Donya Currie is the editor of The Free Lance-Star's Healthy Life section and Healthy Life Virginia newsletter.

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Can a nasty cough be a sign of asthma?

There’s a lot of misunderstanding about asthma and its symptoms, something I was reminded of the other day watching a discussion about it unfold on a friend’s Facebook page.

The friend had a terrible  cough, the kind that keeps you up at night. Initially diagnosed with an infection, she sought another opinion and was told she was having an acute asthma attack.

This time of year, when temperatures plummet like they have this week, asthma can hit especially hard. See how much you know about asthma by considering these myths and facts.

Myth No. 1: If you have asthma, you’ll know it because you’ll be wheezing so badly you’ll think you’re going to die. That’s true for some people, but while wheezing is a classic sign of asthma, it’s not the only sign. Some people — including me — cough a lot during asthma flare-ups. Others make a whistling sound when they’re trying to exhale.

Symptoms can include:

  • shortness of breath
  • tightness in the chest
  • wheezing
  • coughing, especially at night
  • fatigue

The common thread is inflammation in your airways. The inflammation leads to tightening of the airways, which can trigger asthma symptoms, said Dr. Andrew Kim, of the Allergy & Asthma Centers of Fredericksburg and Fairfax.

Things that can trigger a flare-up include allergens, cold air, infections and exercise (though exercise is just as good for people with asthma as for everyone else, as long as the condition is under control.) Kim said uncontrolled reflux is another trigger.

Cold air is a big problem for me, so this time of year, when I walk outside, I wear a black ski mask like this one. It’s a little scary looking but it keeps the cold air out so I can keep exercising without irritating my lungs.

Myth No. 2: If you didn’t have asthma as a child, you can’t be diagnosed as an adult. Not true. Plenty of people are diagnosed with asthma as adults.

“Sometimes, people develop allergies later in life, and allergic inflammation is a major risk factor for development of asthma,” Kim said.

And sometimes, a person who had asthma as a child simply wasn’t diagnosed then — the symptoms were chalked up to bronchitis or other upper respiratory infections.

That was the case with me. I coughed so much at night as a kid that my brother once told me he thought about smothering me with a pillow. But doctors generally diagnosed bronchitis (and asked whether I smoked). Not until I had trouble breathing on a mountain biking trip at 9,000 feet, and consulted a doctor afterward, was I diagnosed with asthma.

Myth No. 3: Asthma medicine is addictive, so you should avoid using it. If you have asthma, you should consult your doctor about the best treatment plan for you.

“All asthmatics will be given a “rescue” inhaler that can provide immediate relief if you’re in the midst of an attack,” Kim said in an email. “Depending on the severity of your asthma, you may also be prescribed a maintenance inhaler that you take daily to keep your symptoms under control.”

During a flare-up, you also might get an oral steroid like prednisone to take for a while.

Asthma medicine is not addictive, Kim said. And you may not need to take it for as long as you’d think.

“In fact, once asthma is well controlled, your doctor will typically taper down or stop “maintenance” inhalers and use your “rescue” inhaler only as needed,” Kim said.

Kim also noted that allergy shots can help people with asthma minimize the need for medications. If your asthma is triggered by an allergen, shots can desensitize you to the allergen, and that can reduce inflammation in your airways.

If you have asthma, be mindful that these cold days can be tough. You may need to stay inside more than usual. You may need to use an inhaler more than usual. And if you have to go out – because of work or a dog that needs walking – I recommend gearing up with a face mask. You can check out a selection of them here.