Exercised Induced Asthma

What are your recommendations for exercised induced asthma. I only seem to have trouble during the winter skiing. The cold dry air only makes me wheeze a bit while skiing. But after a good long ski in the cold air I can get into coughing fits that sometimes I can get momentarily light headed. It helps if I use my albuterol prior, during, and after.

Thanks,
S

Have you looked at
- http://www.webmd.com/asthma/guide/exercise-induced-asthma
and about cross-country skiing
- http://www.easyvigour.net.nz/xcskiers_corner/hxcasthma.htm
and more generally from Tahoe
- http://findarticles.com/p/articles/mi_m1608/is_9_17/ai_80309792

Knowledge is power. I will try a few of the suggestions.

Scott

Hello my exercise induced asthma friend.

Ex induced asthma has been the focus of my research for the last 20 years. We must first determine if your asthma is well controled? Asthma that is well controlled should not limit exercise in any way.---matter of fact that is how we define well controlled asthma ---- no limitations during activity---in your case symptom free skiing There are world class skiers that have asthma --and if their asthma held them back they would never be able to ski at that level. On the other hand, it is not always easy to find the right combination of meds that works for a given indiviual. What meds are you currently on? Do you have symptoms when not skiing?

Coach Ed

Ed,

I only seem to have trouble during XC ski season, with the cold dry air. At least that is when it is clear that I have an issue.

I believe that my symptoms during skiing are manageable, at least I do not usually notice much weasing. My EIA manifests itself USUALLY only after skiing. The longer the workout and the colder the air, the worse my coughing fit afterward. I can cough for at least an hour, sometimes so violently, I can get momentarily lightheaded.

I am only on Albuterol (as needed), which seems to help. I only seem to need it and use it for skiing. I try to remember to take before, during, and after.

I had also tried Advair for a period several years ago, but it did not seem to work for me. It must be for people whose asthma is more of an ongoing everyday issue.

Thanks for your help,
Scott

Do you have allergies??

You may well have a case of Exercise Induced Bronchial (EIB) Spasm---slightly different from EIA (exercise induced asthma). Current studies on asthma suggest that some athletes have EIB—not EIA. Most people with asthma have trouble with exercise when they are in a flare (a time when their airways are irritated and inflamed) hence EIA. Asthma is almost always related to allergies (80-95% depending on the study) and is more persistent and/or seasonal. The kid that wheezes every time they pet a cat has asthma. Now when he/she is wheezing exercise may be a problem. It seems you are experiencing EIB – cold air and exercise are not allergic (although some of my patients claim to be allergic to both) they certainly can be powerful bronchial constrictors in some people. –We are not really sure why the end of exercise triggers increasing symptoms but most athletes with EIB describe symptoms as you do (increasing cough wheeze after exercise) and we have proven in the lab that the bronchial spasm get worst 5-30minutes after exercise. See there is a gene identified Adams33 on chrom 20 that relates to how bronchial hyper-reactive(BHR)a person is. It’s a genetic defect in the smooth muscle in the airway that makes them to twitchy (BHR is how we measure twitchy) Some people have increased BHR –but do not have asthma. You have to be lucky enough to inherit another bad gene –the allergy gene (its way more complicated then this)—to have something that inflames the airway making the BHR even worst, which then brings on the symptoms known as asthma wheeze,cough,shortness of breath, thightness of chest….. These are all secondary to constriction of the bronchial tubes. I your case it seems the bronchial spasm is being triggered by Ex and cold air—and your albuterol isn’t working well enough. You could try a different bronchial dilator ask you doc about Formoterol(Foradil). It is significantly better at blocking cold air bronchial spasm in a couple studies. Another product that works for exercise induced asthma is Symbicort. Like Advair it has a inhaled steroid (budesonide) and a long acting bronchial dilator(formoterol. The inhaled steroid has been shown in many studies to decrease BHR –My own studies suggested that it takes a lot more exercise and/or cold air of longer duration to trigger bronchial changes when on inhaled steroid –it calms down the twichy. You have to be religious about taking it --- every day for a 2 week period of max effect. Then take albuterol (only if needed) 10-20 minutes before exercise.

Ed

Ed?, Very interesting bunch of info. Looks like we really do have an expert on our hands. Is there any indication that EIB effects athletic performance. Is it all post exercise or is there a during exercise component. With cold air I seem to notice a decrease in performance but I don't have any symptoms other than being out of breath. No coughing during, but some afterwards

NY Times article claims it's not the cold but the dryness: http://www.nytimes.com/2008/01/17/health/nutrition/17BEST.html?_r=2&scp=1&sq=exercising+in+cold&oref=slogin&oref=slogin