Helpful asthma hints?

Hello all,

I am new to the forum and am seeking advice. Essentially, I am wondering if any of you have found any hints/non-traditional medicine/traditional medicine that has helped you with your asthma in hill situations. A bit of history:

I have been commuting 10 miles/day for the past 6 years

I have increased my mileage in the past two months, and have actually started riding just for the sake of riding.

I have been riding around 100-150 miles/week.

I was dx'ed with asthma in high school when I started playing competitive sports, but it still was never that much of a problem. I puffed albuterol pre-game, and I was good to go.

Seasonally, about once a year when my allergies were bad, I ended up in an urgent care setting getting nebulized etc. etc., but otherwise my asthma isn't too much of a problem.

I have taken intal, advair, and flovent seasonally, and albuterol prn for years.

However, as I have increased my mileage, I have found myself completely shut down (asthmatically speaking) by hills in a way that is disproportionate to my level of fitness. My commute didn't have as many hills, or as many steep hills, so yes this is mostly new....but, I am still a bit perplexed.

I find myself extremely frustrated when I can pace for a ride group, but get left in the dust on hills. (or I can pump up them, but when I get to the top I have nothing left and I can't catch my breath or put out energy to keep up. Often, if I pull over and stop a few minutes, I can bring my breath back and resume riding, but this is obviously far from ideal for racing/group rides etc. Albuterol in times like this does not seem to greatly relieve my symptoms.

Yes, I need to go back to my doctor. But, I just went two weeks ago for this. He gave me advair to use daily, and told me to continue albuterol prn before/during rides.

I have never had this much trouble with my asthma in an active setting.

So, thank you if you have actually gotten this far. Does anyone have any advice here? Tricks? Medicines that they have found helpful? This same problem? How do you handle/deal? Did your asthma get worse with age? Thank you for any advice!


PS. I am 23, athletically trim, in shape, been active my whole life

I've found it much better if I get a nice long warmup before working my lungs hard.

But, do go see someone about this specific aspect. One doctor I went to said that untreated asthma can lead to lung diseases much, much later in life.

If you're not getting treatment for your allergies, get started on that, since you say at least some of your asthma is allergic.

When you're climbing, focus on the exhale - you probably knew that already.

Looks like it is time to go back to my GP for a referral.

I hadn't really thought about how allergies might be effecting me when I ride---- usually when allergies increase my asthma symptoms I feel the increase of asthma symptoms 24/7. Recently, I haven't had any problem at all in general life.

But, I suppose since I am breathing much more deeply when I ride...maybe??

Thanks!

PS. I wish I could start with a long hill sans hills...but, unfortunately I live in a really hilly area...and I can't really get anywhere without going up a hill!

Quote:

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Originally Posted by Onix

But, I suppose since I am breathing much more deeply when I ride...maybe?

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I'd guess it's less that, and more that your riding probably takes you places where the concentration of allergens is much higher - unless you already live in the country, there's a big difference in the amount of pollen in the air in the country, vs. in a small town, vs. in the city. (Those of us who are very sensitive notice that immediately!)

For me, the hard breathing is kind of a "wash," since the immune system is slightly suppressed during exertion. My allergies are actually much better during a ride, but my asthma is very mild and 100% allergic, not at all induced by exercise, or cold or dry air.

High speed ("ram air induction" :p) does seem to increase the amount of pollen that goes up my nose, but I really only notice that on the moto, not the bici.

Quote:

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Originally Posted by OakLeaf

I'd guess it's less that, and more that your riding probably takes you places where the concentration of allergens is much higher - unless you already live in the country, there's a big difference in the amount of pollen in the air in the country, vs. in a small town, vs. in the city. (Those of us who are very sensitive notice that immediately!)

For me, the hard breathing is kind of a "wash," since the immune system is slightly suppressed during exertion. My allergies are actually much better during a ride, but my asthma is very mild and 100% allergic, not at all induced by exercise, or cold or dry air.

High speed ("ram air induction" :p) does seem to increase the amount of pollen that goes up my nose, but I really only notice that on the moto, not the bici.

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Interesting. I hadn't really thought about all that with allergies! I live in Austin---and allergies can be really funky here...so it is possible that I am running into different allergens a I ride.

Thanks for the replie!

I'm dealing with this myself. I've had asthma almost as long as I can remember. I take Advair, Singulair, Spiriva, and albuterol, prednisone and allergy meds (Xyzal + flonase), but the hills kick my tail (and like Onix, not doing hills is not an option).

I've started trying to just spin up hills and keep my breathing even. I've noticed when I start climbing hard, my heart rate goes way up and I start breathing sporadically. I think I sometimes have a mini-panic when that happens and my breathing can get really bad really fast.

If I focus more on a slower pace and sit up a little bit to open up my chest (relax) and then concentrate on breathing in through the nose, out through the mouth I do better. It still sucks.

I'm interested to hear any other tips.

Onix--if you dont' see a specialist for your asthma, you should. I'm on the hunt for a new pulmonologist, but asthma/allergy specialists can be good as well. They're better equipped than most GPs to deal with this stuff and are on top of the latest/greatest.

This is VERY important regarding medicine...

OK, for your albuterol... are you taking your medicine at least 15 minutes *prior* to your exercise?

If you do not, trying to take it after you are already in a full blown attack will do little, to no, good. Unfortunately:( ...as you have already figured out.

I have asthma /allergies, and live with a house full of people who do as well. We've had some literally near death ICU experiences with the disease. Our monthly meds also literally total more than my house mortgage payment. However... those same meds, and bills for a specialist doc I *love*, are way cheaper that the hospital. Or priceless alternative.

With the right asthma action plan, you should be albe to climb all the hills you want. Or as my doc told me once, "the disease should not 'define you'... or your life's desires, etc.". Did I mention I love him? Oh yea, sorry, already been over that one already lol:o:rolleyes:.

OK... I just stupidly did myself in asthma-wise on my vacation by thinking I could get away without pre-medicating. It was only a short hill / ride to run an errand. Tried it without the RXs. Wrong:mad:. Thought I'd nearly die:(.

At home... I remember to take my meds pre-ride by doing it as "step #1" in my gear prep ride routine etc. I find it takes about that long anyways to eat /drink a last minute snack, check bike tire pressure, get dressed, chamois lube etc. Viola... by the time I'm ready to saddle up... the meds are kicking in.

On the "no place to warm up"... can you spin easy in the sub for laps before heading out? Or even a parking lot when the club ride meets? Just an idea.

I have a hill that comes up pretty quick on my usual leave from home route too. Not super steep. But, the pre-meds are the total key. Plus, I have other ones also as part of the maintenance.

I also check the humidity hour by hour on weather dot com in my riding area before I go out. And from one of our drug companies, get auto-emails on the pollen levels and type in our area. Wind speed and recent wet and/or dry conditions are also a factor in traveling vectors.

It's really become part of a "science" of my riding. I even type it in my Garmin TrainingCenter notes section... "meds were this, felt this asthma-wise on X % grade hill with said drug regiem, percepitation etc.". I know that sounds OTT. But it really helps you nail down what you need. And helps to communicate more effectively with your docs.

Lastly... if you are fully "drugged up well"... and you are sure this is enough... it might just be the need for more hill training to increase your aerobic capacity / fitness level in that situation. Just be safe and smart in doing it.

I wear a HR. If my "wind-less-ness" is due to my HR reaching it's max... and when my HR recovers, and I can breath again... I know it was not the asthma. Hope that makes sense. If it was the asthma... you would not be able to recover when your HR came down... you would still be constricted... and could not suck wind in to breath... that would be the asthma.

Everyone has a VO2 max as you may already know. I think being an asthmatic gives us a slight disadvantage to that. But, other factors apply. I posted some thread about it that a while back. The vo2 max part. Some of it's train-able. Some of it's genetic.

For training... if fully drugged etc... Spinning class is good for hill / wind intervals... a cpr instructor is right there. Indoor trainer... don't have to get back home. Or, outside, as least a ride partner for some SAG support. Let someone else in the group know about this etc.

The performance with the allergies /asthma is accumulative too. If EVERYTHING is working against me... I will modify my ride performance. Finding where your own personal limit is a balance of trial and error.

Good Luck!:)

Quote:

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Originally Posted by Miranda

This is VERY important regarding medicine...

OK, for your albuterol... are you taking your medicine at least 15 minutes *prior* to your exercise?

If you do not, trying to take it after you are already in a full blown attack will do little, to no, good. Unfortunately:( ...as you have already figured out.

I wear a HR. If my "wind-less-ness" is due to my HR reaching it's max... and when my HR recovers, and I can breath again... I know it was not the asthma. Hope that makes sense. If it was the asthma... you would not be able to recover when your HR came down... you would still be constricted... and could not suck wind in to breath... that would be the asthma.

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Hi Miranda, Thank you for the long response. I do take the albuterol before I work out.... and yes, at least 15 minutes before I work out. it is part of my morning "get out the door" routine. My GP told me that it *might* help when I was riding and already short of breath w/ hills---but it isn't.

I may just have to take laps around the neighborhood--but even it is fairly hilly!
Sounds like I need to find a specialist and read up on asthma/allergy docs vs. pulmonologists.

I am waiting on my HR monitor to come in right now (ordered it). How did you determine your max heart rate with your asthma symptoms? Were you able to determine this only when you were medicated properly? Does that question make sense??

Thank you for your thorough reply! Very helpful!

I used to have asthma. I would have attacks at home, while exercising, and just while being. It was no fun at all. Albuterol was a wonderful thing when I finally got some.

The main thing, though, is that I USED to have asthma. I have not had an attack in about five years. The key for me is that I moved out of apartments with carpets into a house with wood floors and NO CARPET. It has made all the difference for me.

If you have carpet--can you either replace it with a wood floor or move to a place with no carpet?

This is in addition to everything that Miranda says, of course.

Quote:

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Originally Posted by Onix

I am waiting on my HR monitor to come in right now (ordered it). How did you determine your max heart rate with your asthma symptoms? Were you able to determine this only when you were medicated properly? Does that question make sense??

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For me, it was a matter of looking at my HR when riding normally, when exerting myself and then when I started having the erratic breathing (which happens to me around 175, but I'm in my late 20s, so yours could vary wildly depending on age, general fitness, etc). When my issues are HR related, it kinda feels like asthma, but kinda not... For me, it's less a feeling of constriction in the chest and more like my throat is constricting. It sounds weird like that, but it's the best way I can describe it.

On the diff between allergy/asthma and pulmonologist:
I've been seeing a pulmonologist, but I'm looking to change. He's just not that interested that I take my inhaler on average 4 times per hour on a ride :eek: As my GP says, "the goal is to not need the rescue inhaler, ever". I think the downside of a pulmonologist is that they may not see many active people. I'm usually the youngest by at least 40 years when I go see him and one of the few not on oxygen. That could just be his practice, but it's not terribly encouraging.

I've seen allergy/asthma specialists in the past. The big downside, in my opinion, is the pushing of allergy shots. They work for a lot of people, but I've been there done that, didn't work. I prefer not to have to justify my decision on every office visit, but your experience could be different. But, they seem to be used to dealing with younger and more active patients. They are much better at treating the underlying allergies to allergic asthma and building a comprehensive treatment plan to cover the allergy and asthma parts of the equation. So, if you think allergies might be playing a role, that may be the way to go.

Quote:

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Originally Posted by tulip

I used to have asthma. I would have attacks at home, while exercising, and just while being. It was no fun at all. Albuterol was a wonderful thing when I finally got some.

The main thing, though, is that I USED to have asthma. I have not had an attack in about five years. The key for me is that I moved out of apartments with carpets into a house with wood floors and NO CARPET. It has made all the difference for me.

If you have carpet--can you either replace it with a wood floor or move to a place with no carpet?

This is in addition to everything that Miranda says, of course.

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Hi there Tulip,

I actually don't have any carpet in my house at all! It is all wood floor! (well, we do have a throw rug or too). My asthma doesn't bother me much off-the-bike...but...I wonder if my lungs are being irritated off the bike (at a degree that I can't really tell), and thus, when I get on the bike...I find myself more irritated.

:)

Quote:

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Originally Posted by lo123

For me, it was a matter of looking at my HR when riding normally, when exerting myself and then when I started having the erratic breathing (which happens to me around 175, but I'm in my late 20s, so yours could vary wildly depending on age, general fitness, etc). When my issues are HR related, it kinda feels like asthma, but kinda not... For me, it's less a feeling of constriction in the chest and more like my throat is constricting. It sounds weird like that, but it's the best way I can describe it.

On the diff between allergy/asthma and pulmonologist:
I've been seeing a pulmonologist, but I'm looking to change. He's just not that interested that I take my inhaler on average 4 times per hour on a ride :eek: As my GP says, "the goal is to not need the rescue inhaler, ever". I think the downside of a pulmonologist is that they may not see many active people. I'm usually the youngest by at least 40 years when I go see him and one of the few not on oxygen. That could just be his practice, but it's not terribly encouraging.

I've seen allergy/asthma specialists in the past. The big downside, in my opinion, is the pushing of allergy shots. They work for a lot of people, but I've been there done that, didn't work. I prefer not to have to justify my decision on every office visit, but your experience could be different. But, they seem to be used to dealing with younger and more active patients. They are much better at treating the underlying allergies to allergic asthma and building a comprehensive treatment plan to cover the allergy and asthma parts of the equation. So, if you think allergies might be playing a role, that may be the way to go.

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Gotcha. Thank you for the clarifications re: doctors and heart rate! I am curious to start having more information about my heart rate (hopefully soon). Thank you!!

Quote:

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Originally Posted by Onix

Interesting. I hadn't really thought about all that with allergies! I live in Austin---and allergies can be really funky here...so it is possible that I am running into different allergens a I ride.

Thanks for the replie!

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I live just outside austin and can tell a huge difference in town vs out by my house. I have had alergy and exercise induced asthma all my life. You can go to a lung doctor...thats the best thing then you can get a full workup. You do not want anything missed.

I must make sure I use an antihistime/decongestant before (long before so they have kicked in)riding. I also make sure I use my abuterol at a min 30-60 min before the ride and again just as the ride is starting (2puffs each time holding in for 30 seconds each time).

Good luck with your referrel.

Tina

Thanks Tina :)

Oh, Onix, I feel your pain!

I've had asthma since I was a kid (I'm 42 now), and for years if I was on a group ride and we came to a hill, you could literally hear me breathing (trying to breathe) all the way up the hill. Even though others said they were maxing out on their heart rates, you couldn't hear them breathe!

Anyway, I tried Albuterol before rides, which helped a little--I had always used it for running. Finally I posted a question about his on RoadBikeReview, and they mentioned a couple of things which helped.
1) Warmups are really important for people with asthma.
2) It's important to take allergy medicine EVERY day, even if I am not having symptoms
3) Go to a doctor!

So,I went to a doctor. He took my blood pressure (92/60), my O2 sats (99) and my resting pulse rate (53) and looked at me and said, "You can't get any better than that!" But, he was a good doctor and sympathized, at least a little, so he gave my Asmanex and told me to give it a try.

The first time I rode with it, the difference was like, night and day! I remember going up a hill, and air was still going into my lungs! "Hey---I can breathe!" I announced.

The next weekend I had an event, the Tour of the Litchfield Hills, mostly hills, hence the name. As a crested one of them, I looked down and was amazed to discover my heart rate was 175 AND I WAS BREATHING FINE! WOW!
It just seemed so much easier than usual!

Anyway, that's my asthma story. I would highly recommend a visit to a doctor. If you can find a Sports medicine doctor, or at least a doctor who is active you might have better luck. It might be trial and error, too--you might need to try different medicines before you find one that really works.

Regarding your maximum heart rate, just wear a heart rate monitor and ride with a group faster than you. On your own it's difficult to really push it to the max.

From years of running and cycling with asthma, I can tell you the better shape you get into, the better off you are. You can almost sort of, get in good enough shape so that the asthma doesnt't kick in.

Good luck to you!

Thanks Karate mom.

Sounds like your past experience on hills is like my current experience! I need to go to the doctor again. I hate dependence on medication--- but it seems like it is time to find a regular set schedule that helps :/

Thank you for your kind words and well wishes!

Me too!!!

I did my first group ride in several years a month ago and got left on a hill gasping for breath and then after that was still struggling for the next few miles. I went to the doctor the following week and got an albuterol inhaler and that has helped. I had a pulmonary function test last week and got the results yesterday. I've got asthma and not just exercise induced. I'm starting on Flovent 2Xs a day and using a flow meter and recording three readings every morning before using the inhaler(s). I also have allergies and take Claritin and Singulair.

I was trying to blame my breathing on being out of shape and overweight. I had done some riding last year but have been seriously (for me) riding since June 1st and it just wasn't getting any easier - legs felt find breathing didn't. I've got over 450 miles in so far this year which for me is huge.

I've read over some of the posts about best times to ride with asthma. I live in Las Vegas so if I wait too late in the day, it's 100 degrees or higher. We do have a lot of dust out here, and I'm sure that's part of the problem. But, I love being out on the road!

I can ride on the flats, it's the hills that get me. What's the best suggestion for improving my performance? I'm over 50, I've dropped 12 pounds since I started riding in June (still have more to go) and I've added yoga to the mix for flexibility and strength. I ride at least 10 miles 4 to 6 days a week and at least one of those rides is around 20 miles.

I want to do the Viva Las Vegas century in October and/or Tour de Tucson in late November but I know I've got to get my speed up (averaging 10.5 to 11.5 mph) as well as being able to handle the hills.

Thanks for any suggestions. I think the biggest lesson for me was not to make excuses because of the weight and being out of shape but to pursue the issue on the breathing when I had problems.

I was diagnosed with asthma ten years ago and am symptom free now. I went to a homeopath who did ELISA blood test, and milk and tomatoes were off the chart! Food elimnation has been tough, and I do cheat and pay the price with small attacks, but I was so glad the testing figured it out.

Also, accupuncture hugely helped. The allegeries here in AZ are horrible due to importation of plant life that simply does not belong in the desert.

A neti pot can work nicely for sinuses as well, but some people don't like the funkieness of it.

Lisa :)

Thanks again for more tips and commiseration :)

I went to my doctor. I got allergy tested---and tested completely clean!! Totally unexpected. They didn't however do the extensive ELISA ? food testing that someone mentioned earlier.


They have started me on daily flovent (2x day), which hopefully will help. And, albuterol for rides.

Interestingly, my allergist told me that my albuterol will be more effective if I warm up before using it (not 30 minutes before like I had always been told).

Something about your body starts creating the "fight asthma" stuff in your body when you are warming up...then you use the inhaler, which doubles the effect, while at the same time keeping your body creating the "fight asthma" stuff instead of your body solely relying on an inhaler pump before a ride. Sorry I can't be more scientific here :) It did seem to help today though. YAY!

Quote:

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Originally Posted by lo123

For me, it was a matter of looking at my HR when riding normally, when exerting myself and then when I started having the erratic breathing (which happens to me around 175, but I'm in my late 20s, so yours could vary wildly depending on age, general fitness, etc). When my issues are HR related, it kinda feels like asthma, but kinda not... For me, it's less a feeling of constriction in the chest and more like my throat is constricting. It sounds weird like that, but it's the best way I can describe it.

On the diff between allergy/asthma and pulmonologist:
I've been seeing a pulmonologist, but I'm looking to change. He's just not that interested that I take my inhaler on average 4 times per hour on a ride :eek: As my GP says, "the goal is to not need the rescue inhaler, ever". I think the downside of a pulmonologist is that they may not see many active people. I'm usually the youngest by at least 40 years when I go see him and one of the few not on oxygen. That could just be his practice, but it's not terribly encouraging.

I've seen allergy/asthma specialists in the past. The big downside, in my opinion, is the pushing of allergy shots. They work for a lot of people, but I've been there done that, didn't work. I prefer not to have to justify my decision on every office visit, but your experience could be different. But, they seem to be used to dealing with younger and more active patients. They are much better at treating the underlying allergies to allergic asthma and building a comprehensive treatment plan to cover the allergy and asthma parts of the equation. So, if you think allergies might be playing a role, that may be the way to go.

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Hi, was this like your throat was shutting off? I feel like this when under stressful conditions (ie: racing) and when it's cold. I had one doctor that said something may have been triggering like a spasm in my larynx or pharynx (sorry not sure!) which stopped my breathing. But why it is stress related..?

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Originally Posted by ABeezles

Hi, was this like your throat was shutting off? I feel like this when under stressful conditions (ie: racing) and when it's cold. I had one doctor that said something may have been triggering like a spasm in my larynx or pharynx (sorry not sure!) which stopped my breathing. But why it is stress related..?

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Not really the throat, but lower. I start making a weird gasping noise and have to really concentrate on controlling how I'm breathing. It's weird. Concentrating helps, but that tightness is still there.

On a side note, I have an appointment with an allergist next week after discussing my issues with my GP. She thinks my allergies are the problem since I haven't had a 'random' asthma attack in over a year.

I have exercise induced asthma, ferocious allergies which have transcended to the food group as well. I react to my allergies shots for heavens sake. I do albuterol and sometimes a powdered inhaler. I have my good times and bad with my cycling. I do a tough ride on Sats "the old man's shoot-out" here in Tucson and sometimes especially winter I simply have to let off -or die. Most of the time I can hang until right before the bridge as the ascent increases and strains my lungs to the max. It is uphill that puts such a high demand on our bodies for blood and oxygen.The men I ride with understand I have a problem and wait for me,hard to ignore this locamotive coming down the line.I have been doing Mt. Lemmon 2x's a week with a long warm-up and then into intervals, sometimes I try to go farther, I feel like this has helped.I do El Tour de Tucson but my warm-up is hampered by having to stand still too long for the start after my warm-up. Last year when they said go, its a sprint start, I was struggling with drowning in mucus, couldn't get air,debated pulling over and calling a paramedic,kept pedaling once out of the pac cleared all the clutter in my lungs and kept going, catching onto pacs as they passed. I eventually caught back to my son, then my husband who had blown up several miles down the road(did that feel good or what) I fell off once again at Rattlesnake pass,due to the climb,but once again clawed my way back on the other side. I was shocked to see that I had won the female portion of the mileage distance we signed up for(not the full race of 100 miles!). I am 60 years old so I just keep plugging along. For me warm-up is the key to racing and as far as hills go, I have small improvements and sometimes I am not last!

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Originally Posted by retread

I react to my allergies shots for heavens sake.

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OMG - so glad to know I'm not the only one! I quit taking them because the reactions got so bad.


I've found that if I 'tough it out' for climbs I do better if I keep riding. If I stop after getting totally worked up, it's like my body freaks out. So that may be something to keep in mind for others. Just don't push too far-it's a fine line