Exercise induced asthma.

[Time Waster]

To add my experience. Back when I was cycle commuting I used to do it regularly in 25 minutes with the odd 22 minute blitz home. Then I started to struggle to even do it in 30 minutes. It started to feel like I could not even get on top of my usual gearing. I was the guy who could mash the high gear up hills as my legs were strong (my gym did not have high enough weight stack on the leg press for it to be hard for me, I could single leg press on full weights if I really wanted to).

After a certain point in time I just took that step change down in terms of cycling performance. I was never an athlete but 5 minutes on a 25 minutes route is significant drop off. I did not notice it at first but looking back I realised it was a sharp cut off.

It also coincided with a cough. I would get to work, get changed into work clothes and put everything away ready to start work then it started, always 10 to 15 minutes after my commute and exercise ended but not during. It got to about a year of doing this when my colleagues in the office started to complain about my coughing and told me to see the doctor as something was wrong. A month later I decided to find out. I got salbutamol prescribed but it took about 2 or 3 years later before I found out that I had not got an asthma diagnosis, just got the medicine for it without actual diagnosis. So I got tested by the asthma nurse and diagnoses. Recently I got put on Fostair as the asthma is now no longer just after exercise. That stuff is two puffs twice a day and it is powerful compared to salbutamol and the brown inhaler I used to have. I feel a little light headed after the first one and after the second puff if I get up too quickly i sometimes fall down again. The Fostair puffer is potent IME.

So it started as exercise induced and now it is not, just normal asthma that is not under control.

 

[wafter]

Interesting to hear - thanks

not surprised to have trouble keeping to the exclusions - sounds a lot of nice stuff!

best wishes anyway

Thanks and likewise

The diet thing certainly sucks and rules out a lot of interesting and tasty food... from what I know currently I should really be avoiding all nightshades, most grains, seeds and fruit, an amount of veg (I seem OK with alliums and cruciferous stuff), most plant-derived seasonings, processed and aged meat, chocolate, alcohol... plus probably a load more I've forgotten.

In reality this is largely impossible due to the practicality of what's available and my poor impulse control, meaning I suffer a constant baseline of chronic lowish-level symptoms. I still frequently think "f*ck it" and eat things I know I shouldn't, but rarely without repercussions.

Past extended fasting has shown what it's like to not be in a constant state of allergic reaction - I'm almost like a different person - however while beneficial in other ways too this is only a temporary fix in this regard and only possible when I'm in a sufficiciently good place mentally to commit to it... which hasn't been the case for at least the past four years.

The doctors were utterly useless in diagnosing any of this and had to be led by the nose much to the disgust of their egos before I finally got to see an allergy specialist (who was fantastically supportive but whose work was only of limited value).

I've long-planned to do a thread on here about it since it took me until middle age to twig what was causing these miserable symptoms, and until that point I'd just assumed it was all just random / how it was, until the worsening symptoms forced my hand... I wonder how many others are in the same boat.

 

[Jody]

Anyone have any experience?
After 2 years of delays, tests, delays, and investigations, it appears that this MAY be the cause of my cycling struggles.
So I am not just an overweight lazy git after all!

I was told I have this about a decade ago and it's always worst at this time of year. Awful feeling like someone is sat on your chest making it impossible to beath in but at the same time you can't breath out proplerly. The blue inhaler helps to some extent.

That feeling is bad enough but it's the coughing fits when I get back into the warm, sometimes lasting for 45+ minutes and really intense.

One of the things which helps which IC pointed out is breathing through a snood so the air isn't dry.

The main contributing factor is setting off out he gate too fast as I live on top of a hill and tend to spin way to quickly without any warm up. Dial this back and it's nowhere near as bad.

The other thing is easing right off at the first sign of it starting.

 

[markemark]

On dry days I cough for a good hour after cycling. Doc said it was a form of cycling induced asthma.

 

[ebikeerwidnes]

On dry days I cough for a good hour after cycling. Doc said it was a form of cycling induced asthma.

Yup - I get that - Ventalin stops it for me

 

[Time Waster]

So exercise is good to reduce asthma but exercise is what triggers the asthma. I think that kind of explains that not all asthma sufferers are the same. Some get it when exercising but not other times. Other get it other times but not exercising indeed exercising helps control it. There are many conditions which get talked about as one thing but it is also another thing to others with the same thing. What is it that causes it to be so different between sufferers??

 

[ebikeerwidnes]

To add my experience. Back when I was cycle commuting I used to do it regularly in 25 minutes with the odd 22 minute blitz home. Then I started to struggle to even do it in 30 minutes. It started to feel like I could not even get on top of my usual gearing. I was the guy who could mash the high gear up hills as my legs were strong (my gym did not have high enough weight stack on the leg press for it to be hard for me, I could single leg press on full weights if I really wanted to).

After a certain point in time I just took that step change down in terms of cycling performance. I was never an athlete but 5 minutes on a 25 minutes route is significant drop off. I did not notice it at first but looking back I realised it was a sharp cut off.

It also coincided with a cough. I would get to work, get changed into work clothes and put everything away ready to start work then it started, always 10 to 15 minutes after my commute and exercise ended but not during. It got to about a year of doing this when my colleagues in the office started to complain about my coughing and told me to see the doctor as something was wrong. A month later I decided to find out. I got salbutamol prescribed but it took about 2 or 3 years later before I found out that I had not got an asthma diagnosis, just got the medicine for it without actual diagnosis. So I got tested by the asthma nurse and diagnoses. Recently I got put on Fostair as the asthma is now no longer just after exercise. That stuff is two puffs twice a day and it is powerful compared to salbutamol and the brown inhaler I used to have. I feel a little light headed after the first one and after the second puff if I get up too quickly i sometimes fall down again. The Fostair puffer is potent IME.

So it started as exercise induced and now it is not, just normal asthma that is not under control.

I agree about the Fostair
I have only 2 a day but since I starte d taking it I have only needed the blue one rarrly - normally st the start or just after exercise of some kind

before that I used a brown one and neeed the blue one several times a day at times

my wife started on the Fostair and it helped a lot - but not enough

but if that happens to you there are other further things they can prescribe - I think some of her meds are officially for COPD even though she doesn;t have that exact thing (but she did smoke so whatever!)


but just to let you know they can go further if you need it!

 

[markemark]

So exercise is good to reduce asthma but exercise is what triggers the asthma. I think that kind of explains that not all asthma sufferers are the same. Some get it when exercising but not other times. Other get it other times but not exercising indeed exercising helps control it. There are many conditions which get talked about as one thing but it is also another thing to others with the same thing. What is it that causes it to be so different between sufferers??

Oh, it also only started a few years ago. Many years of cycling before that with no coughing.

 

[Time Waster]

I agree about the Fostair
I have only 2 a day but since I starte d taking it I have only needed the blue one rarrly - normally st the start or just after exercise of some kind

before that I used a brown one and neeed the blue one several times a day at times

my wife started on the Fostair and it helped a lot - but not enough

but if that happens to you there are other further things they can prescribe - I think some of her meds are officially for COPD even though she doesn;t have that exact thing (but she did smoke so whatever!)


but just to let you know they can go further if you need it!

My partner had it from childhood and is on the next level. Forstair is a more powerful and longer lasting version of the Salbutamol but the other component, the steriod, is the same as the brown one i think the nurse said. There is another one that is a powder dispersion inhaler that my partner has that is stronger effect. I have been told that the Forstair is on a trial and I have a repeat checkup in February to see if I need something more. I reckon I will because it is lucky if I remember to take it every day. I doubt it has had enough chance to do the steroidal help bit of it.

BTW the component that is a more effective Salbutamol alternative keeps working for 8 hours compared to 15 minutes or so with Salbutamol apparently. I can take up to 8 puffs a day of this then I can use Salbutamol on top if needed. I have not needed more than 2 ort 4 puffs a day in fact I cope with none too. I do get periods of tightness and I take this and another antihistamine and I feel better. Mine is at least in part allergen caused as well as the exercise induced cause.

 

[ebikeerwidnes]

My partner had it from childhood and is on the next level. Forstair is a more powerful and longer lasting version of the Salbutamol but the other component, the steriod, is the same as the brown one i think the nurse said. There is another one that is a powder dispersion inhaler that my partner has that is stronger effect. I have been told that the Forstair is on a trial and I have a repeat checkup in February to see if I need something more. I reckon I will because it is lucky if I remember to take it every day. I doubt it has had enough chance to do the steroidal help bit of it.

BTW the component that is a more effective Salbutamol alternative keeps working for 8 hours compared to 15 minutes or so with Salbutamol apparently. I can take up to 8 puffs a day of this then I can use Salbutamol on top if needed. I have not needed more than 2 ort 4 puffs a day in fact I cope with none too. I do get periods of tightness and I take this and another antihistamine and I feel better. Mine is at least in part allergen caused as well as the exercise induced cause.

I have had inconsistent advise about the Fostair

Some say you can use it like Ventalin - take when necessary
some say it is a once of twice in the mornings - same in the evening only

I'm not really sure what is right

I know that I am supposed to take one in the morning and evening - but my prescription is for one month but lasts 2 months
so it is unclear
anyway - my wife used to take 4 a days - 2 then 2 - and was told she coold have an extra if she needed it
In her case that was not enough
but using her advise - if I am having trouble - which is rare - then I go up to 2 then 2 for a few days and it clears it

My wife's advise from from a proper Asthma nurse specialist
but I have 2 doctor's - GPs - telling me I should only use it morning and evening - and that applies to everyone


DUnno

 

[rualexander]

I have had inconsistent advise about the Fostair

Some say you can use it like Ventalin - take when necessary
some say it is a once of twice in the mornings - same in the evening only

I'm not really sure what is right

I know that I am supposed to take one in the morning and evening - but my prescription is for one month but lasts 2 months
so it is unclear
anyway - my wife used to take 4 a days - 2 then 2 - and was told she coold have an extra if she needed it
In her case that was not enough
but using her advise - if I am having trouble - which is rare - then I go up to 2 then 2 for a few days and it clears it

My wife's advise from from a proper Asthma nurse specialist
but I have 2 doctor's - GPs - telling me I should only use it morning and evening - and that applies to everyone


DUnno

As with all prescriptions, it's worth having a read of the British National Formulary information on the prescribed drug.
Fostair :
https://bnf.nice.org.uk/drugs/beclometasone-with-formoterol/

 

[newts]

An asthma assessment from doctor or specialist nurse practitioner is the best place to start. Good asthma management improves quality of life immensely.

Fostair is a combined inhaler.
Used daily as a long term prevented & also for use as an occasional reliever. I originally used salbutamol (reliever) & Becotide (preventor), good asthma management via the preventor inhaler (mild steroid) should mean you very rarely use the blue inhaler (salbutamol/reliever).

 

[icowden]

There are many conditions which get talked about as one thing but it is also another thing to others with the same thing. What is it that causes it to be so different between sufferers??

My understanding is that Asthma is your body thinking it is doing something useful to protect itself but doing it too much or when not actually needed. Your brain gets the message that something is wrong in the lungs so it starts triggering a reaction to block the problem. Mucous starts getting created, and muscles tighten around the airways causing inflammation in the lungs.

The variability is in the trigger. Different people have different triggers and are triggered by different amounts. Even your response can make a difference. If you become anxious immediately that can start to speed up the reaction as your brain goes into panic and thinks more needs to be done.

One of the common factors is an increased sensitivity to stuff - more allergic reactions. Some of us have just been sensitive from birth. I was born with eczema and have had hayfever my whole life. Sometimes a cough or cold illness can be enough to start making the lungs sensitive and you start getting asthma. Car pollution, pollen, some pain relievers, pet dander, mold, dust mites etc There are loads of triggers and once your lungs start having a sensistive reaction to something, they don't ever seem to stop again.

Corticosteroids (e.g. Beclamethasone or "the brown inhaler") can help encourage your lungs to stop being so sensitive whilst a vasodilator such as salbutamol helps to stop an immediate reaction and encourage the blood vessels to relax and let you breathe again. Not everyone gets on with aerosol inhalers - if you find they aren't working, there are good alternatives. I like a turbohaler personally - rather than the stuff being pushed into your lungs at high speed, you suck on it and the micropowder just naturally travels into your lungs. Many people find that with a Ventolin, most of the output ends up stuck to the back of the throat and not where it is needed.

 

[kingrollo]

Anyone have any experience?
After 2 years of delays, tests, delays, and investigations, it appears that this MAY be the cause of my cycling struggles.
So I am not just an overweight lazy git after all!

Even if it is - don't expect a magic bullet cure. I've had asthma all my life it limits my ability on the bike.
It's really annoying that people who do a lot less miles than me whizz around at 19mph - whilst I'm mostly 13 mph.

However I suffered terribly as a kid - missed months of school I was shite at sports - I'm sure all the bullying and jibes - even from the teachers affected my mental health. But the kicker ....I don't ever want to go back too that so that's my motivation to keep fit - yeah I'm slow on the bike - but I'm not overweight and am fitter and more active than your average 61 year old.

Tips
Cover your mouth with a buff on cold mornings - at least until have warmed up.

Take your inhalers daily - even if you think they don't do much.

In the winter months use a saline nasal rinse - disgusting to use - but stops the crap getting onto your chest.

Gym work. Work on keeping that chest wide and a good posture. Pec Dec + reverse fly's are my favourites.

Back off the instant you get a cold.

Get flu + COVID jabs.