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Who has exercise-induced asthma?

Do I have any company when it comes to having exercise-induced asthma or exercise-induced bronchoconstriction?

It doesn't always happen to me, but cold weather and vigorous exercise — say, a brisk run — usually spell an asthma attack for me.  I learned that the hard way a couple of years ago when I started out the year determined to make good on a New Year's Resolution to get in shape by jogging. 

But I've had problems before even when the weather wasn't cold. At the time I didn't know what exercise-induced asthma was or that I had it. I just knew that sometimes if I ran or jogged or did any sort of really brisk, vigorous exercise, I would feel my lungs tighten up and start coughing.

AAFA recently did a blog post about how don't always mix well. And there's an info page about as well.

I talked to my doctor — who also has exercise-induced asthma — and she gave me a pre-treatment plan. If I want to impersonate Chariots of Fire or an Olympic runner, I need to pre-treat with my asthma inhaler first. And before I start off on any sort of exercise, I make sure I have my inhaler close by. 

Have you ever experienced exercise-induced asthma? What has your doctor advised?

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Comments 16

  • Dar007

    I was scrolling through the site and found this post. I have this but didn’t know what it was – I would assume I was just out of shape. But after 6 months of going to the gym and doing other sports, I finally mentioned it to my doctor and a diagnosis was made. I also have seasonal and allergy enduced asthma. I was just wondering if anyone knows if the more you exercise, the more chance that the symptoms will go away? Maybe it is a stupid question, but there are sports I love to do and I would love to do them without the struggle. 

  • Kathy P

    In my experience, more exercise does help. But, you have to have your asthma under control in general and have a good pretreatment plan! With those two things, I've been able to dramatically increase my cardio endurance. What sports do you like?

    I started cycling last April. At that point, I thought my asthma was under control. Boy was I wrong! I would pretreat with Albuterol and then still have my lungs lock up. I was totally out of shape, but still couldn't ride 10 flat miles without a struggle. Add in even the slightest climb – like it looks flat but it isn't – and I was miserable. 

    I had agreed to do a 50 mile ride in September and there was no way! I worked with my doc to get better overall control and a more targeted pre-treating plan. Albuterol alone doesn't cut it for me. I'm a mucus making machine and am so special that exercise-induced reflux is a thing!

    Anyway, after 6 months, I rode that 50 mile ride and finished in just over 4 hrs! I battled heat stroke climbing a mountain in Mexico in 90° temps. My asthma flared as we came back into town and we're riding along crawling traffic. But I did it and in a rather respectable time!

    My asthma still flares and holds me back. Yesterday was a case in point. Usually, if I can pace myself and get past the 5 mile/20 minute mark, I reach my "good to go" point. If my asthma is already flared, like it is right now, I'm not always able to get over that hump or if I can, it takes much longer. It means I don't get to a point where I can push it – I have no reserves and if I do push it, I have a knife in my chest. I'm red-lining my HR nearly the whole ride and still not even keeping my usual pace. Yesterday, I was miserable and we were doing a ride I've done before and know I can do it faster and be able to breathe. I was holding up the whole group which really sucked. About 12 miles in, I took yet another dose of Albuterol (I had pretreated and already stopped for another puff once) and spent a few minutes hacking up a lung. It was not pretty and I was mortified because this was only my second ride with this this friend of dh's. But I managed to got things opened up enough to continue and tackle another steep climb. I finished the day with 30 miles and 1900' elevation. Not my best ride, but not my worst. 

    The first time I attempted several of those hills/sections, I couldn't do it without stopping. But my cardio endurance has improved greatly. And now, even if my asthma is not fully under control, I can still do more than I could 9 months ago. 

    What has really helped me is learning to read my body. It took me quite some time to figure out that 5 mile thing! But now, I just treat that as my warm up. I do a couple slow loops around the neighborhood before starting out. Unfortunately, most of our routes start climbing before I'm I'm over my hump. But I know how to pace myself and get my turtle zen on even though I feel fresh and want to attack the hill. My mantra is "all day pace". I'm longer say it out loud as I'm spinning up a hill – LOL. But saying it out loud in the beginning was actually a good way for me to know what HR zone/effort level I was at. I pay attention to my breathing/HR and can keep my effort mire even. 

    I've actually signed up for another ride in April. This one is 65 mi (100 km). April will be 1 yr anniversary of road biking. I've signed up for a kick-off clinic and progressive training rides. It's an all women ride, so dh can't do it with me, but he'll be my training ride buddy. He does 40+ miles for breakfast – as fast and as far as you can go! Makes for an interesting dynamic! You can read more about my training for the 50 mile ride – link in my signature below. I guess I need to start chronicling my Cinderella ride training! The kickoff is in in 2 weeks!

  • LK

    @Kathy P, That's very interesting how you've learned to work everything to continue riding!  I'm impressed! I'm hoping this graemlin means 'Way To Go!' 

    I am wondering if I may also have EIB as well as my other triggers.  I just thought it was something else triggering a flare when I would be riding horses.  Figured the dust or some other trigger at the barn, but it happened when I was riding a recumbent bike at PT once or twice.  I'll talk with my Pulmonary doctor at my next appointment.

    Thank you for sharing and giving hope! 

  • Dar007

    @Kathy P wow! I tried to get into cycling, but I never enjoyed it because I would start coughing like crazy and it felt like my chest was burning not long into my ride. I just thought I was so out of shape I should just let it go. 

    The sports I do are kickboxing, swimming, and running in the summer and fall. It gets me ready for skiing slope style in the winter. I don’t compete or anything but I do train and have a coach. Just love the challenge and being active. Spring is really hard for me to be outside because major triggers are grasses and trees. So I am miserable when outside. So I train at the gym and pool. I used to do a lot of diving, but kept getting ear infections so I was told to stop. I just love being active and challenging myself. My best friend lives in Michigan and she asked me to run a half marathon with her next fall. So that is new. I would love to try a triathlon! Now THAT would be fun! Thank you so much for the info. I just hoped that maybe one day, if I pushed myself hard enough, this asthma thing would just go away. Twice, doing two different sports I came close to fainting. It was the scarieat thing. Sometimes I forget to bring my rescue with me. The worst was during a hard core HIIT training class at the gym. I thought for sure I was going to die. I made it to the change room just in time but ended up having to go to the ER that night. So embarrassing since I work in trauma there. It scared me so much i haven’t gone back to that class since. But I am going on Tuesday. I have decided my New Years resolution is to not let myself back away from things like that. 

  • Katie D

    It has been great to follow along with how @Kathy P has managed her asthma with her biking!   on the setting the new goal for another ride!  Where is the race?

    @Dar007 Sounds like you are really active and great of you to know when to take your training indoors.  

    When I had EIB I would always have my rescue inhaler with me.  I recall many games in high school where I would have it tucked into my soccer or field hockey socks because I was just that determined.  I have done a couple half triathlons and many half marathons and just one marathon.  I was lucky in that my EIB resolved when I was in college and I was able to play college tennis and really started loving to run then.  My knee is what is keeping me from running currently but I have a goal of starting up again in the Spring.  I like outdoor biking but don't love it… especially currently cause I just don't have the time with two young children, but I love indoor cycling classes.  They are a great motivator for me and I find I can steal an hour once a weekend and do that and it recharges me for the week ahead. I can get the frustration of having to change up and not do what you really love because of asthma (for me it's my knee, 3 knee surgeries and being told well running isn't the best for you.) 

    Maybe starting with a smaller running race, like a 5K or 5 miler would be good to do with your friend and see if you can manage your asthma with those first.  Just a thought.

  • CAPuttPutt

    @K8sMom2002 Yes, you have company (and good company if I might say so myself 😉). I was diagnosed with exercised enduced asthma as a teen.

    I’d always hated running in school, sports, etc. (and still do) but it wasn’t until after I was diagnosed that I really figured out why. I wouldn’t have attacks where I would stop breathing, I’d just have a really hard time breathing and it would take me forever to get back to breathing normal after I quit running….I thought my lungs just hated running. 😝 

  • K8sMom2002

    @Dar007, my doc has told me to pre-treat before vigorous exercise. Sometimes I forget exactly WHAT qualifies as vigorous exercise … say, yard clean up after a hurricane.  

    What keeps you from remembering to take your inhaler with you everywhere you go? Is there something that could be changed or tweaked? A ?

    A keychain holder? You can repurpose a hand-sanitizer holder for this. (But if you're like me, you need to send someone else into B&BW to get it! Else I'd NEED my inhaler!)

  • Kathy P

    Lisa – mine is actually a combination many times. I always have  and that is where I need to do my slow warm up and get through the first 20-30 min. If I can get through that, I'm golden! This (you can download a free PDF) is a great basic tip guide on EIB.

    But often my allergic asthma will rear it's ugly head at the same time! It's wet and rainy here and for me, that means molds. One of my worst triggers! So, I pretreat for that as well before exercise and make sure that is as under control as possible.

    Dar007 – I know what you mean about triggering a full on attack shortly into the ride. It was only recently that I figured out my tipping point. I have to keep my effort low until I can get through that. Otherwise, I have a knife stuck in my chest!

    I have a friend who also has asthma and got into tri. She's done a couple baby tri's and at least one half marathon. We were talking back in Sept right before my bike ride and she told me the story of her first tri. I was still kind of freaking out because my asthma was flared the week before the ride! She hadn't pretreated w/ albuterol and when she hit the water, she started w/ an asthma attack. She thought she was going to wind up DNF (did not finish). So she flipped over, concentrated on every breath and did a very slow swim! She finished, but it was not what she had hoped for. She then set her goal for the next one to be able to do the mile swim without an asthma attack!

    Katie – it's a ride not a race and it's the starting at the Alameda County Fairgrounds.

    DH got into biking about 6 yrs ago because he was told he shouldn't run anymore. He wasn't really running regularly at the time, but wanted to add more exercise. His doc said no running because of other issues, but he was supposed to add weight bearing exercise. Biking is not considered weight bearing. It was kind of a can't win situation! But the doc was OK w/ biking for overall health, it just wasn't going to help w/ the bone density issues.

    He quickly outpaced me since I didn't have my asthma under control. We started not liking riding w/ him because he wanted to go as far and fast as possible without stopping! STILL not my idea of fun BTW! We had a lot of heart-to-heart discussions about respecting my limits when I started riding with him in April. We wind up in a "bait and switch" situation and then I'm in trouble because asthma/endurance/blood sugar/hydration. He's a mutant and just keeps going – he apparently doesn't need water and food! He'll still try to pile on, but he's now seen the consequences of that and will be OK w/ me bailing early if I feel that's right for me. But he also sees my progress – I couldn't climb hills that I now can, I couldn't do distances that I now can. It's just harder for me to build up and I have set backs that he's never experienced.

    Cynthia – I used to have a neoprene inhaler holder that was specifically for that purpose. The hand sanitizer holder is a cute idea! Do you take it out first? I'd worry about the silicone binding w/ the canister when trying to actuate it. Is that a concern or is the hole big enough to not interfere?

  • Dar007

    @K8sMom2002 you know, some really good ideas right there! I usually have my rescue locked in the gym locker, pretty far away from me and the classes I am taking these days. Maybe I can carry the rescue in something. (Haha Maybe around my neck.) Just kidding! I should have it closer that is for sure. There has got to be a discreet way…

  • Kathy P

    What type of workout clothes do you usually wear? When I'm biking, I always have my Camelbak and my inhaler and other stuff live in there. If it's a short ride and I don't need all that, I stick it in my jersey pocket – but not all of my jerseys have back pockets. Sometimes, I'd had to get more creative.

    And these days, I've gotten over being discreet about it!!

  • LK

    Kathy – I can't tell you how encouraged I am when I read about how you and others are dealing with asthma and other difficulties and are persevering! 

    These last few months I've been slowly, very slowly, convincing myself that I just can't do the horse showing that I love.  Perhaps I can still ride horses at a much lower energy level, but for someone who was riding 6-7 days a week, lessons once or twice a week with jumping, and doing jumping classes at shows, albeit low jumps, it's quite a let down.  Not only do I miss the riding but so many of my friends are horse people and the only place I would see them is at the barn or at shows, so I miss all my friends and the comradery, too.  Sorry for the self pity!   I know I sound silly when I think of all the really serious things folks are dealing with compared to me just not being able to ride horses as much.

    Maybe this rant is from lack of sleep since DH has had the flu!   Thankfully he's much improved today.

    Thanks for listening!

     

  • Kathy P
    LK posted:

    Not only do I miss the riding but so many of my friends are horse people and the only place I would see them is at the barn or at shows, so I miss all my friends and the comradery, too.  Sorry for the self pity!   I know I sound silly when I think of all the really serious things folks are dealing with compared to me just not being able to ride horses as much.

    That's not silly! Horses clearly are a part of your social/emotional life! It's NOT just about not being able to ride horses as much as you'd like. It's something that brings you joy and a network of friends.

    Definitely discuss w/ your doc what you can do to better manage things. You may be able to back off a little and build back up to the more intense stuff. I never thought I'd be able to ride 50 miles! But slowly, I was able to get there and now I've stretched my goal to 62!

  • K8sMom2002

    Hear, hear! Our daily activities are how we nurture our relationships, and when we can't do those activities, we can get left behind and left out. Nobody means for it to happen, but it's that "we're all in this together" mentality. 

    As for the hand sanitizer holder, I'm not entirely sure. I just happened upon that idea and thought it was a neat and inexpensive way to do it. Yes, there are purposefully designed holders — there's and another called that I can only seem to find on eBay or Amazon anymore. And then there's that only seems to be available from an overseas provider.

    What I liked about the sanitizer hack is that it was cheap and available. I got the idea off a school nurse's Pinterest page, but of course you'd have to make sure that it would work.

    That's another thing — for those of us who ONLY have to deal with EIB (oh, that used to be me), we do need to remember to prime our inhalers in between uses. It was always the worst time for me to figure out my inhaler needed re-priming when I was in the middle of the (then) rare asthma attack and hadn't had to use my inhaler in a while.

  • Kathy P

    Before I switched to Respiclick, I always had to remember to prime my inhaler before using it. That's actually one thing I really like about the Respiclick – that I don't need to shake and prime! But it's bigger and definitely wouldn't work in the hand sanitizer holder thing.

    One thing I have is a . If I don't have pockets in my jersey and no where else to put things, I'll wear that. It fits my phone and inhaler plus garage door opener if needed.

  • Megan Roberts

    I use something like what @Kathy P uses to always keep my inhaler on hand during exercise, a really inconspicuous SPI belt. It even fits under my shirt so no one can see it. If i'm on the water, I keep the inhaler in a small dry bag that floats. Even during races. For dragon boat (one of my favorite sports), it is a sprint sport, and very high intensity work that can trigger asthma, just like your HIIT class, @Dar007. Sometimes I need a puff between intervals at practices or as soon as I cross the finish line of a race. Even when I'm in the gym, like on a treadmill, I will keep the inhaler right in the cupholder, or in a small bag on the floor next to my treadmill. I don't care how it looks! 

    If you are into the high intensity exercise, which can be more triggering of EIB in my experience than other lower-intensity work, I have had success avoiding flares by making sure I get a good long warmup in, always pre-treating with albuterol (I do that before any type of exercise), and this is going to sound maybe obvious or insignificant but focusing on my breathing. I keep it calm, focus on exhaling as much air as I can, and try to avoid breathing through my mouth (challenging when your sinuses are usually screwed up!). I have learned some breathing techniques that help me maximize oxygen. I'm not going to go into that, because it's super nerdy. LOL. But the biggest thing for me (besides medication — which has been the real game-changer) is not to breathe through my mouth. 

    My biggest trigger is the cold, so I've learned to also just avoid exercising outdoors in the cold sadly. Even covering my face has not been enough of a preventative. Luckily there are plenty of types of crosstraining I can do indoors in the wintertime. 

    Like Kathy and others I also just really have learned to listen to my body. Easing into exercise allows me to observe what is going on and if symptoms are triggered, I can back off. I like to do a progression workout where I start out slow and increase the intensity/pace every 1-2 mins until I'm in a full sprint the last few minutes of the piece. This is my favorite, because my lungs are nice and warmed up by the time I get to the sprint piece, and hardly ever triggers asthma symptoms. 

    @LK I totally get your frustration of not being able to do the thing you love anymore, at least not to the same extent, and wondering if you will ever be able to get back to your old sense of normal. I was there less than a year ago! I did manage to control my asthma symptoms for the most part but it took a lot of persistence in tweaking my treatment and my behaviors (and figuring out what my triggers were). I was struggling a lot with my symptoms during exercise and didn't even realize I was under treated until an AAFA twitter chat on exercise and asthma last May. I have finally found a place where I CAN do the things I love again, and do them just as much as I did before my asthma got significantly worse. I hope that you are able to find the right approach for you to be able to return to horseback riding to the extent you did before and the community it provides you.

  • Jen

    LK -I do hope that, by working with your doctor, you can find a way to incorporate more of what you love.