[TOPIC] Asthma

I have asthma but usually it only affects me when I'm really sick, but my mom has like three daily inhalers for hers. It feels pretty scary when it gets really bad, because you're breathing but not getting any air. When someone starts to wheeze you can hear it - and/or feel it, from the POV of your character. It rattles. You cough a lot. Your chest feels tight, like someone's sitting on it. (This may differ by person, I'm not sure.)

As far as I know it is possible to stop it without medication, by trying to calm down and breathe evenly and slowly. I've heard of this and seen it done in a couple movies, but I can't confirm it. I've been able to work through my (mild) attacks, but it can definitely be fatal for someone who has really severe ones.

I have asthma but usually it only affects me when I'm really sick, but my mom has like three daily inhalers for hers. It feels pretty scary when it gets really bad, because you're breathing but not getting any air. When someone starts to wheeze you can hear it - and/or feel it, from the POV of your character. It rattles. You cough a lot. Your chest feels tight, like someone's sitting on it. (This may differ by person, I'm not sure.)

As far as I know it is possible to stop it without medication, by trying to calm down and breathe evenly and slowly. I've heard of this and seen it done in a couple movies, but I can't confirm it. I've been able to work through my (mild) attacks, but it can definitely be fatal for someone who has really severe ones.

My asthma is triggered by allergens or exercise, and made worse by anxiety (I can't find my inhalor, my breathing becomes more and more restricted, etc.). It does feel like something is sitting on your chest and of course since while you are experiencing an asthma attack you aren't getting a lot of air, I tend to get dizzy, lightheaded, and sometimes get tunnel vision. I know other people have fainted.
My grandmother used hot tea as a treatment. We would sit very still, not be allowed to talk (torture for me!) and breathe in the steam and sip slowly. That's what she said was how people in her day and age (1930s-40s) used. Perhaps tea was used in the Victorian era as well?
As far as a not-so-serious asthma attack stopping on its own, that's tricky. The constriction in the bronchioles would go down eventually and the mucous clogging the airways would have to be coughed up.
During an asthma attack, I tend to get really panicky and have to force myself to calm down. A lot of energy is used to try to force deep breaths (usually my lung capacity is practically nil at that point). At times I get a bit shaky, but I believe that is caused by the medication. My breathing gets more rapid as I have a shorter period of time where I actually can breathe in, and I wheeze (sounds like a whistling noise from the back of the throat, but deeper down in the chest, I'd imagine it would be a bit eerie if it wasn't such a familiar sound to me) when I breathe in.
There have been times when I couldn't find my inhalor, and I fixed myself some hot tea (whether this does anything or is just a way of calming myself down, I don't know, though tea with something sharp like lemon or mint seems to help more), and sat still long enough that it went away on its own, but it takes awhile.
A near-fatal asthma attack....in my mind that would be a slowly and then rapidly escalating situation, starting with a bit of tightness and wheezing and trouble breathing and then panic setting in as breathing becomes near impossible. Without modern medicine though, I'm not sure how near fatal it could be without it becoming actually fatal.
Perhaps contact an allergist in your area for more informed information.

Thanks! *just copy-pasted what you said into notepad to use later* I seem to have got it just about right, so far - it is only more minor attacks that she's able to work through. When she has a really major one she only survives because of TEH MAGIC. Kind of. Ahem.

PennyAnnaPieKin

I had a near-fatal asthma attack in 2006. It was absolutely the worst experience of my life and I wouldn't wish it on anyone. It was worse than torture. A lot of people don't know this, but asthma is the #1 medical killer of young women. It's not just a way that kids get out of gym class.

It starts with wheezing. A deep rattle in the lungs, a wheezing noise in the throat on each intake of breath. Then you do get the feeling of someone sitting on your chest, and that person gets heavier by the minute. It really feels like that kind of pushing, that pressure. What's happening here is the lungs filling with fluid as the bronchial passages constrict, making it very difficult for air to get through.

At this point a modern asthmatic would reach for an emergency inhaler, which contains the drug albuterol. (It's a stimulant, and in addition to almost immediately making breathing easier, it also produces a quickened heartbeat and sometimes a nervous flutter in the hands.) In older times they would've sat down quietly to rest with tea. This may or may not have worked, depending on the severity of the attack. They might also not have identified this asthma but rather an attack of "vapors" or nerves.

As an asthma attack worsens (and this is the really horrible part), you become progressively weaker and start losing color from lack of oxygen. It was at this point that I went to the emergency room. By the time we got there, I couldn't stand up or speak. I was wheezing desperately for tiny gulps of air, fighting the sumo wrestler on my chest. I could move my mouth and whisper but I had no voice and no energy to talk. I was terrified and panicking, which was making it worse. My nail beds were completely white like the tips, instead of pink, and my lips were turning blue. My husband says my skin took on this very corpse-like bluish-white color and didn't even look like flesh anymore.

There comes a point with an asthma attack where no doctor can do anything for you. At this point, you are going to die, end of story. There's nothing to be done about it. They can force air into your throat but your lungs are already full of fluid, so there's nowhere for the air to go; you might as well blow it against the wall. I was pretty close to this point. They put me on a breathing machine with a very high dose of albuterol and gave me a very large steroid shot. The steroid worked fairly quickly and in about five or ten minutes I was getting better. I wound up needing two full rounds on the albuterol breathing machine, and I had to take steroid pills for a week. I also had to use a twice-daily steroid inhaler (Flovent) every day for the next year and a half to prevent further attacks; eventually I moved out of Los Angeles and my asthma cleared up, so I don't need it anymore.

Your character, in absence of modern medicine, would have died of just such an attack. It's basically the same thing as drowning, just lungs full of liquid as she gulps and gulps for no air. Someone watching would hear the gurgling in her lungs get more and more pronounced and her wheezing would get more and more desperate. She would be panicked and very, very frightened. There is nothing more horrible than drowning in a roomful of air that you just can't reach.

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Writing: Connected (2008)
Winner: The Track (2007)

Something you might want to note: very strong, black coffee will help ease an asthma attack in place of an inhaler. My doctor told me this, and it has pretty much saved my life on various occasions when the smoke from forest fires was making it hard to breathe a couple summers ago. Assuming the attack isn't terribly severe, and is limited to that feeling of an elephant sitting on your chest making it hard to breath. If your lungs are filling with fluid, coffee won't do anything.

Only dead fish swim WITH the stream.

All good info above! I have pretty bad asthma. In the spring when the allergens are out in full force it's the worst. Sometimes it gets bad enough that the inhaler doesn't even help.

This has happened to me a few times when I was out on the family farm and couldn't exactly just go to the hospital. The thing that really stands out is that you CAN'T lie down. This makes it much harder to breathe. I've spent nights sitting up in bed wheezing. I eventually would fall asleep, but I'd have to stay sitting up.

By morning it was usually better, but I still had a tightness in my chest, and was even sore in my chest/back from the laboured breathing all night. I'd be coughing up fluid too. So it does get better, if it is not too serious. I agree that panic makes it much worse. I've sometimes had an asthma attack start just by realizing I didn't have my inhaler with me! Stupid disease.

It looks like you've gotten a lot of good information on what an asthma attack is and feels like, so I won't bore you with most of my personal story. I will just mention, that I almost never cough during an asthma attack. I can't cough. To cough would be a relief, but I just can't draw enough air to do it.

For minor attacks sitting calmly and concentrating on slowing and evening out your breathing really can work, as a large part of a mild attack is the panic that having trouble breathing causes. The hot strong black coffee remedy also really works. I'm not sure how readily available coffee was in Victorian England, but if it was readily available it's a good option.

While doctors have been insisting that asthma's all in people's head for a really long time, housewives and herbalists new better. Naturopaths and Homeopaths still prescribe some of their remedies. I've had success with Stinging Nettle tea. It's an anti-inflammatory, and we now know that inflammation is probably the largest component of asthmas with bronchial constriction/spasm being a relatively minor part of the disease. I've also heard good things about Lobelia which is an anti-spasmodic and acts as a broncho-dilator for asthma sufferers. I have a very dear friend who said that Lobelia tinctures have completely replaced her rescue inhaler they are so effective when used in conjunction with a nettle tea regimen. The tea works best if taken regularly more as a preventative measure than as a way to treat an attack, though it can help during an attack as well. Basically if you look up herbal remedies that are anti-inflammatories and anti-spasmodics and/or broncho-dilators chances are pretty good that someone was using them back then to treat asthma.

Thanks, guys. That's all really helpful.

@Kelilah - Like I said, the only reason why she survives is because it's fantasy. It makes sense in the context, I swear.

PennyAnnaPieKin

You got a lot of really good answers, but I figure a different perspective has to help.
My mom has asthma, and has had it since before I was born. As a non-asthmatic I never understood. Wheezing, gasping, late night forays for a new inhaler, etc. did not make sense to me. Mind you, I knew it was not psychosomatic, but it was decidedly uncontrolled at the time, leading me to wonder why the doctor didn't just make it go away. Some years later medicine commercials were on TV with children describing the symptoms (fish out of water, etc.). Interestingly, at this time I thought bronchitis was associated only with asthma.
Just last week I got bronchitis, my mom recognized it in my breathing right away so I went to the doctor before it got really nasty. That "chest cold" was rather like asthma-lite. Being a good wrimo who did not want pneumonia or asthma I followed the doctor's orders exactly. For mild attacks (which all were), I could not walk down the hall at work without an attack, it was a victory when I made it across the street sans inhaler. My first day back at work I had my worst attack (still mild complete with lightheadedness, which I am somewhat prone to) 2 hrs after using the inhaler (too much Mucinex and not enough water) my mom told me to lean forward, take long deep breaths, and drink lots of fluid. None of this stopped it, but it held off the panic attack long enough for the attack to pass.
In short it is very terrifying even when mild to not be able to get enough air, especially when you do not understand what is going on.

Can asthma attacks be triggered by running quickly and getting extremely stressed? Can it be caused by too much of the smoke from the smoke machines in the bar?

To elaborate: one of my characters is asthmatic, but he's also a singer. He walks into the bar where he performs and the smoke machine has gone haywire, which gives him a mild asthma attack. He decides to stay in the Starbucks across the street while the band performs, but as he's leaving someone grabs him, which freaks him out. He runs across the street where the band finds him having a severe attack..

Edit: I can talk sense. I swear.

"Excellence is the act of taking something ordinary and making it extraordinary." Booker T. Washington

I've suffered from asthma for most of my life and although it is possible to have an attack caused by smoke and/or running i've never had it cause a severe one, just a bit of shortness of breath and ended up grabbing my inhaler and been fine. I also don't think that just running across the street would cause an attack unless his asthma was really severe.

From my experience, smoke machines can't really do that. They're practically just water and not something that could irritate you're way of breathing. Him walking into a bar though, now there's a lot of factors that could cause asthma on that fact alone.

Maybe you could consider that he's tired for some reason but instead of taking a breather, he just goes in the bar, cigarette smoke and all and tries to relax in there before the show. It's cramped, very little oxygen space so that doesn't help at all. Then he sings and we all know how that in itself could be stressful to your lungs. As the show progresses, his losing breath because of fatigue. He gets chest pains, starts to breathe funny so decides to step out. On the way to Starbucks, the chasing thing happens then the severe asthma attack.

Just a thought...

And for Anna-Kin

They've practically told you everything that I had to say about a near fatal attack. That's what happened to me too. I just wanted to add a little quirk of mine since I think your character could do it. When I have a fairly violent attack, I lay on my stomach and scrunch tightly into a ball where my knees are tight against my chest. It helps me breathe when I'm in that position. Just a little info...

i haven't found many people who agree with me, but i've gotten through a few asthma attacks by going out in the cold. no one ever told me to do it, i just figured it out on my own. at one point, the inhalers i had just weren't working, and i would wake up in the middle of the night and have to open the window and jam my nose against the screen (fortunately, it was winter at the time). it seemed to help me break up the gunk. i also did it last spring - there was nothing wrong with my inhaler, and i had taken it before bed like i always do, but people had been smoking in the house all night and it eventually sort of filtered upstairs to the room i was sleeping in and got bad enough to start an attack. it was cool outside because it was still early spring, so i took my rescue inhaler out there and sat shivering in the backyard for half an hour.

on the other hand, i know a lot of people who find that the cold makes their asthma worse. personally, i'm far better off with cold air than warm air.

See, cold air really irritates my asthma, warm air makes it better. I assume that that's because I'm in Texas and my body just somehow wants to adjust to the weather.

I don't think I can add much to others' asthma stories. Cigarette smoke irritates mine, as does being cold, getting winded after running (if I get too winded, I just can't catch my breath back; it's like you're trying and trying to breathe, and no air's coming to you...)

I would suggest emphasizing how painful the asthma attack is. It feels like your chest is caving in, every breath feels like a major chore. I don't think you'd be being over-dramatic; every asthma attack I've had has sucked major ass.

Also, I'm a singer, and it's *very* difficult for me. Coffee helps, as does a warm rag on your chest sometimes. I would think that would work in Victorian times.

Hope I helped, somewhat.

Another "breathing position" that might help is lying flat on your back with both arms raised above your head. It opens up the chest cavity a little. It's possible to kill the pain involved in an asthma attack by having someone pinch the web between the thumb and forefinger and hold it continuously. It could just be a physical quirk though.

Borrowing someone's oxygen concentrator -- a machine that literally forces pure oxygen down your throat through CPAP (continuous positive air pressure) will also help. Portable oxygen tanks work sometimes, but during the worst attacks nothing other than continuous air flow will work. Home nebulizers will do in a pinch, but that requires borrowing medication (Albuterol, Xophenex) which is illegal and potentially dangerous.

Everyone's pretty much said what I would have said. I'll add this though:

-I have found that mint is very helpful in opening up my airways. Whether sucking on an actual mint, or just brushing my teeth with mint toothpaste. It's great. Sometimes, it works when my inhaler doesn't.

NaNoWriMo 2008: Povo
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Read Proust, an actual Victorian asthmatic who wrote while lying in bed in his cork-lined room.

I didn't see this anywhere, and I wanted to say it just in case it helps anyone. Laying down flat when you're having an asthma attack is not a good idea. In fact, most asthmatics sleep with a lot of pillows, or with something under the pillows, in order to keep their head elevated. It helps, trust me.

Also, Something that seems, as far as I can tell, to be just me. Whenever I have an asthma attack, my hands automatically go to my throat. for something very mild I will rub it, almost constantly, and as it gets worse so does what my hands are doing to my throat. During the worst episode I ever had, the only one that ever ended with me in the hospital, I ended up breaking the skin on my neck because I was literally clawing at my throat. I don't really know why.