One of the things that you should recognize is that the closing of your airpipes is basically your bodys defense against the lowering CO2 levels caused by you breathing more than is appropriate for the amount of physical work you are doing. It is your defense against your releasing more CO2 than you produce.
So when you suck the Asthma Relief chemicals into your airpipes, their powerful effect over-rides your defense, and allows you to breathe as deeply as your breathostat wants you to. It is a great feeling of relief when the airpipes are pushed open again, and you are able to go back to breathing many times more air than you need. Aaaahhhhhhhh.
If you use a drug with a long action, you can breathe as much as you want all day. Almost no restriction at all. The only problem is that after a while, it may be days, weeks or years, your defenses will start to get a bit more serious about stopping the CO2 loss [which it knows is fatal].
An Example of the Development of Severe Asthma
Let us follow the development of a typical asthmatic. Let us say the young boy had a cough [bronchitis] during childhood, and probably some hay fever. As a teenager, the cough reduced, but was replaced by a restriction in his breathing, usually very early in the morning, or when he exercised.
A worried parent took him to the doctor, who did various measurements, and the doctor diagnosed, “Asthma!” The shame of this was hidden, and the teenager instructed on the use of a puffer [let us say “relief-puffer”]. At the start, all it took was two puffs, every now and then, say twice a week, and the wheeze disappeared like magic. Not too bad.
Later in the same year, the winter was quite nasty. He found he needed to use the puffer more and more. His mother, having read about the increased death rate associated with high use of puffers returned him to the doctor. “Ahh” said the doctor wisely, “we will need to introduce a .preventative puffer”, as this has been shown to reduce the death rate that had apparently risen because of the increased use of the relief-type puffer.
He had to take the preventative puffer every morning and night. “Is this for the rest of his life?” asked his mother. “Very likely, but we will see,” said the doctor.
Despite the new puffer, he began to get more and more tighter, more and more often. The two puffs of relief puffer no longer worked well enough, so they bought a machine that sprayed the chemical out of a mask he wore on his face. This gave pretty good relief, but on some days he needed it 3 or 4 times. He was a large teenager, so he received the full adult dose, and made sure he used all of it. [Note: .1 puff of relief puffer is 1/ 10,000th of a gram. A full nebule of relief puffer is 50/10,000th of a gram. So one nebule is equal to 50 puffs, but a lot gets out of the sides so let us say it is equal to 25 puffs from the relief puffer.]
Mother is getting very worried now, has been back to the doctor, who has doubled the dose of preventative puffer and referred them to a “pulmonologist.” This doctor sees mostly asthma, and is considered the best in the area. He immediately does more tests involving mostly huffing and puffing, and puts our lad onto 50mg of oral steroids per day, for 6 days, then on a reducing amount. This reduces the asthma, and two weeks later, only puffers are needed. A few weeks later, it all starts again.
The family learn to live with it, and have some periods of good health. Their pulmonologist sees them every month, and gets hold of new drugs earlier for them to try. Which work for a while, but then seem to fail, a trip to the emergency ward is made about twice a year.
Then, after 8 years, the family moves to a different area near the beach. The lad takes up surfing, and within 1 week the asthma has stopped. A call to their pulmonologist gets the reply that this happens quite often, .they seem to just grow out of it.
This story illustrates how the amount of relief medication needed usually increases with time in many people. Others never need much more that a couple of puffs a day.
What is really happening? Your overbreathing pattern is causing you to lose more and more CO2 from your lungs. When it gets low enough, your body acts to trap more in. When you feel this restriction, it feels unpleasant and you feel you are not getting enough air. The bronchodilator you take tells the air pipes to open up. [Turns off your defense, and stops it for about 4 hours.] This means that you can return to the breathing that caused your need for the defense in the first place. If your breathing has not improved when the drug wears off, your defense will start again. You will want more drugs, to improve your airflow again.
Over a period of time, this will cause you to need more and more of the drug, as your body becomes more resistant to it. Where one puff per day was enough before, you may start to need many more puffs, plus the addition of other drugs. If this loop continues without an improvement [decrease] in your breathing, your body will work harder and harder to stop the CO2 loss, until the point where hospitalization is needed because your airpipes no longer respond at all to your drugs.
One technique that has been shown to help people with this issue is the Buteyko Breathing Method. The Buteyko Breathing Method teaches you to use your breathing to trap in more CO2 at the first sign of asthma, and after a short time use your fast acting, short acting drugs then only if needed.