Asthma & general rant

[RoadTrekkie]

I apologize in advance because this may be a long and rambling post and I'm not sure I have a goal other than to vent. Naturally, any insights/advice/encouragement are welcome. :)

#1. Asthma (most likely sport induced). When I had to drop out of last year's Foxy's Fall Century due to breathing issues, I began a long series of doctor's visits. My pulmonary function showed improvement after albuterol, but that may have been offset by my 107% average lung capacity. My cardio stress test came back normal. Chest x-rays normal. Flowmeter (?-that little tube you blow into) not alarmingly below normal. Visit to allergist in March was the most recent. She is sure I have asthma based on the pulmonary volume (vs percentage) improvement after albuterol. The albuterol gives me nasty side effects (increased heart rate and shakiness), so I have only used it a dozen times since it was prescribed in November. Allergist switches me from fluticasone nasal spray to Astepro and from albuterol to Xenopex inhaler. The blood serum sensitivity test shows I have NO allergy sensitivities, despite increasingly worse nasal/respiratory symptoms since I moved to Sacramento. I now religiously take my shots of Xenopex before every ride and use the Astepro in spite of my non-allergies and have been mostly symptom-free since the change. Mind you, there are no generics for either of the new meds and the Astepro is $25/refill and the Xenopex $35. :eek:

#2. Weight gain. I was doing pretty well last summer/fall until my breathing went to hell. I pretty much didn't ride all winter and made half-hearted attempts to start back up. I finally decided to face the music and weighed in in February and discovered to my horror I gained back 30lbs that I'd lost over the last year. I am now (gulp) 215lbs and that's down after gaining 5lbs after making a concerted effort to ride consistently in March. Seriously, who did I piss off in a former life? I didn't regulate my diet that much, figuring the biking would burn it off. Or I would just gain 5lbs. Now I'm trying to consciously watch what I eat, adding more protein and a bit less carbs, fruits & veggies and no processed sugar. That's when I finally saw my weight start to dip. In the meantime, I figure being seen in public in my biking clothes is the price I pay for letting my weight get back up.

#3. Training/getting back up to speed. I HATE riding the trainer, so I've used the weather as my most cosistent excuse not to ride. We're having a rare spring in Sacramento rather than the usual 2 weeks of nice weather and then bam! summer. So, we get 2-3 days of nice weather then 2 days of so-so weather then 2-3 days of rain. Supposedly, I am doing my yoga DVD workout on my non-riding days, but I can't get motivated to do that either. On the advice of my riding/dating partner/coach, I am trying to do the bulk of my rides at 70% of my max heart rate, which due to my crappy lungs and overall lack of conditioning, puts me at a pathetic 11-13mph on the trail. I'm slow, I get it.

Most days I know I need to tackle exercise/dieting one step at a time and not get hung up on what I want to happen or what I screwed up in the past, but some days I just want to throw in the towel and give up. It's much nicer to stay curled up in bed with the cats!

[RoadTrekkie]

I should add, the kick in the pants to get me motivated this month has been pledging to ride 600 miles in May. I have a 100k ride coming up on 5/15 that I already know I'm going to limp through. I have sworn I will finish this year's Foxy's Fall, which means hill workouts start at the latest next month. I would also like to do the Princess Promenade 100k in October. They have a 3 mile uphill time trial, but I think that's a bit much to expect... :cool:

[ny biker]

What specifically were your breathing problems during the century last year?

Are you/have you ever taking any daily meds to prevent asthma symptoms?

My asthma symptoms are almost entirely exercise-related, and I take Pulmicort every day, 2x per day. It's an inhaled powder corticosteroid. I used to take Advair, which is a combination of two different meds, but I switched to Pulmicort a few years ago. It keeps me largly symptom free unless I'm riding up a steep hill, in which case I need the albuterol.

[Jolt]

As far as the "allergy" symptoms, is there a lot of pollution etc. in the air where you are? Irritants like pollution, smoke, and dust in the air (pollen etc. in high enough concentrations can fall into this category too--it's particles in the air after all) can cause nasal symptoms similar to allergies but generally without the itching that is usually associated with allergies. That could be what you're experiencing.

[bmccasland]

(EIA = exercise induced asthma)

I find humidity also causes problems. Especially hot humid days, which may or may not be a problem in your area. Then there are the totally random "good days and bad days".

I was doing pretty good on my med regime, but it took 3 seasons of working with my doctor to figure out what worked best for me. What seemed to work at first, would need to be changed down the road.

[zoom-zoom]

(EIA = exercise induced asthma)

I find humidity also causes problems. Especially hot humid days, which may or may not be a problem in your area. Then there are the totally random "good days and bad days".

I was doing pretty good on my med regime, but it took 3 seasons of working with my doctor to figure out what worked best for me. What seemed to work at first, would need to be changed down the road.

Yep. And sometimes the side-effects from one med are so bad that no relief is worth it...4 bouts with thrush in the back of my throat made me give up on Advair. I'm on Qvar now and have had no issues. So even the same type of med in a different form (Advair is a powder, Qvar is a fine liquid mist...I think the Advair ended up more on the back of my throat than in my lungs) can have different results.

But asthma issues that are more than occasional should really be treated with a daily maintenance med. Albuterol is really not intended to be used daily, at least not without a maintenance med. It's a "rescue" inhaler. I don't understand why an allergist wouldn't have you on a continuous inhaled steroid. That's pretty much SOP for asthma, nowadays.

[Pedal Wench]

Yep. And sometimes the side-effects from one med are so bad that no relief is worth it...4 bouts with thrush in the back of my throat made me give up on Advair. I'm on Qvar now and have had no issues. So even the same type of med in a different form (Advair is a powder, Qvar is a fine liquid mist...I think the Advair ended up more on the back of my throat than in my lungs) can have different results.

But asthma issues that are more than occasional should really be treated with a daily maintenance med. Albuterol is really not intended to be used daily, at least not without a maintenance med. It's a "rescue" inhaler. I don't understand why an allergist wouldn't have you on a continuous inhaled steroid. That's pretty much SOP for asthma, nowadays.

On QVAR too, with Foridal - another inhaled powder. I was on QVAR daily, and the Foradil on exercise days, but my new GP suggested trying Foradil daily too.

[RoadTrekkie]

The original incident I had in October was that when I started the ride, I just couldn't get up to speed, I was tired, and then we hit very tiny rolling hills around mile 40 and I started hyperventilating on an uphill, couldn't unclip and fell over. :rolleyes: My self-diagnoses were everything from acid reflux to bronchitis, but everything pointed toward asthma.

No daily asthma meds. I snort the Astepro daily, which is a steroid allergy med. I think the allergy sensitivity results mentioned something like "nonallergy irritants" which is what give me exactly the same symptoms as allergy sufferers except itchy eyes. The Xenopex is to be used 20 min pre-ride and/or as needed during rides. I am due for a recheck with the allergist, but from what I've been told by her and my GP, they want to avoid steroids if bronchodilators will be useful. I'm wondering whether to start experimenting with riding without the asthma meds because it was cold weather that seemed to set off my EIA.

On a fun note, I solo crashed today when I drafted too close, overlapped wheels and didn't realize what was happening until I got slapped down. Some nice road rash, a very sore shoulder, mildly sprained thumb, and broken nail. Definitely need to do yoga for this weekend's 100k ride.

[Catrin]

I have asthma, but only use my rescue inhaler. I am one of those people for whom the usual asthma treatments (inhaled steriods, etc.) only makes matters worse. Much, much, much worse. As long as I avoid any other kind of inhaler, the combination of cats + carpet :( and do not get a respiratory infection, I have no asthma problems. Very rare use of my rescue inhaler. The oral medications have proved to not be beneficial to me so I gave up on those as well. The doctors have been surprised to learn this, but we found that my sensitivity to the side effects are far worse than the norm.

I must admit that I am wondering if the summer heat + up-hill riding will be a trigger, time will tell. I always have my albuterol inhaler with me though, and do use it before a ride just to be safe.

[Crankin]

I am another case similar to Catrin. My asthma is mild and only flares up once in awhile, mostly never. I use the Albuterol before a ride ifI am not feeling well, i.e. allergies are flaring up. I tried Advair and Singulair (which is more for allergies) a couple of years ago. There were no visible improvements, and I stopped taking it. And the potential side effects scare me. Once my allergies are under control, which they are now that I take medication for that on a regular basis, the asthma goes away. Since I have osteoporosis, I am not about to take a steroid on a regular basis. I even stopped taking Flonase.
Riding in the heat and humidity does bother me, but I seem to have built up some tolerance to it. I used to get asthma/allergy induced bronchitis on a regular basis in the fall (even in AZ), but I haven't had that in many years.
My asthma is somewhat strange. I rarely, if ever wheeze, just get the constriction.

[abejita]

So what are the symptoms of exercise induced asthma? I've been thinking about this lately and plan on talking to my Dr. when I go in for my yearly checkup.

I feel like my lung capacity hasn't increased like I would imagine it should. Or maybe my aerobic capacity. Last summer, I weight 220 and could hardly do 10 miles around the lake. Now I weigh 140 and can do 50 miles are so and I am riding around 100+ miles a week. I still struggle so much on the hills (I am in Dallas, it really isn't all that hilly) Starting on the first hill of my ride, it feels like I can get enough air and sometimes I wheeze. It also takes me awhile to catch my breath again. I don't know if I am just not a hill climber or there may be something else.

Any thoughts?

[bmccasland]

Upon being stressed - like doing hills -

Just

can't

catch

your

breath.

When others that you normally ride with have recovered. I find that I take longer to recover from a sprint or hills, or if I'm riding with a faster paced group, I just run out of air. And I wheeze. Not little lady-like wheezing, more like a freight train. According to the guys I ride with, they get really worried when they don't hear me - I've either dropped off, or am about to pass out. So when my meds where changed to the current regime of Flovent daily and Seravent pre-ride (Advair is a combo of these two) and I was breathing easy for the first time ever, they had to get used to my now normal silent breathing.

But I still have trouble recovering after doing hills. And muggy days are definitely worse. Classice southern summer "heavy" air is hard to breathe.

[abejita]

Thanks Beth! I am do for my yearly exam next month, but I might move it up so that I can ask the Dr about this.

BTW, I am from Lafayette!

[ny biker]

Thanks Beth! I am do for my yearly exam next month, but I might move it up so that I can ask the Dr about this.

BTW, I am from Lafayette!

Before I started taking the daily meds, I used to sometimes notice that I couldn't take normal deep breaths while I was exercising at the gym. Like I would try to breathe in but my lungs just wouldn't expand as much as normal.

Riding up really hard hills, I will start to wheeze.

Riding on cold days, I don't have such severe symptoms but I do have problems with coughing and increased mucus.

The most important thing I've learned is not to panic if you're having an attack. Staying calm helps you get past it more quickly.

[bmccasland]

Riding on cold days, I don't have such severe symptoms but I do have problems with coughing and increased mucus.

The most important thing I've learned is not to panic if you're having an attack. Staying calm helps you get past it more quickly.

Yeah, I forgot to mention the cough up your lungs part. Doesn't just happen in cold weather for me, but is worse then.

I guess I never worried that much because I always figured that if I stopped riding, I'd be able to catch my breath.

[abejita]

I cough too sometimes. I found that if I practice my 'yoga breath' that I can catch my breath faster. I try to concentrate on on slow deep breath. My yoga instructor says that when you do fast shallow breaths, it makes your body panic. who knows, but the purposeful slow deep breathing works for me.

[lo123]

another thing to think about.... Though I doubt it's the case since albuterol helps....
If you only experience problems when riding, and only at high exertion, a heart issue could be at play.

I thought all my breathing issues on the bike were my asthma (had it all my life), but turned out I have a congenital heart defect. Now, if I watch my exertion (I have HR alarms on my HRM to help with this) and don't push so hard, no "asthma".

If there's a ton of pollen, then I need my inhalers, but otherwise, I'm good. Contrast that with last fall: I was at the point of taking 6-8 puffs on the inhaler and still not being able to breathe.

[RoadTrekkie]

For me, it just feels like I have no energy to tap when I'm riding. Only rarely did I actually wheeze on a ride. And my heart rate skyrockets when I have to exert myself on hills. Hoping some of that will self correct if I can ever lose weight. On a randomly-related note, I threw away my scale yesterday. :D

[Vega]

I'm surprised to see so many people with asthma that are riders. I have asthma also and have had it since I was about 7 (34 now). I usually get exercise induced asthma attacks but I'm also allergic to cats and dust and some pollens. I take Claritin to keep my allergies in check and to keep them from sparking an asthma attack. I've always used a rescue inhaler(albuterol) and it will increase your heart rate. Don't use your rescue inhaler too often in a short time as it can become dangerous for your heart. I've read of several people who have died from over-using their rescue inhalers. Aside from that, I've used so many different other inhalers to manage my asthma. I've been on beclovent, serovent and singulair. The only one that has worked for me really well is Advair which is a combo of beclovent and serovent or fluticasone and salmiterol. I take the Advair generic Seroflo that I get from India because it's too expensive in the US. Since using Advair, I use my rescue inhaler about once a month compared to once a day before taking Advair. I still can't go all out like sprinting without wheezing but at least it's manageable and I've learned to live with it. And my asthma hasn't stopped me which is most important.

[colorisnt]

Glad to know that there are tons more women like me out there coping with asthma. I have learned to tame mine pretty well, but when it flares up, my asthma is very, very serious. Last week, out of the blue, I had the worst flare up in 6 years. The day before, I was prepared to ride 42 miles and in great shape. I had to go to my specialist and get injections and was almost admitted to the hospital. I was at home for a week before I felt okay to go back to work. We didn't know what had caused the flare up.

Then, I realized that I had serious pain on Monday morning. I couldn't breathe and realized I needed to go to the ER. I had kidney stones that had moved out of the kidney. It was unbareable and they think the inflammation that had been going on for over a week (I just ignored it) caused the reaction. Scary stuff. I had to have surgery to remove it today and already feel a ton better (still can't ride, though, as I have a stent in).

Mine is usually fine, but I don't push myself to run in very humid/hot conditions. I just love the sun and heat, but it makes it very difficult for me to breathe (and mine isn't even EIA). I just don't need to make myself ill. I take about 3 maintenance medications a day to control it. I used to run 5 miles a day and that was MUCH more touch and go, but biking seems to actually help build up my lungs, so you may find that it actaully HELPS your PF over time. My peak flow is always pathetic for a normal person - my 100 year old-great grandmother had better Pulse ox levels than I did on a good day, but I don't let it get me down.

When I was a teenager, my asthma was so out of control that I was terrified to leave my house alone for fear that I would have an asthma attack, die, and have no one notice. I was hospitalized all of the time and even had to have sinus surgery as a kid (I'm ironically in a medical journal somewhere). I feel so much stronger on my bike. It's a great feeling of confidence, which is why I think I love it so much. For a couple of hours, I can be in control of my body!

[rain]

colorisnt- hope you feel better soon

& agreed, I had no idea there would be so many of us though i guess asthma has become common. I had awful asthma as a kid. It's upsetting to think back on. My exercise consisted of walking until I was in my mid-twenties. that's why I love biking, it feels so good --it's amazing. And I get better and better at it. (relatively speaking ;-)

Yesterday the group ride I did started at 9:00 and the air was already hot. I had to take my inhaler right off the bat, which I usually never need to do. I have made it a principle to exercise below the threshold where I need medication. I've worked HARD to get off the meds, I can't imagine giving that up.