After 8 years without it, I do.

The recent cold weather triggered an attack while I was (ahem) running one night last week. I knew what it was and was pretty angry that the attack slowed me down. In truth, the pain in my chest was so bad it stopped me in my tracks. Crap-tastic.

Now I have a Flo-vent inhaler to use 2x/day, a "rescue" inhaler ( one more thing to carry on the bike), and a spirometer to use & chart my progress. So far I have the lung capacity of a 48" tall kid. Frack!

The other day when I left the house to ride it was 31*. I wore my balaclava and since I didn't have an attack over the course of a 50-mile ride I guess it helped. But when I went out to run the other night I had to use the rescue inhaler twice, and I still couldn't finish the run.

The lesson here is probably to stop running...yet who here with EIA stops cycling because of it?

I'm still researching it, and am grateful for tips, insights, anecdotes you care to share.

The cold air is definitely a trigger for me, too. I ignored my EIA symptoms for years and learned how to just warm up hard and trigger an attack and then chill out and recover and then I'd be ok for hours of hard effort without an attack. But then I just decided to consult my new doctor about it and he gave me an albuterol inhaler and two shots of that 30 minutes before I head out to run or ride and I haven't had an attack yet. It totally changed my life! (I carry it with me just in case).

A bit of hope for you.

I have two friends with exercise asthma that they have learnt to control with various inhalers. It does not affect their cycling whatsoever and I just wish I could get up the hills as fast as them.

I was diagnosed with chronic cold/exercise and allergy induced asthma at age 4 some 67 years ago. Through necessity I discovered that I could run through an asthma attack as the eventually it would mitigate somewhat. I did up to 4 mile runs down to 8 degrees that way for decades.

Even today with the beta-agonist rescue and time-release inhalers, I sometimes have to do the same thing both running and cycling, but it's infrequent now.

My regime is to do Serevent every 12 hours. About a half hour before I start exercising I'll do one puff of a rescue inhaler (Albuterol) . About 10 minitues before the start of the ride I'll do another. If it's cold, I may do another a half hour later. That generally does it. If it doesn't, I'll tough it out.

These beta-agonist inhalers can kill ---- sudden death. Too many puffs too close together does it. They need to be spaced out.

I suspect that the victims have really severe asthma and are not in good shape.

Experimentation is worth while.

Al　
　
　

My wife is a certified asthma educator. She works for the Asthma and COPD Education Center, ACEC, with many clients who have exercise induce asthma. Cold can be a main trigger for asthma, whether exercise induced or not. Using a spacer with your MDI (meter dose inhaler) greatly improves the deliver of the medicine to the lungs and bronchi tubes. All her counseling is free with the ACEC’s main funding coming for a century bike ride we put on every spring, The Woody Y Century and Family Fun Ride, April 9, 2011 (site update in progress). If you would more info and help with managing your asthma you can contact her by dropping me a PM with your contact info.

I also have EIA. I was diagnosed after an attack at a water park while on my honeymoon. I was away from cycling for about 20 years, but when I returned last winter, so did my EIA. After speaking with my doctor, and experimenting with a couple of methods, we've found the following works for me.

About 30 - 60 minutes before a ride, I take 2 Primatene tablets. If the ride is going to be more than 3 hours, then I continue taking the tablets during the ride (every 3.5 - 4 hours apart). I also bring a rescue inhaler with me on the ride. The Primatene tablets (at least for me) are a very good preventative measure, but I have to remember to take them, and take them BEFORE I start the ride.

It seems EIA is more common than I'd thought.

Thanks for your suggestions and replies; they're very helpful. DanteB, a PM is on the way. Thanks for your generosity.

Just call me Wheezy.

Cold weather seems to cause more problems for me. I was using a Flo-vent inhaler for about three years. Can't explain it, but the warm weather attacks just stopped. Cold weather is an entirely different thing. If I don't breathe warm air (i.e. thru a face mask of some sort), I have problems. I'm assuming you didn't have your face covered during your run?

It is pretty common for elite cyclists since the layer of mucus that protects the lungs thins. Alessandro Petacchi got in trouble using an inhaled drug. Many of the drugs are performance enhancing but not illegal to take out of competition but cannot be used in competition. Check out the site below to see if your drug is performance enhancing. At the track, I see a lot of inhalers due to the extreme deep breathing. I can cough for a couple of days after a pursuit but do not use one. Stop running in the cold.

https://www.globaldro.com/

I was diagnosed with EIA two years ago, at the age of 53. Never had any trouble prior to that. I only have a problem in cold weather. In the winter where I live, morning temps are usually in the 20s, sometimes dropping into the single digits. I bike commute year-round, so that's a consideration. I use a FloVent inhaler, which helps a lot. Sometimes, though, I just forget to take it with me. Then I'm coughing for a few hours at work. Mostly this is just a nuisance. I also find that the inhaler, which is advertised as holding 100 doses, only really holds 40-50.

My daughter, who is a cross-country runner, has a more serious asthma condition. She uses a steroidal asthma inhaler morning and evening, and another inhaler at the time of exercise as well. Even this does not work entirely. She gets frustrated with the insufficient efficacy, but keeps on doing what she's doing. Her asthma also is only an issue in the fall-winter.

I have E-IA and have been using Advair Diskus for over 20 years. Its been a lifesaver for me. If I skip more than a day, I'm raspy, short of breath and can't do much of anything. I have not had any side effects from Advair. For the past few years, I've been symptom-free with just one puff/day (mornings) instead of the prescribed two uses/day.

You will probably hear pro and con opinions of Advair. The main thing to remember is that every medication affects every person differently. While I have no side effects, others can have major ones. Thrush mouth for one. So make sure you rinse out you mouth after use.

Hope you can get your breath back - I'd hate to see you give up activities for those symptoms.

You can say that again! I write the date on each one as I start to use it and though my ProAir Albuterol says "200 metered inhalations" on each cartridge, no way do I ever get more than 80 or so. I finally convinced them to give me two at a time so that when one is dead I have a backup and don't have to be without it until I get back to the pharmacy. With my insurance (Kaiser) they only cost $5 each!

I only have trouble in chilly weather. Breathing the cold air through my mouth triggers it, but fortunately it's mild enough for me to get by without drugs. I find that wearing a balaclava that covers my nose and mouth helps a lot.

I have Regence BlueShield and I pay $20 per inhaler with my insurance. My daughter's refills, with insurance, cost $50 for both of them. Nice to be able to breathe, though!

I have my doctor prescribe 3 every three months. I don't use that many, but I like to have 4 or 5 on hand. I like to keep them in several locations. I don't always do all the refills.

I get 3 Serevents at a time for three months. Each one lasts 30 days.


Al

Thanks for bringing this up. I have it, but so far it only happens in the summer, and after I've been active outdoors for weeks. I use my inhalers so rarely (not even 10 times) before they expire. When I finally get it, I use the inhalers for a day or two and not ride for a few days.
As some of you were diagnosed when you were older, I will stay tuned to how it strikes me in the future.

I've had it ever since my lung surgery. I do a rescue inhaler before rides and did twice a day Asmanex for quite a while, but my EIA has gotten so much better this year that I'm only doing the Asmanex once a day.

It does get worse with the cold though. I'll do fewer really hard efforts in the cold. It's not nearly as bad with an easy pace ride.

I'm sure you already know that only inhaling through your nose helps. That's something I had to train myself to do. A balaclava does help, too. Good luck and hang in there.

I had asthma (cold and exercise induced) really bad when I lived in MO, but since I moved to CA (15 years ago) it hasn't been much of a problem.

Now, one hit of albuterol before the start of a cold double century (usually start before sunrise) is all I've needed . . . until yesterday when I had an attack on a really easy ride with my wife. Hit me hard but I breathed my way through it since I didn't have my inhaler along.

Agreed, you never get as many dose out of an inhaler as they say you should! Anyway, all I've needed for the last several years is Albuterol and even that not very often, so I'm not complaining!

Rick / OCRR

I have it too, but it certainly doesn't impact me on every ride. I have found that doing a slow warm up keeps it from impacting the ride. As another person said above I sometimes just make it happen in the first couple of miles, rest for 10 minutes, and then I can ride for hours with no impact. What is really frustrating is that I can't seem to always tell when it will hit. I might ride for weeks without an issue, then the next day EIA cause a ride abort.

So I show up for the group rides early, do a 3 mile warmup loop and then I am usually good to go. Nothing more frustrating than watching the group disappear while you wheeze and cough for five minutes.

Thanks for the reminder too, I am seeing the doc tomorrow so I need to get my albuterol refill.

Mark

Yeah... I'm going to consider that I have it as well... Last few tough rides have really hurt afterwards. In fact I think I just got over this last one.

Time to talk to the doc once I get home from school.

Thanks for your good wishes. It'll take a lot more than this to keep me down. My plan is to make like the Energizer Bunny, even if I have to stop periodically to catch my breath. "Give up" doesn't exist in my dictionary.

Now why didn't I think of that?

When the temps start to drop I have it when I first start off on my ride...once into the ride and my body acclimates to the temps it seems to get better and usually goes away.