So, as you’ve learned from my previous post, asthma is a lung disorder characterized by chronic, reversible airway obstruction due to lung inflammation and bronchospasm. But what does that mean in terms of how it looks on the outside? What does it make a person do or feel?
That’s what I’m going to talk about today: Asthma symptoms.
Asthma symptoms are wide and varied, and depend to some degree on how severe your asthma is and what type of asthma you have (I’ll talk about types and classifications of asthma in later posts). Some of the most common symptoms include:
- Wheezing is what happens when your lungs are tight enough that when you breathe out it makes a whistling sound. The whistling sound may be quiet or loud. Wheezing is always a sign of airway obstruction, even if it’s not caused by asthma. Asthmatics vary greatly in how much we wheeze, and sometimes we don’t wheeze much at all. Some asthmatics I’ve met describe wheezing as feeling like a rubbing feeling in their chest, whereas for me it feels more like a deep vibration. Others say they don’t really notice what wheezing feels like.
- Coughing is, well, coughing. It happens when your cough reflex is triggered. It may or may not be a sign of airway obstruction, but it’s a sign of airway inflammation. Asthmatic people – particularly those with cough-variant asthma – tend to cough a lot. You may or may not cough up gunk (the medical term for this gunk is sputum) when you have asthma. Sputum is often clear between and during attacks and may look pus-like afterwards. An asthma cough is a deep, chesty cough that often but not always is loud. It’s not the little “ahem-ahem” they sometimes show on TV. Asthma coughs rock your whole body and can cause things like pulled muscles because you’re coughing so hard. Think less “I have a mild cold” and more “bronchitis”. In fact, asthma is often misdiagnosed as recurring episodes of acute bronchitis, especially in mild intermittent asthmatics, who may go months or years between symptoms.
- Shortness of breath is a thing that I prefer the alternative name of: air hunger. Air hunger is far more descriptive and accurate than the shortness of breath name. It’s that feeling that you can’t get enough air, and to me it’s the single most unpleasant asthma symptom out there. It is a fundamentally different feeling from that normal people get when they work out too hard, and one that’s hard to describe. It’s one of those things that if you’re not sure whether or not you’ve ever experienced it, you haven’t. When you’re air hungry you know. Everything in your body screams, “must get air” and you can’t, like the proverbial person stuck on a life raft in the middle of the ocean. Air, air, everywhere, so why can’t I breathe?
- Chest tightness is a catch-all term for dull chest pain, chest discomfort, and chest pressure. It is a general term for discomfort in the general chest area without another explanation and that doesn’t fall under some other category like a pulled muscle or the crushing pain of a heart attack. I pretty much always have some degree of chest tightness. I’m kind of used to it. For me, chest tightness feels like that burning chest feeling you get if you’ve spent too long at the bottom of the pool. Others describe it as feeling like an iron band is around their chest. I couldn’t find a good description link for chest tightness because it is a rather vague and ill-defined term.
The above four symptoms are the classical asthma symptoms, and the most common. Almost all asthmatics will have at least one and often more than one of those symptoms. Less common symptoms of asthma include prolonged exhalations, feeling as if you have to work to exhale, and feeling as if you can’t get all of your air out when you breathe out, all of which are signs of air trapping, with which I’m very familiar (in fact, as I write this, my I:E ratio is 1:5, where normal is 1:2. And, no, I’m not wheezing. I almost never wheeze). My doctor has told me that small-airway inflammation can cause air-trapping without wheezing, and this is backed up by my lung function tests, which indicate a more obstruction in my small airways than my large ones (more on lung function tests in a later post). Additionally, there are symptoms that are not necessarily associated with flares but that may be signs a flare is coming. These warning signs include:
- Frequent cough
- Reduced peak flow meter readings (more on this in a later post)
- Losing your breath easily
- Shortness of breath
- Feeling tired, weak, or not with it during exercise
- Coughing or wheezing more than normal during exercise
- Being tired, irritable, grouchy, cranky, or moody
- Cold or allergy symptoms
- Difficulty sleeping because of nighttime symptoms
- Dark bags under your eyes
- Rapid breathing
- Itchy neck
- and others
The above is by no means an exhaustive list. Asthma symptoms are as varied as people with asthma, and each person who has it should keep a symptom diary until they figure out what their early warning signs are.