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Physical Effects of Asthma

Having asthma can affect a person in many ways. Physical effects can range from the somewhat annoying (an occasional cough) all the way to the life-threatening (not being able to breathe). The frequency and seriousness of asthma symptoms are dependent on how well a person's asthma is controlled (with medicines and other measures) as well as how severe that individual's asthma was to begin with.

The psychological and social effects of asthma are less often acknowledged but can for some people be at least as troubling as the physical ones.

Physical Symptoms

Asthma symptoms and severity vary substantially from person to person. Most people with asthma do not have symptoms constantly. Bothersome asthma symptoms can mean that asthma is not controlled sufficiently, or that an acute asthma episode may be starting. Common asthma symptoms include:

  • Cough
  • Wheeze
  • Tight Feeling in the Chest
  • Shortness of Breath
  • Awakening at Night from Cough or Wheeze

Children are not always able to express in words that their asthma symptoms are worsening. They may have noticeable coughing and wheezing, but these are not always the first indications of breathing distress. Different children show asthma trouble in different ways. Some possible indications of the beginning of an asthma episode include:

  • Unusual Tiredness Or Restlessness
  • Trouble Sitting Still
  • Crankiness
  • Looking Worried or Scared
  • Pale, Sweaty Skin
  • Fast Breathing
  • Slouching Over

If you do not have asthma, you can help yourself imagine what it feels like to have an asthma episode. (No need to try these if you do have asthma-you already know what it feels like, and you don't want to risk triggering a real episode.)

  1. Run in place for a minute or two, until you can feel your heart start to beat fast. Take a plastic drinking straw and put it in your mouth. Hold your nose closed and continue to breathe through the straw. OR
  2. Take a deep breath in and hold it a moment. Now let out about a tenth of the air in your lungs. Breathe back in. Breathe out that same small amount of air. Breathe back in. Repeat until you can't stand it anymore.

For an explanation of what happens inside the body in asthma, see How Asthma Works.

Asthma Severity

Just as we do not yet know exactly what causes asthma, we do not know why the disease is mild in some people and very severe in others. National guidelines, developed by an expert committee in 1997, classify asthma severity into four levels:

Mild intermittent

  • Wheeze or Cough 2 or Fewer Times Per Week
  • Symptoms at Night 2 or Fewer Times Per Month

Mild persistent

  • Wheeze or Cough 3-6 Times Per Week
  • Symptoms at Night 3-4 Times Per Month
  • Increased Symptoms with Activity

Moderate Persistent

  • Daily Symptoms
  • Daily Inhaled Beta2-Agonist (Bronchodilator) Medication Use
  • Symptoms at Night 5 or More Times Per Month
  • Decreased Exercise Capacity

Severe persistent

  • Continual Symptoms Limiting Activity
  • Frequent Exacerbations
  • Frequent Symptoms at Night

A single individual's asthma does not necessarily remain in the same category permanently. With effective ongoing asthma control, a person can move into a less severe category. A person with seasonal asthma triggers may find that at a certain time of year (for instance, when ragweed pollen is in the air) she is in a higher severity group than she is the rest of the year. Asthma that starts during childhood may also become less severe as a person grows, and his airways become wider.

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