hard workout/breathing bronchial pain

[mimitabby]

when i was in 9th grade, for the first time in my life, someone expected me to exercise. I was in a school with a PE program and we were expected to run 440 yards. The result of this would be I would feel a soreness from breathing too hard down (I guess) in my bronchial tubes.

Last weekend I did some tough hills and really tried to keep up with the other riders, and I got that same thing. Unlike my 14 year old self who felt better the next day, over a week later and there's still some irritation there.

What is it? how can I prevent it?
Thanks

[IFjane]

Mimi, I would love to hear some feedback about this, too. I do not seem to have the lingering irritation that you do, but following a ride (in fact, almost every ride), I have an almost constant tickle down in my throat. I have to cough every few minutes for hours.

I have been diagnosed with exercise induced asthma, but I know others with the same diagnosis & they do not have the cough.

Anyone out there have any ideas?

[mimitabby]

the next day I did have some irritation that made me want to cough. It's hardly noticeable now though, 9 days later.

[Jenn]

I wish I knew what it was to, because when I rode Saturday in the lovely hurricane force winds on the hills, I was hurting. When I got home my lungs ached and I coughed for the longest, it always happens when I ride really hard. Almost like....I hate to say it when (MANY years ago) I use to smoke.

[IFjane]

You too, Jenn? At least we aren't alone out there! I would like to say it's the pollen - and this time of year maybe it is - but it happens to me all year long so that can't be the only reason.

Mimi - I HATED to run in school. I was never very fast & it hurt, both my breathing and my legs. Oh yeah, and then there was that stitch in my side that I would always get. Funny how we can bicycle 100 miles but can't run around the block!

[mimitabby]

IFJane, i too got the stitch in my side. But it took me to be 50 years old before i understood why. I was out of shape! i was not conditioned. I spent too much time sitting around and drawing horses. and reading. I was a rather sedentary child. So... exercise HURT, it was no fun.
I am now more active than i ever was! (how strange) and it took a few years of riding before i got the energy to sustain.
I used to average 9mph and just plain run out of steam after 5 or 10 miles. My puny legs couldn't take it.
So maybe that's the answer. I am now strong enough to work harder, so I was breathing too hard? and roughed up my throat?

[Popoki_Nui]

I get the same symptoms after a hard ride, especially in winter when it's colder (damp or dry doesn't matter). Summer isn't much better.
I got a trial turbuhaler from my Dr. which helps treat the inflamation and opens the broncial passages.
For a less phamaceutical treatment, I put a kettle of boiling water in a bowl, add ~1 tsp of Vicks VapoRub in the water and allow it to dissolve. Gently inhale the steam for 10-15 minutes. (gently is the key; inhale deeply but slowly) Nice and soothing, and eases the cough well.

~S.

[IFjane]

IFJane, i too got the stitch in my side. But it took me to be 50 years old before i understood why. I was out of shape! i was not conditioned. I spent too much time sitting around and drawing horses. and reading. I was a rather sedentary child. So... exercise HURT, it was no fun.

OMG - we must've been twins separated at birth!!

I did become much more active in high school. Still no running; instead, riding those horses I used to draw & water skiing, neither of which put a lot of aerobic demand on my system.

Popoki_Nui, thanks for the reminder about Vick's - I think I will try that next time and see what happens.

[Kathi]

I, too, have been diagnosed with EIA, and have had episodes of coughing after exercising. Both riding and snowshoeing at atitude in the winter. My allergist told me it was "delayed onset EIA". I googled it and this is what I found.


The manifestations of EIA offer some insight into possible causative mechanisms. In persons who have EIA, the first 3-5 minutes of physical activity usually have normal effects. When the physical activity stops, lung function decreases (as measured by PEFR or forced expiratory volume in one second, FEV1) within the 5-10 minutes after the activity stops; if physical activity resumes, symptoms begin to manifest during the first 5-10 minutes of resumed activity. This decrease in pulmonary function is usually accompanied by symptoms and persists for 15-40 minutes; pulmonary function then normalizes, and symptoms resolve (Figure 1).3 Decreases in FEV1 or PEFR often range from 20% to 50%. This early-phase response is the most common manifestation of EIA. In a few individuals, a late-phase response related more to inflammatory changes may occur within 3-10 hours after physical activity stops. The degree of late-phase decrease in pulmonary function is usually greater and more prolonged than in the early-phase response. A refractory period ranging from 40 minutes to 2 hours follows an episode of EIA; during this refractory period, it is difficult to recreate symptoms.

Multiple factors appear to affect frequency and severity of the change in pulmonary function and symptoms. To study possible pathologic pathways by which symptoms are produced, two primary models of asthma have been used: induction of symptoms by exercise and induction of symptoms by isocapnic hyperventilation. Use of these two models has led to the following information:

The greater the person's baseline level of bronchial hyperreactivity as measured by histamine or methacholine challenge, the greater the likelihood of EIA developing or worsening.
The greater the minute ventilation (with all other factors controlled), the greater the intensity and duration of EIA up to a maximum of two thirds of the individual's maximum working capacity.4
The less humid the inspired air, the greater the trigger for EIA (Figure 2).5-8
The cooler the air, the greater the trigger for EIA (Figure 2).5-8
Exposure to airborne allergens worsens EIA.
Certain air pollutants (eg, ozone) may worsen EIA

Here is the entire article, http://xnet.kp.org/permanentejournal/fall99pj/eia.html

I use my inhaler 20 minutes before I exercise and if I feel like I need it during exercise. I've had more symptoms snowshoeing and hiking than I do on the bike. If I do get coughing after I exercise I use my inhaler and the coughing stops immediately.

BTW, I don't remember that any of these episodes were after very strenous bike rides, it did happen after 2 long 4 hrs+ bike rides. I'm thinking that it was something like air pollution, dry air, pollen or humidity that brought them on.

[mimitabby]

inhaler? asthma? really? I will read the article, thanks.

edit:
I read the article. I did not experience any tightening or difficulty in breathing later, when i did a more strenuous hill. This happened not at the beginning of the exercise, but in the middle, it was the first of a series of hills.

what the article mentioned, it being a drying of the passages (which the body finds irritating) makes sense.
I wonder what can be done about it besides using inhalers!

[Kathi]

I'm relatively new to this asthma thing, besides EIA I have regular asthma. Mine, however, is brought on by certain triggers, humidity, air pollution, smoke etc.

In the beginning, I was pretty casual about it but I knew in certain cases I needed to use it, especially when I started coughing. Before I had my inhaler I went into a bar to talk to a friend. I wasn't there more than 5 minutes but had to leave because of the cigarette smoke. I coughed for at least an hour and felt like I couldn't get my breath. It was pretty scary. About that time I started seeing an allergist. He gave me an inhaler but didn't tell me I had asthma. I thought I only needed the inhaler for cigarette smoke. I didn't know that other things would set me off.

In 04 we did Bike Virginia. We were driving to the college where the tour started. It was a warm day so we had the windows down in the car. We were about 30-45 minutes away from our destination when I started coughing. My inhaler was packed in my bag in the trunk so instead of stopping and using it I ignored the symptoms. My cough got worse. Finally, I was so bad that I couldn't get a breath. At that time I thought I was panicking so I still misinterepted my sypmtoms. By the time we got to the school and stopped the car I was so short of breath that I could barely breathe enough to find my inhaler. After I used the inhaler my symptoms subsided.

After that experience whenever I feel symptoms coming on I use my inhaler. I also take Singulair which helps me some. We have a friend whose daughter-in-law died of an asthma attack because she didn't have her inhaler with her. By the time her husband got help she was gone.

I think the article does talk about alternatives but using an inhaler is such a simple solution. For me its 2 puffs before I exercise which translates to 8-10 puffs a week.

After that experience that day in Viriginia I realized that Asthma is not something you want to play games with. Now, I keep my inhaler with me at all times.

[RoadRaven]

Mimi's and Kathi's may be exercised induced asthma... however, some of you others who have what Jenn describes - just the coughing for a few hours, sometimes a few days after a solid ride, may have "Pursuiters Cough".

It's kind've like you've sandpapered your throat with air due to heavy breathing (I get it after most races I do).

<<< Raven trying to breath in a TT

There are a few threads on PC here, and I think EIA also gets a mention in those as well. If you search for either you should find some other perspectives also.

[mimitabby]

PURSUITERs cough!!! That's it!!
thank you.

[kelownagirl]

I have an inhaler for EIA and get Pursuiter's Cough when I ride really hard in cooler weather. Yesterday I read that taking Omega 3 may reduce symptoms of EIA, as does reducing your salt intake.

I am looking online to find more sources but here's a snippet of one article.


Dietary Supplements
Accumulating evidence suggests that a diet low in salt and high in omega-3 fatty acids and antioxidants can reduce the incidence of EIA. Animal studies indicate that salt loads can affect leukotriene release. Many studies show a beneficial effect of a low-salt diet of about 1,500 mg per day, while other authors suggest less than 2,400 mg per day of sodium to reduce the severity of EIA.8,18,19 Eicosapentaenoic and docosahexaenoic acid are omega-3 polyunsaturated fatty acids found in fish oils. These agents competitively inhibit arachidonic acid metabolism, thereby reducing the generation of inflammatory prostaglandins and leukotriene mediators, as well as the inflammatory cell production of cytokines. Therefore, it has been postulated that diets high in fish oils may reduce diseases caused by inflammation, including EIA. To date, clinical data of the short-term use of fish oil supplements for asthma are controversial. Further clinical trials are needed to evaluate the effects of omega-3 fatty acids in people with asthma.17,20,21

Evidence suggests that oxidants produced during the inflammatory process may contribute to asthma; thus, antioxidants may be effective in reducing the severity of EIA. Ascorbic acid (vitamin C), in doses ranging from 500 to 2,000 mg taken one to two hours before exercise, has been shown to improve EIA to subclinical levels in several clinical trials.22-24 Beta-carotene, dosed at 64 mg daily for one week, and lycopene, dosed at 30 mg daily for one week, have also demonstrated efficacy.25,26

Caffeine causes bronchiolar smooth muscle relaxation and can reduce EIA severity. However, the doses required to achieve this exceed the limits permitted for international competition (<12 mcg/mL in urine) and are likely to result in disqualification from professional athletic events. The doses of caffeine required to show benefit (7 to 10 mg/kg taken 90 minutes to two hours prior to exercise) are also likely to cause significant diuresis.27,28

(That was from:

Management of Exercise-Induced Asthma
Cathy L. Bartels, PharmD, FAAIM
Associate Professor of Pharmacy Practice
Creighton University School of Pharmacy and Health Professions,
Omaha, Nebraska

Amy F. Wilson, PharmD
Assistant Professor of Pharmacy Practice
Creighton University School of Pharmacy and Health Professions,
Omaha, Nebraska

US Pharm. 2006;7:42-48. )

[kelownagirl]

I also found this from Indiana University.


Fish oil eases exercise-induced asthma symptoms.

People suffering from exercise-induced asthma were able to reduce their symptoms below the threshold used to diagnose the disease by eating a diet supplemented with fish oil, according to research findings by Indiana University exercise physiologist Timothy Mickleborough. The special diet reduced narrowing of the patient's airway and enabled the person to use less asthma medication, the study showed. These and related research findings by Mickleborough, an assistant professor in the Department of Kinesiology in IU's School of Health, Physical Education and Recreation, offer the prospect of combining dietary supplementation with reduced medication in a treatment that could be at least as beneficial as either in isolation. There would also be fewer of the potential side effects from medication, such as reduced effectiveness from long-term use and toxicity from some medications. In the fish oil study, the post-exercise lung function of participants -- adults with mild-to-moderate persistent asthma -- improved by about 64 percent and their use of emergency inhalers decreased by 31 percent when they consumed a diet supplemented with fish oil, rich in omega-3 polyunsaturated fatty acids, for three weeks. Mickleborough's fish oil findings were published in the January issue of the journal Chest. His poster presentation, titled "Protective effect of fish oil supplementation on exercise-induced bronchoconstriction in asthmatic subjects," is included in the respiratory function session on Thursday (June 1). Co-authors are Martin Lindley, research scientist in the IUB Department of Kinesiology; Alyce Fly, associate professor in the IUB Department of Applied Health Science; and Alina Ionescu, Department of Respiratory Medicine, University of Wales College of Medicine, Cardiff, UK.

Mickleborough can be reached at 812-855-0753 and tmickleb@indiana.edu.

Vitamin C reduces exercise-induced asthma symptoms.

Vitamin C supplementation reduced the severity of exercise-induced asthma symptoms in asthmatics during a study by Indiana University researcher Sandy Tecklenburg. The research by Tecklenburg, a student in the IU Department of Kinesiology's highly ranked doctoral program, involved eight asthmatics who also had EIA. For two weeks, they ingested either ascorbic acid, commonly known as vitamin C, or a placebo. All subjects underwent a one-week washout period before crossing over to the alterenate diet. In EIA vigorous exercise triggers an acute narrowing of the airway afterward making breathing difficult. Tecklenburg's research found that the post-exercise lung function, as measured by the forced expiratory volume in 1 second, decreased by an average 6.4 percent for study participants receiving the ascorbic acid supplementation, compared to decreases of 14.3 percent and 12.9 percent for participants on a normal diet or receiving a placebo respectively. In addition, several proinflammatory mediators were also significantly reduced on the ascorbic acid diet. Her research also found that the reduction in the severity of EIA may occur through a mechanism by which ascorbic acid supplementation reduces reactive oxygen species, thereby leading to a reduction in bronchoconstrictive mediators, which are chemical messengers that trigger airway narrowing. Tecklenburg's adviser for the project was Timothy Mickleborough, assistant professor in the Department of Kinesiology. Her poster presentation, titled "Ascorbic acid supplementation reduces severity of exercise-induced asthma," is included in the respiratory function session on Thursday (June 1). Co-investigators are Mickleborough; Joel Stager, professor in the Department of Kinesiology; Alyce Fly, associate professor in the Department of Applied Health Science; and Yeon Bai, a graduate student in the Department of Applied Health Science. The research was funded in part by a grant from Gatorade. Tecklenburg received an award for the best research poster in the doctoral student category at the most recent Midwest ACSM conference, where she presented this research.

Tecklenburg can be reached at stecklen@indiana.edu.