This is my asthma explanation. The progression of a flare looks like a list in my head, so that’s how I explain it to friends and family. Maybe it will make sense to you, too, although I’ve included some medical links below if you prefer the more technical breakdown.

This is Normal Breathing

1. You breathe air in.

2. Air heads down your windpipe into the right and left bronchial tubes, or the tubes that connect the windpipe to the lungs.

3. While the air travels through these clear and open airways, mucus traps dirt, bacteria, and other stuff you don’t want in your lungs.

4. Finally, the air passes through tinier bronchioles at the end of the airways, inside the lungs. (see photo) And at the very end of the bronchioles, alveoli are tiny sacs that grab oxygen out and pass it into the blood and exchange carbon dioxide in return (the exhale).

(An actual pair of plasticized lungs. All those tiny branchlike structures are bronchioles.)

This is Breathing with Asthma

1. You have inflamed and swollen airways all the time. No one knows why, although there are some risk factors.

2. Swelling narrows the airways and makes them more sensitive.

3. You breathe in, and various triggers like allergens or airborne irritants make those inflamed bronchial tubes start spasming and producing more mucus than they should. This is an asthma flare.

4. Since swelling already narrowed the airways, the extra mucus and spasms don’t help.

5. You therefore cannot exhale as much air as you need to.

6. The “dead air” stays trapped in the bottom of your lungs, forcing you to breathe shallowly with just the top of your lungs. You cannot take deep breaths without intervention, and that’s where the inhaler comes in.

If you say asthma, most people will free-associate the word wheeze, and that’s the whistling sound air can make as it tries to travel through narrow, spasming airways during a flare. But wheezing, is not the number-one asthma symptom. Coughing is. Many asthmatics–including my daughter–never wheeze at all, but they will cough and cough and cough without stopping as their lungs try to force the air out.

Treatment for most asthmatics means taking preventative medicines to keep the inflammation down so that flares are less frequent and less severe, avoiding triggers for the same reason, and using an emergency inhaler for any flares that do occur.

More Information
What is Asthma? (National Jewish)
Childhood Asthma: An Overview (American Lung Association)
Adult Onset of Asthma (Asthma and Allergy Foundation of America)