Gareth O'Callaghan: I would have died alone if my wife wasn't home during asthma attack

Ireland has the second-highest asthma mortality rate in the European Union — but free access to a simple inhaler would prevent many of those deaths 

One in ten parents say their child went without their prescribed asthma medication because of financial pressures.

Breath is not just nature’s greatest gift, it’s the key to life. Just think about it — the ability to breathe. Without that power, none of us would exist; and yet every single breath is taken for granted. I never knew how much I valued breathing until one morning five years ago when it was no longer possible.

I was having an acute asthma attack; so severe it was in the “near fatal” zone, an emergency medicine consultant at Cork University Hospital later told me. I came within minutes of dying.

Without an optimal quantity of air to breathe, we can expect to survive no longer than five minutes. Asthma is the enemy of breath.

I have lived with asthma since I was a young boy. My first episode occurred while we were getting an extension to the family home. It started late one night with a nagging cough and an inability to catch my breath. Within minutes, I couldn’t inhale enough air to fill my lungs. It felt as though my throat was squeezing itself closed. I was terrified.

Our GP — one of those kindly old-fashioned doctors who made himself available 24/7 — arrived at some ungodly hour. He brought one of the old corticosteroid inhalers which felt like I was inhaling tiny grains of salt, but it slowly worked over the course of a few hours.

There were a few unnerving episodes over the years, but nothing as serious as that bright November morning in 2021.

Asthma needs a trigger in order to bring on an episode, as it’s known. Once that episode is triggered, time is limited and treatment with an inhaler is what usually prevents it from becoming acute — but not always.

I had been cleaning out our hamster's cage (without wearing a mask) and wasn’t aware that rodent spores, which are often found floating in the air close to where these tiny creatures hang out, can quickly trigger an acute asthma episode.

I stood up. At first I felt it in the back of my throat — a weird sensation as though I’d had a reflux moment. I looked at the clock. It was 10.35am. Within seconds I could feel a burning sensation just above my chest, and I could hear the familiar wheeze kicking in.

Instantly I knew I needed my ventolin inhaler, but being a lazy day at home I wasn’t carrying it. I found one on the mantlepiece and started pumping it, inhaling once, twice… It should have eased, but it continued to get worse.

Within seconds it had become so severe I could barely breathe. I was gasping and choking, and staggering around the room as I started to lose balance

My legs were losing strength. More inhaler puffs, more again. At that point it was barely getting through to my windpipe.

I held my throat and tried to reason with what was happening. I told myself it would ease, but it didn’t. It was getting far worse than anything I had ever experienced.

I made a bolt for the front door and stumbled out into the front garden, into the bright sunshine, landing on my hands and knees. Now I couldn’t move. I had no sense of up or down. Disorientated, I stared at the grass, completely unable to breathe in or out. The cold morning air made it worse.

Just as I was about to collapse, a hand grabbed the back of my belt. My wife was holding me upright on all fours while talking to the ambulance dispatcher on her phone in her other hand. I heard a voice saying two ambulances were closing in.

“Less than five minutes.” I didn’t have five minutes. My whole body was shutting down. I tried to focus on the blades of grass, and how each one had a unique shade of green. I knew I was suffocating. There was no oxygen getting to my brain. My heart felt like it would explode at any moment, while my lungs and windpipe felt like they were being microwaved.

While the light and energy dimmed, my sense of hearing remained surprisingly sharp. 

All the time my wife’s voice kept saying, “Stay with me,” gently but sternly. My last memory was of the ambulance siren

My consultant at Cork University Hospital called it a “near-fatal asthma attack”.

It wrecked my body so severely I spent a month in hospital and was sent home with a reminder I will never forget: Asthma is the enemy of breath.

In hindsight, I know now it could all have been avoided if I had treated the illness with the gravity and respect it needs, and taken my medication in a timely manner.

It’s simple really — a single inhaler that both prevents and treats (or in my case, four inhalers because I now have COPD). Take the inhaler on time every day and I have the advantage over asthma episodes.

I also know that if my wife hadn’t been at home, I wouldn’t be writing this. I would have died alone in our garden that morning.

Eighty-one people died from asthma in Ireland in 2023, with provisional figures indicating 94 deaths in 2024. We now have the second-highest asthma mortality rate in the European Union, while women are twice as likely as men to die from what is a highly manageable condition.

Financial difficulties

And here’s a modern-day fact of Irish life that is even more shocking in the light of those avoidable tragedies — I was so furious when I read it that I sat down and wrote this column: one in ten parents say their child went without their prescribed asthma medication because of financial pressures.

It doesn’t take a genius to read between the lines: With equitable access to recommended treatment and improvements in asthma care, many of those deaths could have been avoided. Children who — for whatever reason — don’t take their asthma inhalers, unbeknownst to them, are dicing with death.

This week, the Asthma Society of Ireland launched its Pre-Budget Submission 2027 — Backing Every Breath, Building Better Care — which calls for free MART inhalers for children aged 12-17.

The inhaler costs around €80 per month, not including the prescription fee (which should be abolished). It’s possible that up to 150,000 households would benefit if this life-saving inhaler was free.

This would have an estimated annual cost of €12.1m — which is a fifth of what the government generates annually from the tobacco products tax. It’s less than 0.0005% of this year’s annual health budget — a drop in the ocean that could save hundreds of lives every year.

The MART (Maintenance and Reliever Therapy) is the gold standard for asthma treatment among children. As the name implies, it’s a combo of prevention with the built-in ability to treat a mild asthma episode before it takes hold.

In terms of price comparisons, it’s a rip-off here. The MART inhaler costs €25 in the UK, while a ventolin inhaler costs €1.75 (€12.95 on average here). In Spain, most asthma inhalers cost between €3 and €10.

What's your view on this issue?

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Asthma needs to remain dormant — think of a volcano.

Take the inhaler, avoid potential triggers — smoking, allergens and stress — and you shouldn’t have a problem.

It remains one of the most misunderstood illnesses in the world. As a result, the level of ignorance around it is staggering. People tend to skirt around the issue because they don't know much about it — unless you live with it. It’s also worth noting that asthma isn’t selective. Anyone at any age can become asthmatic.

Almost half a million people here in Ireland have been diagnosed with asthma. We have the fourth highest asthma rate in the world.

A similar proposal by the Asthmatic Society of Ireland to government to address the affordability of asthma medication was completely overlooked in last year’s budget. It should be interesting come November if it’s a case — yet again — of let them eat cake.

In the hierarchy of the budget, and the €27.4bn allocated to healthcare this year, what is the value of a child who has a serious illness and needs a life-saving inhaler but can’t afford it? Not much, it seems.