DR. HOOK- Breathless: Asthma attacks take your breath away

"Don't hold your breath," is something I hear a lot. Maybe people will do what's right and forget any politics involved? Don't hold your breath. 

Maybe the Olympics in Beijing will reduce human right violations in China? Don't hold your breath.... or maybe you should, with all the pollution there! 

For those with asthma, irritants from dust to pollution can make it difficult to breathe. Asthma is due to airway inflammation of the lungs. Asthma attacks are like being under water and using a thin straw to breathe.

The lungs fill up with air and actually over-inflate because it's hard to exhale all the air from the constricted airways. So the chest starts to feels full– like going from a Chinese gymnast to Pamela Anderson. 

Wheezing occurs mostly on exhaling and sounds like a high-pitched musical whistle. But you can't whistle while you work in this case because of the shortness of breath. And that can result in missing school, missing work, not being able to participate in events. 

Coughing fits are awful because asthma doesn't allow you to catch your breath. Plus, if mucus builds up in the airways, it makes it even more difficult to exchange air.

Don't irritate the airways! But postnasal drip and acid reflux do irritate the airways, triggering asthma attacks. Cold air, viral cold, pneumonia, or bronchitis all can irritate the airways to make breathing as fun as sucking in car fumes.

For most, asthma is an allergy of the lungs, so allergens like pollen, mold, cockroaches, bed mite poop, furry critters, and fumes can set off an attack. Cigarette smoke is horrible for the lungs, and bad for asthma, but I still have a handful of asthmatic patients who smoke. "Doc, I need more inhalers so I can inhale my tobacco. I still have a long way to go to catch up with how many cigarettes Bette Davis smoked. Cough...hack." 

I once interviewed for a job at a chemical plant that would have required me to wear a full-body suit with a gas mask to protect me from the harmful fumes. I guess that's an example of Occupational Asthma– if you didn't wear the oxygen tank. Some folks have breathing problems only at work due to exposure to something there.

Exercise-induced asthma occurs about 10-15 minutes after exercise and usually goes away within an hour. I have exercised-induced asthma, but I've had no attacks in many years. Once, when I was a medical resident in LA, we had a staff retreat at Lake Arrowhead. After a grueling tennis match in the hot, humid, pollen-filled forest, I started coughing like an extra in La Boheme. 

Of course I didn't have albuterol because I hadn't had an attack in years. So I hacked my way over to the swimming pool. "Does .... anyone .... have ....  al ... buterol?" All those docs and no medicine. It was like being with a bunch of chefs out of the kitchen. 

There are good medicines to control asthma to minimize the number of attacks and the severity. Waking up in the middle of the night due to asthma or needing the rescue inhaler too often are bad signs, because many of these asthmatic patients end up in the ER– or dead.

Asthma shouldn't control a person's life. It is like Pink Floyd sings, "Breathe, breathe in the air. Don't be afraid to care." There are so many misconceptions about asthma, so seeing the doctor can really make a difference. I hope I haven't been long-winded about how important this is.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.

Correction: The original version of this story contained an unfounded allegation about entertainer Clay Aiken. The allegation has been removed.– ed.

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