Breathing and running at the same time is hard!

April 12, 2015 3:07 PM

I am making an appointment with my doctor to talk about exercise-induced asthma. She expects to prescribe me an inhaler. What will that be like? Has an inhaler significantly helped any of you with running or other cardio exercise?

Specifically, I feel like there is a heavy weight on my chest when I run for even extremely short lengths of time. With Couch to 5K-like programs, I can eventually get to about 20 minutes without stopping or walking, but it's painful. I am strong enough legs/muscles-wise, thanks to strength training; it's just the tight chest that stops me.

I've never used an inhaler. Are there specific kinds that are better than others for exercise-induced asthma? (I trust my doctor will choose the right one, but I'm interested in your experiences.) Is it likely to make a big difference in my cardio endurance? Anything else I should know?

posted by dayintoday to Health & Fitness (10 answers total)

I didn't realize how much my exercise-induced asthma was affecting me until I started using an inhaler before I exercised. I use albuterol, which I think is fairly standard for people with pretty mild asthma. Basically, I thought that feeling like you were about to keel over was part of the experience of exercising, and it turns out that it's not! I still get tired and even out-of-breath sometimes, but I don't get that tight, gaspy, panicky thing. I don't think that I experienced any immediate improvement in endurance, but I did find it a lot easier to stick with a program when exercising didn't feel completely awful, and so my endurance did eventually improve.
posted by ArbitraryAndCapricious at 3:33 PM on April 12, 2015 [5 favorites]

Your doctor may prescribe ventolin, a "rescue inhaler" if you truly have exercise-induced asthma. It's the typical "puffer" you see on tv and in movies. It's not intended to manage your condition, but instead "rescue" you when you have an asthma attack. If you use it more than twice a week, you should really get "controller" medications. Controller medications are taken daily and prevent asthma from occurring at all; if you take those medications then you should never need your "rescuer."

Ventolin is not great because the accelerant in it can damage the lining of your throat over time.

So, if your doctor prescribes "controller" medications that you take daily, trust him/her and take them.

Some athletes receive a "beta-agonist" to prevent asthma before working out. You may get that, but then again you are not an athlete, and your asthma is likely the result of your physical health.

For me, hayfever, if unmanaged, can trigger asthma. Or serious colds. I used to take asthma medication but I don't anymore.
posted by Nevin at 3:35 PM on April 12, 2015 [1 favorite]

The blue ventolin (albuterol) inhaler is a "rescue" inhaler and it does an amazing job of opening up the airways right away for me. It takes away the problem of having to quit running simply because I can't breathe. So I can keep running until I'm actually tired. I take a puff or two about five minutes before I do any cardio, and then I'm fine. Or if I'm having an attack because I forgot to take it, then it opens the airways up.

If you only have this problem while running and never at any other time, the blue might be all you get. But if you're running often, and need to take this daily, then they might give you another steroid-based inhaler as a preventative treatment.
posted by lizbunny at 3:40 PM on April 12, 2015

I've had like half a dozen friends get diagnosed in the past year, and every single one of them has reacted after their first use with WHERE HAS THIS BEEN ALL MY LIFE??!?

Several of them did end up going through at least a period of ongoing treatment (and one ended up going on allergy shots because they were just too bad to get on top of with regular allergy medication), it wasn't a big deal except that their workouts were so much better.
posted by Lyn Never at 3:40 PM on April 12, 2015 [2 favorites]

Chalk me up as another one of those "where has this been all my life" people. I grew up with a bit of wheezing thanks to irritants and a lot of shortness of breath and feeling like my throat and chest were tight when exercising (and I was a very active kid). I'd be clutching my knees and struggling to breathe during tough workouts and sports practices. I just figured I was out of shape (definitely not the case, when I look back at how much exercise I got and how fit I was). As an adult I finally asked a doctor about it... "oh, that's asthma!"

The doctor gave me two things: first, an emergency inhaler. Second, a prescription for an inhibitant to be taken daily. I use a very common pill, but the generic version (there have been TV ads for this one, for perspective's sake). It works really well for me and it's not too horribly expensive for me... about $40 or so per month (your prices may vary of course). I very rarely use my emergency inhaler these days- only during very, very strenuous exercise on days where I'm out during peak pollution times, or when there's a lot of dust/particulates/irritants out. That's good for me, because albuterol inhalers work almost too well for me. They kill off my breathing problems, but very easily make me feel light headed and twitchy.

For the most part nowadays, I am able to get out and exercise without any ill effects... just normal strain, but no throat/chest tightness.

Anyway, ask your doctor about daily preventative options. For me, a daily preventative pill worked a lot better (and was a lot more convenient) than a daily preventative inhaler treatment- the most common one out there requires you to rinse your mouth out afterward which is annoying.

I know the pills don't work all that well for everyone, but they sure did for me. If it works, it makes you even less likely to need that emergency inhaler.

And, once you get the inhaler, try to be sparing in how you use it at first, just to see how much you really need. Your doctor will probably give you the same advice. If you can solve your issues with one puff, that's better than just taking two by default. Or, even a "half" puff where you take one, but don't hold your breath in for nearly as long.

TL;DR: Just be sure to ask your doctor about other options, whether a daily preventative option might work. They'll give you some good advice and feedback. If all you get is an emergency inhaler (an albuterol one), try to go light on it until you find the right usage for you.
posted by Old Man McKay at 6:40 PM on April 12, 2015

I was prescribed Albuterol after having a bad cold/lung infection. I took one puff and was shocked at how immediately helpful it was, even with an infection. I could breathe better than when I was healthy - I never knew lungs could expand that much and I didn't feel the weight on my chest. I stopped taking Advair after I got better, and found that I couldn't run a mile on a treadmill without "seeing stars." I ended up on Advair (a preventative daily steroid/bronchodilator inhaler) and Singulair (a leukotriene inhibitor that works on both asthma and pollen). I still take the rescue inhalar Xopenex (albuterol) before exercise, and I'm fine. I've gone for periods of time where I've stopped with the daily inhalers and tried to exercise with Albuterol only, and the daily maintenance meds, for me, definitely make a difference.

Knowing your triggers is really important. Cold air? Allergies and/or post nasal drip? Exercise induced? I'm not sure if I always had asthma or if it was being sick that caused it. Whatever the cause, I've figured out that by knowing my triggers I can avoid it flaring up. My triggers are cold air, allergies and post nasal drip. During allergy season I take Flonase, my daily asthma meds, and 2 puffs of Albuterol (when I exercise) and I'm good to go.
I'm most affected by cold air, so running in the wintertime means I wear a balaclava on my neck/face to cover my nose and mouth when I breathe. Warm air makes a huge difference - you'll know it helps if your throat doesn't hurt.

Data point: when I travel to high-altitude climates where the air is clean, I don't need my asthma medication. None of it. Not hiking, not running, nothing. So I see it as a combination of environment (good/bad air quality) and weather (allergy season in particular).

If you're concerned about actually taking the medication, yeah, the inhaler thing can take some getting used to. You can ask your doc about prescribing a spacer. It looks fancy, but all it does is hold the medication in the chamber and makes a whistle sound if you breathe in too fast. My doc said most people breathe in too fast, so most of the medication ends up in your mouth instead of in your lungs where it should be. You need to breathe all the way out, and breathe all the way back in, slowly. Your doc might ask you to do this in the office to ensure you've got it down.

Good luck, and feel better!
posted by onecircleaday at 6:47 PM on April 12, 2015

One more data point: I'm in the exact same boat, exercise induced asthma. With my inhaler, I'm able to run so much farther. Now, instead of my lungs aching, the limiting factor when I run is pain in my lower back or legs.
posted by Tooty McTootsalot at 7:57 PM on April 12, 2015

FWIW, I am on a daily controller inhaler (Asthmanex) that made a big difference for me. It doesn't give me the wanting-to-climb-out-of-my-skin response that the rescue inhaler does, though apparently there are some different rescue inhaler meds that are less likely to cause that (annoying, but not actually problematic) reaction, depending on the person. So if you don't like your first inhaler, ask about switching it up.
posted by you're a kitty! at 8:42 PM on April 12, 2015

Xopenex

I wanted to clarify that Xopenex is not exactly albuterol. It's almost the same thing as albuterol, but not quite - sort of like a chemical mirror image of albuterol. Albuterol is generic and therefore much cheaper than Xopenex. A systematic review/meta-analysis showed that Xopenex is no better than albuterol, therefore, I would give the side eye to any doc prescribing Xopenex to some extent. I haven't read the systematic review, but the word on the street is that Xopenex doesn't make your heart rate go up as fast as albuterol, and so I've seen it used for people with heart arrhythmias or who get fast-heart-rate related side effects they find bothersome with albuterol, however, I am not sure this is warranted or worth the money.
posted by treehorn+bunny at 1:52 AM on April 13, 2015

I am not that fit, but I used to find cardio, especially stair climbing, a real hardship, which I always thought was because I was unfit. But after I started using my preventer inhaler, I realised that I could climb up stairs and do uninterrupted cardio without getting as winded - that it wasn't really my general fitness but my lungs specifically that were letting me down. It was a very freeing realisation, and has really helped my general fitness because I can exercise more now.

I have two inhalers, a preventer steroid inhaler for use in the mornings and a rescue inhaler for when I have an attack. Using the inhaler is easy, and easier with a spacer, though I don't need a spacer all the time. I get a hoarse voice from using the steroids if I'm not using a spacer, but no other side effects.

Good luck! I'm pretty sure you'll find it really improves your quality of life.
posted by Ziggy500 at 2:44 AM on April 13, 2015