Coughing Attack??

I had been off the bike for nearly two weeks but went for a ride after work last night. The weather was nice and cool but all that was needed was arm warmers. I felt good before the ride but about 5 minutes into it I felt my airway being choked off by mucus (sorry) and my nose was really running...which isn't unusual for me. I was having a very hard time keeping up with the two other riders and our avg. speed ended up only being 14.4 mph. About 2 miles from the end I actually had to stop from a coughing attack that I had. I was coughing (a barking sound) and dry heaving (again sorry). After about 5 minutes I was able to get back on the bike. A bit of background...I've been having mild to moderate chest pain since September 1st and have had a lot of tests done with more to come. They did find a nodule in my left lung but I don't think this is related. Over the last few months I've found it harder and harder to keep up on rides. I just chide myself for being out of shape but I'm thinking now it's something else. I'm starting to wonder if this could be asthma. I will tell my doc about it the next time I see him but I was just wondering if I could be right or am completely in left field?

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Originally Posted by li10up

I I'm starting to wonder if this could be asthma. I will tell my doc about it the next time I see him but I was just wondering if I could be right or am completely in left field?

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Google 'exercise induced asthma' that's what it sounds like to me. I've had that since I was 12. I've finally almost "cured" it 2 years ago when I read an on-line article discussing possible mechanisms (no one knows what causes it, but it isn't all that uncommon). This article suggested wearing something around your neck in fall->spring - and voila! I can breath. I still get hives (<10% of the people who have exercise induced asthma get hives with it), but I no longer end up sitting on the curb coughing while people discuss calling an ambulance.
Also, I've been told by several doctors that there are no documented cases of death from EIA - so although it feels miserable, it isn't as deadly as asthma can be. I don't have an inhaler, never got one, just suffer through it.
If you want to try the neck warmer thing, I use a buff when it's warm outside (70ish) and a turtle fur when it's cooler. When it's really cold, I breathe through the turtle fur, which is a little icky due to dampness, but makes me feel a whole lot better.
http://www.campmor.com/webapp/wcs/st...roductId=18339

Good luck!

I agree on the exercise induced asthma possibility. Have you seen a pulmonologist or had pulmonary functions done? If it is, it could be as simple to control as taking a couple of puffs of an inhaler before you go ride. I'd definitely talk to your doc about it.

I did see a pulmonologist on Monday. I have a PET scan scheduled for the 30th to check out the nodule. I also have a Pulmonary Function test scheduled for Nov. 26th and I will see the pulmonologist after that to go over all my test results. Does this sound like how asthma starts? I don't normally feel short of breath ...although sometimes just going up a flight of stairs makes me breathe like I just ran a couple of blocks. Could the mild chest pain be associated with the asthma? They haven't given me any answers about the chest pain yet...kind of focusing on the nodule they found right now.

I (and my doctor) was convinced my chest pain and breathing difficulty last year was exercise induced asthma. I was taking the inhalers, etc. for it and it helped - just a little. Of course it turned out to be something much more serious than asthma.

I'm glad you're getting all the scans, etc. Definitely tell your doctors about this and ask them what they think about this new symptom. However, from what I understand, adult onset asthma is apparently not very common - especially if you've never before had symptoms. Once I was finally diagnosed, etc., I was talking with a doctor friend who specializes in all this sort of thing, pulomonolgy/allergy (he lives in NYC or I would have gone to him originally - and I don't generally like to bother my doctor friends with my "stuff" - my friends don't generally bring their law "stuff" to me.) Anyway, he told me that it is apparently quite unusual for someone with no previous asthma to suddenly come down with it, exercise induced or not.

You may also was to be checked for allergies - maybe there's something "blooming" this time of year that set you off. Or you might have a chest cold.

It's hard to say; I have asthma and while some of the symptoms you describe sound a lot like what I experience, I would tend to think that it also may well be related to the nodule/chest pain. If your lungs are inflamed, that may be the cause of the shortness of breath.

How long have you been cycling? Has this happened to you before? Do you have any shortness of breath related to things that you can predict, i.e., allergies, cold weather, etc.? I thought for a long time that I'd just had asthma as a kid and discounted shortness of breath as an adult because it would usually go away after a couple of hours or a couple of days, whereas it was much more severe when I was a kid.

I have never experienced asthma-related chest pain, though after one bad bout of asthma when I was in Europe with no meds (I didn't really think I had asthma...) I got pneumonia. Then I had chest pain. But to me chest pain is always a sign that something else is going on. Normally I just feel like I have a huge rubber band around my chest, wheeze and cough a lot.

I think you should explain all of your symptoms to your Dr.; My asthma definitely worsened after the pneumonia episode, but it is something that I've always had to one degree or another.

Anne

I do not have EIA - but I do have an allergy (cedar trees - which I've only really discovered now that I've been living in the PNW) that causes me some similar symptoms. I get a nasty hacking cough - like cough until I want to puke cough......

The cough is from the constant post nasal drip - and you did say its not unusual for your nose to run, so I'd say that it may be a good possibility that you either have an allergy or you could have non-allergic rhinitis, which is to say the stuffy drippy nose, without the itchy eyes, from other causes - like cold air, changes in humidity etc.

I do have a stuffy nose year round. I get quite a few sinus headaches but not as many as before I had my deviated septum fixed. So at least things aren't as bad as they were. I don't have the typical allergy symptoms such as sneezing and watery eyes. But I do get sticky eyes every now and then and just take an antihistimine. I also had a really bad case of heartburn about 5 minutes into the ride as well that lasted for about 15 miles. I didn't think allergies could induce such a violent coughing attack. I'm thinking it might be asthma because I just can seem to keep up lately. My lungs always give out before my legs...and after two years of riding (almost 3000 miles this year) regularly I don't think it is a fitness issue...especially since my performance is degrading. My heart rate is higher than normal even on the flat stretches. Heck...I don't know what's going on!

Could be a combination of many things. A decrease in performace along with the higher heart rate even sounds like possible over training. You may need a rest to let your body sort itself out and repair.

Trust me - allergies can cause violent coughing - I've been there, bent over double coughing until I think I'm going to puke or my eyeballs are going to fall out and I have absolutely no asthma - doc said I have the best lung function he's seen in a long time - the coughing was all from the post nasal drip.

I meant to ask this in your earlier threads... have you been tested for TB?

Don't know what it could be given your recent health problems, but what you describe can happen to me - I have exercise induced asthma. There can be several triggers: exercise, pollutants, allergies, nasal drip, cold symptoms, etc.

spoke

Sounds like good advice from everyone and you have the ongoing medical tests and such, and I'm not sure if what I has to share will be helpful or not, but I had no idea I had allergies and asthma/EIA until I was tested earlier this year. I never had those things when I lived in Southern California, but after 14 years in NorCal, I guess I got 'em.

I'm allergic to just about everything in the air and home environment around me, and am on an allergy immunology program now. But the biggest difference in my life has been using an inhaler before I exercise. I used to get so out of breath and go into such coughing spasms that I would wet myself (sorry :o ...TMI...or is there such a thing as TMI on this site??? :p ) Four years ago when I was training for a marathon, I kept wondering when the breathing was going to get easier. It never did! Now I can ride and run without those sorts of breathing problems.

The other good thing for me was Allegra every morning, which has stopped the post nasal drip, and an asthma medication that helps the ongoing irritation in my lungs. I don't like the thought of having to take/use meds every day, but boy, what a wonderful difference it has made in my life!!

Good luck. I hope all turns out well for you.

About 4 weeks ago I had a cold. Three weeks ago I had a sinus infection and took antibiotics for it. It cleared up and for the last two weeks I've been clearer than I"ve been in a very long time. No stuffiness, no runny nose (except when exercising). But for the last two weeks I keep feeling like I have to clear my throat all the time and I've never had to do that before. It was kind of scary how "cut-off" my throat felt from the mucous build up. I hadn't really thought much about it until the coughing spell last night. Thanks for the input everyone. I'm starting to think that my allergies, the heartburn, exercise and the colder air all contributed to the "attack". Asthma or something else? That will be a question for my dr. too...but I don't get to see him for another month.

Edited to add: No, I've never been tested for TB.

And: Eden, I was off the bike for two weeks...wouldn't that be enough rest if I was overtraining?

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Originally Posted by TsPoet

I still get hives (<10% of the people who have exercise induced asthma get hives with it), but I no longer end up sitting on the curb coughing while people discuss calling an ambulance.

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Thanks for giving me something to research! I've had problems with EIA since middle school but didn't get officially diagnosed until adulthood. Several years ago I started getting hives, mostly when I exercised. Nobody ever told me the two could be related though it makes perfect sense (all tied to autoimmune response). Cold weather triggers my asthma and hives though both have improved greatly in the past 2 years.

Good luck with your tests li10up and I hope they find the root of the problem and get you fixed back up!

Lora

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Originally Posted by li10up

About 4 weeks ago I had a cold. Three weeks ago I had a sinus infection and took antibiotics for it. It cleared up and for the last two weeks I've been clearer than I"ve been in a very long time. No stuffiness, no runny nose (except when exercising). But for the last two weeks I keep feeling like I have to clear my throat all the time and I've never had to do that before. It was kind of scary how "cut-off" my throat felt from the mucous build up. I hadn't really thought much about it until the coughing spell last night. Thanks for the input everyone. I'm starting to think that my allergies, the heartburn, exercise and the colder air all contributed to the "attack". Asthma or something else? That will be a question for my dr. too...but I don't get to see him for another month.

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I wonder if you have bronchitis? That can cause coughing up mucus. Perhaps the antibiotics for the sinus infection didn't quite kill all the buggies, and they went into your lungs and multiplied into bronchitis.

Good luck getting to the bottom of it!

Emily

EIA here too. I only have to use my puffer if the temps are below 10 celcius. If not, I hack up a lung... I am glad to hear you're seeing a doctor. They'll help you figure it out.

I also thought about "Pursuitor's (sp?) Cough" but it doesn't sound like you were working that hard. (I get the awful hacking cough if I ride very hard and it's cooler out whether I've used my ventolin or not.)

I'm guessing that once they slurp that embolism out of your lungs the irritation and excessive mucous and poor lung function will clear right up!

Bike on! :D

Thanks again ladies. I rode this morning in similar temps and did fine...but it was a little slower pace, flatter, and with less wind. I guess the lung function test next month will give me more info. I will tell the doc about it though.

Knotted, just to clarify-it's not a PE but what was called a "nodule." From what I've read a lesion less than 3cm is called a nodule and over 3cm is called a mass...but yes, if it has to be removed I hope all my problems will be solved...thank you.

emily, bronchitis...that's a thought...maybe the cold didn't completely clear up.

Can't wait until I actually get some answers to my questions from my doc!

Wait...you don't get to see your Dr. for another month?!?

I haven't followed your whole story, but personally, I would insist on being seen sooner than that or find someone that can see you sooner. Yea, Doctors can be busy, but this sounds like it could be serious.

I've learned the hard way that letting things go at the schedule of the Dr. can result in a lot of unnecessary complications. You need to be your own advocate, and pushy sometimes, to get things taken care of.

I'm glad your most recent ride went better & hope things clear up quickly!

Anne

Well, I got up the nerve to call today (thanks Onimity) and ask if I could be seen sooner than a month. She told me that they schedule the appointments that far out but if they see anything that "concerns" them they will call me before then and ask me to come in. So, now I'm hoping NOT to see him for another month!

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Originally Posted by li10up

I also had a really bad case of heartburn about 5 minutes into the ride as well that lasted for about 15 miles.

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Just an FYI: Post nasal drip can irritate the esophagus and give you heart burn type symptoms.

It is good that you are having all the tests done. I'm sure it must be frustrating not having any answers.