Guide to Asthma

Lesson #1: What Is Asthma?

Different people experience asthma differently. Some people with asthma have cough, wheezing, and difficulty breathing nearly every day. Others feel perfectly well in between occasional "attacks" of chest congestion and wheezing. Some Olympic athletes with asthma experience only a tightness in the chest during world-class athletic competition.

All people with asthma share the tendency that their breathing passageways (the bronchial tubes) narrow more than normal. Breathing through narrowed air passageways makes one feel short of breath and may cause a whistling sound, like a flute. Excess mucus made in the walls of the bronchial tubes can fill up the breathing passageways, resulting in cough, chest congestion, and sometimes lots of phlegm to be coughed up.

What is special about asthma is that the narrowing of the breathing tubes and the mucus production can come and go. With asthma sometimes you can breathe normally; at other times breathing can be very labored, as though you were trying to breathe through a straw while an elephant sits on your chest. Present all the time in asthma is the potential for the airways to become narrowed and filled with mucus. Having asthma means always being prone to abnormal narrowing of your airways.

No one knows exactly what causes asthma. In part we inherit a tendency toward asthma in our genes, and in part we are exposed to things in the air we breathe that brings out this tendency. One simple example: you may inherit a tendency to make allergic reactions to cat dander. Growing up with a cat and being exposed every day to the cat dander to which you are allergic can lead to allergic irritation of your bronchial tubes. Once irritated or inflamed in this way, the bronchial tubes react not only to cat dander but also to all of the other usual stimuli that make asthma worse, like smoke and exercise and respiratory infections.

If you have asthma, your bronchial tubes stay irritated even on a good day, when the your breathing is normal and you feel well. You are unaware of this sensitivity of your breathing tubes until something sets off a reaction. Then two things can happen, causing the breathing passages to narrow. One is contraction of the muscles that surround the breathing tubes, the other is swelling of the walls of the tubes and weeping of mucus into the tubes. It is worth making note that two different processes can cause breathing to become difficult in asthma, because two different types of treatments will be used to restore the breathing to normal.

Children with asthma often grow out of their illness, especially in adolescence. Adults rarely have their asthma just "go away." On the other hand, asthma does not turn into emphysema, and with good medical care it does not need to worsen as one grows older. In fact, if you have asthma, you should anticipate that you will be able to be free of symptoms and fully active almost all the time. Don’t settle for anything less.