hard workout/breathing bronchial pain

[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?

[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. )