Machka 

I have been through a whole heap of tests since I got back from Australia at the end of December ... especially heart and lung tests ... for some chest pain I was having, and for the fact that I hack up a lung when I cycle in cool, damp conditions or when I really exert myself.

After all the results came in, an appointment was booked with an "internal" specialist (heart and lung), and I went to see him today.

He asked me 1001 questions; looked over all my test results, X-rays, etc.; did a bunch more tests ... and then we talked . . .

As I already knew, I have slight valve damage and a mild heart murmur ... he reconfirmed that for me.

And then he told me that he strongly suspects that I do indeed have Exercise Induced Asthma. He has prescribed a stronger, longer lasting inhaler, and has told me that I need to use it BEFORE I go out on my long rides to hopefully prevent anything from starting.

I am to do that for the next couple months. If that doesn't help, then it probably isn't Exercise Induced Asthma ........ and option #2 doesn't sound so good.

BUT ... most likely it is the Exercise Induced Asthma, and most likely this new inhaler will do the trick!! While using an inhaler might not be ideal, if it can help me cycle more strongly, that would be wonderful! I would love to be able to take a full breath of air when I ride in cooler conditions or when I climb a hill!!

Anyone else cycling with Exercise Induced Asthma?

Roody

After I had a heart attack five years ago (happy anniversary!) I did my first deliberate exercize since childhood in a cardiac rehab class. Every time I got sweaty on the treadmill or bike I would start hacking and coughing. They sent me back to my doctor, and he said I had, you guessed it, exercize induced asthma. He prescribed an inhaler (Albuterol) and it helped a lot.

Within a few months, I was exercizing a lot more, and I finally quit smoking. One day my inhaler was empty, but I decided to go ahead with my plans to exercize. This time, no asthma! I have not needed the inhaler since then, and I also don't get bronchitis for 2 months every winter like I used to.

I know this doesn't apply to you, Machka, since you have exercized more than anybody for years, and I'm pretty sure you don't smoke. But there are a couple things you might want to check into.

First, I have read that asthma, even the exercize induced kind, can be related to an allergy or irritant. In my case, I think I was sensitive to tobacco smoke, even though I smoked like a chimney. You might want to ask your doctor if you should see an allergist.

Second, since you are into competetive cycling, will your inhalers cause a problem with the pee tests? I believe that albuterol is considered a performance enhancer in some sports, for example. Also, these inhalers can affect heart rate and maybe blood pressure, so you might need to factor that into your training and cycling. Finally, I can reassure you a bit because I was able to exercize when I had the asthma. I wasn't at your level, but I was on a progressive program from total couch potato to above average fitness during that time. The inhaler didn't stop me from progressing, but I did have to factor it in.

Good luck to you. I'm confident that this will not be much of a setback, if any, for you.

Pedal Wench

Machka, my sister! Similar deal. Here's my story.

Always thought I had EIA. Always carried Albuterol to use in case of an 'attack', but I never had that real wheezing, I just knew I was breathing a lot harder than anyone around me. Before we went out to Colorado, I thought I would try to get it under control. Went to the lung doc, who prescribed Singulair at night, Advair each morning, and still carry the inhaler in case I needed it. Well, riding out in the Rockies, I needed it every day, without fail. It didn't seem to matter that I was taking the daily meds. So, I stopped taking the regular medicines, and again waited until I noticed a problem to use the inhaler.
Last week, I went back to the doc and told him I stopped taking the medicines, because they didn't seem to work. He agreed and said that I should just start using the inhaler BEFORE I need it. I've only been doing this for a week, so I can't offer a full response, but it seems to be much nicer. I'm as out of breath as everyone around me - not gasping while they're just breathing heavy. Oh - since most of my rides are long (not Machka-long, but long) he suggested taking it every four hours, and again, not waiting until I need it. He said something about letting the asthma act up can lead to emphysema (sp?) much, much later in life. In other words, don't let it go untreated.

Machka 

Well, I'm not thrilled about having to carry an inhaler with me every time I get on a bicycle, but I'm really looking forward to being able to breathe!

It had gotten to the point where, not only was I hacking up a lung on every ride where the temperature dropped below about 15C/60F and/or if it rained (both conditions pretty much describe the last two summers here!), but when I really exerted myself much more than normal (like trying to keep up with fast riders, or climbing steep hills), I would start hyperventilating, and would have to stop to calm my breathing down again. There's nothing quite like that feeling of panic when you can't breathe.

My GP put me on Ventolin, but this specialist told me that Ventolin only lasts for about an hour, and for my type of cycling (yes, I told him I did long distance riding), it wasn't ideal. He has prescribed Serevent which is apparently lasts for about 12 hours.

My type of cycling doesn't have any rules regarding drug use, so I can use whatever I want (thank goodness!).

As for allergies, I've been for allergy testing and we discovered that I am VERY allergic to tobacco (cigarette smoke) -- and no, I've never smoked, I get sick just being around it -- and also that I am "sensitive" to practically everything else. One item is particularly bad for me, and that's rapeseed/canola ... and unfortunately they grow it EVERYWHERE here. I lived about 100 yards from a major rapeseed processing plant for about 10 years when I was growing up and haven't been able to be around that stuff since. I live on Claritin for the months of June and July.

Machka 

That sounds like what my specialist told me too!

Pedal Wench

Yeah, it took me a while, but now I just consider the inhaler as essential as my patch kit. I always keep one in my seat post bag.

I loved telling my doctor how many hours I usually ride. He just kinda looked at my breathing chart (I'm like in the 65% of normal group...) and said to just use the puffer every 4 hours, or as needed.

My symptoms weren't so much the hacking, but more like I couldn't catch my breath. After a ride, I would have trouble getting enough air to speak loudly. Not what you would normally think of as asthma, but indeed, it was. I just knew I was in better shape than my breathing would indicate.

Roody

I drove through western Canada a few years ago and there were fields full of beautiful yellow flowers as far as the eye could see. I was told they were rapeseed. That was before everybody started eating canola oil, so I bet there's even more now. It was pretty, but I would hate to be allergic to it because it was literally everywhere.

I had the hacking and the shortness of breath five years ago, and I still do get the shortness of breath once in a great while. About a month ago I went for a ride about midnight when the temp was still 80 deg F. and it was very humid. I got so S.O.B. (that's the legitimate medical abbreviation for short of breath ) that I thought I was going to faint. It really scared me until I figured out that it was that old asthma thing. I had to give up the ride (OMG!) and head for home at about 7 mph. But that is one of the few times this has happened since I quit having the active symptoms. (We sound like old ladies in Florida kvetching about our ailments )

mtnroads

I have had asthma since I was a kid but it hasn't prevented me from doing lots of aerobic exercise for most of my adult life. As a kid though, it was miserable since we didn't really understand it in those days. I have both EIA as well as allergy-triggered from pollens, molds, certain foods, and pet dander. The allergic reactions are more debilitating and can literally send one to a hospital, although it's only happened a couple of times to me. I now take shots for the allergies, moved to an area of cleaner air, and have cut out foods like dairy that exacerbate it, so it rarely acts up anymore.

The EIA is not usually as bad - it reduces lung capacity and strength but one usually feels it coming on, can back off, and then remain functional to some degree. There have been a few times when I had to walk back from a run when I started out too fast. For me, cold dry air is a killer - I will get an attack in 5 min from shoveling snow or x-country skiing if I don't use an inhaler first. Warm, dry air is best - one reason people used to move to AZ for it. You learn to manage it and it isn't a problem. I don't even carry an inhaler with me anymore, unless I'm going somewhere overnight where I might run into a problem. And I keep one in the car.

Now, with respect to exercise. In pollen season or when it is cold, I don't run or bike without taking a puff off the inhaler first, the rest of the year I'm fine without it. Warm up slowly, and breath through the nose as much as possible, to pre-heat and filter the air to your lungs. BTW, yoga is excellent for learning to control your breathing. Once you get going on your workout, especially if you make it past 45 min, most people will not experience a problem. This is the key that will eventually allow you to reduce the use of the inhaler. Many trained athletes with EIA also have a starting routine to warm up slowly, and prevent it from occuring.

Lastly, I cannot emphasize enough - do not live, work, or exercise where the air is bad if you have asthma! Smog, smoke, diesel particulates and chemicals are really bad for your lungs. You have to make it a priority to protect them. Even though you can get away with using the inhaler to prevent an actual attack, as I did for years when running in Sacramento, in the summertime, you will still cause damage that is cumulative. Between the air quality and the pollen, it got so bad there that I had problems breathing at night, which is the main reason I eventually moved out here near the coast, where we get really clean air off the ocean year round. You have to make it a priority.

john

muccapazza

Yes.

Developed it as a kid, I was active in sports and needed to take some pill combo before exercize. Really was pretty potent. Hypothetically, when/if I was offered some Coke at a party when I was younger and marginally dumber, I was/may-have-been really disappointed, I got that sensation, but stronger, from the asthmar medicine I was taking when I was like from 10 to 16 years old! Againa, hypotheyically.

Later in my teens, I was XC skiing, and was given a new thing to try, called Intal, which is Chromlyn SOdium, non steroidal inhanlable stuff. First thought it was'nt gonna work, didn't get my heart racing like the other stuff. But it worked, with no side effects such as sitting around in a chair coming down from my buzz, I guess you might call it, snapping at friends and family after games and races the other stuff caused.

Then a few years later, I was out of the Intal one time, discovered that if I went out slowly for a bit at first, say the first 10 minutes, at slow warmup speed, I didn't get an attack, could ride like a normal person. I still need to take the Intal if I would want to go for a run, woulkd get an attack, but not for cycling.

Anyway, that's my story. Good luck with your situation, might want to ask your doctor about Intal.

Pedal Wench

My symptoms don't usually kick in until quite a while into what I'm doing. Hours and hours into a hike, or usually about 60 miles into a ride. Not sure if warming up for 45 minutes would help me at all. And, I should mention that I have a very hard time breathing through my nose while exercising (horribly deviated septum and sinus problems) so I think I have no choice but to puff.

FatguyRacer

I got diagnosed with EIA back in 1995 just after i started racing again in my 30's. I was using albuterol until 2000 when i stopped racing. I starting training again this year to race next year. I've only needed the inhaler once and that was early on. I really thing it has more to do with allergy and pollution related irritants, but the stuff did help. I also have a deviated septum and the added bonus of still having tonsils at age 42 leaving me with a condition known as sleep apniea. I've been sleeping with a c-pap machine for 3+ years and have noticed a difference on the bike vs all the years before when the condition was undiagnosed.

I really think in the long run i was misdiagnosed. As such i havnt renewed my Albuterol prescription in years.

superdex

Yup, I have it too. Was diagnosed in high school because I'd come home from basketball practice wheezing and unable to take a deep breath. Instead of an inhaler, I tried the Primatene tablets, about an hour before exercise (basketball, hockey, mostly) and in the colder months it works great. I've been able to get away with generic pseudoephidrine as well.

My experience with EIA on the bike has been strangely minimal, though. Have to admit that I haven't ridden a lot in colder weather, but that will change this year, so if ya want I can report back in in say, October?

zebano

I had a couple of allergy attacks as a kid that sent me to the hospital when my family was out camping (we are all allergic to everything). However, it was very sporadic, and the doctors wern't terribly concerned. As I got into high school and cross country, it almost disappeared entierly. My brother OTOH had his own nebulizer (you hook a mask up to it and it pumps some chemicals in mist form into your mout) and 2-3 differnt inhalers (albuteral, ventalin, etc.) at any given time. When I had a problem I just used one of his inhalers, and I was fine (btw our doctor knoew about this and approved).

In college, the freshman 15 turned into the junior 75 and I tried to play ultimate frisbee. I soon found that any exercise induced an asthma attack. I went and visited my brothers specialist who proscribed albuterol for me to take before exercising. My gf moved in and she had a rabbit. I found that being in our apartment could set off my asthma.

I hate being dependant on anything, medicine included, so I kept trying to exercise w/o the albuteral (and live through spring w/o flonase or claratin) and I learned a few things:

1. Slow warm ups (10-15 minutes at ~15 mph) help immensly.
2. Morning exercise is less likely to trigger the asthma (maybe because I am less fatigued?).
3. Being in better physical shape helps (I don't race, so my riding is nowhere near as strenous as yours).
4. Weather below 40 degrees farenheight is the worst.

Nowadays for anything less 50 miles I don't bother with the inhaler. For over 50 miles I carry it with me, but don't need to use it before hand (I average around 18-19mph). 99% of my attacks occur in the winter (probably around 8/year) and I commute by bike 3-4 times a week(year round) and run 2 miles every other day (except in the winter).


I guess all I am trying to say is there is hope, just pay attention to when you have your problems, and you should be able to figure out when you need to use the inhaler ahead of time (the best course).

watchman

I have EIA as well, I take singulair and advair daily and use an inhaler of combivent for running and biking. Not a big deal, as your dr. said, use the inhaler before you start out on your rides. Additionally, your pulmonologist can induce you into having an asthma attack to see if you truely are asthmatic. Not a very fun test though.

lovemyswift

I also have asthma, EIA and delayed onset EIA. In Cincy my alllergy doctor took it pretty lightly, but here in Denver they are much more concerned about it. My triggers are humidity, (I really suffered in Cincy) air pollution, cigarette smoke, wood smoke, perfumes, air fresheners, super cold air, hiking ove 7,000 ft etc.

Since I've been here I've had a lot fewer problems but my allergist also recommended I use my inhaler before I exercise. I've missed a few times and haven't noticed any problems.

Sometimes I start coughing after I finish exercising, and have to use the inhaler. That's what the allergist means by delayed onset.

I also use Singulair and my inhaler is Maxair.

Last summer I forgot the inhaler a couple of times. I was on a ride in Virginia and if a friend hadn't rescued me with his inhaler I wouldn't have been able to finish the ride.

I'm 57 and all this has started within the last 5 yrs.

Kathi

Machka 

That's how mine started ... years ago! On long, cold, damp rides I would come into where it was warm, and hack up a lung, but while I was riding, I felt fine.

Last year it got much worse.

lovemyswift

I started with exposure to cigarette smoke, then wood smoke, etc. It's funny, the first time I had problems with air pollution, humidity was about 3 years ago after we were in Australia for 3 weeks. It had been cool in Cincy and of course it was winter in Australia, then I returned and hit the heat, humidity and pollution in Cincy. It was all downhill from there.
The delayed onset started last summer, but I haven't had much occurance of it here
in Denver, I don't know if its the drier air or using the inhaler faithfully.
In several instances, my inhaler has been a life safer.
I've really had to pay attention to my symptoms. It's been a real learning process, just when I think I know all my triggers something else pops up.
Good luck, using the inhaler before riding just becomes part of the getting ready to ride routine.
Kathi

Machka 

A couple of interesting things about what you've ridden ...

One of my worst attacks was during a 3 month cycling tour in Australia ... in the Grampions. Apparently the Black Wattle was in full bloom, and was causing a lot of hay fever among the residents. I was a mess!

I'm glad to hear that Denver is better because I'm coming to Denver in a few weeks to do another long ride. It would be nice to be able to breathe!

Miles2go

I developed Asthma due to the pollution here in Utah. Regardless of what I do, I can't ride to my ability.

In July we flew out east to bicycle tour from Burlington Vermont to Bar Harbor Maine and back. I stopped taking my meds the day we flew from Utah and never had a single problem. Felt awesome the whole time regardless of how hard I was pushing. Back in Utah one night and the next morning I'm spending the first five minutes after waking up blowing my nose and now it's back to the same old routine.

I retire in 1-3 years and sooo want to move somewhere that I can breath. My wife needs to stay here five more years for her career though.

I'm headed out to Colorado Springs for six weeks starting this September. I'm hoping that's another place I can work as hard as I want on the bike and still be able to breath. We'll see.

Best of luck to you all in dealing with this menace.


Ron
Wasatch Mountain Range, Utah

Machka 

So ... it's not just my imagination that when I'm fighting with my breathing, I'm not as strong? This year in particular I've felt so weak out there ... like it is taking all my effort to do the same things I used to do.



And to you too!

mtnroads

You haven't experienced a bad attack fortunately. I say that because if you had, you would know that when you do, you won't just be limited - you won't be able to do anything. As in walk up one flight of stairs. Pedaling a bike would almost impossible in that situation. A really bad attack prevents you from breathing out - you can inhale slightly but can't push it back out. I have had 5-6 of these over the years, usually from molds in hotel rooms, animals, or a specific food allergy, and it is very frightening. Sometimes even the inhaler barely works, because the passageways get blocked so fast that the medication can't get in there. If caught without an inhaler, be prepared to get to a hospital, drink strong coffee, try to not panic.

Asthma is increasing in frequency especially among children in inner-city environments. I am convinced that air pollution is making it worse, even though the air is supposedly cleaner in many cities than 30 years ago. There could be other factors of course. Denver is better than some cities but can be pretty nasty in the winter, due to the inversion. That is where my problems worsened again as an adult, and the next stop, Sacramento, was just as bad. I finally found clean air out here near the coast where we have almost constant prevailing winds from the west, and after 7 years the problems are virtually gone. Of course, my beloved dogs have since passed on, so I am not exposed to that either, at this point.

Speaking of which - we love our pets, but it suprises me how many people with asthma and other breathing problems have indoor house pets, especially cats and dogs. I had two labradors for years and even though I kept them out most of the time and was careful to clean up, the hair and dander gets on everything eventually - clothes, carpet, bedding, etc. If you have any allergies to pet dander it will eventially affect your breathing, and will become a chronic irritant. And with allergies, it is all cumulative. If the pollen or air quality is bad one day and you pet the neighbors cat, you could have an attack, when either one by itself isn't a problem. It all adds up.

It takes a lot of detective work to figure out what is causing your problems, and usually they can be resolved, but if not, consider moving to a better environment instead of having chronic issues and depending on inhalers all the time. You just have to sit down and carefully evaluate your environment - the air quality indoors and out, pollens from trees, grasses, weeds, presence of animals, humidity - which causes molds and dust mites, smokers, chemicals, etc. The person who mentioned feeling better when on vacation - that is a wake-up call that something in your environment is causing a problem.

Machka 

I've had two attacks which I thought were pretty bad. On one occasion I was cycling in cool temps in rain, and I was really pushing it trying to keep up with a friend. As I rode, I was finding it harder and harder to breathe until all of a sudden I started hyperventilating ... panicking ... and crying. None of which helped me breathe. We had to stop cycling for a while until I calmed down.

The other was on a 1200K brevet in Australia with those black wattles around. I struggled through that whole 1200K, hacking up a lung every time I stopped at first, and then just hacking up a lung all the time. Toward the end I was climbing a steep hill shortly after a break. Those breaks just killed me ... going in somewhere warm, and then back out into the cold again and so I was struggling to breathe in the first place, then I was pushing it on the hill. I hyperventilated so badly I nearly blacked out that time.

Both times, but especially the second time, every breath I inhaled hurt, and it felt like such an effort to get the air in there.

But that's as bad as it has gotten so far.


I live in a house with four cats. I've had at least one cat, and more often more, for the past 14 years.

And I know what you mean about the pollen. I lived right next door to a canola processing plant for 11 years with no problems, but you could smell it most of the time. I moved to a province where all they grow is canola and within about a year ... I had developed allergies to it. I can't cycle past canola without stuffing up and my eyes watering, and I can smell a canola field long before I can see it.


Trouble is ... I haven't found a place where my breathing is good yet. I've been struggling with this for almost 2 years and I've had trouble all over western Canada, all over eastern Australia, and all through west coast USA.

Although, I'd have to say that Queensland Australia, where it was very, very hot wasn't too bad.

Machka 

What a difference!!

I used my short-acting inhaler BEFORE my ride today, because it was a short ride (60 kms) ... one I dubbed, "The Tour of Ten Hills".

The hills were various shapes and sizes, and I made it up each and every one of them without having to walk. On a couple of them I was puffing quite a bit, but never had to cough. I felt great out there, and recovered quickly from all the climbs!! I could BREATHE!!

When I got home ... I was fine! Not a single cough!

Al.canoe

I've had chronic Asthma since I was 4 and I'm now 66. It's almost killed me twice. It's exercise, cold and allergy induced. I've kept it under reasonable control with inhalers like Albuterol (a Beta Agonist for symptomatic relief) and inhaled steroids.

Some 4(?) years ago they came out with a time-release Beta Agonist, Serevent. You can either take it a few hours before you exercise or once every 12 hours every day. I do the later.

My first use of Serevent was the first time I did not have exercise induced Asthma in 58 years. It's been that way ever since. I can also exercise hard down to the low 30's with no Asthma. I was able to stop using the inhaled steroids and my use of Albuterol is down at least 90%.

Al

womble

I am generally asthmatic. If it's cold outside and I start excercise without any warmup, I'll probably get a mild attack.

Solution? Take a shot of ventolin before heading out and I'm fine for the rest of the day.