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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [kathy_caribe] [ In reply to ]
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Heart monitor installed, did not like how it felt once the lidocaine wore off, haha.

D-Dimer was done also, should hopefully know early-mid next week if it comes back positive/negative. Will inform either way.

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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Good luck, sincerely hope it's nothing
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ChrisM] [ In reply to ]
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I have not forgotten about you all and promised I would up date!!!

So the Special Olympics were pretty good to me, amazing to oversee the Ops of the first ever triathlon in the Special Olympics. Very proud of that. My breathing got better too while I was there and I was optimistic. However it shortly returned after the games and i've only ran like 4-5 times since and lifted weights about the same amount of times. Electrocardiologist believes my problem is more pulmonary or cardio based so I headed back to my GP and she was convinced I should get a bronchodillator (sp) inhaler and come back and take a breathing test. I've attached those results for you all.






So as you can see, when I hadn't used the inhaler, my breathing was far below what it should be for my age/sex. The inhaler bumped it up quite a fair amount, to the place it should actually be. While this was exciting news, the problem is, it doesn't alleviate my symptom of having a tight chest and feeling like I can't breathe. Thus yesterday my GP prescribed me a steroid inhaler which she hopes will alleviate that problem.

Problem is, apparently that inhaler is not under my insurance so my doctor is currently having to request an exemption based on need to get it covered. So I'm waiting on that. So it'll probably be about 4 weeks until I will know whether this inhaler is the solution to my problem. In the meantime I can take the albuterol inhaler which forces me to get air even if I continue to feel like i'm not getting it.

So there you have it. That's where I stand. I won't leave y'all hanging, I promise.

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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Hey, thanks for the update, sounds like you are on the road to figuring it out.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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Welcome (?) to the wheezer club.

There are lots of different steriod inhalers so if that one isn't covered another one probably is.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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thanks so much for responding! so the numbers you're looking for are vital capacity, FEV1 and FEV1/FVC ratio. all those numbers increased post albuterol? did they use albuterol? so really all that does is show response. it doesn't necessarily mean asthma. i'd go see a pulmo and/or allergist.

did you ever get a d-dimer and/or BNP or (even better V/Q scan)? another thing is to query all the asthmatics here and see if they don't have significant response from albuterol. I feel it within minutes. i'm a little concerned that you're not feeling significantly better and something is still being missed.

again, thanks for the update!

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [kathy_caribe] [ In reply to ]
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kathy_caribe wrote:
thanks so much for responding! so the numbers you're looking for are vital capacity, FEV1 and FEV1/FVC ratio. all those numbers increased post albuterol? did they use albuterol? so really all that does is show response. it doesn't necessarily mean asthma. i'd go see a pulmo and/or allergist.

did you ever get a d-dimer and/or BNP or (even better V/Q scan)? another thing is to query all the asthmatics here and see if they don't have significant response from albuterol. I feel it within minutes. i'm a little concerned that you're not feeling significantly better and something is still being missed.

again, thanks for the update!

Well, for starters, they finally found a cheaper steroid inhaler but the CHEAPEST one on my plan is $141. How is that even a thing? How is a damn steroid inhaler $141 AFTER insurance. I feel robbed.

My followup is 5 Oct, that will give me one month on a steroid inhaler, if I don't feel 101% by then, I'm going to go see a Pulmo.

D-Dimer came back negative.

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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that looks like a 3rd degree heart block. you need to see the cardiologist right away. maybe you already did. avoid strenuous exercise and get in immediately.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ironhonu] [ In reply to ]
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Cardio said my heart is a go. On to the pulmo in October if a steroid inhaler doesn't help me.

Still f'n stunned that a steroid inhaler covered by insurance is $141! Absolutely criminal. How do people afford inhalers?

Currently the albuterol inhaler runs $50 for two weeks so you need two a month and the steroid inhaler is good for one month so you've got a grand total of...

$241/month to be on two inhalers. Or $2800/year for two little inhalers. Can anyone please tell me how that's a thing when I'm fully covered with insurance?

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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justarunner wrote:
Cardio said my heart is a go. On to the pulmo in October if a steroid inhaler doesn't help me.

Still f'n stunned that a steroid inhaler covered by insurance is $141! Absolutely criminal. How do people afford inhalers?

Currently the albuterol inhaler runs $50 for two weeks so you need two a month and the steroid inhaler is good for one month so you've got a grand total of...

$241/month to be on two inhalers. Or $2800/year for two little inhalers. Can anyone please tell me how that's a thing when I'm fully covered with insurance?

That's terrible. I pay $20/month for each of my inhalers (and I think it's less if I get them from my mail order pharmacy) from my employer sponsored healthcare. Unfortunately there aren't any generics anymore since they had to change the propellants to take out the CFCs.

My first job out of college had a $500/year cap on prescription meds, and my inhalers were a lot of money. My allergist took pity on my and gave me bags of sample inhalers.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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Subclinical hypothyroidism is one condition that could connect your wide global symptoms. TSH and free T4 were in "normal" range, but your free T3 might still be low. Re: your pulmonary function: Try immersion to the neck in a pool to test whether that impairs your breathing.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [Pedalhead] [ In reply to ]
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I'm here to close this loop.

After we found my breathing was way below normal we started yours truly on a steroid inhaler. At first we went with 40mg 2x a day (morning/evening). We did this for 5 weeks. There was improvement for sure but I still struggled when trying faster efforts. For example, I tried a 200 hard, 200 easy, 200 hard, 200 easy, 400 hard, 400 easy workout. I made it through 3 sets and I just couldn't do it.

So I went back to the doctor and we upped it to 80mg 2x a day. Since then i've shown solid progress. I did 8x400 at 70.5s and didn't start to really gasp until 7 and 8. Then I turned it around last week and did 10x400 at 70.5s with no gasping and did a 5k tempo earlier in the week at 17:15 which was preceeded by 4x200.

Thus I think it's going away. I believe after all these months that one of the biggest correlations with my bad breathing was the air quality. On days where the air quality was bad per airnow.gov I struggled. When I visited other states like New Hampshire, Colorado, or even headed down to San Diego, I would suddenly find myself breathing quite a bit better.

From here i'm just going to keep taking my steroid inhaler for the foreseeable future. I could careless if I have to use an inhaler if I run well.

I'm going to jump into a Turkey Trot and hopefully run like a 16:15 which would put me just 10s behind where I was before this entire ordeal began. And then focus on doing the best training I can do leading up to the Carlsbad 5000. Then I'm going to turn my sights to the Air Force Marathon next September.

I really appreciate all who commented and took an interest in this. It was a very emotional roller coaster ride this summer. I'm glad the ride is almost over, I've been waiting to get off of it for a while now. :)

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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Thus I think it's going away. I believe after all these months that one of the biggest correlations with my bad breathing was the air quality. On days where the air quality was bad per airnow.gov I struggled. When I visited other states like New Hampshire, Colorado, or even headed down to San Diego, I would suddenly find myself breathing quite a bit better. //

Dan and I had the exact same experience, so we moved. Desert climate or right on the coast where the wind blows everyday were the cures, and I mean total cures. After medicating for over a decade, and the issues just getting worse and worse, pretty amazing what a change in location can due for your health. My advice, don't stay somewhere where you "KNOW" aggravates your asthma. Not worth it in the long run.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [monty] [ In reply to ]
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Yea, I live 30 miles east of LA. It's right north of Chino, specifically the town of Claremont.

The problem is Mt Baldy lies 2 Miles to my north, San Gorgonio is 40 miles to the East, Saddle Back is 40 miles to the South, and the Chino Hills are just 5-10 miles to my South West. Thus I live in a bowl.

Here's a perfect example of it. I live right above Chino where the 210 label is. As you can see, I live in a perfect little bowl where the airquality is always worse than its neighbors. It's fun. :)



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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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I can sympathize, I lived between LAX and the Chevron oil refinery. To top it off, house was all carpet, and virtually every house older than 10 years had mold. Like you, I had the perfect storm of environmentals to set off my asthma. Took awhile to figure out, but like you every time i went out of town to race, things got better. Finally clubbed me over the head, but until i moved to the desert, I never knew it was 100% so. You always think that outside factors contribute to an underlying cause, but sometimes it can be the cause. Drug free for about 15 years now and breathing like a mountain climber..
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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Not meaning to sound whatever but is the "steroid inhaler" allowable under the anti-doping regulations??? I really do not know but it seems like anytime anyone uses anything involving steroids, testosterone, etc, someone raises the "you're a doper" accusation:)


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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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Steroid inhalers are localized to the longs, they don't really operate outside of that realm. So performance enhancement isn't what the drug is about. It essentially reduces inflammation in the lungs to allow you to breath better if your airways are inflamed for whatever reason.

Having said that, I do believe USADA/WADA ban their use outright. However, if you need one for medical use, they will give you a TEU (Therapeutic Use Exemption) good for a certain duration. Galen Rupp has had like 1-2 TUEs for steroid inhalers in his career as has a variety of breathing afflictions.

And it's a shame they don't help performance, cause I stunk up the track tonight with my awful workout lol!

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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justarunner wrote:
Steroid inhalers are localized to the lungs, they don't really operate outside of that realm. So performance enhancement isn't what the drug is about. It essentially reduces inflammation in the lungs to allow you to breath better if your airways are inflamed for whatever reason.
Having said that, I do believe USADA/WADA ban their use outright. However, if you need one for medical use, they will give you a TUE (Therapeutic Use Exemption) good for a certain duration. Galen Rupp has had like 1-2 TUEs for steroid inhalers in his career as has a variety of breathing afflictions.
And it's a shame they don't help performance, cause I stunk up the track tonight with my awful workout lol!

Ah, i see, thanks for the explain. Asthma inhaler use is very high in the competitive swimming world, with something like 30% or so of all swimmers at national meets using an inhaler. I don't know if these are "steroid inhalers" or some other type but, apparently lots of top swimmers have asthma and get a TUE for an inhaler. In fact, it is so prevalent that some people have questioned whether the inhalers are giving these swimmers some sort of advantage. I haven't read much about it lately but it has been a hot topic off and on over at least the past 7-8 yrs or so.


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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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Under the WADA code, the most common asthma inhalers (albuterol, formoteral, and salmeterol) are not prohibited and don't require a TUE provided they are used in "normal" amounts. They are prohibited only in very high doses (such as more than 10 to 16 puffs a day depending on the drug).
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [craigj532] [ In reply to ]
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Eric is correct here. The typical albuterol inhalers were approved for mass use quite a bit ago (mid 2000's iirc).

Studies have shown that even in people without asthma that an albuterol inhaler will open your airways a bit more (a couple percent I believe) but that they found no correlation between that extra dilation in your airways and performance enhancement. I think they believe that this is because oxygen is not the limiting factor in performance in the people they were testing.

I can't remember where I read all this, sorry about that!

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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [justarunner] [ In reply to ]
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justarunner wrote:
Eric is correct here. The typical albuterol inhalers were approved for mass use quite a bit ago (mid 2000's iirc).
Studies have shown that even in people without asthma that an albuterol inhaler will open your airways a bit more (a couple percent I believe) but that they found no correlation between that extra dilation in your airways and performance enhancement. I think they believe that this is because oxygen is not the limiting factor in performance in the people they were testing.
I can't remember where I read all this, sorry about that!

I wonder though if in swimming, where you can't just breath as often as you want but rather have to stay in your stroke rhythm, if the extra 2-3% of air might help. Don't know if you've followed the swim threads on breathing every arm stroke (rather than every arm cycle) on occasion when extra oxygen is needed. Apparently, Sun Yang and other top D swimmers take two breaths going into their turns most of the time, so it would appear that they are pretty low on O2. OTOH, the widespread use of inhalers could be due to a placebo effect. Actually, all of this discussion has got me thinking i should stop by my local Walgreen's and get one to try it out myself, just to see:)


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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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ericmulk wrote:
justarunner wrote:
Eric is correct here. The typical albuterol inhalers were approved for mass use quite a bit ago (mid 2000's iirc).
Studies have shown that even in people without asthma that an albuterol inhaler will open your airways a bit more (a couple percent I believe) but that they found no correlation between that extra dilation in your airways and performance enhancement. I think they believe that this is because oxygen is not the limiting factor in performance in the people they were testing.
I can't remember where I read all this, sorry about that!


I wonder though if in swimming, where you can't just breath as often as you want but rather have to stay in your stroke rhythm, if the extra 2-3% of air might help. Don't know if you've followed the swim threads on breathing every arm stroke (rather than every arm cycle) on occasion when extra oxygen is needed. Apparently, Sun Yang and other top D swimmers take two breaths going into their turns most of the time, so it would appear that they are pretty low on O2. OTOH, the widespread use of inhalers could be due to a placebo effect. Actually, all of this discussion has got me thinking i should stop by my local Walgreen's and get one to try it out myself, just to see:)

You can't get an albuterol inhaler without a prescription. There used to be OTC inhalers that weren't albuterol (can't remember what they were) but they're pretty ineffectual, even if they're still around.
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [Erin C.] [ In reply to ]
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Good news that the heart is good but, why did the ECG show skipped or irregular beats? Problem with the test protocol maybe?
Last edited by: NealH: Oct 27, 15 12:08
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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [Erin C.] [ In reply to ]
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Erin C. wrote:
ericmulk wrote:
justarunner wrote:
Eric is correct here. The typical albuterol inhalers were approved for mass use quite a bit ago (mid 2000's iirc).
Studies have shown that even in people without asthma that an albuterol inhaler will open your airways a bit more (a couple percent I believe) but that they found no correlation between that extra dilation in your airways and performance enhancement. I think they believe that this is because oxygen is not the limiting factor in performance in the people they were testing.
I can't remember where I read all this, sorry about that!


I wonder though if in swimming, where you can't just breath as often as you want but rather have to stay in your stroke rhythm, if the extra 2-3% of air might help. Don't know if you've followed the swim threads on breathing every arm stroke (rather than every arm cycle) on occasion when extra oxygen is needed. Apparently, Sun Yang and other top D swimmers take two breaths going into their turns most of the time, so it would appear that they are pretty low on O2. OTOH, the widespread use of inhalers could be due to a placebo effect. Actually, all of this discussion has got me thinking i should stop by my local Walgreen's and get one to try it out myself, just to see:)


You can't get an albuterol inhaler without a prescription. There used to be OTC inhalers that weren't albuterol (can't remember what they were) but they're pretty ineffectual, even if they're still around.

Ah, i see, thanks for that info. I was mostly just kidding but the thought had occurred to me:)


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Re: Need a Doctor in the LA/SD area who specializes in Endurance Athletes... [ericmulk] [ In reply to ]
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ericmulk wrote:
justarunner wrote:
Steroid inhalers are localized to the lungs, they don't really operate outside of that realm. So performance enhancement isn't what the drug is about. It essentially reduces inflammation in the lungs to allow you to breath better if your airways are inflamed for whatever reason.
Having said that, I do believe USADA/WADA ban their use outright. However, if you need one for medical use, they will give you a TUE (Therapeutic Use Exemption) good for a certain duration. Galen Rupp has had like 1-2 TUEs for steroid inhalers in his career as has a variety of breathing afflictions.
And it's a shame they don't help performance, cause I stunk up the track tonight with my awful workout lol!


Ah, i see, thanks for the explain. Asthma inhaler use is very high in the competitive swimming world, with something like 30% or so of all swimmers at national meets using an inhaler. I don't know if these are "steroid inhalers" or some other type but, apparently lots of top swimmers have asthma and get a TUE for an inhaler. In fact, it is so prevalent that some people have questioned whether the inhalers are giving these swimmers some sort of advantage. I haven't read much about it lately but it has been a hot topic off and on over at least the past 7-8 yrs or so.

there is a study somewhere with a correlation between chlorine swimming and asthma. FWIW. as for steroid inhalers, they are not required for a TUE. systemic steroids are but not inhaled unless you're taking in nebs and i did the calculations once - i think it was 5-6 nebs a day. when i'm doing that much i'm not even able to get out of bed so no worries on needing to be drug tested.

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