Sometimes it starts as a high whine in my throat, a soft whistling as I inhale.
Sometimes it starts in my shoulders, as I hunch up and lean forward, in search of elusive oxygen.
Sometimes it starts with a gentle cough. Nothing moves, but I keep coughing anyways, coughing until I'm in a slightly dry-feeling pain.
These episodes follow a predictable course: a reach for my bag, a little fumbling, and then my fingers close around a very slightly pebbly plastic case. I pull it out, caressing the plastic, and pull off the pink cap. The feeling of the medication as I suck it into my lungs is a delicious metallic sensation, and an emotional relief swells as my breathing pattern resets. I can feel my blood racing and my head pounding a little as I replace the cap, and I remember the druggie kid I knew in college who once asked me if she could use my albuterol inhaler to get high.
Sometimes I follow this with puffs of other inhalers, medicines in greenish teal or brownish orange plastic casings, to prolong my renewed ability to breathe like a normal person.
The frightening times, the ones that panic me, are the times when this does not work. I recently had a reaction to an allergy injection. First my blood felt on fire, then my palms started itching, and suddenly my lungs were in a vise. Hit after hit of aerosol albuterol failed to work, and it was unbelievable to me that I got progressively worse for almost 20 minutes before the epinephrine injection started to kick in. I never knew I could get worse than a certain awful level, and if I hadn't been so frightened I probably would have passed out. The truly eerie part was, 45 minutes later I felt exhausted but otherwise completely normal. My doctor had held me through the experience, and my nurse stood there and fanned me to cool me down. My breathing had gone from completely normal to almost completely blocked to completely normal in under an hour. As my breathing passages relaxed, I touched my face and realized I had been crying, probably due to the emotional trauma of being unable to breathe.
Even though these times are rare, they always exist as a possibility in my mind. When I exercise, when I walk from a warm building into cold winter air, when I spend too much time in a bathroom with heavily scented soaps and perfumes, I wonder what it is like for others to experience these everyday occurrences without worrying about how quickly that inhaler can be located. I wonder what it's like to be somebody who didn't ask her parents for a nebulizer for her 17th birthday. I wonder what it's like to go to bed each night knowing that breathing inability will not awaken me.