I guess I didn’t knock on wood hard enough or maybe I was fooled by a full month of good breathing. Whatever is was, It caught me off guard as usual . As of yesterday, I’ve slipped back down into my yellow zone and I’m starting to air-trap… big time.
This is the one aspect ( or symptom if you like) of this disease, that I dread the most and here’s why;
It comes on out of nowhere, its extremely uncomfortable because it makes you so short of breath, it can last for several days and most asthma medications don’t help . You’re kind of in limbo. You’re sick, but you’re not sick. Your peak flows are near normal, but you feel like hell. You rarely wheeze, but you’re still very short of breath. There are times when I would much prefer an intubation rather than breath like this. It takes a lot out of you. For me its very frustrating because it makes walking very difficult. On some days , like today, Im just too dyspnic to walk at all.
So what does air-trapping feel like? To give you some idea… Take a normal size breath in. Now, exhale only half of that breath out, now take another breath in, then half out. And so on and so on……See how long you can keep that up. This feeling of not being able to fully exhale, can be extremely uncomfortable and the symptoms can vary from mild to severe. Breathing this way can make you very anxious , which in turn ,can make your breathing worse. The good news (if there’s any), is that ,unlike a full blown asthma attack ,the symptoms of air trapping are pretty much self limiting and rarely progress to the point of an actually medical emergency, though it does happen.
So what’s really happening here? Well, without getting into all the technical lung mechanics involved, air-trapping is usually caused by flabby, spasmotic, clogged and/or inflamed air passages. In severe asthmatics and people with COPD, air trapping is also caused by the loss of alveolar attachments ( little fiber bands that pull the alveoli open from the outside).
During normal breathing, the act of inhaling is always an active process, requiring several muscles… the main one being the diaphragm. When you take a breath in, the diaphragm muscle contracts and pulls down causing a vacuum effect in your chest cavity. The airways are literally pulled open by this negative pressure and your lungs fill with air. Exhalation on the other hand, is normally passive…. kinda like letting the air out of an inflated balloon. Its not supposed to take any effort! Well, if the airways get clogged up in any way, in order to overcome that obstruction, you literally have to squeeze the air out of your lungs. Naturally you can’t squeeze all the air out, but with all the extra effort needed ,you’ve now turned the act of exhaling… into a workout.
The way you actually sense this respiratory discomfort depends on how your lungs are wired to your brain. You also have what they call stretch receptors. Some people sense the slight change in the way their lungs are working ( called over perceivers). Others don’t notice it as much ( under perceivers). The bottom line, is that this sensation is telling you that something is wrong.
Is air-trapping dangerous? In and of itself, not really. More than anything it’s just extremely uncomfortable. However, in combination with other asthma triggers, it can make a mild exacerbation much worse and can prolong the recovery time.
So how do I cope with it? I just do! I just prepare myself for a few days of hell. Sometimes Ill practice some diaphragmatic breathing exercises, though there’s no scientific proof that it help, and sometimes I take anti-anxiety meds ,but they make me too sleepy. So I just do the best I can until my lungs decompress.