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Old 08-17-2008, 09:17 AM   #1
Larry A Henrikson
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My exercise induced asthma, compare to yours

I've finally discovered my asthma at 24 years of age. I've been active all my life with sports or weightlifting but only after increasing my run distances, have I found the asthma. Interval training has never flared it, even something like Murphy or The 50.

I get a tightness in my chest and a little bit of wheezing on a slow exhale. I only decided going to the doctor after running a 2 mile and the tightness never subsiding a day later. He diagnosed Exercise-Induced-Asthma since it only happens when I train or am overly stressed. I was prescribed some Proventil Albuterol to take before running or anything cardio heavy.

I used the inhaler a few hours after seeing the doctor and before running, noting that my chest was still tight before running, but by warmup's end, the tightness was subsiding. I managed a decent 1.5 mile, but chest stayed tight the rest of the day.

The next day I went to the track for another 1.5 mile. My breathing was better with the inhaler than ever before but my chest stayed tight. My 100 meter was slightly faster as well and my recoveries were quicker.

Now it's Sunday morning, I'll be resting until at least wednesday (Saturday to Wednesday) to see if this damn tightness goes away since the inhaler is only helping my wheezing and quality of breaths.

My question is if anyone has started an Albuterol treatment, did it take a while for the tightness to go away? I've read a couple testimonials that it took a few weeks for it to disappear and then the albuterol before training prevented the tightness from ever coming back. What I'm thinking is that I ran too much and flared it too far I just need to rest and wait for it to go away before preventing it again. I'm going back to the Doctor but I wanted to ask others who have experienced it.
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Old 08-17-2008, 06:35 PM   #2
Mike Neill
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Re: My exercise induced asthma, compare to yours

My asthma is diagnosed as "very severe," a measure of how often I get sypmtoms + how bad they problem is. It is fully controlled with an inhaler marketed as Advair, containing two drugs, salmeterol and fluticasone. The salmeterol is a very long acting drug of the same kind as albuterol. I hardly ever have to use my albuterol. The Advair is RX'ed for me at 2x/day but I am OK with 1x/day.

That said, albuterol is what the medical industry calls a "rescue" drug to be used only when you have acute symptoms. It should act instantly. It does not build up in the body. It does not take any period of days or weeks to kick in. In fact, using it too frequently can not only dull its effectiveness, it is kind of easy to cross the line into toxicity. One freaky effect of overusing it is that it can make an asthma attack worse, but that is very unusual.

Here are my responses to your specific questions:

1. You say that it improves breathing but that your chest remains tight. This might suggest albuterol is not as effective for you as for others, or that it needs to be used with another asthma drug. When I have to use albuterol, *all* symptoms (which in my case can be incapacitating) go away quickly.

2. Albuterol is 35 or 40 years old but Advair (just one of the controller drugs) is much more recent so for a long time I had only albuterol. Back then, using it as a preventative 15 or 20 minutes before exercise worked fine, including exercise in cold dry air, which is the worst condition for asthmatics. By "worked fine" I mean I could exercise in a normal manner without symptoms or distractions. Depending on some variables, sometimes I might have to use it a 2nd time well into the exercise period. If that is not your pattern of use, try it and see how it works for you.

3. If you still have symptoms well after exercise ends, use the albuterol again. You don't say how its use was RX'ed but as a general rule of thumb, being a rescue med, you use it up to 2 or 3 times within 20 minutes or so until the symptoms go away. If the symptoms don't go away, you are having an uncontrolled asthma attack (uncontrolled because the drug you have isn't working). In that case, the drug isn't working for you so now you have a different issue.

It doesn't sound like *you* are at a high risk, but in my case, an "uncontrolled asthma attack" could easily become fatal and represents a major medical emergency requiring 911. Asthma is a very serious condition, and it can change over time (good or bad). Keep those points in mind.

4. A more general comment is that, as I said above, albuterol is a rescue drug. It should not be used to control asthma. A pulmonologist will tell you flat-out that albuterol is not a drug for controlling asthma, period. There are 3 reasons why this is so: 1st, using albuterol all the time is bad for you. Using it chronically raises the blood pressure badly. 2nd, with that in mind, there are less toxic yet longer-acting drugs, so the way the medical industry makes judgments leads to the conclusion that an asthmatic should use those other kinds of drugs for controlling asthma. 3rd, long-term corticosteroid use might or can interfere with your HPT axis. Some say that this is impossible because the albuterol goes only to lung tissue and is not absorbed by the body in a big way, but others disagree. The fact is that long-term corticosteroid use *does* interfere with your HPTA so whether or not albuterol can cause bade effects, why risk it? (unless your only choice is that or die from an asthma attack)

Note: corticosteroids have *nothing* in common with anabolic steroids except in the broadest sense that they are in the same very large chemical family called steroids.

To my eye you left a lot unsaid in your post so it's hard to tell exactly what you have going on but my takeaways for you are: (1) albuterol is a rescue drug, so go back to the Dr. to get a control medication and (2) discuss in detail with the Dr. how you use the albuterol vs. when and how fast your symptoms subside, as it sounds like albuterol in general isn't working very well for you.

Your assumption that you have to use albuterol for a while before it starts to work is just wrong, so drop that image entirely. I don't know about those "testimonials" but the idea is just plain wrong; if you have a problem one dose of albuterol works immediately and if it doesn't, then albuterol is not the drug for you or maybe there is something other than or in addition to asthma going on.

Sounds like you need to go back to the Dr. and have a detailed two-way conversation.

If I am being a good boy, conscientious with the things I need to do to keep my asthma under control, there is no limit to hard or how long I can exercise no matter how cold and dry the air is. My asthma is extraordinarily bad, so I'm telling you that no matter what, you can get this under control and maximize your fitness despite this obstacle. The right Dr. understanding the particulars of *your* situation, then prescribing the right drugs, is the ticket.

Last edited by Mike Neill : 08-17-2008 at 06:46 PM.
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Old 08-18-2008, 08:37 AM   #3
Larry A Henrikson
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Re: My exercise induced asthma, compare to yours

Wow thanks, that's some solid info I will bring up when I go in again. I'm going to ask for a different or another drug before anything else.
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Old 08-18-2008, 12:20 PM   #4
Melissa Whittle
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Re: My exercise induced asthma, compare to yours

I've had pretty good luck with Asmanex on a daily basis to control the asthma and Albuterol when I have an attack working out. I am still having to use the rescue inhaler more than I'd like, but my symptoms have at least been manageable since I went on Asmanex.

But I often still have some tightness in my chest after a workout even if I have no trouble breathing.
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Old 08-20-2008, 12:24 PM   #5
Larry A Henrikson
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Re: My exercise induced asthma, compare to yours

Went back and got a 2 week trial of Advair. Doc said it should work within 4-5 days. Problem is, the stuff is stupid expensive so I won't pay for it after this dosage. I'll probably remove all running and heavy cardio from my workouts until I get some drug coverage.
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Old 09-17-2008, 01:23 PM   #6
Larry A Henrikson
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Re: My exercise induced asthma, compare to yours

Switched over to Asmanex, 14 days now and it still isn't completely working. Tightness has subsided but now I'm wheezing consistantly. Tried training but even after a shot of albuterol I can't reach my full capacity. This is infinitely annoying because the 8 months I've been doing Crossfit, I've lost all of that progress in only 4 weeks and I still can't train like I want to. As a result, I've stopped training 6 days a week. I think in the past 4 weeks, I've only trained 6 days. And of course, I have to avoid heavy cardio so I'm stuck with basic strength training. I did some heavy bag work but only 60 seconds at a time, full power but low pace. Oh well, just has to live with what God gave me and not complain too hard. It could be worse.
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Old 09-17-2008, 01:46 PM   #7
Frank E Morel
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Re: My exercise induced asthma, compare to yours

Changing meds is like changing a diet. Your body needs to have time to readjust itself and to the new meds.

keep working out, just scale back the intensity, and the frequency. Working out 6 days a week may not be your optimal level.. maybe 3x is or 4x . Start from scratch and build slowly to find where your comfortable work level is vs what tips you over. Your going to have to work out to your lungs, and not to your heart and ego ( meaning.. its not a good workout unless i sweat thing)

Asmanex is a good drug for some people but the most asthma meds of this nature take a good solid 6 weeks before you notice a rock solid improvement. Like the downwards trend of using a rescue inhaler.

Are you using your asmanex at night or in the morning?
considered using your albuterol before working out say half hour before?
What kind of Md is looking after your asthma? A family practise md or a pulmonary Md?
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Old 09-18-2008, 11:25 PM   #8
Stephen R. Lampl
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Re: My exercise induced asthma, compare to yours

Larry,

I've had sub-clinical (mostly exercise-induced) asthma for my entire life. Most of the time, I have no problem whatsoever and need do nothing. On the off chance I start to feel tightness in my chest and resort to using Albuterol (2 puffs, each one 1 -2 minutes apart), I have no further problem or tightness.

If you haven't seen a good pulmonologist or allergist, find one and get some tests done. There may be certain allergens or other triggers which cause your attacks or exacerbate them.
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Old 09-19-2008, 05:22 AM   #9
Larry A Henrikson
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Re: My exercise induced asthma, compare to yours

"meaning.. its not a good workout unless i sweat thing" Funny, that's exactly what I said the other day but told myself to slow down and wait for my lungs to catch up.

Last time I was at the doc's I forgot to ask how long the Asmanex would take. I am seeing a General but the next time I go I may switch to a Pulmonologist if I still have problems. I have another 2 weeks.

My first 14 days of Asmanex I took in the am, but the Pharmacist switched me to at bed time. Been doing that for 3 days now.

I take a shot of albuterol before I train, and another if my chest acts up but I've been keeping it slow and only need 1.

As for allergies, that would be the next area of exploration. The weather is changing and my seasonals are kicking in (not to mention the allergens have been high since August when my Asthma started). I took a Claritin and it removed the whisper wheeze. We'll see what happens when the trees are clear and the weeds are dead. I may not need the Claritin and my wheeze or whatever will come under control until next season. Just have to go along with it.
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Old 09-19-2008, 09:02 AM   #10
Melissa Whittle
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Re: My exercise induced asthma, compare to yours

Hmmm...have you explored dietary asthma triggers? It's possible that you are eating or drinking something that is aggravating your asthma symptoms.

I don't know about you all, but I have been finding that the new non-CFC Albuterol inhalers don't work for shyt. The old ones that were bad for the ozone layer are much much better. I'm not sure what to do about the fact that it is next to impossible to find the old kind since they have been phased out.
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Last edited by Melissa Whittle : 09-19-2008 at 09:09 AM. Reason: the new style are HFA (non-CFC)
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