Trouble Breathing.. Need Help!

Triathlon Forum
1

First off I want to say I have done a search on the site for this topic and a lot of what comes up is Asthma or Exercise Induced Asthma… according to the doctor that is NOT what I have. My first tri of the season this past Sunday about a mile into the run (a 5k) I started to wheeze (that was new to me) and about 30 sec later I literally felt like I couldn’t breath. I walked maybe 30 seconds and then was able to run again but only for short distances (finished the race run/walking). Now I’m no speedster on the run but my split of 28 minutes is about 6 - 7 minutes longer than normal for a (triathlon) 5k. The doctor didn’t think it was asthma for two main reasons, the difficulty was in breathing in (not out) and it cleared up right after the race and was not accompanied by coughing etc. He thought it was a spasm in my voice box which constricts air flow (not dangerously as in asthma) but is not treatable with inhalers. Rather it is treated by breathing excercises and techniques. This is new territory for me as I have been a competitive “something” since I was a kid; this is my 3rd year of doing tri’s and have never experienced anything like this. My splits tend to be around 1 min 45 on the swim, 22 - 23 mph on the bike and around 7 min miles on the run (give or take 10 seconds). This certainly does not put me at the top but I would say I’ve been competent at the sport of triathlon and have really enjoyed my experiences.

Here’s what I need help with -

Has anyone experienced something similer that was NOT asthma? Can it be dealt with and how? Please be detailed as I have a race in 3 weeks and am seriously thinking about not doing as this past Sunday was not only not enjoyable it was somewhat scary; mostly because it had ever happened before not because I thought my life was in danger. I would very much like to have as much information on this issue as possible so if/when it happens again I can deal with it effectively. That is another thing my doc said; the onset probably caused me to be anxious which then “fueled” the condition making it worse which made me more anxious… well you get the idea.

For more background, I was having a pretty good race up this point, started the run at about 53 - 54 minutes so I was pretty much on my target of 1:15 race (1/2 mile, 13.5 mile, 3.1 mile). Heart rate was pretty much between 165 - 170 most of the race and never got above 171 which occurred on the bike. Run course was flat except for a short rise right out of T2 to the shore drive where the run takes place. Also, I’m 36 years old and in pretty decent shape.

If anyone can help or point me in a direction of learning about breathing technique(s) that deal with this, I would really appreciate it. The doctor gave me one which is to breath in slowly through your nose and out through your mouth, seems pretty basic. Sorry for the long post and thanks in advance for everyone’s help. Good luck!

2

My wife and son both have asthma. From this I have learned that GPs or regular Peds MDs don’t know much about asthma and whether you have it. I would highly recommend getting a second opinion from an allergist/asthma specialist. If you have asthma, you are much, much better off getting it taken care of ASAP as the asthma will be causing permanent damage to your lungs until you do.

This might turn out not to be necessary, but sometimes so is getting off your bike and checking it carefully when you hear a really strange noise before heading down that steep hill.

3

I’ve experienced this twice, both times in the last mile or two of a marathon. It sounds like I swallowed a whistle. I can’t say for certain what caused it, but attributed it to complete exhaustion of energy.

Did you drink well and take an energy gel at the start of the run? It is hard to imagine this happening in a sprint tri, but stranger things have happened.

4

Tom, drank about 8 - 10 ounces of energy drink on the bike. Drank 2 - 3 mouthfulls of straight water before the run. After my warmup about 1/2 hour before race, I had one packet of gel. This has been pretty much my routine for a sprint tri. Did not feel particularily exhausted although I would not rule this out; even though excercise routine has been regular and steady, work has been busy. As I said, I did not feel exhausted and don’t think its very likely, that does not mean it didn’t happen. Thanks for your observations.

5

CTL, I agree 100% with your comments. The person I saw is someone who is in sports medicine and competes in triathlons as well (he is an elite level so he’s very good). Not ruling out getting a second opinion but at this time I’m going to follow his advise and try to control with breathing techniques. He did say if it persisted to come in and they’d put me on the treadmill. Thanks for your help.

7

He is probably correct. This is not uncommon. (Although you could have both exercise induced bronchospasm and laryngospasm.) The treatment is exercises. usually speech therapist do this.

I get a little of that on the swim, sometimes. I also have a little asthma and EIB.

8

I have had a similar issue in the past and also thought it was sports asthma. I was given an inhaler from my General Pracitioner which didn’t seem to do a thing. Started asking around and found that Acid Reflux often has similar effect on lung capacity. I’ve found that I do have some Acid Reflux issues and while I haven’t been completely treated with prescription drugs, and probably should, I’ve found that watching the acidity of things I consume around races and long training rides as well as a cycle of Prilosec OTC (over the counter) has made a big difference.

I’ve met several more casual athletes (jogging and such for recreation) that had virtually given up there sports b/c of lunge capacity until they figured out it was Acid Reflux. At least one had been mis diagnosed with sports asthma. Hope this helps.

9

Docfuel, Thanks for your post. He never gave me the medical term but doing a google search on laryngospasm the decribed episode on one of the sites was exactly like mine. Also it does sound like the best way to manage it is to breath slowly. Do you have any other suggestions? I’m feeling a bit better about what happened and am feeling like I can deal with it if it comes up again. Thanks again for your help.

10

yeah i’ve gotten this kind of thing sometimes when I start swimming in the pool on my workouts sometimes I have problems breathing in…feels like I can’t get enough air in…happens only on the pool and seems to be a sometimes reaction to the chlorine in the pool…not always there…I will get it checked out too…

11

I had a similar problem at IM Florida last year. I had been having the problem to a lesser extent throughout the year and couldn’t figure it out. After IM Florida the VA put me through a whole series of tests including lung function tests, and a CAT scan, and they checked my serum ferratin. The result was that at age 61 I have emphysema (I never smoked) and adult onset asthma severely compounded by extremely low serum ferratin levels. (NB: If you get a CBC you won’t get your serum ferratin levels. You usually have to ask for it.)

In December my bike power for one hour was down to 131 watts! I couldn’t walk up stairs without huffing and puffing. After 6 months of iron therapy I’m now up to 173 watts for an hour.

In addition, I’m on Albuterol, which is a rescue enhaler.

I also have found my three cats and dog are asthma triggers, as are grass and ragweed pollens. (I’m do for another workup with the allergist next month.) Since this is ragweed/pollen/grass season, I would investigate allergies.

You need to start with a pulmonologist in my opinion. Get a CAT scan of your lungs (not an x-ray). Follow up with the allergist.

I almost died from lack of oxygen at IM Florida. This is not something to fool around with. If you have adult onset asthma it could be fatal when you least expect it. (out on a run by yourself in the woods you could die before help came)

Good luck and get some treatment and let us know what YOUR problem was. We are all different and my comments are not intended as a diagnosis or a substitute for the judgment of your doctors. But, please go NOW.

-Robert

12

I’m not a speech therapist or and ear-nose-throat doc, but I try to consciously open my throat (larynx) and breathe deeply, when I feel I’m doing it. I also go to every second stroke breathing (instead of every third stroke) until I can relax.

13

I always thought until last summer that I had exercise induced asthma. But last year I went to an asthma/allergy specialist and almost everytime I have trouble breathing is a result of some type of allergen. You may have been racing and an allergen triggered your breathing difficulties. Go see an allergy/asthma specialist, tell the Dr. that you are an endurance athlete and the Dr. should give you the medications that will help you and your breathing problems.

14

See a pulmonologist who has experience with athletes.

15

I second the suggestion to see a pulmonologist. I just did a pulmonary function test. Nearly broke the machine because the probably don’t see many endurance athletes. But, they do the testing before and after giving you a brohchial dilator to see if the measurements change. It might rule out asthma as a cause and direct your sports med guy to look in other areas such as allergens.

16

Athletes can pass pulmonary function tests because even with asthma they can do better than the general population. If the pulmonologist has experience with athletes, he takes this into account.

17

That is actually pretty close to the truth. The numbers are skewed for the general population. In 1990 my FEV1 was >125% of predicted (I maxed out on the then state of the art equipment). With my impaired breathing my current FEV1 is now 103% of predicted for my age and weight. (FEV1 is just one of about 6 or 7 tests they do when you get a lung function series. It takes about 45 minutes or more for the tests.) The VA doctors specifically told me, by the way, to keep exercising hard. I told them I wouldn’t stop even if they told me to stop. :slight_smile:

So, yes, the doctor needs to know your “history”. :slight_smile:

-Robert

18

this thread is ancient history, but I found it while searching for info on eia etc. I’m adding this post for information, in case someone else is searching similarly…

The name for the problem that the doctor diagnosed, is VCD (Vocal Cord Dysfunction). There’s no medication to treat it, just breathing exercises and speech therapy.
See:
http://www.nationaljewish.org/disease-info/diseases/vcd/about.aspx#symptoms
I know at one good triathlete who’s had this, and was successfully treated at National Jewish.

Breathing exercises:
Supine Position (knees bent)

Place book on the abdomen for kinesthetic awareness of abdominal movement (outward and upward movement during inhalation and downward movement with exhalation)

Keep shoulders and upper thorax still throughout all exercises

Sniff in through the nose slowly (visualize smelling a flower) and gently exhale through pursed lips (visualize blowing out a candle)

Train deep inhalations and long exhalations

Alter release of exhaled air after deep inhalation

Alter speed of inhalations and exhalations, focusing on abdominal movement

Replace book with hand on the abdomen, feeling the active outwardmovement during inhalation and passive inward movement during exhalation

Pant quickly in and out of the nose, feeling the abdomen movequickly in and out, and then slowly breathe deeply in through then ose and out through pursed lips

Practice releasing the exhaled air saying a soft ‘‘s,’’ ‘‘sh,’’ or ‘‘f’’

Upright Position

Continue reinforcing abdominal breathing, sniffing in during inhala-tion and exhaling through pursed lips

Maintain relaxation of the oropharygeal and upper body musculature

Reinforce kinesthetic feedback with hand on the abdomen or hand splaced at the sides grasping the lower ribs, feeling expansion and contraction of the lower rib cage

Practice breathing when bending over, squatting, crouching, and sit-ting forward

Memorize the action and sensation of the muscles during inhalationand exhalation

Stand in front of a mirror for visual feedback of breathing patterns

Keep a relaxed upper body, and at the first sign of stridor, immedi-ately sniff in through the nose and exhale through pursed lips

Increase activity level after practicing easy, relaxed breathing by climbing stairs, walking and running on the treadmill, and sprint-ing

General

Perform diaphragmatic breathing exercises 3 to 5 times per day

Maintain adequate hydration by drinking 2 L of water daily

Take small sips of water or dry swallow to help relax the larynx

Document the activity or drill, number of times, length of episode,and length to recovery of the PVCD episode

Make a list of drills that may elicit PVCD and rank in hierarchy(most severe to least severe)

Establish a plan to eliminate PVCD from least to most severe

*from the Blaine Block Institute for VoiceAnalysis and Rehabilitation.

19

Have you been swimming before you get this?