Table 5.

Theme 4, “Holistic Approach”

Theme 4: Holistic Approach
Subthemes	Exemplars
The puffers	“Sometimes I wish the Ventolin would just open the airways just a little bit more. But I don’t go over the dosage. What I do if I’m quite clogged, then I get the nebuliser out and take the heavier ones.” Helen, female, 76 “No [I don’t like the puffer], the puffer is the thing that - so sometimes they make you cough and coughing can sometimes set you off for ages, even though its making me better.” Rhonda, female, 56 “Ventolin is one thing that relives you.” Rhonda, female, 56 “Seretide is important. Even though I’m on the Xolair I think that Seretide is still very important - it’s focussed.” Jane, female, 64 “Ventolin, that was just a miracle to have an instant reversal, because when I was young it was an instant reversal. It was for many, many, many like several decades. You’d have a puff and - you’d be wheezing your head off; have a puff and you’d get on with it. It was as if you’d never had a tightness at all- [but it] and when you’re - I guess for somebody that’s never had asthma, but you know what it’s like, so that struggling to breathe and then [gasp] …” Jane, female, 64 “I find the puffers have been good. You know, I sort of keep out of trouble but if I get a chest infection then that’s when the cortisone and the antibiotics come in.” Anthony, male 72 “[Symbicort and Ventolin] just kept me bubbling along at a reasonable level I think”, Judy, female, 66
The right cocktail	“It’s a combination I think [of medication]. Yes, and I think it’s also the help that you get. There is a place to go to get help” Helen, female, 76. “The problem is, most of these drugs I also understand they’re not short-term. It’s not like taking Panadol and they kick in in four hours and it’s that sort of dose, most of these are cumulative … you’ve got to be taking it continuously to get any effect or have it built up, so it’s not just take it now and maybe take it in three days, they don’t work like that.” Rhonda, female, 56. “So, it’s hard - when you are doing all these different things [treatments] it’s hard to separate what’s - what is causing that effect” Anthony, male, 72 “I think that each one I’ve mentioned has had its own impact in certain ways. To tie it down to one - so it’s like a combination has worked.” Michael, male, 48. “It [the add-on medications] just seems to - how would you - complement or help or … help the others” Melissa, female, 41
They understood my asthma	“[My GP was] absolutely phenomenal, he’s up to date on all the research when I was getting sick so he would do things and so when I got sick, I then had to wait for a specialist. I got that specialist and he actually said that my GP is so good that there’s actually nothing he could do for me.” Rhonda, female, 56. “They understood my asthma [the doctors]. They understood that, that inhibited capacity to breathe. What triggered it was really the eosinophil count.” Jane, female, 64 “… go to a proper respiratory person … and then take the time with the puffers and follow the bloody - what you’re told and give them the time. A lot of people miss doses; and that’s not only for asthma drugs, that’s for all drugs and they wonder why they don’t work.” Michael, male, 48. “… before I was diagnosed … I went to different doctors and it’s like, here’s a Ventolin puffer, take that mate, you’ll be right; out the door … the doctor I’ve got now, he was the only one that took some interest and hospitalised me and got me on the right track. So yeah, find the right doctor.” Michael, male, 48.
Staying healthy	“Quite obviously I can’t expect that medication to have any lasting improvement on my health if I don’t lose weight; hence the exercise classes that I’m currently in, or the diet that I’m currently on. You know, I try to be more proactive after I’ve got myself into a - well, I’ll say a shitful [sic] state, to try to at least lose the weight, give myself half a chance.” Clyde, male, 57. “I guess I’ve always tried to remain as active as I can … ” Judy, female, 66 No one else [will take care of your health] - you know, your doctors and all of that are only your coaches kind of thing, that’s the way I put it as a physio. Like I used to say, I can give you the exercises, but no one is going to do them and no amount of treatment that I do here is really the treatment; the real treatment is what you do at home.” Rhonda, female, 56. “I’ve always been one to do as much exercise, because I think the worst thing you can do is sit down. So, I keep moving as much as possible.” Helen, female, 76 “I take it as prescribed and add to it. I think [the doctor] knows I do that and I’m going to do that whether you say I can or I can’t, good, bad or otherwise, because I know how I feel. I know that that’s what I need to do and that’s - is it arrogant?” Jane, female, 64. “I do not know why [people miss their medication]. It’s just silly. Really, if you want to stay out of hospital you have got to take your medication. They give them to you for a reason, not to put in the drawer. You have got to take them.” Diane, female 66.
Attitude towards asthma	“I guess the only thing that I would say is when I do come across people who have had similar sorts of issues, number one most of them seem to be a lot worse than me and I do try to stay - you know exercise a bit, I do try to make sure I have the medications. It does impact on my life and how I live it because there are things that I have to do. But I just find if I can keep on doing these things and stay healthy and exercise, then hopefully you know my lungs are not going to cark it on me before anything else.” Judy, female, 66 “Yeah, you just don’t think about, it’s called staying alive, really. You know, in my category of asthma that’s pretty much what it is, so you do what you do, you know?” Rhonda, female, 56 “I think when you’ve been sick for a long time and like I said, you evolve to be able to do. I’ve always been like a doer; so it’s just like, well it has to be done so [we’re going to have to get] it done some way. I guess, when you work for yourself and when it just has to be done, some people can say well I can’t do anything and just stick with that; oh, I’m not capable of doing it, so I just won’t do it. Where I’m one of the people, well we got to get it done.” Michael, male, 48