training and asthma

[Natalie]

Just wondering if anyone can give me some tips.
Although having been diagnosed with adult asthma some 15 plus years ago, it has only been the last few years (winter mainly) that the asthma has been bad. Usually I'll cut back on training until the episode has passed (and I'm back off the prednisone), but as I'm training for my first TNF 100, I feel I can't back off on the training for long without losing too much ground (I'm a novice runner aiming for a finish).
Does anyone (particulalrly asthmatics) have any suggestions on alternative training? Also, I often bring on an episode (as was the case this time) by upping my training intensity in a session.  Any tips to prevent this?

[Paul]

Hi Natalie,
I have asthema too, albeit well controlled and relatively mild. It's more 'allergic' asthema which is worse in winter because of the damp and cold starts. When you say you back off, how long are you talking? Days/weeks? Unfortunaltley it seems the only and best training I've found is running. I do also do some cross training and mix up some core work and a small amount of yoga/pliates style stretching etc. Depends on the lenght of time you're talking I guess.
Regardless, happy training & good luck for mid-May!
Paul

[Brett]

Gday Natalie

I too have very mild asthma, ie I will have a puff before I start and may at times during a training session/event have a top up, this may be trigged by cold blast of wind, or a sneeze that may trigger, or it just comes on. If I am heavy on the lungs in training, I do more sprint work and stair sets. You need to be fit (sprinting helps) and stair sets, as there is much up and down on the track. During the day you walk, run, jog, crawl, survive..... so in training if I find I have a bit of asthma kick in I am not shy to walk and control it, as there is much walking on the day. The important thing is being able to get back into a jog after walking, and not being sucked into the comfort of walking for too long.

Good luck.

[Natalie]

Thanks Paul and Brett. When the asthma is mild, yep, a couple of extra puffs - usually symbicort - and I'll be right to get through a session. Didn't usually need any preventers during summer (until this past year) and got away with daily symbicot during the winter months. If cold, or windy, or added intensity, may get through a session reasonably well but will crash quickly when I finish. End up on prednisone the next few days and will be out of action (or struggling) for up to a week. My peak flows are not always a good indication. This week for example came out of the blue after being dumped at the surf: thought I'd recovered two days later and went for a 15 km run / walk on a hot morning, and by the time I drove the 45 min home after, was struggling. 3 days later I can finally breath again, but walking is still my limit (may try something more strenurous tomorrow). I've missed several training sessions this week and am getting frustrated. Last winter I struggled for a couple of months - funny though - managed trailwalker without issue except during a particularly cold stage in the middle of the first night.
When fighting fit, will walk / run (building up my intensity and duration) 3- 4 days a week (1/2 - 1 hr sessions for 3 and then a longer (2 - 4 hr) walk / run / hike on the firetrails / hills once a week), and crosstraining at the gym (pump, spin bike, step or aerobics) for an hour on 4-5 weekday mornings. Am thinking of adding pool swimming (squad)one evening a week for the anaerobic workout and to strengthen the lungs. And yes, I still manage 1 - 2 rest days a week depending on work commitments. This week though even a shower has left me breathless, so have done nothing since the run three days ago.

[Lise]

Hi Natalie,

I have quite severe asthma. I'm on a preventative and take ventolin just prior to exercise and 'in case of emergency'. The cold definitely makes my asthma worse. In saying that, I managed to complete my first 100k race in November without much breathing difficulty. I took up swimming almost a year ago and that has seemed to help. Also, just focusing on my breathing while running and learning how to regulate it when speed / terrain changes has also helped a lot! As soon as I start to struggle, I slow my pace until I can regulate my breathing and then pick up the pace again. I did struggle quite a bit during the Sydney marathon with shortness of breathe and later learned that I was anemic. It might be worthwhile getting your iron levels tested as this can contribute to difficulties with breathing. Also, I omit dairy (only cow - sheep, goat and buffalo cheeses all seem to be fine) completely from my diet when I have flair ups with my asthma. This seems to help quite a bit. I don't eat any cow's milk for several weeks in the lead up to a big race.

Sorry, that all seems a bit random. Hopefully some of it is helpful. Best of luck with your training!!

[Ana]

I have an interesting story there...I have asthma since I was 5. I took ultras 3 years ago (TNF 3 times, GNW once, I'm 38 now - and no other races, I have gone straight into ultras). The first TNF I was using Ventolin after the first 2km and kept using it often during the race. Later on, during training, I learnt a very interesting thing - you can actually control an asthma attack by pacing yourself into the running.

I got tired of getting out, planning to do a 20km run and then turn back home after 1km or 2km because I forgot to use Ventolin. I decided one day to try to deal with it as when you face a hill that leaves you breathless - concentrate on the breathing, slow down, take more air in than out (I breath in while counting to 3, out while counting to 2 - exactly the same technique I use if I want to run all the way in a very steep hill). After a few minutes, the wheezing goes away, like you have used Ventolin - it's amazing, but it requires a lot of concentration when you first start doing this, as our first instinct when breathing is hard, is to stop running. Another interesting fact I noticed was, whenever I was wheezing and doing this breathing technique and a steep hill came up, by the top of the hill my breathing would get normal again (ie. the intensity seemed to speed the breathing recovery).

I talked to my doctor, she found that interesting, but another thing I changed since then was my treatment - I now use a puffer that is meant to prevent asthma - like allergies, asthma is a chronic disease, so the best thing is to keep it under control (in my case that was Seretide, but there are a few available and you may need to experiment until you find the best one for you, the are usually corticoids with some kind of "long-lasting Ventolin"). By taking this preventative medicine (which I started taking 2 years ago every day, now I am using it only twice a week), I avoid any wheezing and the constant running helps with cardio vascular fitness - I now do as much training as I want and I am not bothered by the asthma anymore. While the breathing technique works, I find it very tiring to do it, although I truly believe it made my running more effective just by learning this. I think it makes all sense in the world, because swimming for example, is an activity known for its benefits for asthmatics, and if you think about it, the reason is probably that you are pacing your breathing, as I do when I am running while trying to get over the asthma.

My asthma used to be very bad, I am also allergic to many things (and the reaction to this allergy is to trigger the asthma), so I also try to keep the allergy under control - at the first signs of allergy, I take a Telfast (but usually I take one strong one and no second one is needed the following day).

[Stephen]

I am also not a really severe asthma sufferer, but an attack can really slow my pace and sometimes stop training altogether. I have suffered probably all my life, but was only diagnosed in my teens. I am allergic to grasses and pollens mostly, but like most, I can also suffer from exercise induced asthma, mainly in the cold weather.

I have always taken a preventer (I currently use Seretide), but when i get lazy (and poor as it is over $30 each puffer after PBS)and don't take it regularly enough, I have noticed my asthma will return. I normally take seretide once in morning and once in evening. If my asthma is bad, i sometimes wake up with an attack in the middle of the night. If i take seretide before going to sleep, it will stop that happening.

About four years ago i volunteered in an asthma challenge for research purposes (for WADA) where medication was varied and asthma was induced over a few months, I really found that I became a lot more comfortable with my condition and I know asthma can be a scary thing at times. I now deal with it a lot better than I used to.

Stephen

[Natalie]

Thanks for the suggestions. I was travelling much better the last few weeks after I figured that by getting up an hour earlier (430 instead of 530am !)and taking the symbicort then, and then again just before the exercise an hour later, I was getting through the exercise sessions much better with only one or two shots of ventolin.  Thought I finally had it beat. Went running in the rain last Friday however, and was felt like I was busting my lungs by the 8 km mark (kept going although slowed the pace) ...and was headed back to the prednisone by lunch time due to non-relief.  Was great the next day - did a fast 20km hike no prob, but the following Tuesday running on a cold and misty morning I was battling again. Fine again the next day for 90 min gym cardio session.  I had apparently been underestimating the effect of the asthma however when my GP turned to the medical student besdie me and uttered "asthma kills you know"!!! Just out of curiosity though - how do you mange the breath holding required after using ventolin while still running and already battling for breath!!! ....Can't get a specialist appointment until the end of April.

[Ana]

Stephen - you can get Seretide as accuhaler (that funny round thing) or inhaler (like ventolin). The inhaler comes with 120 doses, so if you are really bad, taking one dose a day (what you should do regularly, initially), it will last you 4 months, so it's not that expensive this way (still costs around $30 on discount chemists).

Natalie - yes, asthma can kill you. I was an international flight attendant for years and once a passenger died in my arms in an asthma attack. It was very intense as I knew what he was going through. But get a good doctor and the right treatment will put it under control. Regarding your question, stop running and have your ventolin properly, otherwise it's unmanageable as you pointed out. My GP is great, if you like I can give you her contacts, she's in neutral Bay. You can find me on Facebook...http://www.facebook.com/profile.php?id=1496675659

[Natalie]

Thanks Ana - still battling. My Gp has now added Atrovent to the symbicort and ventolin. Still asthma post run and sometimes during, but had someone spray airfreshner today to mask cigarette smoke (usually each a major trigger) and I could still breath! So maybe we've made progress after all! Still finding morning the worse - once my puffers catch up (up to an hour lag), I feel much better, but until then...... Also reducing dairy and it may have helped, haven't yet managed to get in the pool. Still trying to figure out why the asthma can be fine during a run, and then about an hour after I stop, I'm struggling to breath again. My boss always knows what days I've run - I lose my voice and struggle for the rest of the day!
Stop to breath...hmmmm - then I have to run faster to catch up with the group afterwards!!!!
Scary re someone dying in your arms - that must have been horrific for you, especially if powerless to act.