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coopSwim
August 12th, 2013, 05:49 PM
Hi,

I'm sure this has been covered at some point in the forums, but I haven't had much luck in finding much information on this here.

The short version is I've developed exercise induced asthma over the past year. It probably developed over the past few years and just expressed itself over the past 6 months as I've upped my training to 5 days a week in preparation for meets this summer.

I started with an inhaler (albuterol) a few weeks ago and upped it to a steroidal inhaler and some sort of pill to take before I work out, but I'm still finding the whole experience to be incredibly disappointing, as I've been training hard (for me) and just can't catch my breath after sprint sets, and anything over a 75 at race pace leaves me wheezing on the pool deck for 5 min until I can recover enough to get back in.

The meds are letting me get through practice, but they're letting me scrape by - at my last visit to the pulmonologist, I was told I exhale c02 at 80% of normal. I asked if that was 80% of a normal person or athlete. Normal person, of course.

This is all new to me and really frustrating, as I was a lifelong runner (before I lost too much cartilage to continue) and never had breathing problems until now.

For fellow asthmatics out there - any advice would be really appreciated on how to manage this condition.

I was making really great strides in my swimming this past year and just completely tanked my last race due to breathing issues (well, that but more due to my own inexperience and going out way too fast)

much thanks,

Jeff

pendaluft
August 13th, 2013, 02:14 PM
I am sorry you are having so much trouble. I do believe that if your symptoms are truly due to exercise induced bronchoconstriction, that there is a solution that will allow you to perform at your optimum. I have some experience with younger athletes with EIB as I am a pediatric pulmonologist and have cared for a large number of swimmers.

The first thing is to be sure of the diagnosis. Usually this requires pulmonary function testing with albuterol administration at a minimum. Often, when it is not clear that the athlete has airflow limitation that responds to albuterol, an exercise test is performed. If your symptoms are replicated in the exercise lab, then lung function testing at that time should be informative. It is important to be sure that the diagnosis is really asthma as there are several entities that cause exercise limitation that are often misdiagnosed as exercise induced asthma.

The next question is are you getting your inhaled medication deep into your lungs. If you are using your inhalers without a valved holding chamber (spacer) such as an aerochamber or optichamber then most of the medication is just sticking to your mouth and not much is hitting your lungs. Hopefully you were given one of these devices and instructed in its use.

With regards to your lung function -- I don't know what testing you have had but most PFTs are expressed in terms of percent predicted using a series of regression equations based on age and height. In general 80-120% is considered the normal range but might not be normal for you.

I hope this is helpful. I suggest going back to your doc and questioning the diagnosis carefully and outline a plan to improve the situation. If you aren't using a chamber with your inhalers, fix that. There is a recent (May 2013) clinical practice guideline from the American Thoracic Society that should enlighten practitioners that are less familiar with these issues.

dc_in_sf
August 19th, 2013, 05:53 PM
I have issues with pool induced allergies rather than full blown asthma, but have found a nose clip has immeasurably improved things for me. For <$5 investment it is certainly worth trying.

Katherine Neustadt
August 21st, 2013, 12:08 PM
I can only speak to anecdotal evidence, as I am not a pulmonologist (by all means, follow pendaluft's advice!!). I have some problems with asthma (both exercise-induced and bog standard). I bought a PowerBreathe device and it's had a noticeable effect on how well I breathe while swimming. It, of course, does not cure asthma. However, I do think it's made my breathing more effective.

I don't work for PowerBreathe or anything, I've just found it useful. I've got the blue one, if you're interested.

coopSwim
September 25th, 2013, 06:14 PM
Thanks everyone - I did take the advice and got a spacer for my inhaler. So far it's improved a bit, but not to where I'd like it. I can finally swim 3500+ sets again, but sprinting is still rough as far as breath recovery goes.

Thanks again