Asthma

March 14, 2005 8:31 AM

Anyone here get asthma?

I've had mild asthma all my life and it's fairly well controlled with preventative and attack inhalers. I'm over 40, in good health but never been physically fit. For the last couple of months I've been taking the football (the round one) to the park several times a week as a way of getting some exercise before middle age takes over completely. Of course, I knew it wouldn't be easy and I knew a state of physical perfection wouldn't happen overnight, but exercise-induced asthma is really hampering my efforts. My leg muscles have settled down and I (usually) look forward to the nightly kickabout, but a gentle jog of only a couple of hundred meters is all I can manage before wheeziness overwhelms me and I turn to my inhaler. I then walk, or practise bending it like Beckham, until my breath returns and I can do a little more running.

Have any AskMeFites dealt with this problem? Googling brings up very general asthma answers: using the inhaler before exercising (I find it can make things worse); doing some "gentle 200 meter sprints" to warm up (200 meters?!?! Who dey kid?). Anyone have any tips for overcoming shortness of breath?

posted by TiredStarling to health & fitness (20 comments total)

I have exercise-induced asthma, and I use ADVAIR every morning. It is the first medication I have ever used that completely cures this problem. It has, in effect, changed my life.

Sorry if that sounds like I am shilling for this product, but I have been in and out of hospitals all my life for Asthma, chronically sucking back ventolin inhalers by the truckload. Advair has completely reversed this for me.
posted by Quartermass at 8:38 AM on March 14, 2005

As Quartermass suggests, you need to talk to your doctor about being put on a preventative program. Rescue inhalers are fine for when you unexpectedly have an attack, but ideally you'd prevent them. Sometimes it's advair, sometimes it's a combination of a couple of inhalers that you take every day, your doctor should be able to help you find something that works for you.
posted by jacquilynne at 8:42 AM on March 14, 2005

I have exactly the same symptoms and again I'm not the most active guy in the world, but I found that taking a ventolin to the park and puffing once rather than twice when it starts to set in solved the problem.

I also found the symptoms were significantly reduced the fitter I got. You've probably got a bagload of mucus sitting around in your airways and as it gets (exhaustedly) wheezed out it will irritate your windpipe. The more often you exercise and shift the muck, the less muck there will be to shift and the less irritation.
posted by NinjaPirate at 8:49 AM on March 14, 2005

I have mild asthma, I find that using my inhaler before any serious exercise [the two puffs routine, five minutes apart, AT the park, not at home] does the trick for me. I've also found that cutting down on wheat/dairy in the morning when I know I'm going to be exercising [NO bowl of corn flakes NO muffin, NO toast] also helps. Also, and this is probably not helpful, a lot of asthmatics find that their exercise-induced asthma is NOT triggered by swimming, if you'd consider that a good exercise outlet.
posted by jessamyn at 9:13 AM on March 14, 2005

i've had very mild exercise/stress/exhaustion induced asthma a couple of times in my life, only. i wouldn't have bothered posting, except that it seems relevant that those were all before i started running. running seems to have improved things, for me. so in the long term hopefully the exercise will be a gain.
posted by andrew cooke at 9:19 AM on March 14, 2005

Quatermass: sounds like we should start an Advair fan club.

I was diagnosed with severe asthma when I was a baby, and usually had one or two emergency room visits a year. I've been on it all, albuterol, maxair, serevent discus, daily nebulizer treatments, combivent, accolade... (the list goes on and on, really).

The combination of Advair and Singulair has changed my life. I went from using my inhaler 4 times a day to using it maybe 1 or two times a week. Truthfully, I didn't realize it could get any better than constant inhaler use.

What prompted me to ask my (wonderful) doctor is that I was trying to do exactly what you are, TiredStarling, and get some exercise into my life (burning 400 kilocals on the elliptical machine 3 or 4 times/week).

I'm only 21, and I don't want to waste what's left of my youth being so overweight.

Oh, and what jessamyn said re: diary. Dairy is bad for asthmatics... increased mucous production makes it hard to breathe. I had trouble believing this until I took dairy out of my life for a while, but it actually does make a difference and is not just hippie-vegan-peta-mumbo-jumbo. (I haven't tried the wheat gluten cutting-out diet though.)
posted by chota at 9:35 AM on March 14, 2005

I used to have fairly severe allergic asthma (a bad attack would leave me unable to walk across the room) before I started cycling, but my experience parallels that of NinjaPirate: the asthma greatly decreased in severity the fitter I got.

Initially I'd always take along a ventolin inhaler (which would stop an attack in the space of minutes) and I built up the distances I'd ride slowly. Over the space of two or three years I went from being totally winded after riding about a mile to being able to ride thirty miles plus with no problems. At the same time attacks caused by the allergy greatly reduced in severity: after five and a half years of riding the bike regularly they've gone from being incapacitating to being nothing more than a couple of hours discomfort at worst.
posted by arc at 9:56 AM on March 14, 2005

I've been asthmatic most of my life (25 of my 30 years). My disease was getting worse, at least with exercise, despite daily Serevent + Azmacort (similar to Advair).

When I started on Singulair about a year ago, my exercise-induced asthma went away. Singulair, I guess, works only for about half the people that try it.

I can now go from zero to full bicycle sprint (to catch the caltrain, usually) and not have any symptoms. Two years ago, I would've taken the whole hour long caltrain ride to recover from the asthma induced by a sprint to the train station.
posted by u2604ab at 10:07 AM on March 14, 2005

I had horrible exercise-induced asthma until I cut all dairy products out of my diet. It went completely away after about a month - pretty amazing. When I say horrible, I mean like spending 9 days in ICU under an oxygen tent once because I had an attack while exercising with a cold, and never being able to even climb one flight of stairs without some shortness of breath afterwards. But I couldn't stand living the rest of my life on inhalers and meds so I changed what I ate. It's a pretty drastic way to overcome shortness of breath, but whatever works.
posted by iconomy at 10:34 AM on March 14, 2005

I, too, have had good results from singulair. I work out 2-3 times a week, 30 minute walk/jog and 30 or 45 minutes of free weights. As noted above, I've gotten good results from using my inhaler before or during the workout. (In my case, I usually take two puffs between the running and the weights.) Some good preventative medication of any sort goes a long way in addressing these problems. Are you taking any sort of medication, or just the inhaler?

Also: "baby steps." I don't know what you're doing, so I can't tell if you're overworking yourself, but be patient. Fitness (if you'll forgive the pun), is a marathon, not a sprint. When I first started, my distance and speed (running) and weight and reps were both laughably tiny. Gotta start somewhere, and (if you're anything like me), the breathing problem will start to diminish as you continue exercise.

(PS: Also, I prefer a walk/jog to a run. Better on the knees, easier on my lungs, and with almost identical caloric payoff.)
posted by absalom at 10:39 AM on March 14, 2005

I have Moderate Persistent Asthma, and take two daily meds. Like the others, I consider Advair a godsend. I take that twice a day along with Accolate once a day, and I only have to take my rescue inhaler maybe once every two weeks or so.

When I did ballet, I'd take a puff of the rescue inhaler about 15-20 minutes before the start of class. By the time class started, it had already kicked, in, and I would have no problems breathing. (Of course, shaking from the high like a cracked out bunny in a leotard and ballet slippers while trying to do jumps was a different matter - but at least I could breathe!)

I'd talk to a doc about your asthma. I've had it since I was a kid, but it didn't get bad until I was 27; that's when I started on the maintenance medications.
posted by spinifex23 at 10:39 AM on March 14, 2005

I have exercise-induced asthma, and I use ADVAIR every morning. It is the first medication I have ever used that completely cures this problem. It has, in effect, changed my life.

Sorry if that sounds like I am shilling for this product, but I have been in and out of hospitals all my life for Asthma, chronically sucking back ventolin inhalers by the truckload. Advair has completely reversed this for me.

Yep. It's a fantastic drug. I use it twice a day and my ventolin use has gone way down, to almost zero, and this from a lifelong asthmatic with a heavy emotional attachment to inhalers (one of my very first memories is the doctor making a house call while I was having an attack, and giving me a magical hit of whatever they gave asthmatics in the 1960s; the relief was something I've never forgotten).

TiredStarling, unless I am misreading your post, I don't see that you are currently exercising somewhere other than the park, which is probably loaded with potential allergens, tree pollen, dust, car exhaust, etc. You might find that exercising elsewhere would be a different experience, and could be worth giving it a go if you haven't already, just to check out what effect the environment might be having on your reaction. Good luck; gaining cardio fitness does make a difference, but even when I am reasonably fit getting a faceful of bus exhaust will do me in. I exercise in a gym, and never have difficulties there.
posted by jokeefe at 11:08 AM on March 14, 2005

I had asthma since age 3 (currently 34). In high-school I had a very hard time running. After 2 laps at the gym I would need many puffs of ventolin and hours to recover. However, now I am completely symptom free without any drugs at all. In 2000 I took a course given by Alexander Stalmatski (book)
on the buteyko method of breathing exercises. I did the breathing exercises prescribed religiously for 5-6 months at the end of which not only had my asthma been eliminated but I got some instant fitness. I could just go and run 3 miles without any problem. This is my personal experience and I am quite convinced that I am not unique. There is signifcant physiological theory on the mechanisms underlying this approach. For a non-commericial source of information I recommend this site.
posted by blueyellow at 12:40 PM on March 14, 2005

I'm asthmatic too...but i guess i'm in the minority when it comes to advair. It tends to irritate my airway and gives me coughing fits all day and doesn't do much in terms of preventing attacks (though to be fair to the makers they do specifically say that african american women should not take advair - for whatever reason).
I use albuterol/ventolin and find that 2 puffs before any strenuous activity seems to keep the wheezing at bay.
posted by ramix at 1:03 PM on March 14, 2005

For me, (and I assume others) it is very easy to tell the difference between the change in breathing caused by the exercise, and the change in breathing that means I'm going to have asthma in a few minutes, even though the later often occurs in the midst of the former. The easy route for me is taking one puff of ventolin at the first sign (ie significantly before it results in sufficient shortness of breath that you're tempted to pause the exercising for a minute or two), and stopping the exercise while doing this, seems to stop things in their tracks for me.

However, the less easy (though probably healthier) solution for me is to ease right up on the exercise (though not necessarily stop) when noticing that first sign, and I find the asthma will not develope into an attack, but will still worsen for a few minutes, then go away, and once it's gone, it's gone for good.

Funnily enough, it seems to be much MUCH harder (or take much longer) for it to go away on its own if I'm aware of it (watched kettle never boils), so I think about other things for a while. An MP3 player may help in this respect.

Lastly, I took a job on the other side of the world. When living in this other contenent (North America) I have basically no asthma at all! I stop my preventatives and it makes no difference! I go back home for vacation, and it's the same there as it always was. I read somewhere that asthma can be the result of the body reacting to something in the environment (eg pollens in the air), and that if you can live in a place without whatever that is for 3+ years without returning, your body loses the antibodies, and you can return yet the asthma remains gone. I take a vacation home each year, so no luck for me, but just thought I'd pass on this yellow-brick-road-to-a-cure story :-)
posted by -harlequin- at 1:05 PM on March 14, 2005

I too have pretty bad exercise-induced asthma. Taking Singulair has made a huge difference. I almost never need my inhaler before aerobic activity now, unless I've been sick or the pollution level has been too high for too many days. Before Singulair, I found using my inhaler(bronchodialtor) at least 20 min. before aerobic activity was the key. Any closer to the activity and it didn't work well enough.

Aerobic activity is so much more enjoyable now that I can get enough air in my lungs without my heart racing from an inhaler. Strangely, I've always been a fast walker despite my asthma. I finally realized I was tearing up the hills and such because the sooner I got to the top the sooner it would be over and I could breathe again.
posted by lobakgo at 1:15 PM on March 14, 2005

blueyellow:
Are the buteyko breath exercises something you do each day for a period (much like exercise itself), or do you try to train your body to breath differently 24/7?

How much effort/work/time was involved?

(The info in the link concentrates on why it's good, etc, and isn't giving me a good idea of whether it would be worth the hassle since my asthma already doesn't bother me where I'm currently living)
posted by -harlequin- at 1:15 PM on March 14, 2005

You're describing dyspnea on exertion. Exercise induced asthma is one of the things that can cause this symptom, but it's not the only one, and it's certainly not the first thing I'd be thinking in a 40+ year old.

You should see a doctor.
posted by ikkyu2 at 1:48 PM on March 14, 2005

Like others here I have this symptom and have used Albuterol about 20 minutes before exercising to prevent it. Before that I had had this symptom for my entire life and always assumed I just needed to be in better shape. It was when it worsened, at the same time that I was training and competing regularly in a very aerobic sport, that I realized that perhaps I was in relatively good shape already and something else was wrong. That was when the asthma was finally diagnosed, and the inhaler before exercise made a huge difference.

Now I am on daily Advair as well, which has helped a lot in general, but I still need the inhaler before skating, running, etc. (Singulair didn't work for me, darn it.)

Serevent is also prescribed as a preventative for exercise-induced asthma -- until I started taking Advair daily I used Serevent 30 minutes before exercise, and it worked too.

Anyway, ikkyu2 is right on -- under the circumstances, it's probably a good idea to see a doctor.

For me, (and I assume others) it is very easy to tell the difference between the change in breathing caused by the exercise, and the change in breathing that means I'm going to have asthma in a few minutes, even though the later often occurs in the midst of the former.

-harlequin- , it was not that easy for me, because I had had lifelong symptoms that no one diagnosed as asthma. (I don't wheeze audibly, generally, but when I have an attack I cough and gasp like crazy and my chest hurts. And I have the lovely frequent bronchitis/pneumonia that goes along with it -- though Advair has made a huge difference on this.) So I was so used to that feeling whenever I exercised that I was never sure if I was really feeling asthma or not. It took some time, along with daily use of a peak flow meter, to understand how the asthmatic response differs from a normal one in my case. Now I know, but I remember at first being very unsure if I really had asthma, because I always thought it was supposed to feel different, somehow. :) In the original poster's case, he sounds like he was diagnosed at a younger age, so he's probably more familiar with the way his asthma works.
posted by litlnemo at 7:46 AM on March 15, 2005

harlequin:

You can get immediate benefits like being able to end an attack without an inhaler in a few minutes.

The exercises require about 20-30 minutes once or twice a day for a period of time that depends on your current condition (your initial control pause).

The thing is that once you have attained a sufficiently high control pause you don't have to do the exercises regularly anymore as you have effectively "reprogrammed" your mind/body.

So in my mind it is very much worth it as you put in the effort once and enjoy the benefits for the rest of your life.
posted by blueyellow at 4:44 PM on March 15, 2005