Question:

Hi! My name is Jessica Racusin. Robert’s my dad, I’m using his account while home for the holidays. I have had asthma since I was a little kid, and now I’m running for Williams College. This past XC season I had terrible trouble with my asthma, I missed a large part of the season. My doctor recently gave me Beclovent. I also take Intal and Ventolin or Proventil inhalers. Is there anything else I can do to help my asthma? It seems to be getting worse lately, despite my new medication. Also, are any of these inhalers banned substances? They don’t seem to give me much of a competitive edge: sometimes I do well, sometimes I still suck! Thanks everyone and have a good holiday. Jess

Response:

I have exertional asthma, and I agree that use of the "instant relief" inhaler should be limited to extreme attacks.  However, from my experience, the wheezing does not go away while exercising – in fact, it gets worse, so that I feel as if my lungs have collapsed.  When I do stop, the effects do not just go away.  It can take up to two hours of sitting or laying down before I can breathe normally again.  I have been known to use an inhaler during a run, or face the long, painful walk home.

This to me sounds more like a chronic asthmatic condition.  I experienced as a child, when I often had asthma bad enough to require house calls by a doctor.  In any case, as often happens, the asthma mostly went away as I entered adolescence and adulthood.  I still get the exercise-induced variety on occasion, and it never lasts more than 10 or 15 minutes if I ease up a bit.  The asthmatic condition you describe above would, indeed, warrant an inhaler.                      <… Anyone who has problems wheezing while running should see their doctor immediately.

With conditions as you describe, I thoroughly agree.  Acute asthma attacks can be deadly. – Curt Vaughan

Response:

I have exertional asthma, and I agree that use of the "instant relief" inhaler should be limited to extreme attacks.  However, from my experience, the wheezing does not go away while exercising – in fact, it gets worse, so that I feel as if my lungs have collapsed.  When I do stop, the effects do not just go away.  It can take up to two hours of sitting or laying down before I can breathe normally again.  I have been known to use an inhaler during a run, or face the long, painful walk home. This to me sounds more like a chronic asthmatic condition.  I experienced as a child, when I often had asthma bad enough to require house calls by a doctor.  

I have symptoms similar to Tanya’s (although it’s never been so bad that I felt as if my lungs had collapsed) but mine is almost certainly exercise-induced. I never had asthma as a child, and I never even had exercise-induced asthma till about 1.5 years ago. Even now I never have asthma except during and after exercise. However, the symptoms (like Tanya’s) do persist throughout exercise and (for me) the worst period is the half-hour or so after I stop exercising. According to the Running Times article and also according to my doctor, this is a very common way for exercise-induced asthma to manifest itself. I need to use my inhaler some time *before* exercise and do a long slow warmup to prevent the symptoms from occurring. — * Siddarth Subramanian           Austin, Texas, USA             *

Response:

- Hide quoted text — Show quoted text – (Steven Fagan) writes: A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it? — There was an article dealing with exercise-induced asthma in a cycling magazine which I read recently.  It indicated, and I can confirm this by experience, that exercise-induced asthma generally starts fairly soon in the training period, and usually goes away in 10 or so minutes. There are some things which aggravate the situation, such as cold air, which can cause fluid to accumulate in the lungs, and some foods (such as bananas).   I was a chronic asthmatic as a child, and now occasionally have onsets, usually triggered by allergies and/or colds.  I would _not_ recommend using many of the inhalers on the market while exercising (I’m not referring to the steroid preventative inhalor, which one takes once or twice per day). Most of these inhalors contain stimulants such as epinephrine, which if inhaled frequently can cause the heartrate to speed up dramatically.  This can really stress the body when compounded with the stress produced by exercise.  If you truly have exercise-induced asthma, try slowing your pace for 10 to 15 minutes and see if the symptoms fade. – I have exertional asthma, and I agree that use of the "instant relief" inhaler should be limited to extreme attacks.  However, from my experience, the wheezing does not go away while exercising – in fact, it gets worse, so that I feel as if my lungs have collapsed.  When I do stop, the effects do not just go away.  It can take up to two hours of sitting or laying down before I can breathe normally again.  I have been known to use an inhaler during a run, or face the long, painful walk home. With use of the steroid inhaler, the need to use the decongestant decreases.  Running will also help build up the lungs’ strength.  Note that my above remarks were from experiences that I had while not using the steroid inhaler, and when new to running. Anyone who has problems wheezing while running should see their doctor immediately.

I have had asthma since I was five and found out that it works very fine to use an "instant relief" a B2-inhibitor. As soon as I feel anything that weakly resemblance an attack. Sometimes am I even taken the B2-inhibitor in preventive purposes. It works fine. I have not seen any studies that can prove that this is bad. Compare to people taking B-blockers for high blod-pressure. This is my recomendation. Another recomendation I have is when it is cold outside some people asthmatic or not, get cold-indiced asthma. This can easily be prevented by using a preheater in your mouth. Works fine. arne

Response:

I too have exercise induced asthma.  Usually only on hot dry days when I really extend myself.  The inhaler that I used to use is a banned substance, for good reason in my experience.  Does anyone know of an inhaler that does not have the performance enhancing side effect? Paul Stek

Response:

I too have exercise induced asthma.  Usually only on hot dry days when I really extend myself.  The inhaler that I used to use is a banned substance, for good reason in my experience.  Does anyone know of an inhaler that does not have the performance enhancing side effect? I have had asthma since I was I kid. Of all the drugs and inhalers i have used, I believe Provental is the best. I take one puff before I run and I never have trouble anymore. My doctor prescribed this for me when I complained about other inhalers with steriods and adrenaline in them. Provental can be taken by any athlete as it contains no performance enhancers.

I agree completely on the provental. Also my doctor put me on a program of beclovent several times a day and over a period of time (a year or so) it has reduced the exercised enduced problem to where it’s almost never a problem anymore (but you can never be sure).

Response:

I too have exercise induced asthma.  Usually only on hot dry days when I really extend myself.  The inhaler that I used to use is a banned substance, for good reason in my experience.  Does anyone know of an inhaler that does not have the performance enhancing side effect?

I have had asthma since I was I kid. Of all the drugs and inhalers i have used, I believe Provental is the best. I take one puff before I run and I never have trouble anymore. My doctor prescribed this for me when I complained about other inhalers with steriods and adrenaline in them. Provental can be taken by any athlete as it contains no performance enhancers.

Response:

Hi — Sorry if this has been brought up recently. A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it?

I have had asthma since a child, though not exercise induced. What type of inhaler is she using? To my knowledge there are two basic types of inhalers: the preventative type which is taken regularly; and the other type to fight an attack. The general rule seems to be if you are using the later type inhaler (ventolin, bricanyl? ..) too frequently then you may need the former, preventative, type as well. I think these preventative types are generally referred to as "inhaled steriods".  The type that I have been prescribed contains a very mild dose of some steriod. They have no/minimal side effects so my doctor says (I’ve been on it for over a year now). I’m no expert but if she needs to inhale often during a run then there is probably a need for further medication. They say that if you rely too much on the type of inhaler that is just for treating an attack then it’s effectiveness will gradually reduce and you are looking for trouble. My occurrence of weasiness/attacks has reduced greatly since I’ve been on the preventative inhaler (I forget I’m an asthmatic sometimes). However, I have found that some chest infections (particularly with congestion) will make breathing very difficult and even the inhalers have no effect. In these cases I’ve gone back to my doctor and he’s wacked more drugs into me (antibiotics, I think) which have cleared up the infection and subsequently the asthma. I don’t know if her asthma will go away. I know my asthama is still lurking behind the medication and my guess is it wont ever go away. I don’t want to go promoting drugs unnecessarily so I suggest you find a better doctor, or get referral to a specialist, if the one she is seeing now is not helping. I wouldn’t settle for battling on. This is just from personal experience and, again, my asthma is not exercised induced (I don’t know whether there is any difference in treatments for the different types of asthma). Steven

Response:

 (Steven Fagan) writes: A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it?

– There was an article dealing with exercise-induced asthma in a cycling magazine which I read recently.  It indicated, and I can confirm this by experience, that exercise-induced asthma generally starts fairly soon in the training period, and usually goes away in 10 or so minutes. There are some things which aggravate the situation, such as cold air, which can cause fluid to accumulate in the lungs, and some foods (such as bananas).   I was a chronic asthmatic as a child, and now occasionally have onsets, usually triggered by allergies and/or colds.  I would _not_ recommend using many of the inhalers on the market while exercising (I’m not referring to the steroid preventative inhalor, which one takes once or twice per day). Most of these inhalors contain stimulants such as epinephrine, which if inhaled frequently can cause the heartrate to speed up dramatically.  This can really stress the body when compounded with the stress produced by exercise.  If you truly have exercise-induced asthma, try slowing your pace for 10 to 15 minutes and see if the symptoms fade. – Curt Vaughan

Response:

– Hide quoted text — Show quoted text – Hi — Sorry if this has been brought up recently. A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it?

I was diagnosed as having exercise-induced asthma last spring too, and it seems to have gotten worse this fall (doesn’t affect me in the summer), so I’m interested in the answers to some of these questions also. I have had asthma since a child, though not exercise induced. What type of inhaler is she using? To my knowledge there are two basic types of inhalers: the preventative type which is taken regularly; and the other type to fight an attack. The general rule seems to be if you are using the later type inhaler (ventolin, bricanyl? ..) too frequently then you may need the former, preventative, type as well.

That’s interesting. What frequency would you consider frequent? I have been prescribed Ventolin and I’ve found that I pretty much have to use it before a run on a cold day to prevent an attack. Even then, on some days, or when I’m running particularly hard (like a race), if I haven’t warmed up for long enough, I get attacks anyway. In those cases, I’ve found that using the inhaler after exercise (when the coughing and wheezing are at their peak) immediately reduces the symptoms. The feeling of suddenly being able to breathe a lot more air was amazing to me because in the past I had just not noticed that I wasn’t breathing enough. Anyway, my question is: would once or twice a day through fall/winter/spring (just before and sometimes after exercise) be considered frequent? Should I talk to my doctor about getting the steroidal inhalers? To all those with exercise induced asthma – the Running Times article some time back contained some useful tips. The chief among them was slow, long warmups. I tried this on the last race that I ran and found an enormous improvement over my previous race even though conditions were actually more conducive to my getting an attack. I’d like to hear what else works for others. — * Siddarth Subramanian           Austin, Texas, USA             *

Response:

– Hide quoted text — Show quoted text – (Steven Fagan) writes: A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it? — There was an article dealing with exercise-induced asthma in a cycling magazine which I read recently.  It indicated, and I can confirm this by experience, that exercise-induced asthma generally starts fairly soon in the training period, and usually goes away in 10 or so minutes. There are some things which aggravate the situation, such as cold air, which can cause fluid to accumulate in the lungs, and some foods (such as bananas).   I was a chronic asthmatic as a child, and now occasionally have onsets, usually triggered by allergies and/or colds.  I would _not_ recommend using many of the inhalers on the market while exercising (I’m not referring to the steroid preventative inhalor, which one takes once or twice per day). Most of these inhalors contain stimulants such as epinephrine, which if inhaled frequently can cause the heartrate to speed up dramatically.  This can really stress the body when compounded with the stress produced by exercise.  If you truly have exercise-induced asthma, try slowing your pace for 10 to 15 minutes and see if the symptoms fade. –

I have exertional asthma, and I agree that use of the "instant relief" inhaler should be limited to extreme attacks.  However, from my experience, the wheezing does not go away while exercising – in fact, it gets worse, so that I feel as if my lungs have collapsed.  When I do stop, the effects do not just go away.  It can take up to two hours of sitting or laying down before I can breathe normally again.  I have been known to use an inhaler during a run, or face the long, painful walk home. With use of the steroid inhaler, the need to use the decongestant decreases.  Running will also help build up the lungs’ strength.  Note that my above remarks were from experiences that I had while not using the steroid inhaler, and when new to running. Anyone who has problems wheezing while running should see their doctor immediately.

Response:

A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it?

Pretty much the same thing happened to me this spring. Initially I was prescribed an inhaler designed to relieve the symptoms of an attack. Whilst this dealt with some of the worse effects I couldn’t run far without it. What made the biggest difference so far was getting a second inhaler, designed to remove some of the causes of breathing problems in asthma by reducing swelling and mucus in the airways. Now I use this one regularly and the relieving inhaler much less, usually just before running. Whilst I am also uncomfortable with the idea of having to use medication for the foreseeable future, the good news is that the goal of the treatment these days is apparently that most people should be free of asthma symptoms. As well as the drugs this involves identifying factors that trigger the condition. In addition to exercise you may find that things like poor air quality, allergies, or stress make things worse, some of which are easier than others for the individual to do something about. Neil Dyce.

Response:

Hi — Sorry if this has been brought up recently. A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it? thanks, john

Response:

Hi — Sorry if this has been brought up recently. A friend has just been diagnosed with exercise-induced asthma. Kicks in while running or even after a fast flight of stairs. Youch. It seemed to be triggered by a very long viral chest infection last fall, and she’s had shortness-of-breath problems for months now. She has an inhaler, but it doesn’t seem to work terribly well, nor does she want to be sucking it over her whole run. What no one seems to be able to tell her: Will exercise-induced asthma go away? What can she do to ameliorate it?

There was an article on exercise-induced asthma in the November 1993 Running Times.  They talked about treatment via drugs (most of it), breathing exercises, stretches, and some other things.  Different things worked for different people.  See the article for more details. I’m sure there are other good sources of information also. — Milt Epstein Department of Computer Science University of Illinois

Response: