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Training with asthma

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triathchris

Apr 10, 12 9:48

Post #1 of 43 (1655 views)

Training with asthma	Quote \| Reply

I have a question for the forum. This is my first post, so I'm interested to see what comes back.

For the second time in a little less than 4 months I got hit hard by illness. This most recent time it included strep throat, which really hammered me. During this time I tried to step back and take a more objective view of my training and recovery. Initially, I thought I was just asking my body to do a little too much, too soon. But after digging into it a little more, I came up with another hypothesis that I ran by my doctor who agrees with me. That is, my asthma is the cause. I treat my asthma with Advair 2x/day, and very occasional use of an albuterol inhaler. I never have to stop a workout because I'm short of breath or feeling like I'm not taking in enough oxygen. But I realized that asthma is about more than simply breathing. It's my whole system that is effected and it effects my whole system. So that when I'm fatigued, my asthma has the potential to cause more problems even if I'm breathing just fine. Also, I noticed that my latest illness came about 2 weeks after I started injecting more intensity via intervals into my running and cycling. I guess that leads to a few questions for you?

1) Does my analysis make sense?
2) If so, how can I build this into my training?
3) Should I just train less? At lower intensities? When I do intervals, do fewer?

I'm 38 and I've had asthma as long as I can remember. It hasn't prevented me from doing much--other than flip turns--but I realize I will have to deal with it for the rest of my life. If that means scaling things back here and there, I'm confident I'll continue to improve. It may just take a bit longer.

(This post was edited by triathchris on Apr 10, 12 11:47)

Elsa

Apr 10, 12 13:23

Post #2 of 43 (1596 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

I'm no expert, but my experience is similar to yours. Last fall I got the flu, then pneumonia, and left me with asthma. I also use Adair
2x daily plus albuterol.

My doc who is both an asthmatic and an athlete told me that with asthma, I'd be more susceptible to getting sicker from normal viruses, etc. Normal colds, etc could easily be worse than prior to the asthma and could trigger more severe asthma attacks.

I have also definitely noticed the fatigue thing. If my breathing is bad, I'm exhausted.

One big trigger for me in workouts is allergies, so this time of year I take Allegra.

Can't really answer to the intensity question though, sorry.

(This post was edited by Elsa on Apr 10, 12 13:24)

TriCook

Apr 10, 12 13:29

Post #3 of 43 (1588 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

1) My doc has me on the same routine, Advair (inhaler not disc) 2x a day albuterol as needed.

2) Not sure what you mean. I guess answer for 1, would be answer for 2.

3) I train to the best of my abilities and don't let asthma be an excuse to slack off. That includes doing flip turns. Haha.
http://tricook.blogspot.com/

kaolelo

Apr 10, 12 14:12

Post #4 of 43 (1560 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

i've been intubated 2x, on steroids (oral) all during growing up, but i find that the better shape i am, the better my asthma is. that being said, if you have a lot of breakthrough wheezing even on advair, you can go up in strength (250, don't stay on the 500), and/or add an additional med, like singulair. the best is to keep a symptom and peak flow diary, then take it to your provider.

gildasd

Apr 10, 12 14:52

Post #5 of 43 (1548 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

Hi,

I'm an asthmatic, since the age of 9 to now, age 36. I'm allergic to dust mostly.
When I was 13, I could not go up a flight of stairs without stopping for air half way up.
Last year I did 2 IM, 1HIM and 3 or 4 1/4IM. Last week I did the Tour Of Flanders, 244km, at 26.5kmH average (training objective, kill kill kill until I blow up, then fake it to the finish - I held about 165km).

LOng story short; when I was 12, I was given the choice, by a very good English GP, to take the drugs route (that is, lets face it, doping to stay alive) or the long painful route.

The long route took me about 7/8 years, but it involved gradually reducing my asthma drugs and doing "not for asthmatics" sports:starting by swimming 2x a week when I was 12. Building up to 6 hours of daily high intensity basketball when I was 18. I took my last Ventoline when I was 19. And have not touched any drugs since. I keep doing endurance sports, notably triathlon, to push back the date when I will have to take them again. You never fully win against asthma.

The english GP started the ball rolling, but the big break came after a disastrous attempt at homoeopathy at 14. I convinced my mum to spot half arsed attempts, and consulted a lung specialist and his allergy alter ego. I was tested for allergens, was mildly allergic to most with a spike at decomposed cat hair and standard house dust. Thus desensitising was not really effective in my case (but at least I knew what to avoid: girlfriends with cats and no hoover). The lung guy took about 6 hours to teach me how to breathe consciously and exercises to increase my lung capacity. For the first 6 months it made me cough up masses of phlegm, but I noticed improvements within a couple of weeks. I still do deep breathing exercises to get to sleep. Or when my heart rate is at 180 up a climb and I must beat a mate to the top.

I also did a lot of free diving two summers in a row, short 20/30 sec dives, but non stop for 1 hour +. The nudist beach and teen hormones helped on that one :)

Lastly, when I was 18, I did a couple of weeks of serious body boarding. 7am in the water. Don't stop till it's 11am... The act of having to gulp down a massive breath in fear because I was going to get slapped and then spin cycled a couple of time before I could get out of the shore break really opened the last of my lung capacity in a very short time. This being Europe, the cold water (15/16�) probably also helped.

By then I had moved from being the 12 year old that could not run 400m to the 18 year old who could run all day. I finally quit drugs the next summer.

This contains no real advice, but to consult specialists and sport doctors, not a random GP (their remedy is always: drugs and rest). Any solution will take a least 1 year to implement fully. A full program is a 5 year plan.
If possible, with their help, try to aim to drop the drugs when doing sports. Mostly for your personal satisfaction of scoring a tactical victory on the disease. And from personal experience, the asthma drugs really fuck up your heart rate when you are really pushing, then, when your effort level passes a threshold, they do the opposite of what's written on the box. Plus weird reactions in extreme hot and/or slight dehydration. Even if they have the potential to make you go faster, not having a extra variable to manage when racing (and muddle up your blood deprived brain), should end up with you having a better, more satisfying performance.
http://brokeniron.blogspot.com/

(This post was edited by gildasd on Apr 10, 12 15:03)

pk

Apr 10, 12 15:03

Post #6 of 43 (1537 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

From what I see less interval work and more steady state seems to work . One of my clients wins nat champs with asthma and dosnt take too well to max efforts and trains a bit slower than one would like in an ideal world. But on race day boom .. it takes a bit longer to recover from races but thats fine you just have to plan well when to race.
But since consistency is paramount ie getting ill as less as possible. you have to find the way to get the most hours in . Not sure where you live and it applies, but when the weather gets better you can be a bit riskier as you have less chance to get ill when it is a bit warmer.
If you live in colder parts focus more at the end of the season and finish the season late.

I have to be honest I dont know as much about asthma as I should since as it is an (surprisingly)issue with many top ager and elites.
I am sure some want to get the inhaler but its defo a fact that there is quite a few asthmatics in the higher levels
Chlorine dosnt seem to be helpful and saltwater almost a treat but again thats really based on few athletes I have worked with.
Love to hear more too .

http://www.pb3coaching.com

triathchris

Apr 10, 12 15:09

Post #7 of 43 (1532 views)

Re: Training with asthma [Elsa] [In reply to]	Quote \| Reply

Good point w/r/t allergies. I hadn't factored that in as well. I live in DC and it's definitely pollen season here.

triathchris

Apr 10, 12 15:15

Post #8 of 43 (1528 views)

Re: Training with asthma [pk] [In reply to]	Quote \| Reply

It's good to hear you work with others in the same situation. I think I'm going to scale back the intervals a bit. Combining that with what you said about longer recovery makes a lot of sense. It's not the intervals themselves that are causing me problems, but recovering from them. They generally take a lot out of me whereas the long, slow rides and runs, while fatiguing, don't deplete me nearly as much. And yes, the chlorine is NOT an asthmatic's friend. There's no getting around that though. I know lots of swimmers with asthma routinely bring their inhalers to the pool just to open up their lungs I don't necessarily like the idea of dumping more meds into me, but I may play around with that and see how I feel.

triathchris

Apr 10, 12 15:16

Post #9 of 43 (1527 views)

Re: Training with asthma [gildasd] [In reply to]	Quote \| Reply

Good tips on who to see. I've seen an allergist--pretty much everything environmental--but I was wondering who to see about this. Thanks.

pk

Apr 11, 12 0:27

Post #10 of 43 (1483 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

send me a pm with your email and I will ask my client to get in touch with you
ps there is alternatives to clorine in some pools which are great for people that have a blocked up nose after each swim

http://www.pb3coaching.com

(This post was edited by pk on Apr 11, 12 1:24)

DC Pattie

Apr 11, 12 3:31

Post #11 of 43 (1458 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

I've thought the same thing. Over the past few years I've been getting 3-5 colds a year - and with asthma - they can spiral out of control very quickly. I've also had similar conversations with two pulmonologists. Its sort of a chicken and egg scenario. Ultimately, the trigger (for me) is exposure to a viral pathogen. A slight cold that most folks can kick in 2-3 days is a 3-week cough-athon for me. All the inhaled steroids in the world only show modest improvements for me.

I wish I could report a better story, I generally just have to wait it out.

Allie

Apr 11, 12 5:56

Post #12 of 43 (1439 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

I have always had seasonal allergies that responded well to Flonase and Allegra until the birth of my 3rd child. After that the antihistamines did seem to control most of the issues with symptomology, but when I started swimming I discovered the chlorine exacerbated EVERYTHING and I ended up on Pro-Air from the wheezing and cough while swimming. It then started to occur while running.

I find that as long as I take the inhaler before I swim, I am fine. Running is one of those things I just avoid the times of day with high pollen counts if possible.

To the OP, Advair is a steroid, and steroids increase the potential for infections due to their ability to compromise the immune system. I work ad nauseum at my job educating patients and parents on asthma control and preventative tactics. One of the things that we absolutely do not see enough of are people that trend peak flow on a peak flow meter. It is dirt cheap and will give you a really good indicator of when you are not under control; even before you figure it out with symptoms. I would encourage all asthmatics to use one. My daughter has one and uses it every other day when allergy season is at a low risk but several times a day in the Spring and Fall.

Best of luck to you!

Chucifer

Apr 11, 12 6:55

Post #13 of 43 (1427 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

triathchris wrote:

Good tips on who to see. I've seen an allergist--pretty much everything environmental--but I was wondering who to see about this. Thanks.

DC area resident here, too and I have a history of childhood asthma. The recent pollen here has been absolutely terrible that I've been experiencing asthma after intense outdoor runs that I didn't have to deal with a month ago. As such, I've been hitting the Benedryl/Flonase about an hour before a planned intense outdoor workout and will be carrying an inhaler this weekend at Rumpus.

triathchris

Apr 11, 12 7:26

Post #14 of 43 (1419 views)

Re: Training with asthma [Chucifer] [In reply to]	Quote \| Reply

You know, I generally just try and ignore this stuff and act like it doesn't effect me. It does though. The chlorine doesn't bother me too much, but it varies by pool. Wilson is really good. The Lab School is unbearable. I think on the high pollen days, it's worth it to just run inside. Good luck this weekend! I'm kicking off with the Lake Monticello Olympic on May 6th.

triathchris

Apr 11, 12 7:28

Post #15 of 43 (1418 views)

Re: Training with asthma [pk] [In reply to]	Quote \| Reply

How do I PM you? I'm still figuring the forums out.

manitou820

Apr 11, 12 7:50

Post #16 of 43 (1407 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

I've had asthma as long as I can remember. I wasn't very active as a kid because my asthma was so severe. I've been on Advair and nasal spray for most of my adult life. Getting into Triathlon's was definitely very difficult in the beginning. The new drugs do make quite a difference and have allowed me to train harder. The more fit I've become the better my symptoms get at least during training. While I'm resting, my symptoms haven't seemed to improve. I haven't found anything that helps other than listening to your body. WIth asthma there is a good chance you need a little more recovery.

My asthma is primarily allergy induced. So this time of year it's absolutely brutal. I started allergy shots two years ago and this is the first spring I haven't been on any asthma meds. I can't believe how much the shots have helped. It's been a big pain in the ass to get the shots (two shots, twice a week for the first 6 months! Now once a week) but it now looks like it's paid off. I've been told everyone responds differently to the shots. Some people see no improvement, others like myself are able to finally get off their meds. If allergies are you primary cause of asthma I would definitely look into the shots. But they take two years to start making a difference. Not a quick remedy.

Good luck. Asthma sucks, but don't give up!

TriNewfSlaney

Apr 11, 12 8:05

Post #17 of 43 (1398 views)

Re: Training with asthma [manitou820] [In reply to]	Quote \| Reply

Alternative treatment - the side of asthma the pharmaceutical companies don't want you to know about (and you don't, right?).

The best thing I can recommend is the Buteyko Breathing method. Go google it now, and buy the book. If you are dedicated to curing your asthma, you will do it with this. In about 6 months you can be medication free. This takes dedication but absolutely does work.

Whats involved:
- Asthmatics are bad hyperventilators. If all day, you have chronic asthma. If not, than you only hyperventilate during exercise, thus EIA.
- Overbreathing = acute and long term drop in lung CO2. Asthma is a defense mechanism to limit the losses of CO2. Low CO2 = asthma symptoms.
- Buteyko method reduces your breathing and chronically increases lung CO2, thus reducing the need for the safety mechanism (asthma).
- With enough practice, your symptoms will completely diminish and only occur during times of severe trigger, like illness or allergies. but even then the symptoms are not as bad.
- You will have to breath through your nose all the time (except training of course). You will have to keep your mouth closed at night. For me, this means clean shave and duct tape. It works.
- You will have to do "breathing exercises" 2-3 times daily. one set takes 25-30 minutes. I do these while in class, or studying. Work it into your day.

Good luck. This method works if you want it to. Cheers.

Oldnewdad

Apr 11, 12 8:09

Post #18 of 43 (1397 views)

Re: Training with asthma [manitou820] [In reply to]	Quote \| Reply

I also have had great success with allergy shots. I had to go once a week for the first year and am now at a point where I just go in every few weeks. (I was hypersensitive to grass among a few other triggers). If you can find a doctor close to your office or home, it's really not a big deal to get them. Have been able to step down my advair doses considerably as a result (once per day now on the lowest concentration) without having any attacks in three plus years. Training has not been an issue. Might be worth a try to get tested.

1drbread

Apr 11, 12 8:42

Post #19 of 43 (1385 views)

Re: Training with asthma [Oldnewdad] [In reply to]	Quote \| Reply

Great topic!! Thank you for submitting the question. I just ran last night in very cold temps and was struggling all evening to get back to where I was prior to the run. Cold air and ashtma are not a mix. When you run, cover your mouth and nose with a something that allows you to breath in moist, wet air.

Here's a decent starter article from women's health about running and asthma.
LINK

I think the breathing technique mentioned earlier is something I'm going to try as I struggle to get any runs in.

doug in co

Apr 11, 12 8:46

Post #20 of 43 (1378 views)

Re: Training with asthma [Allie] [In reply to]	Quote \| Reply

a third recommendation for the flow meter - I use it before and after most workouts, and at least every day when not working out. This lets you find the patterns in your asthma, and it also can tell you if the medication is helping airflow, or is just giving psychosomatic help.
Advair raises my blood pressure significantly, to borderline hypertensive, and can cause glaucoma in the long term. With the flow meter and a couple of years' data from it I can avoid taking the meds most of the time. On bad days just switch the workout to something easier on the asthma, there have been days when I just go for a walk.

Instead of doing intervals try the 30-30 type of session. I find these are a lot less likely to induce breathing problems, and I've had good results with them. In any case you don't need intervals or anything like them for most of the training year.

my son has asthma and swims competitively, needs the inhaler during pollen season. I wish the local pools would switch to the non-chlorine alternatives..

gildasd

Apr 11, 12 11:55

Post #21 of 43 (1337 views)

Re: Training with asthma [TriNewfSlaney] [In reply to]	Quote \| Reply

TriNewfSlaney wrote:

Funny, this is the polar opposite of what I was taught to do, my lung doctor basically made me do controlled hyper inflation and hyper ventilation of the lungs to slowly increase capacity. While the Buteyko Breathing method seems fine and dandy for sedentary sufferers, I highly doubt it's effectiveness in a for a person in a sport where the capacity to process oxygen is a baseline performance parameter.

As for the questions about intervals:
I have found, that in my case, long intervals (anything over 1 minute in fact) is hard to recover from. But I respond, and recover, very well to short intervals usually 30/15 rest/effort for intensity/cadence and 15/30 rest/effort for power/strength, and I can loads of reps, like 2x 20 reps with a 10minute break. I respond also well to long high intensity, cadence and high tempo endurance (200km plus rides at 26kmH+ average). But everything in between short intervals and (for example) a 5km cadence run is leaves me hurting till the next day, low intensity endurance is also not so good. Problem is, my "no go" zone is bang in the middle of exactly what my triathlon club does in the pool, on the bike and on the run. So I end up doing 90% of my training alone.
http://brokeniron.blogspot.com/

darkwave

Apr 11, 12 14:32

Post #22 of 43 (1312 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

Related question: I have EIA, and sometimes struggle a bit with breathing, but never to a dangerous level -- it's just performance-affecting.

When the air's dry or heavy with pollen, I have some trouble with my breathing even on easy workouts, but nowhere near the issues I have with hard workouts. I usually avoid using my inhaler except for hard workouts, and just deal with it on my easy workouts (I always carry the inhaler) - I just slow down.

How do others handle this situation? I've asked doctors, and gotten conflicting advice (with no one being particularly firm). Do you use the inhaler every time things are a bit tight, or save it for hard days?

Allie

Apr 11, 12 18:52

Post #23 of 43 (1282 views)

Re: Training with asthma [darkwave] [In reply to]	Quote \| Reply

darkwave wrote:

Do you take anything other than a rescue inhaler?
Did they ever suggest an antihistamine or Singulair?
My MD offered to put me on a steroidal inhaler if I had to use my rescue inhaler too often (other than when swimming as a preventative), but I would prefer to avoid that if at all possible due to the side effects.

If I can feel the cough starting, I will slow down, but I will use my inhaler if I need it because the inflammation can really do some damage to the lungs and airways if it is not well managed. I do best when I stay on Flonase and Allegra. That seems to cut down on the need for my inhaler since most of my issues are chemical/environmental allergies run amok.

geodee

Apr 12, 12 3:42

Post #24 of 43 (1253 views)

Re: Training with asthma [triathchris] [In reply to]	Quote \| Reply

I've found a pattern with taking drugs for my asthma. I don't get it as often as I used to, and it's usually not as intense. I use ventolin when I have an attack, and a steroid when I've been having a cluster of attacks. After reading this thread, perhaps that's and old way of dealing with it.

If I take my ventolin for an attack once, then it becomes easier for me to get more attacks. It can go on for weeks, when I switch to the steroid and cut down the ventolin. If I can stop whatever is causing the attack (allergies or cold exercise) and avoid ventolin use, then I don't have weeks of problems. The drugs are clearly making the problem worse.

Now I try to do what I can to avoid the initial attack. I know which times of the year are bad for my environmental allergies (always at the first race of the season), I avoid cats, and if I have to deal with either I'll take allergy medication. That said, I still carry one inhaler in the car, one in my swim bag, one in my winter jacket, and one in my bike bag for emergencies.

I believe that training and especially swimming may have helped me deal with it. Now in our master's group, I'm one of the few who are able to swim over 25m underwater, and during hypoxic sets, I'm usually the one who takes the least number of breaths. I think my body may just be used to working with less oxygen than most people. So maybe there can even be a bit of a benefit to it.

(This post was edited by geodee on Apr 12, 12 3:44)

Allie

Apr 12, 12 5:16

Post #25 of 43 (1234 views)

Re: Training with asthma [geodee] [In reply to]	Quote \| Reply

Prevention of the attacks is key for all asthmatics. The bronchial airways undergo remodeling in poorly controlled asthma that resembles COPD (think smokers and their chronic coughs).
For whatever reason, women are more prone to the adult onset. Lucky us.
I use the Proair as prophylaxis when I swim (and we do this at the school as well with the kids that are highly reactive during their time of triggers and pre-medicate them before they go outside) and that seems to help the incidence of any flare ups.

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