When Asthma Attacks

I’ve never had an asthma attack before. Mostly I’ve had allergy attacks, where a specific allergen knocks me flat for a couple of days — I’ll get a runny nose, wheezing, hives, and body-aches. I think my last really good bout with allergies was the time I pruned the tree.

But I do have asthma. It’s mild, and because I was on a swim-team three decades ago my lung capacity is something like 120% of normal for my size. Asthma knocks that back to about 90% normal, so I almost never notice.


Yesterday in church I suddenly felt a cold draft. It got hard to sing. I started to feel weak.Within 20 minutes I was wheezing good and solid, but I didn’t have the runny nose or itches I associate with “somebody dumped pollen in the ducts.” I went home a little early, and discovered that I was kind of staggering around. I took a breathing treatment (albuterol in an industrial strength nebulizer, like they use in hospitals — we got it for the kids back when they were suffering from croup every winter) and the wheezing went away.

Of course then I had to deal with the albuterol side-effects. I was ravenously hungry and I had a case of the shakes that would have had me worried about my career as a cartoonist if I didn’t know it was temporary. I fell into bed and slept it off.

For most of the rest of the day I was dealing with lingering side-effects. I was almost as wiped out as I would be during a full-on allergy attack, but it only lasted a few hours rather than two days. We had friends over for dinner, and the evening was delightful.

When our friends had to leave I walked out to their car with them. The air temperature was 7 degrees farenheit. It felt nice — invigorating, and even a little refreshing. They started their car to warm it up, and then we all headed back inside to talk for another five minutes in the entryway. Two minutes in I was wheezing again.

Cause and effect seemed pretty clear. Apparently sometime during the last few weeks I’ve developed a sensitivity to “sudden change in air temperature” and it triggers an asthma attack. This time around I opted against the breathing treatment, and waited it out. My breathing improved after about half an hour.

It’s cold again today. And now I have an excuse to not go out in it. This does not make me happy, because I’m pretty sure the moment I start using this as an excuse to avoid cold weather I’ll end up with a psychosomatic asthma trigger. Of course, if that’s true then I ought to be able to walk outside and consciously DECIDE not to let it affect me. Hypochondria works both ways, right?

17 thoughts on “When Asthma Attacks”

  1. As a lifelong asthmatic who used to end up in Emergency about once a year, I sympathise! Temperature triggers are different from allergen triggers (so they say), but both stop up your breathing rather effectively.

    If you continue to have seasonal asthma troubles, there are maintenance-type drugs that can help. Singulair (Montelukast Sodium), for instance, is a wonderful little once-a-day pill that works quietly in the background, so has a less strong-and-immediate effect than the “rescue inhalers” do. By all means, though, chat with a respirologist about modern options in asthma treatment — asthma claims about 5,000 lives in the USA annaully. Please don’t be a statistic, Howard!

  2. you may want to look into a standard albuterol hand-held inhaler. You probably don’t need a nebulizer treatment for these small attacks, but the metered dose in a non-mechanical inhaler would do the trick.

      1. maybe a daily pill then? I take singulair and advair (a powder inhalor for daily use), but unless this is a growing problem, I don’t know if you want to get into a daily regimen.

    1. I’m surprised you went straight for a nebulizer rather than having an inhaler on hand if your asthma is so mild you only get occasional attacks. (This is not a finger-wagging, just an expression of not being familiar with that reaction to an attack. I’ve had asthma since I was 11 or so, and have only had nebulizing treatments when I’ve had an attack so bad I had to go to the emergency room, perhaps 3 or 4 times in my life–all times at which I didn’t have my asthma under control.)

      If you get the “albuterol shakes,” you might want to ask your doctor for an albuterol alternative. I used to get heart palpitations from albuterol, so the dr. put me back on an older inhaler (Alupent), which I’ve been happy with for a good ten years. My current dr. found out that I’d been using this ancient, hard-to-find prescription and moved me over to Xopenex, which is related to albuterol but doesn’t have as many side effects. It’s new, so it’s a little more expensive and doesn’t have a generic, but if you rarely need it, it’ll last you quite a while. (Not sure if it’s the only one of its kind, or if there are other brands out there that do similar things, but it’d be something to ask your doctor about.) It works great–I’ve never had heart palpitations or shakes with it. Just be sure to get a spacer so you can inhale it slowly all into your lungs, rather than having it spray the back of your mouth.

      When I lived in Utah, it was asthma heaven. I generally have more problems with humidity and the pollen that comes along with it. But as you said, it could be the sudden change in temperature. But there’s no need to let even major asthma inhibit your activity, if you have it under control. Mine’s severe, especially in the Seattle climate, and between all the drugs I take for my allergies and asthma and my rescue inhaler, I rarely feel stopped by the asthma (the allergies, now there’s another story…).

  3. It depends. It sounds like your asthma has a specific, non psycological trigger. If that’s so, it probably won’t yield to psycosomatic therapy. In other words, if it’s not all in your head you won’t be able to think it well.

  4. For me it’s not the temperature that triggers the asthma, but the dry winter air. Also the albuterol shakes vary depending upon whether I’m well rested and have eaten enough that day.

  5. a simple preventative measure

    is wearing a scarf. it rarely gets cold enough here to trigger my asthma, but it has been for the last week and after one mild attack, I started wearing the lovely scarf my sister-in-law knitted for me. Having that pulled up over my mouth warms the incoming air enough that it doesn’t trigger.

    I still need to go get my inhaler refilled, though…

  6. I’ll agree with zandperl – it’s probably a humidity shock.

    You went from warm moist air to cold dry air, and that causes the alveoli to have… issues. I know this from personal experience.

    It’ll wear off if you’re doing one of two things – prewarming the air, or putting out enough activity that the body starts producing excess heat (which helps cushion the blow)

    I’d guess that you were nicely shocked by the draft, and sucked in a huge lungful – that’s enough for the muscles to contract in the lungs.

    As for the albuterol shakes – I had those, but they wore off after using it a few times. Kind of fun, however.


  7. axolotl has the same advice I was going to give you. I am asthmatic sensitive to cold and wear a nice warm scarf. It really helps, as long as I also keep my core body temperature up.

    1. Re: An ounce of prevention:

      “Stop getting old???” That’s the _last_ thing we want him to do!

      Howard, please, by all means, get as much older as you want. It sure as heck beats the alternative. I second the comment above about not becoming a statistic.

  8. My wife has similar issues with her Asthma and one thing that seems to help her is a hot cup O coffee. What I don’t know is if it’s the caf or the heat that help her but it’s an easy thing to try.

  9. Any chance that the breathlessness I feel after minimal activity — like a half-flight of stairs, or getting dressed — is asthma? Or is that just incredibly out of shape?

    Man, in my teens and twenties I felt like we Taylers came from superior genetic stock. Now that I’m 32 I think one of the faultiest genes I inherited might’ve been the one that gives a false sense of confidence.

  10. albuterol shakes

    My daughter has both allergy and exercise induced asthma. This means we have used a nebulizer quite a bit. We found that the albuterol causes an insulin spike. This causes hunger and shakes. We found that Hot Cocoa after a treatment really helps by relaxing the chest muscles, giving sugar to counter the insulin, and a small amount of caffeine to help with the immediate symptoms.
    Oh and to Randy: If the shortness of breath after moderate exercise lasts for more than five minutes, then there is a good chance that it is asthma. Otherwise you are just out of shape, and need to do those stairs several more times a day… 😉

Comments are closed.