How do you deal with your exercise-induced asthma?

October 8, 2007 11:27 AM

How do you deal with your exercise-induced asthma?

As a teenager, I was diagnosed with exercise induced asthma. It only was an issue when I was involved in strenuous activity. I was a competitive swimmer, so I would use my inhaler before swim meets.

Now, I am an adult, and haven't used any medication for about 12 years, and have started more strenuous exercise. I start to have trouble breathing when I get to a certain point.

What treatments are people using these days? I'm assuming since I don't have my medical records from then that I'm going to have to go get re-diagnosed. Do people have any techniques for not using medication?

posted by hazyspring to health (14 comments total)

I also suffer from mild excercise-induced bronchiospasms (EIBs). The medication hasn't changed much in the last decade, though the delivery systems are a little different. It's still the same family of corticosteroids (e.g. Advair) for prophylaxis and inhaled stimulants (e.g. salbutamol) for relief. Caffeine provides some relief to asthma unless you are allergic to caffeine (as I am).

If you shun medication, you will have to accept diminished athletic performance. Not a big deal if you just want to stay healthy and lose weight, as moderate (but consistent) excercise is the best recipe for success anyway. But if you want to be competitive for your age group, then get medicated.

I'd suggest getting an inhaler as a matter of course for emergencies. You never know when your asthma might suddenly flare up into a dangerous attack.
posted by randomstriker at 11:42 AM on October 8, 2007

Oh yeah, you'll probably need a new diagnosis. Basically you blow through this tube that measures your airflow. You then take a puff from an inhaler, then blow again. If there's a significant difference before and after taking a puff, then you need the medication.
posted by randomstriker at 11:44 AM on October 8, 2007

A recent discovery is that some folks with EIA are actually allergic or sensitive to gluten, which is a protein found in wheat, barley and rye. If cutting that out of your diet seems possible, you might try it for a month or two and see if it helps. It's harder than it sounds, though - gluten is in a lot of very common foods.
posted by ikkyu2 at 12:08 PM on October 8, 2007 [2 favorites]

When this happened to me this year my doctor determined the fact that I was caffeinateing myself before running was the trigger. I cut the caffeine out and it stopped.
posted by sourwookie at 12:11 PM on October 8, 2007

Hmm. Makes my scenario the opposite of randomstriker's.
posted by sourwookie at 12:12 PM on October 8, 2007

ikkyu2, thanks for mentioning that. I have EIA and had never heard that. For anyone who is interested, here is a list of gluten-free foods.
posted by triggerfinger at 12:18 PM on October 8, 2007

For my EIA, I take an inhaled corticosteroid every day, and I keep albuterol on hand for when I need it. I find that the chlorine in most swimming pools can trigger problems, which is ironic since swimming is supposed to be good for asthma. I'm fine for most exercise, but running will always be hard for me. I tend to stick to biking, hiking and (some) swimming.
posted by bassjump at 12:21 PM on October 8, 2007

I was diagnosed with nonallergic asthma years ago, and it turns out the diagnosis was just plain wrong. I manage my allergies pretty aggressively and have no trouble with strenuous exercise.
posted by caitlinb at 12:48 PM on October 8, 2007

The biggest breakthrough in recent years is Advair, which is a combination of an inhaled corticosteroid and a long acting beta agonist. Studies have found the surprising result the that combination drug is more effective than taking the two separately. You can get Advair in three different dosages in which the long acting beta agonist is the same, but the corticosteroid component varies. In your case, if you have mild symptoms generally, you could use the lowest corticosteroid dosage. The side effects of low dosage inhaled corticosteroids are very minimal.

Going backwards, the previous major advance was the long acting beta agonists (LBA). Serevent (salmeterol) is the LBA in Advair and can be used separately. It is a bronchospasm prophalactic. It doesn't treat acute symptoms.

You are probably familiar with the short acting beta agonist abuterol (Proventil, Ventolin, etc). These work for treating acute symptoms but their effect is short. When you use albuterol alone, your symptoms follow a rollercoaster throughout the day as the drug wears off between doses.

Serevent, on the other hand, eliminates this rollercoaster effect so that your lung function is pretty much a good flatline all day and night. For Serevent to work properly, you must take it twice a day, every day as a preventative.

One of the most effective treatments for exercised induced asthma is to use Serevent every day to improve your overall condition and to use a dose of albuterol shortly before you begin exercise to prevent acute bronchospasm. You may find that Servent alone works so well that the albuterol is unnecessary, but the combination is very effective.

So the three treatments in increasing aggressiveness are short acting beta agonists (Ventolin, etc), long acting beta agonists (Serevent, etc) and corticosteroids (Advair which is Serevent plus steroid). These can all be used in combination as needed. Don't be shy about aggressive treatment. The most important factors are quality of life and prevention of long term damage.

Allergists are much more aggressive in treating asthma symptoms than in the past. You may find that you have mild background asthma symptoms even when you aren't exercising that you are not aware of. Only pulmonary tests can tell. Researchers have found that a lifetime of mild symptoms can do permanent long term damage to your lungs, making more aggressive treatment beneficial.

Of course all of this is conditional on your seeing a physician to determine if you are a candidate for these drugs.
posted by JackFlash at 12:54 PM on October 8, 2007 [1 favorite]

I've had asthma since I was 3, exercise and allergy induced, coupled with other allergic symptoms like hay fever, conjunctivitis and eczema. 7 years ago, I took a a Buteyko breathing course, and practiced consistently for about 5 months afterwards. Since then I have not had any asthma or any of the other symptoms. Surprisingly (or not) It also gave me a fitness boost without going to the gym. I realized after doing this that I could just go out and run for miles without any symptoms or tiring out (except for my legs).

Buteyko breathing is a russian approach developed by a russian doctor who over 40 years ago noticed that asthma sufferers (as well as other chronic diseases in the family) seem to be chronic hyperventilators when they are NOT symptomatic. A good non-commercial site about it is Peter Kolb's.
posted by blueyellow at 12:59 PM on October 8, 2007

What ikkyu2 said. When I stopped eating gluten, my asthma and eczema went away FOREVER, which is very exciting. Avoiding gluten is not really hard. It's hard for about six months, and then it's like being a vegetarian, I think (I'm not a vegetarian). I had a lot of other symptoms to movtivate the diet change, though...
posted by Eringatang at 1:21 PM on October 8, 2007

I do interval training, which lets me get the benefits of strenuous exercise without getting me into the "bad breathing " zone. An example of what I do is: sprint one lap, walk the next, repeat. There are lots of studies showing interval training has many benefits. I don't have a problem with asthma unless I overdo it, so I didn't want to bother with drugs.
posted by melissam at 7:33 PM on October 8, 2007

Other asthma drugs:

Singulair, a tablet taken every day, not chemically related to any of the above.
Intal, an inhaler that should be used every day but usually isn't prescribed that way. Also unrelated to any of the above.
Tilade, an inhaler related to Intal that is probably more effective for more people but less widely known.

None of these drugs are steroids. Inhaled steroids get a bum rap though - it's theorized that regular inhaled steroid use can halt progression of the disease, a pretty good thing if it can't be cured or reversed.

I've been using Tilade, an inhaled steroid (originally Vanceril, now Flovent) and occasional albuterol every day for ~15 years. I regularly ask other asthmatics what meds they take and have never met anyone who took exactly the same drug cocktail as mine. My son takes Singulair, Zyrtec, and Advair. His mom uses only occasional albuterol. The point is, no two people are the same - their attack triggers, the details of the actual attacks, the drugs that work for them - all very individualized. Don't make the mistake of thinking your friend's (or your sister's) meds will necessarily work for you.
posted by prcrstn8 at 7:34 PM on October 8, 2007

Advair, taken twice daily, has eliminated my exercise-induced asthma. I don't even carry a rescue inhaler half the time.
posted by chickaboo at 1:12 PM on October 9, 2007