Margaret wrote this account when she was 75. It looks back on decades of asthma, ABPA and other health problems, and on how diagnosis and care changed during her lifetime. The treatments and advice described are from that period, not current medical guidance.
I was often unwell as a child, with coughs and wheezing, though I was not diagnosed with asthma. In 1956, I had an episode of severe sinus congestion and brought up thick brown material. I recovered and thought little more of it at the time.
In 1962, my husband and I went to Nigeria to teach. The country and its people made a deep impression on us, but the years were also marked by political violence and civil war. During that period, I developed a worsening cough and became very ill. Local medical facilities were limited, and I was treated for asthma.
When we returned to the UK in 1968, I had a fever and a chest X-ray that raised concern about pneumonia, tuberculosis or cancer. A chest physician performed a bronchoscopy and removed brown material from my lungs. The laboratory identified aspergillosis. I was treated with positioning, physiotherapy and steroids. After weeks of coughing, I began bringing up thick plugs and could breathe more easily. I recovered and returned to family life.
Living with recurring symptoms
My consultant warned that aspergillosis could return. Over the following years, I had repeated coughs and episodes that I now understand may have been ABPA flare-ups. At the time, the condition was not well understood by many of the doctors I saw. I was often treated for infections, and the cause of my symptoms was not always recognised.
A second opinion at the Royal Brompton Hospital in 1990 changed things. Scans showed bronchiectasis and mucus plugs. I learned breathing and airway-clearance techniques and began long-term treatment. I felt that my illness was finally understood, and I was better able to get help when symptoms worsened.
In 1995, after several viral infections, I became very weak. During treatment, I injured both Achilles tendons. The following year, tests for a prolonged stomach illness led to another diagnosis: a rare leukaemia that affected my neutrophil count. I felt relatively well, so treatment for the leukaemia was postponed, but I learned to take feverish infections seriously and seek care promptly.
As I grew older, coughing became increasingly difficult to cope with. In 2010, a consultant prescribed itraconazole. I still coughed, but the episodes became less violent and prolonged.
Looking back
When I wrote this account, I was 75 and described my quality of life as good, despite fatigue, fragile skin, a croaky voice and poor sleep. I paced myself, walked when I could and valued the support of my husband and the care I had received from NHS staff.
I wondered whether different parts of my life—including illness, stress or exposure to bat droppings—might have contributed to my health problems, but I did not know the cause. I was grateful for the research and medical care that had helped me.
Margaret G
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