‘Breathing Better Is A Game-Changer’: Veep Star Tony Hale Shares His Story About Asthma And Anxiety
When most people travel to Italy, they eagerly await the Colosseum, Mount Vesuvius or Cinque Terre. Not Tony Hale. “As a child, I just wanted to know, ‘Where’s the closest hospital?’” The two-time Emmy winner for HBO’s Veep is raising awareness for asthma, a chronic lung condition which he has been managing since childhood. Hale specifically wants the public to know about a subtype, eosinophilic asthma, and a simple blood test that can guide people in the right direction. The versatile actor also points out that respiratory distress can be anxiety-inducing. “When you’re breathing better, it’s a game-changer!
Asthma 101: What Is It?
The Centers for Disease Control and Prevention (CDC) define asthma as a chronic disease of the lungs where airways become narrow, swollen and may produce extra mucus. This can lead to repeated episodes of wheezing, shortness of breath, chest tightness and coughing at night or early morning. The cause of asthma is unclear but according to the Mayo Clinic, it’s likely related to a combination of environmental and genetic factors. Risk factors include being a smoker, being overweight, having an allergic condition (e.g. atopic dermatitis), and exposure to secondhand smoke, pollution or occupational chemicals (e.g. manufacturing, hairdressing and farming)
Asthma “triggers” include airborne allergens (pollen, mold spores, dust mites, pet dander); respiratory infections (bacterial, viral, fungal); air pollutants and irritants (e.g. smoke); physical activity; stress; cold air; acid reflux; and medications (e.g. aspirin, ibuprofen and beta-blockers).
How Is Asthma Diagnosed and Treated?
Your doctor will complete a health history, evaluate your symptoms and perform a physical exam to rule out other conditions such as a respiratory infection (influenza, pneumonia, Covid-19) or COPD. The most common lung function test, spirometry, estimates the narrowing of your airways by assessing the amount and speed of the air you exhale. A peak flow meter measures how hard you breathe out. A chest x-ray can identify an infection or structural abnormality that could impair breathing.
Blood tests can help with phenotyping asthma which can help doctors confirm the diagnosis and create an appropriate treatment plan.
“Asthma due to eosinophils is the most common subtype we see,” describes Talal Dahhan, MD, MMEL, FACP, FCCP, a pulmonologist and critical care physician at Duke University Hospital. “In contrast, some patients may have the neutrophilic inflammatory phenotype.” Each may require a different treatment approach (discussed later).
While we have many effective and sophisticated testing strategies now, Hale had a different experience growing up.
“I didn’t know a blood test could detect eosinophils and predict flare-ups,” says Hale who finds easthma.com to be a great resource about eosinophilic asthma. The Arrested Development alum also created a funny Instagram video to raise awareness about this inflammatory subtype.
Can Asthma Be Treated? YES!
A key message that health agencies like the CDC and physicians like me always convey: you can control your asthma. Tony Hale couldn’t agree more.
“As a kid, I didn’t know there were so many asthma communities and fellowships out there,” says Hale, who currently stars as twins in the Disney+ drama The Mysterious Benedict Society. He continues to use inhalers to manage his asthma. “It’s part of my life, but it’s not a one-size-fits-all approach.” This is a key point: your individual regimen should be tailored to your symptoms, frequency, phenotype and more.
“For eosinophilic asthma, step up therapy is the treatment approach using different combinations of inhalers,” explains Dr. Dahhan.
Inhaled corticosteroids such as fluticasone (“Flovent”) and budesonide (“Pulmicort”) reduce swelling and inflammation. Short-acting beta-2 agonists like albuterol (“ProAir” or “Ventolin”) act within minutes to open up airways and provide short-term relief during an asthma attack. Long-acting bronchodilators and steroids are often administered as combined inhalers such as “Advair” (fluticasone-salmeterol). Leukotriene modifiers such as montelukast (“Singulair”) can also relieve asthma symptoms.
Covid-19 and Asthma
The Covid-19 pandemic has been challenging, exasperating and downright distressing for most of us. Those with moderate-to-severe asthma have been additionally fearful based on CDC reports of increased risk of hospitalization (this is disputed by the American Academy of Allergy, Asthma & Immunology which asserts that there is currently no evidence of increased Covid-19 infection in people with asthma). Increased infection or not, both the CDC and AAAAI agree that individuals with asthma should continue taking their medications and get vaccinated against Covid-19 and influenza in order to optimize their lung function.
Of course, as we all know, Covid-19 has impacted our lives well beyond physical health.
“Everybody’s been taken out of their routine,” describes Hale. “For me, it’s been a time to reflect on how much asthma has affected my career, my life.” He talks about taking a step back, thinking about how he’s managed his asthma, avoiding certain triggers and exploring new resources. While we both agree that it’s unfortunate that it took a global infectious disease outbreak for us to stop and reflect, Hale encourages those with asthma to evaluate their condition and environment.
Asthma and Mental Health – What’s the Connection?
“There’s a reason why I can play anxious very characters well, very authentically,” reveals Tony Hale.
I confess that Arrested Development is one of my all-time favorite shows. After an exhausting day in clinic, I would come home and watch hours of this brilliant comedy, much-needed laughter easing my tense mind. His brilliant portrayal of the neurotic, hapless man-child, Buster Bluth, was infused with equal parts absurdity and pathos. Buster was prone to panic attacks – a feeling Hale understands all too well.
“People ignore the mental association with asthma,” explains Hale, who recalls during childhood pushing his body vertically in order to get more air. “As a kid, that’s terrifying.” Forgetting his inhaler on school trips induced a panic state which led to asthma attacks. “I remember the anxiety from a very young age. I felt comfort in my inhaler and knowing a hospital was nearby.”
This is an important learning point for doctors who think of asthma as essentially a respiratory condition. To a person gasping for air, however, it is utterly frightening and angst-inducing. Something to be mindful of in the midst of historic, pandemic-related job-, food- and housing-insecurity where a record number of people are reporting symptoms of depression and anxiety.
The Gift of Empathy
Want a great health tip? Empathy is good for your health. It connects us to one another in deep and meaningful ways. Tony Hale personifies the empathic mindset.
“So much of what excites me as an actor is raising empathy. When I’m stepping into characters, I have to have empathy for that character in order to present the most authentic version.” With his advocacy on asthma, Hale continues, he is helping people become aware of a story that’s not theirs. “When you use empathy to help somebody else, to use your story and see someone else’s struggle, don’t ever underestimate that gift.” He pointed out the similar importance of empathy in my role as a doctor: “When you sit there and listen to a patient and try to fully understand their struggles, that’s a game-changer for the patient.” An important reminder of the privilege and responsibility of our job, rooted in empathy for our patients’ pain and suffering.
In the final moments of our interview, I convey my heartfelt gratitude to Hale for bringing desperately-needed humor to the public for nearly two decades. Laughter, indeed, is the best medicine. In his humble and authentically empathic way, he thanked me and all frontline healthcare workers: “You are the boots on the ground. I am incredibly grateful for what you all do.” As for his comedic genius: “It comes from so much pain!” Hale’s comedic gift, coupled with his consistent advocacy, have been the real game-changer for people with asthma.