My Different Asthma Symptoms (And Why They Matter)

As a certified asthma educator (AE-C), I attend asthma conferences every year to earn CE credits and keep my certification current. At one conference, a doctor said, “If you’ve seen one case of asthma, you have seen one case of asthma.”

He was referring to the fact that asthma is an umbrella term, and there are different types of asthma.

Just as we all look different on the outside (tall, short, straight hair, curly hair, different colors of skin or eyes), our insides can also be different, which means our asthma can be different too. That’s why some of us have strange or different asthma symptoms that don’t match what’s on the usual lists.

Identifying common asthma symptoms

With asthma, the most common symptoms are:¹

• Coughing
• Wheezing (a sort of whistling sound when you breathe out)
• Shortness of breath
• Chest tightness

Some people don’t wheeze, but people with asthma don’t all have the same symptoms. They can have one or more of the symptoms listed above, which means they might not wheeze. I don’t wheeze, yet I can hear my daughter wheeze across the room. Everyone is different, even in families.

My early warning sign: A tickle in my throat

For me, my asthma attack will have an early warning sign: a tickle in my throat. I feel like I need to clear my throat, and I do it several times. Then I start to cough, and the coughing gets worse. And worse.

When different asthma symptoms get overlooked

I have cough-variant asthma, so I will have a dry cough during an asthma attack or flare. This can be a BIG problem if I end up in the emergency room, because nurses and doctors always listen for wheezing when you have asthma.

A few years ago, I was having a bad asthma flare due to wildfire smoke and was getting worse. Even though I was having breathing treatments with my nebulizer, they just weren’t helping.

I gradually became worse over a couple of days until I realized I was struggling to breathe and was completely focused on breathing in and out. My husband was nearby, and I told him, “I (took a breath) can’t (took a breath) breathe (took a breath).”

When you can’t speak a full sentence without stopping to take a breath, that’s called “clipped speech.”

It’s an emergency asthma symptom, so we drove to the hospital – fast! Good thing it’s only a few minutes away from my house! On the way, I was panting and trying to tell my husband that I couldn’t talk, and he would need to speak for me in the ER.

When we arrived at the hospital, they quickly took me to a triage room; the nurse listened to my lungs and said, “Well, you’re not wheezing, so…” and then shrugged.

The importance of having an advocate

I weakly pointed to my husband, who said, “She knows what she’s talking about. She works in public health and is a certified asthma educator. She doesn’t wheeze. Never has. But she has clipped speech, which is why I am speaking for her. And that’s an asthma emergency.”

I could have kissed him! I had taught him all about asthma, including medical terms, and he remembered!

The nurse was still dubious but agreed to give me a breathing treatment. My husband told her that I had been doing breathing treatments for 2 days, but I needed the next step – steroids, which was why we were there in the ER.

My husband also had to repeat the information to the doctor. He told the doctor that I’m an asthma educator and know the national asthma guidelines, and that I had clipped speech, had been doing breathing treatments for two days (in addition to using my daily controller inhalers), and needed a steroid.

They gave me a steroid shot and then later followed that up with another breathing treatment. I was there for several hours until the steroids kicked in, and I felt like I could breathe a little better.

I don’t know what I would have done without someone there to advocate for me. When your asthma symptoms are uncommon, having an advocate can make all the difference.

Navigating paroxysmal cough

Another unusual asthma symptom I experience is paroxysmal cough. Sometimes, I’ll cough so hard I will throw up. Doesn’t that sound fun?!

A paroxysmal cough is sudden and violent. It can make you gag, throw up, or pass out. For me, my eyes will also water when I’m coughing hard, and tears will stream down my face.³

The last time I had a paroxysmal cough, I was the only one home, and I started to panic because I was doubled over, coughing hard, and felt like I was going to pass out. My nebulizer was close by, so I quickly put the pieces together and sat on the floor to give myself a breathing treatment. That way, if I passed out, I wouldn’t have far to fall.

I have a smartwatch with a “fall detection” feature that will call an ambulance and notify my emergency contact (my husband) if I have fallen and I’m not responding.

When I have a paroxysmal cough, it’s impossible to use my inhaler because I can’t breathe in deeply enough; instead, my breathing is shallow and jagged. And – I’ll just cough the albuterol right back out again.

So, I use a nebulizer breathing treatment because I can sit and slowly inhale the mist. It takes a little longer, but works much better for me.

What are your different asthma symptoms?

Since asthma can be different for everyone, I would love to know what your asthma is like. Do you have any strange or different asthma symptoms?