Gemma’s comment:
In my teens, I attended a boarding school in northern New York State. I found that in winter I could always develop a noisy wheeze if I opened a window and took big gulps of cold air. The choking cough and noisy breathing that followed was enough to get me excused from what was called winter “sport” (usually shoveling snow off a basketball court!), and that was what I wanted. I didn’t think I was sick, just smart. Certainly, I never discussed these symptoms with a doctor, because they served me well: they excused me from unwanted activity. Of course, such wheezes might not have been diagnosed as asthma . . .
Yes, most individuals with asthma can recognize when they are wheezing. They may become aware of the abnormal sound of wheezing as inhaled air travels though narrowed bronchial passages. One might say, “It sounded like a cat purring in my chest.” Others may notice an uncomfortable mid-chest pressure. Wheezing should never be ignored or dismissed as unimportant.
The most reliable method for a physician to detect a wheeze is by performing a physical examination that includes auscultation of the lungs with a stethoscope. The physician places the chest piece of the stethoscope on the patient’s upper torso—over the front, back, and sides— and listens as air enters and exits the lungs. The patient takes several deep breaths, breathing through his or her mouth, as quietly and smoothly as possible. The physician pays close attention to the symmetry of the breath sounds and to any audible abnormalities, such as wheezing.
In a variant type of adult asthma called cough-variant asthma, wheezing is absent, and a dry, nonproductive cough is the major symptom of asthma. The emergence of wheezing, or of persistent dry cough in the case of cough-variant asthma, is always significant and must be reported to the treating physician. The development of wheezing indicates inadequate asthma control and may herald the beginning of an exacerbation of the disease. The same is true of a cough in cough-variant asthma because the cough is equivalent to a wheeze.