David did not worry when diagnosed because his children had asthma and could control it well, but over time he has got worse. Esther had always strongly opposed any medication and took a while to accept using her inhaler:
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A person may have to try several different inhalers to find the one that best controls the symptoms:
Occasional adult asthma is triggered by something at work. See Andreane’s account of occupational asthma in ‘Asthma in the workplace’.

(Also see  ‘Being diagnosed with asthma’, ‘Early signs and symptoms’, ‘Medication and treatment – inhalers’, ‘Managing asthma – reviews and action plans’, ‘Exercise, diet, weight and lifestyle issues’, ‘Coping and emotions’ and ‘Triggers’).


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