Training & Nutrition - Excersize Induced Asthma

As I mentioned I'm seeing my lung specialist today. Once the Pulmicort became less effective as an EIA preventive (over 10 years wasn't bad) I started to use the Albuterol without success. Reading the replies here and other research led me to use the Albuterol differently on my ride yesterday. I had been using the Albuterol somewhere between right before and 5 minutes before riding without success. Based on the recommendations I took one puff about 20 minutes before and another a few minutes later. I purposely planned a difficult ride, with the toughest hill on Long Island in addition to a few others in a 55 mile solo ride.Well the Albuterol must of worked as I except for a very brief period on the first hill (up to 22%grade on parts with an 18% average for the hill) had no affects of the asthma. I was able to complete the ride at a decent pace without any of the effects of EIA. So I think this increases my options when I discuss my situation with the doctor.

yea, i used the albuterol 20min before my ride, then taking another puff five minutes later. i also used a spacer because i felt as if i wasn't getting the full effect without it. hope you get some results.

My regiment looks like this:
Allegra
Flovent 2xDaily
Flonase
Albuterol before I ride

I have been taking nearly this same regiment for 10 years and am 37 years old. Works for me. Oh....Don't miss a dose though the rebound will have your lungs locked up tighter than Fort Knox.

It's amazing how well medicine will work when taken properly.

I just came back from the pulmonologist and he put me on Advair. The medium dosage of 250/50 2X per day. Since I had success with just a steroid for so long without Albuterol he wants me to try it without the Albuterol before riding. If it is not enough then I will need the Albuterol. It is a more conservative approach which both of us prefer. No sense taking a lot of medication I may not need. He would rather add on as needed instead of a shotgun approach.

Advair is a very good product, good luck. Please take your albuterol with just incase something happens and the Advair does work, it would be nice to have your rescue inhaler with you to get you out of a pinch.

Advair is a very good product, good luck. Please take your albuterol with just incase something happens and the Advair does work, it would be nice to have your rescue inhaler with you to get you out of a pinch.

thanks for the advise. I hope my wishful thinking is reality. I'll report back on how my ride goes with only the Advair. Hopefully these threads can be helpful to someone in the future with a similar situation. The beauty of the internet.

For those following the thread and new readers I have now done 3 longer rides (I have also done some shorter ones) with the Advair. I mainly had two EIA asthma symptoms when riding; shortness of breath or not being able to catch my breath being unable to keep up with the effort mainly on hills and a general feeling of fatigue, where I could not make any effort peddling, feeling very weak. On the first two rides with the Advair on major efforts up hills while I was breathing heavily I didn't have that feeling where I couldn't catch my breath or keep up. Unlike before the Advair I recovered normally in a minute or two after the effort. But strangely I still had that feeling of weakness after about 25 miles on a 55 mile ride. On both of my rides toward the end I couldn't go over about 12-14 mph on the flats where usually I can maintain an 18 mph or more. My average speed after 25 miles was around 16-17 mph where at the end it went down to about 14-15 for the whole ride meaning I was averaging around 12 mph the second half. I found it very strange how my breathing could appear normal but I also felt weak.

So yesterday I decided to try Albuterol about 15 minutes before the ride. It worked great. I felt really strong the whole ride, never had any breathing problems and finished with the lead group, where previously I was dropped ,coming back to the lot 10-15 minutes behind the group. The Advair has a long lasting bronchodialator as one of its components and I guess coupled with the Albuterol it really freed up my lungs. I was courious if this made sense to anyone or if it was a good idea taking two bronchodialators at the same time.I did this without my doctors advise. I will be calling my pulminologist in a while.

Never tried Advair. Albuterol is what they gave me, and it seems to work OK.
I am reluctant to use medicine, so I often use a Chinese herb called cordyceps.
But whenever things get bad, I get out the Albuterol.

I spoke to my lung specialist and he said I should have no problems with taking the albuterol 15 minutes before riding. So hopefully I should be feeling strong when riding.

Isn't amazing how good you feel when you take the proper medicines and take then properly.

Isn't amazing how good you feel when you take the proper medicines and take then properly.

Definitely.

I have EIA, and am gradually seeing less of it the more I ride. I started using Asthmanex in replacement of my Advair. The Asthmanex seems to work better as a preventive.

Now...I can't stand the new albuterol/ethanol inhalers. Guess I'll get used to them though :(

I have EIA, and am gradually seeing less of it the more I ride. I started using Asthmanex in replacement of my Advair. The Asthmanex seems to work better as a preventive.

Now...I can't stand the new albuterol/ethanol inhalers. Guess I'll get used to them though :(
So I take it you take the Asthmanex on a (bi)daily basis and the albuterol 15 minutes before you ride/exersize?

I have EIA, and am gradually seeing less of it the more I ride. I started using Asthmanex in replacement of my Advair. The Asthmanex seems to work better as a preventive.

Now...I can't stand the new albuterol/ethanol inhalers. Guess I'll get used to them though :(

Sooner or later they will have dry powder inhalers for albuterol, they just are slow about getting them out. Last year went I was in Poland they had them already.

This thread has been very helpful to me. I always thought I had a breathing problem but it only affected me during exercise. Saw a specialist three weeks ago and was put on albuterol. Now when I'm climbing my lungs don't feel like they are dying., and I'm recovering my breath alot faster once I clear the hill. Now my legs have to catch up with my breathing.

This thread has been very helpful to me. I always thought I had a breathing problem but it only affected me during exercise. Saw a specialist three weeks ago and was put on albuterol. Now when I'm climbing my lungs don't feel like they are dying., and I'm recovering my breath alot faster once I clear the hill. Now my legs have to catch up with my breathing.
I am glad this thread proved helpful for you. When I started it I was looking for answers for my situation but was also hoping this thread be a source for people in a similar situation searching the forum and internet.

This thread has been very helpful to me. I always thought I had a breathing problem but it only affected me during exercise. Saw a specialist three weeks ago and was put on albuterol. Now when I'm climbing my lungs don't feel like they are dying., and I'm recovering my breath alot faster once I clear the hill. Now my legs have to catch up with my breathing.

Did he give you a spacer for your albuterol?

Did he give you a spacer for your albuterol?
I forgot to ask him about it. I even had a note. He was hoping just the Advair would work since it has an anti inflammatory and long term broncho dialator so he was figuring I might not need it. I tried the Albuterol on my own then called to ask if it was OK which he said yes. So far after 3 tough rides the Albuterol seems to be working without the spacer. If it would work better with it I don't know.

I take Albuterol 20 minutes before my ride with a spacer 5 minutes later. My Doctor also told me allergies and asthma were on the same gene so if you have one you could have the other.

I see that this thread is alive and well during the three weeks I've been out of town.

I'm being switched to Advair from my Serevent. Apparently, the only difference is the addition of steroids. I never responded to steroids in the past, but since the death rate from Beta-Agonists is lower with the added steroids (according to my doctor), my insurance company insists on the switch.

My Albuterol is kaput too as I was switched to the more environmentally friendly, but more expensive powder substitute. Be careful with all this stuff as the death rate is high enough that there was a move in the FDA(?) to remove them from the marketplace. They had the big decision conference some 6-months ago. Too many doses of Albuterol or any Beta-Agonist too closely together can kill. Space them out and it is far less dangerous.

On a bad day, I may need two doses of Albuterol before I ride to breath well. That's in addition to the prescribed twice a day use of Serevent. I space the Albuterol doses a half hour apart.

I don't think there is such a thing as exercise induced Asthma per se. The Asthma is there all the time. Some with mild cases may not notice it until they exercise which causes it to intensify, but it's there non the less.

Al

I don't think there is such a thing as exercise induced Asthma per se. The Asthma is there all the time. Some with mild cases may not notice it until they exercise which causes it to intensify, but it's there non the less.

Al
It is interesting you say this. I always thought I just had exercise induced asthma but in discussing it with my doctor he said I had asthma and the exercise was my trigger. I also think I may have other triggers like pollen but the cortisteroid helps to keep my lungs from being inflamed so I don't get the asthma symptoms.

I am also curious if the addition of the cortisteroid in the Advair helps you to perform better on the bike?

It is interesting you say this. I always thought I just had exercise induced asthma but in discussing it with my doctor he said I had asthma and the exercise was my trigger. I also think I may have other triggers like pollen but the cortisteroid helps to keep my lungs from being inflamed so I don't get the asthma symptoms.

I am also curious if the addition of the cortisteroid in the Advair helps you to perform better on the bike?

For me it doesn't. I was on both a Beta-Agonist and steroids for about a decade (15 years ago?) before I decided to stop the steroids. There was zero difference in how well I did exercising. Now that it's combined in Advair (I think that's the one I'm getting next time), I have to get back on Steroids according to my insurance company.

I'm sure steriods will help some folks exercise more Asthma free. Unfortunately, little is really known about Asthma and what brings on an episode is so individual specific.

In the old days, steroids were thought to prevent long term lung damage. Now they have data that it reduces the death rate to over-use of Provachol and other like drugs. They actually find dead folks with the Albuterol inhaler in their hand.

There can be a lot of triggers for an Asthma attack, For me it includes stuff like orange juice (put me in the hospital once, age 10), over the counter asthma medicines (put me in the college infirmary), sulfated apricots, winds that blow from the more northern directions in the fall/winter bringing who knows what pollen, nitrites in wine, aspirin taken for too long and so on.

Serevent and Advair are nothing more than a time-release form of Albuterol by the way. It suppresses the Asthma that most folks who have what they say is exercise induced Asthma don't know they have.

Al

I don't like Advair. I really don't like it. It's supposed to be a long-acting all day type of treatment. I prefer taking ventolin only when I need it. I was on Advair a few years ago. It eventually lost its effectiveness for me. I think that right now, the optimal treatment is still a steroid inhaler every day, and ventolin only when needed. Exercise-induced asthma especially is not all the time, so why take a drug that affects your body 24 hours a day?

I don't like Advair. I really don't like it. It's supposed to be a long-acting all day type of treatment. I prefer taking ventolin only when I need it. I was on Advair a few years ago. It eventually lost its effectiveness for me. I think that right now, the optimal treatment is still a steroid inhaler every day, and ventolin only when needed. Exercise-induced asthma especially is not all the time, so why take a drug that affects your body 24 hours a day?

Interesting comment. There was some talk in the media when Serevent first came out that the time-release drugs may in fact lose their effectiveness over time. I thought it was happeneing to me some years back as I started having more problems at night. That's when I discovered that Nitrites in wine made me more susceptible to having Asthma problems.

Some time after I retired, I started having a glass of wine every day at diner. That's about the time I thought the Serevent was losing it's effectiveness. I tracked it to the wine. Before, I had drunk wine only occasionally. Had to give it up.

Al

I don't like Advair. I really don't like it. It's supposed to be a long-acting all day type of treatment. I prefer taking ventolin only when I need it. I was on Advair a few years ago. It eventually lost its effectiveness for me. I think that right now, the optimal treatment is still a steroid inhaler every day, and ventolin only when needed. Exercise-induced asthma especially is not all the time, so why take a drug that affects your body 24 hours a day?
As I mentioned way back in the thread I was on Pulmicort (a cortisteroid) and it was enough to keep my EIA in check without any Albuterol (Ventolin) before riding. Was that way for over 10 years. Once that became ineffective I tried the Albuterol before riding. While there was a definite improvement I was not where I should be. So the doctor prescribed Advair thinking/hoping that alone would be enough. Again eventhough there was improvement I still didn't feel as strong as I did 6 months ago when the troubles started. (I have a 53 mile set route with some tough hills, so I can compare how I'm doing) As mentioned I tried the Albuterol on my own before riding and with the daily Advair I have felt pretty good on 3 rides now. In fact maybe even better than I have felt in a few years. However all of this about the Advair being dangerous and probably since I have introduced a short acting broncho dialator scares the sh*t out of me.

However all of this about the Advair being dangerous and probably since I have introduced a short acting broncho dialator scares the sh*t out of me.

I wouldn't worry about it. Just follow your prescription and when you use short term stuff, space the usage apart. I don't believe the Advair/Serevent is any more dangerous than the Albuterol. I do know that they were all looked at recently by the FDA for removal from the market place.

I've been using this stuff from their inception and have had no problems.

To me the biggest issue is to track your dosage. For example, should you forget you used Advair in the morning and double dose then use Albuterol or equivalent and space the doses too closely together, that might be dangerous. If you can't remember if you took your Advair, err on the safe side and skip that dose.

I suspect that the deaths are of those who have severe chronic Asthma and just keep dosing on the stuff in a desperate attempt to get relief. I had a case that before I knew that aspirin aggravated my Asthma, I got into a situation where I could barely breath and the Albuterol had zero affect. This was before Serevent. Had I not known about the danger of the Beta -Agonists, I might have kept puffing away on the stuff. That was in the early days of the trend to take an Aspirin a day for cardio health. It took 10-days of Aspirins before the serious Asthma started.

Al

Have you tried other options, like Singulair, etc.?

Look, lots of opinions, but in medical matters, ultimately, you know how your body responds. You might also want to think about some medical evaluation outside the sphere of asthma. It could be a red herring that both you and your doctor latches onto. You always have to make sure it's not a heart problem.

If you need more regular inhaled steroid, and you have reached the dose limit, sometimes they might let you try a short course of oral steroids to more rapidly resolve some inflammation. You can't be on them too long, though.

Personally, when I was on Advair, I did not worry about the supposed increased risk of death. For me, it eventually caused severe bronchospasm rather than resolved it - like I'm breathing fine, then I take it, and I can't breathe. So my doctor stopped it.

I just want to follow up. I have been on the Advair 250/50 2X a day now for about 4 months. I take two puffs of Albuterol about 20 minutes before riding and the regimen seems to be working well. As long as I don't push too hard in the first 15-20 minutes I am OK. Sometimes I have to fall a little behind when the group starts out fast. Still not thrilled with the long lasting broncho component but I guess I shouldn't complain if it is working with no side affects.

I was wondering how I missed this thread, but I see it was started when I was in Europe and away from a computer.

I was diagnosed with EIA a few years ago, and I use Serevent for my long distance rides. It seems to work quite well for me. The one thing I do need to remember to do is to clean the container. When I don't clean it, I get half a puff, and then I'm puffing down the road.

I tried all the drugs you guys mentioned and I just got a new one last month. New to me anyhow and it works better than all the others I tried over 15 years, Combivent. If I don't take it, or I forget to take it, any medicine before I take off, in cold and windy conditions, forget it. Anyhow, I take the Combivent and once a night Asmanex and I'm pretty much set.

my question is this, are you allowed to use an inhaler if you race? like I carry an albuterol inhaler in my seat bag just in case i get an asthma attack.

Here is a resource for information on asthma, the different drugs available, the proper techniques to administer them and their delivery systems. Contact Sharon at the American Lung Association 661-847-4700, asthma counseling is her main job there. All the information from the ALA is free. The ALA has a fund raiser bike ride in May called "The Lung Ride" (http://www.mrsnv.com/evt/home.jsp?id=1692). Please check "The Lung Ride" (http://www.mrsnv.com/evt/home.jsp?id=1692) website and I'm raising money also for the ALA, check my personal ride page, Dan's page (https://www.mrsnv.com/evt/e01/part.jsp?id=1692&acct=0313085802&rid=0). Thanks, remember then you can't breathe nothing else matters.

My wife's been using Advair 250/50 2X/day for years now. Oddly enough her asthma has gradually gotten much better so that now she almost never uses albuterol - and that's what you want. I use Flovent 220 1X/day, daily, plus Serevent 1X only before a hard ride. Sometimes I'll take an albuterol puff at the top of a pass, but usually never need it.

My wife's been using Advair 250/50 2X/day for years now. Oddly enough her asthma has gradually gotten much better so that now she almost never uses albuterol - and that's what you want. I use Flovent 220 1X/day, daily, plus Serevent 1X only before a hard ride. Sometimes I'll take an albuterol puff at the top of a pass, but usually never need it.

That's great news to hear. If you're using albuteral more than twice a week, not counting taking it before exercise, then your asthma is out of control. If you're having trouble with asthma check with a pulmonologist and use the resources of the American Lung Association.:D

My exercise induced asthma is acting up again. I had a pretty bad ride today. On the way back to the lot, on a 60 mile group ride I had trouble catching my breath. Not real bad but I was breathing heavily for about 25 minutes during a stop for someone to fix a tire. I eventually caught my breath but was very weak after that. The past few weeks I haven't had trouble breathing but have not been riding that well, especially breathing heavily on hills and lagging behind.

I have been taking Advair 250/50 twice a day for about 8 or 9 months. I take two puffs of Albuterol about 20 minutes before riding. On a hard ride I might take one or two puffs more which is 3 to 4 hours after the initial puffs during a lunch stop. Assuming I didn't start my rides real hard it was working pretty well. Today and the last few rides haven't been quite as good. I have not been thrilled with Advair because, one I'm not sure my lungs need to be dilated 24/7 and two I think it makes me antsy. I sometimes have trouble sitting still and don't sleep as well as I used to. I would like a few suggestions for a replacement before I speak to my pulminologist tomorrow. Thanks

Without having read the entire thread (only read the first three or four posts), if you are mostly riding two times a week for about 75- 100 miles, plus you have EIA, I think you are probably doing way too high intensity riding. Riding twice a week is not going to help you much here.

What I would recommend is doing the group rides once per week and doing your own rides where you can so you can build a better base- and I would recommend no less than 6 weeks of riding 4- 5 days a week for an hour minimum, and then one long day where you ride 2- 3 hours- on your own.

Once you pass that base building, start working on your interval training. You've got to work on those hard efforts where you can manipulate heart rate for a quick recovery. You should still be doing that one day of long rides on your own, but change around about three of your other hour workouts to 45- 60 minute interval rides (aerobic intervals and anaerobic intervals). Give the fourth day a tempo training ride day for an hour, and give that last day a recovery ride day. If you can do this for another 6- 8 weeks, then you'll be ready for riding with the group. In those last few weeks, give yourself a day of hill riding in all that, and subtract out one of your interval rides. This is kind of a "last minute training ride" guide, but unfortunately, it's summer now, and the training started late.

I know this may seem like a long time... I'm asking you to take 12- 16 weeks away from group rides, but a big part of your problem may simply be that you need to train yourself a bit better. Two days a week of riding in a group ride is not going to help you any better. Taking time for yourself to get into better shape so you can ride with the fast groups will make all the difference in the world, I think.

koffee

koffee? Back with us? :)