Many people wonder what an asthma attack feels like and how to recognize they're having an asthma attack. Today, we'll look at the physical changes that take place and how it feels during an attack. First, we'll take a look at the normal breathing process.

Normal Breathing
Breathing, for a healthy person, comes naturally and easily. Normal breathing is the process of ventilation--inhaling and exhaling--to move oxygen into the body, while removing carbon dioxide. Blood circulates through the lungs to carry carbon dioxide waste for removal and then picks up oxygen to carry to other parts of the body. Carbon dioxide and oxygen are exchanged in the alveoli (small sacs in the lungs). The normal breathing process is quiet and efficient and there's no need for conscious control as we breathe.

Unconscious breathing is controlled by specific parts of the brainstem that automatically control the rate and depth of breathing. According to the body's need, these parts of the brain will send signals to make necessary changes to our breathing. For example, if you're jogging, your body will need to rid itself of an increase of carbon dioxide in the blood, while increasing oxygen levels. The brain automatically makes these changes. Another example of automatic breath control is when your body is at rest, the breathing rate is lower due to lower levels of carbon dioxide.

Breathing is Harder During an Asthma Attack
During an asthma attack tightening of the smooth muscles around the airways, inflammation of airway lining and increased production of thick mucus all work to cause the airways to narrow. Narrowed airways make it harder to get air in and out. Breathing out becomes more difficult during an attack, leading to more and more air trapped in the lungs.

Symptoms You May Experience During an Asthma Attack
Each asthma patient's symptoms and triggers are different--you may experience many of these symptoms or maybe only 2 or 3.

Early Asthma Symptoms
• Cold or allergy symptoms
• Trouble sleeping (may include nighttime coughing)
• Feeling tired and/or moody
• Lower peak flow measurements (shows changes in lung function)
• Frequent cough
• Losing your breath or shortness of breath
• Feeling tired or weak after exercise
• Chest Tightness

Any of these symptoms may signal an asthma attack is on the way; however, there are some asthma patients who may not show any signs of an impending asthma attack.

Asthma Attack Symptoms
Asthma attacks are scary--you can experience something similar to an asthma attack by breathing through a coffee stirrer straw. Put the straw in between your lips, plug your nose and then try to breathe through the stirrer straw. The straw is very narrow and doesn't allow adequate airflow to your lungs. You'll have the feeling of not getting enough air. This is what it feels like when a person has an asthma attack.

During a mild asthma attack, there may be a burning feeling in the lungs and speaking will become slightly more difficult. Chest tightness may also cause mild pain in the chest, neck and shoulders. Activities, such as exercise or walking, may become more difficult due to shortness of breath. You may also experience coughing or some wheezing. You may also feel slightly anxious during a mild attack.

During a severe asthma attack, the fear and panic increase and may lead to hyperventilation. It may be difficult to speak, with many patients able to only get out two or three word sentences. Chest tightness may bring on pain in the chest and lungs, along with a burning feeling in the lungs. The patient may feel as if they are being slowly suffocated or feel like they're breathing in very cold air, leading to an increase of fear and panic. It can feel as if you're drowning and unable to get a breath in or out. This entire process is horrifying for both the patient and those nearby.

Pursed-Lipped Breathing
One of the worst mistakes asthmatics and bystanders make is to panic. While it's difficult not to become scared during an asthma attack, calmness and easy breathing may keep an attack from worsening in some instances (especially during a mild attack).

When I was at National Jewish Health, in Denver, Colorado, they taught me pursed-lip breathing. This method of breathing helps to relax and calm the asthma patient, while controlling shortness of breath by slowing their breathing and allowing movement of air in and out of the lungs. This method is also used by patients who have COPD and other lung diseases.

Here are the steps for pursed-lip breathing:
1). Relax your neck and shoulder muscles.

2). Inhale slowly and normally (not deeply) through the nose for two counts, keeping your mouth closed.

3). Purse your lips as if you're going to whistle.

4). Slowly exhale and gently (do not blow your breath out hard or fast) through pursed lips, while counting to four. Exhaling should always take longer than inhaling.

This method works by creating back pressure that helps to keep the airways open a bit longer, allowing more air to come out. This also works to make it possible for more air to go in.

The benefits of pursed-lip breathing include:
• An increase in the amount of air taken in and breathed out
• Releases air trapped in the lungs
• Opens the airways for a longer time
• Improves the amount of oxygen and carbon dioxide exchanged
• Relieves shortness of breath; and relaxes the body

You can practice this breathing method several times a day and it will soon become natural to breathe in this way. Once it becomes a habit, use it as a tool when you feel shortness of breath and/or feel an asthma attack coming on. This method can also be used during an asthma attack.

Practicing this method not only gives you another tool to manage your asthma, but you'll feel more in control and confident when asthma does strike. This sense of confidence helps you to relax, which can also lessen the symptoms you may be experiencing.

In addition, be sure to always keep your emergency asthma medications with you at all times. Know how to use them properly and follow your action plan in order to keep your asthma stable and avoid asthma flares and attacks.

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