Cycling with Asthma

[mgm777]

Back in December, around Christmas, I visited my local Urgent Care facility ill with what turned about to be a nasty case of what the Doc diagnosed as Bronchitis. Now, in April, four months later, I still have a lingering cough and airway restriction. After another couple visits to my Doc, she says the Bronchitis may have triggered asthma. She put me on Albuterol and Symbicort inhalers, which relieve my airway restriction, thankfully. We're not sure if this is going to be a permanent or temporary condition, going forward. In any case, I suspect there are some fellow Paceliners who ride with Asthma. I'd love to hear how you manage cycling and asthma. This is all new to me. Thanks in advance.

[gasman]

I have asthma triggered by allergens, colds and exercise. I use a steroid inhaler (Flovent) pretty much daily. Before hard rides I use my albuterol inhaler. If I'm going out for a 6-8 hour ride I also use Serevent beforehand.
The combination seems to work well for me even when racing.

[mgm777]

I have asthma triggered by allergens, colds and exercise. I use a steroid inhaler (Flovent) pretty much daily. Before hard rides I use my albuterol inhaler. If I'm going out for a 6-8 hour ride I also use Serevent beforehand.
The combination seems to work well for me even when racing.

Thanks gasman. I think that's my situation as well. Chest tightens up and can't exhale in cold (skiing) and cycling and with colds. I tried to ride a couple of weeks ago without the inhaler...huge mistake. I thought I was going to pass out on a ride that is usually a non-event for me. Albuterol only controls the tightness for about 4 hours or so. With Symbicort, one puff lasts 12+ hours.

[maxn]

I was just diagnosed with it last year as well, and also after a lung issue, but mine was the flu. It manifested itself only under strong exertion, and was treatable with albuterol, like you. My lung doctor then put me on a preventative medication called seretide, which worked fine until it didn't! I never tried albuterol+seretide, but right now I'm on an augmented dose of seretide to try to get on top of the wheezing, at least temporarily

[gasman]

Thanks gasman. I think that's my situation as well. Chest tightens up and can't exhale in cold (skiing) and cycling and with colds. I tried to ride a couple of weeks ago without the inhaler...huge mistake. I thought I was going to pass out on a ride that is usually a non-event for me. Albuterol only controls the tightness for about 4 hours or so. With Symbicort, one puff lasts 12+ hours.


You should be able to be helped, sounds like you are on the right path. I use an inhaler before cross country skiing.

[shovelhd]

I have asthma triggered by allergens, colds and exercise. I use a steroid inhaler (Flovent) pretty much daily. Before hard rides I use my albuterol inhaler. If I'm going out for a 6-8 hour ride I also use Serevent beforehand.
The combination seems to work well for me even when racing.

Same except I am on salmbuterol. Two puffs 20 minutes before warmups.

[theprep]

Advair diskus, changed my life. I go months at a time with zero symptoms or need for rescue inhaler.

The diskus design does not need propellant. The propellant can aggravate some asthmatics lungs.

You open, swing a small lever, which slices opens up a capsule containing one dose of medicine. The medicine is in powder form and easily inhaled deep into your lungs.

[jimoots]

On topic but off topic...

I have a persistent cough, triggered by exercise.

Doc initially diagnosed it as exercise induced asthma, but inhalers didn't work (and I think made the cough worse).

Lung X-rays all clear.

Saw an Ear Nose Throat guy and had some scans on my sinuses, all clear.

So basically a persistent 'tickle cough' that hangs around for days after a hard ride - when I'm nudging on my limits. No noticeable tightening of the chest, no breathing problems... And I haven't noticed any drop in power.

I want it to be a simple case of bad pursuiters cough, but something tells me it shouldn't hang around for days.

Is this ringing any bells for anyone?

[mgm777]

James-aus - your cough description mirrors my own, except that I also have the airway restriction, mostly on exhalation(vice inhalation). When my airway is clear, after using the inhalers, my cough also goes away. My doc feels the onset of Bronchitis irritated my respiratory system, and as a result, made it more susceptible to allergen induced asthma. Now, any airborne irritant(dogs, smoke, pollen, cold, exercise) seems to trigger onset of my asthma condition, if I am not dosed up on an inhaler. I hope this is only temporary until my respiratory system settles down or heals.

[Tandem Rider]

I have cold induced asthma, struggled with it all my life. I have never had a problem when it is warm out. Always struggle with early and late season races as well as skiing.

This year a teamate hooked me up with an asthma specialist who works with athletes. There is a lot of knowledge out there that the common family doc and general practitioner are not familiar with. You need to find yourself one of these guys. It took several tests and some trials but I can tolerate way colder temps with my respiratory system now than before.

Start searching for a specialist.

[jimoots]

James-aus - your cough description mirrors my own, except that I also have the airway restriction, mostly on exhalation(vice inhalation). When my airway is clear, after using the inhalers, my cough also goes away. My doc feels the onset of Bronchitis irritated my respiratory system, and as a result, made it more susceptible to allergen induced asthma. Now, any airborne irritant(dogs, smoke, pollen, cold, exercise) seems to trigger onset of my asthma condition, if I am not dosed up on an inhaler. I hope this is only temporary until my respiratory system settles down or heals.

Yeah that's the thing that's weird, I don't have any noticeable restriction in breathing, my riding is still good, etc.

It's only when I am really pushing myself into the red (at the limit or above the limit for whatever my current fitness level is) for 5-10 minutes that I start to get affected by coughing and/or breathing issues. I don't find that I'm restricted - but when I inhale, I get a tickle in my throat and that triggers a cough.

And of course there is the natural 'throat burn' that comes along with a super hard short effort, well at least its natural for me.

The waters are pretty muddy.

I will see how it goes over the coming weeks. It was really bad a few months ago (in line with some heavy training). I'll see how I go after this next big block of training, and if it worsens I'll get in line at a respiratory specialist.

[gasman]

James-Some people don't get asthma symptoms until they are at 90-95% effort. You may think it's brought on by a tickle when in fact it's your asthma kicking in. I'm fine until about 75 % effort so I never need albuterol when commuting or running errands.
Eugene has been home to a lot of world class runners over the years, some have them have been diagnosed with asthma only when they are put on a treadmill and have to crank it out at a 4 min/mile pace. Their spirometry clearly shows their asthma kicking in only at high efforts. It is real and measurable. The results have been accepted several times by the IOC and they have been allowed to use bronchodilators.

[Bruce K]

Cold/allergen/sports induced asthma for years

Qvar when the allergens are bad or when I travel to altitude & ProAir as a rescue

This seems to be a combination that works when it hits

I am trying to train/ride this year without any so I can continue my back-of-the-pack cross racing but if it doesn't work I'm done. It's not worth the time and effort for a TUE and with the new random testing at all levels and races around here it's not worth the hassle of "getting caught"

Besides, breathing and enjoying the rides is worth much more

BK

[tigoat]

I suffer from allergy my entire life with severe sinus issues every freaking season. About 3-4 years ago, what seemingly another usual allergy reaction turns into asthma like attack the first time in my adult life. Since then, I get the same symptom every spring and this year is no exception. I am actually breathing hard right as I type this note and flowers are not even blossoming yet in Cincinnati. Amazingly, this breathing problem has no effect on all of my workout activities including my cycling ability. In fact, I ran 10 miles yesterday after work even with this difficult breathing problem lingering. Tonight I plan to l ride 50 miles after work and I bet this problem will not bother me at all. Nonetheless, to remedy the problem, I use a combination of sinus pressure relief medications, allergy medications, asthmas medications, and a prescribed inhaler. I used to take one single medication, which didn’t do much so nowadays I take several medications together and it seems to be working every year. I expect my allergic sinus and asthmas problems will go away in about 2 months.

[shovelhd]

James-Some people don't get asthma symptoms until they are at 90-95% effort. You may think it's brought on by a tickle when in fact it's your asthma kicking in. I'm fine until about 75 % effort so I never need albuterol when commuting or running errands.
Eugene has been home to a lot of world class runners over the years, some have them have been diagnosed with asthma only when they are put on a treadmill and have to crank it out at a 4 min/mile pace. Their spirometry clearly shows their asthma kicking in only at high efforts. It is real and measurable. The results have been accepted several times by the IOC and they have been allowed to use bronchodilators.

For me it's about 12 minutes at FTP. My throat tightens up, then I get fluid buildup. Once the hacking starts, it's over. No chance of recovering in the race. Pro Air HFA helps, but I am thinking of trying a different approach.

[Bkat]

I have exercise-induced asthma. Showed up two winters ago when I was putting in a lot more miles. At first I figured it was all the road salt I was sucking in. Anyways, now it's two puffs on the inhaler before a ride. Not a big deal. In fact, I found it improved my lung capacity.

I think I recall reading that a few pros have EIA. Not sure if anyone knows this for a fact? It would make sense considering most races are spent in close proximity to cars and motorbikes and those riders must inhale a lot of exhaust fumes.

[Tandem Rider]

I have noticed that my asthma is triggered at lower efforts when the temperature is lower. At 75deg or so I can't go hard enough to bring on an asthma event, drop the temp to 40 or so and it will happen at a about 85-90% FTP. Drop the temp to 25 or so and it only takes about 75% FTP to bring it on. With age I found that these temperatures crept up. When I was in my 20's it had to be below 40 to even have an event, and then it was only occasionally and usually in a race.

Everyone is an individual and there is no blanket one size fits all solution. You need to find a specialist who understands the problem. I went through several "solutions" before we found one that worked. I doesn't "cure" asthma, or eliminate all symptoms, but it makes it manageable and the process teaches you a lot about it, and this knowledge is invaluable.

[jimoots]

For me it's about 12 minutes at FTP. My throat tightens up, then I get fluid buildup. Once the hacking starts, it's over. No chance of recovering in the race. Pro Air HFA helps, but I am thinking of trying a different approach.

Yeah I get the fluid buildup, lots of spitting.

Worst (memorable) time for me was after 140% FTP for about 3 mins 40 secs. Was chasing a segment on Strava. Took me about 45 minutes to properly recover, and to be honest I should have just ridden home - the rest of the k's on that ride were junk.

But I got it pretty bad the other day after 5 minutes at 125% FTP followed by 2-3 minutes trying to sit on FTP. Was doing a 5 minute effort, then finished, but ego got the better of me and I tried to hold onto a group that passed me after I finished my interval.

Usually 125% for 5 would be a piece of cake but I recently had a 3 week break (honeymoon) so I'm clawing back my fitness.

And on that, for me it seems inextricably tied to fitness. If I am pushing the boundary of my fitness at any interval that is sub 10 minutes, its gonna happen. So it's a bit of a balancing act - knowing my limit at any given fitness level, and then trying to not push too hard in a session.

I find pushing my limits on longer interval work much more manageable and it doesn't seem to affect me so much. Probably because it's less demanding work on the engine, esp lungs.

[Seramount]

life-long asthmatic, have tried tons of treatments.

cortisone emulsion injections, allergy shots, albuterol, Flovent, Serevent, etc etc.

Advair is the answer for me.

since it was prescribed, I never even think about asthma.

[Veloo]

Same thing happened to me in 1995. Came down with a very bad case of bronchitis. I was an intern at the time and I was out of work for at least a week. Went to hospital and they put me on a Ventolin puffer. I was too weak to walk across the street to the pharmacist. Had to sit and take a break on the bench.
As a result, I developed asthma. It would be triggered by exercise, cold, alcohol, dust, pet fur/ dander.
I just kept the puffer at my side and pull it out as the asthma came on.
Over the years things got better. I'd say about 5 years later the asthma only comes on now with some alcohol, if I spend a lot of close time with pets that shed and sometimes in really dusty conditions. I haven't bothered with a puffer in over ten years. When asthma sets in, it's extremely mild. I just back off from what may be causing it and it goes away quickly. I can't recall any exercise induced asthma in many, many years.

[potatochip]

Albuterol before rides


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[Tandem Rider]

life-long asthmatic, have tried tons of treatments.

cortisone emulsion injections, allergy shots, albuterol, Flovent, Serevent, etc etc.

Advair is the answer for me.

since it was prescribed, I never even think about asthma.

I tried everything on your list except the cortisone and then some, even the Advair didn't work. You have to keep trying, something will and when you find it, it makes you feel almost normal.