The two types of asthma wheezes

I have written a couple posts explaining how you cannot hear bronchospasm without the aid of a stethoscope. I described it in my post, "The 9 Different Types of Wheezes" and "What albuterol does, and does not do."

Here is your question:

"My 10 year old son has asthma. Sometimes, I can hear him wheeze when he walks in the room. I put my stethoscope on him and hear wheezes throughout. He says it's hard to breathe. He uses his albuterol inhaler and feels better. I can't hear the wheezes anymore. I put my stethoscope back on him and hear improvement. So what am I hearing when I can hear him wheezing without my stethoscope? That wheezing is not his asthmatic bronchospasm?"

Here is my answer.

Great question. I observed the same thing in myself when I was a kid, that I would sometimes audibly wheeze when I was having asthma symptoms. My theory is you can't hear bronchospasm without the aid of a stethoscope. However, asthmatics also produce excessive amounts of mucus from an abnormally high number of goblet cells. This mucus makes it's way to upper airways, causing a wheeze as air moves throu them (it's usually just heard on expiration, although it may be inhalation and exhalation).

As air moves through these airways, an audible wheeze may be heard. I had many nurses tell me when I was a kid that my wheezes were audible, so they can't be bronchospasm. She was right to think that an audible wheeze was not bronchospasm. But what she failed to consider was that you can have both upper airway and lower airway (it's bronchospasm) wheezes at the same time.

Keep in mind this is just my theory. However, I have also been living with this disease, and studying this disease, for over 40 years.

Also keep in mind that both these articles were not meant to imply that albuterol has no place in the treatment of asthma attacks. It was to imply that not all that wheezes is asthma.