Asthma and Cardio

rbiss · December 2015

I have been recently diagnosed with adult onset asthma that came up after a cold. The wheezing and shortness of breath wouldn't go away and after 2 weeks I ended up being hospitalized because my airway closed off. Doc put me on prednisone for 10 days and said I should have no problems. Well, I had problems and round 2 of hospital/prednisone. The PFT showed mild asthma, and I am now on symbicort. I haven't had any trouble breathing or wheezing, but I am TERRIFIED of being active.

I am switching doctors because the guy I was seeing always says I'll be fine and doesn't have useful advice. The new doctor can't see me until mid January and I really miss working out.

My question is, to those with asthma, if I work out and have trouble breathing but then stop and I feel okay once I use the rescue inhaler, is that okay? I have noticed the inflammation seems to have a cascading effect and once I get the wheeze, it doesn't seem to stop no matter what I do. I don't want to work out and get the wheeze which is what I am afraid of. The last doc said I can work out no restrictions, but his advice landed me back in the hospital so I am warry to follow it.

Unfortunately, I have no allergies (recently re-confirmed) or known triggers, so I'm just trying to figure it all out on my own.

AllanMisner · December 2015

As far as working out, I assume you’re talking about cardio. Have you considered resistance training? I good resistance training program can help you develop strength and retain/add muscle mass and if you do it without much rest, can have cardiovascular health benefits.

Allan Misner
NASM Certified Personal Trainer (Corrective Exercise Specialist, Fitness Nutrition Specialist)

mandyrene21 · December 2015

I was advised by my doctor to use my rescue inhaler right before working out as a preventative measure. If I'm doing something high intensity then I may need it during the workout as well. After a short rest (a couple minutes) I'm usually okay to start again.

I was very scared at first too, mine is also adult onset so it's not something I grew up with. For the longest time I would only work out with my husband, it made me less nervous knowing he was there if I needed help.

Good luck! I hope you get everything figured out

FitPhillygirl · December 2015

My daughter is on a swim team and uses a rescue inhaler before each practice and meets. She's never had any problems.

rbiss · December 2015

Thanks. I want to work out with lifting for now because I am pretty sure that won't trigger anything but cardio is what I am really concerned about. I love biking, swimming, and snowboarding, but those are all pretty cardio intense activities. The only attacks I have had come up slowly but get bad very fast (I go from slight shortness of breath to the ER within 6 hours) and don't respond to albuterol once there is an audible wheeze.

About how long after an attack do you resume working out? My doctor said and I can do whatever I want and basically pretend like nothing happened but that just doesn't seem right.

lithezebra · December 2015

You should talk to your doctor if your rescue inhaler hasn't been taking care of any shortness of breath. My asthma isn't triggered by exercise, unless it's very cold outside, but some people really can't do some types of cardio. I've read that swimming is often ok.

shabaity · December 2015

I'm adult onset with exercise as a trigger I take 2 spaced out puffs on the rescue before mma starts and a 3rd if I need it during class with a short break usually a min or so then back in the game.

CharlieBeansmomTracey · December 2015

like others have states take a 2 puffs of the rescue inhaler(one min apart from the other) about 10 min or so before you start your cardio. you are on symbicort and it should prevent any wheezing and shortness of breath,but may take a bit to get controlled. I have asthma too (on advair-symbicort didnt work for me, and I dont need my rescue inhaler as much anymore).For me I did/do cardio,stamina boosting exercises(hiit,tabata,) and also lifted weights when I started and would need my rescue inhaler sometimes during exercise. since I have strengthened up my lungs I dont need the rescue inhaler when exercising(before or after). I use it about once a month if that now. so most likely things will improve for you. now if you find you are using the rescue inhaler and its not helping,seeks medical attention immediately dont take more puffs then recommended unless the dr says its ok.since the symbicort is a preventative you shouldnt need the rescue inhaler as much .(mine is severe without meds) so if that doesnt(or the rescue inhaler) seem to be preventing the wheezing and shortness or breath talk to the dr. they can either adjust your dose or try something else.you should get some relief from the rescue inhalers though. make sure you are taking the albuterol correctly. also using whats called a spacer can get the meds in your lungs better(if you dont have one).

rbiss · December 2015

Thanks everyone. I don't have a spacer, so I will look into getting one. I haven't had to use the rescue inhaler since I started symbicort, so maybe that's a good sign that it's working and can add back in some activity. I guess the only way to find out is to do it. I am switching doctors soon. Ending up in an ER twice while under doctors care for mild asthma is unacceptable.

V_Keto_V · December 2015

It is ok to use your short acting beta-2 agonist prophylactically 15 mins before exercise; this does not count as a rescue dose & doesn't need to be factored into being controlled or not controlled when considering your ICS + LAB2A dose (Symbicort). Keep taking Peak flow readings daily and continue chronically using Symbicort until advised to step down therapy according to your physician (asthma is reversible).

Asthma guidelines suggest using a rescue dose when PEFR is < 80% of your personal best; <50% calls for a corticosteroid (systemic/per oral) taper of 40-60mg/day prednisone equivalent.

MelodyandBarbells · December 2015

I use my rescue inhaler prior to workouts and can go really hard. As hard as I want, really. If I forget and have to take it after I've started working out (rather than a couple doses starting about fifteen minutes before), I can really tell the difference

Even if your doc can't see you till January, you should see if they could at least tell you if it's okay to use your rescue inhaler in this manner. You're recently diagnosed, etc etc. All you know from chatting with us is that it is likely a good idea. You should confirm this with someone responsible for your medical care. As you know first hand, asthma can be extremely serious

rbiss · December 2015

Thanks guys. I won't be doing any cardio until I see the other doctor. I feel great today, but I am not taking peak flow readings or anything. The other doctor didn't mention this or keeping an asthma diary which really upsets me (part of the reason why I am switching). Another question, is the peak flow measurement a rolling personal best? I would assume that after a steroid dose I would have a good number and if I loose more weight this number would get better. So does the 50% off personal best adjust when the best number keeps getting better? I guess this number stabilizes eventually.

prairielilly · December 2015

I also have adult-onset asthma and mine is exercise-induced, and I've also found that once the wheezing starts things can get seriously scary extremely quickly. But, I have learned to recognize when it starts - for me, my breathing will become just a bit more difficult and my throat will become a bit inflamed/raw - then I stop whatever I was doing that aggravated it (usually some form of exertion), and I don't do any more cardio that day as once my lungs and throat are inflamed they're 'touchy' and it'll take even less to set them off, and it's just not worth an ER visit. So my solution is to go slow, like snail slow if I must, and only increase the intensity when there's zero signs of lung reactivity. The flip side is, the better shape you're in the less likely exercise is going to aggravate your lungs. If you could do things before you can quite likely still do them now albeit with less intensity and learning to recognize when your airways are getting irritated - I'd say it's not about seeing a new dr and getting a prescription that'll let you do everything you did before, it's about finding a way to work with the condition, recognize your body's signals and scale back if and when you need to. It's a delicate balance but definitely achievable. Maybe there are those who can use a daily puffer and it's like they don't even have asthma and cool for them, but I'm allergic to almost all asthma meds and this is what I've found to work.

tiny_clanger · December 2015

I have had asthma all my life, but deteriorated pretty spectacularly last year (in hindsight, my control had been deteriorating for several months before my near crisis ). I lost a lot of confidence after that. I found the most useful thing (once I was medically controlled again ) was to start gentle cardio to relearn the difference between out of breath with exercise again and dangerous lack of breath. Running without music was the best thing I did- it meant I can hear my breathing and hear the control.

kuranda10 · December 2015

I have exercise triggered asthma all my life. Allergies trigger it too (yea).
The ONLY preventitive that has ever made a difference is QVar. I'm not sure what it's called in the states. For cardio, I was a figure skater and, later on, an off-shore sailor. I used the rescue inhaler whenever I needed it during exercise and slowly my body adapts to the cardio and I can stop using the inhalers. If I stop the cardio for any period of time (even a two weeks) I need to strt the process over.

MelodyandBarbells · December 2015

rbiss wrote: »

Thanks guys. I won't be doing any cardio until I see the other doctor. I feel great today, but I am not taking peak flow readings or anything. The other doctor didn't mention this or keeping an asthma diary which really upsets me (part of the reason why I am switching). Another question, is the peak flow measurement a rolling personal best? I would assume that after a steroid dose I would have a good number and if I loose more weight this number would get better. So does the 50% off personal best adjust when the best number keeps getting better? I guess this number stabilizes eventually.

Honestly, I didn't take continuous measurements or keep a diary, either, so unfortunately I do not know the answers to those questions. What was important is that I was diagnosed and given the prescriptions and tools to feel better.

kuranda10 · December 2015

I also make sure I get plenty of magnesium. They ssay it helps with the inflammation. I can tell a bit of a difference.

I have never kept a diary beyond "Walked the dogs up hill in 28 C heat. had trouble breathing at the top. Used inhaler". I have no idea what my peak flows might be or even how to test it.

lithezebra · December 2015

rbiss wrote: »

Thanks guys. I won't be doing any cardio until I see the other doctor. I feel great today, but I am not taking peak flow readings or anything. The other doctor didn't mention this or keeping an asthma diary which really upsets me (part of the reason why I am switching). Another question, is the peak flow measurement a rolling personal best? I would assume that after a steroid dose I would have a good number and if I loose more weight this number would get better. So does the 50% off personal best adjust when the best number keeps getting better? I guess this number stabilizes eventually.

The steroid takes a while to work and it should be helping you all the time. It might not make a difference immediately. You should have a good number after using your rescue inhaler. I concur with the posters who use the rescue inhaler before exercise, when exercise is a trigger.

I know that steroid inhalers are only supposed to work in your lungs, but mine made me panicky, which made it hard to believe that I could go out and exercise without having an asthma attack. I challenged myself in very small, safe, steps until I was back into my normal routine. (Eventually, the horrible combination of allergens, forest fire smoke, and building material dust that triggered my asthma cleared up, and I was able to stop using Symbicort).

CharlieBeansmomTracey · December 2015

V_Keto_V wrote: »

It is ok to use your short acting beta-2 agonist prophylactically 15 mins before exercise; this does not count as a rescue dose & doesn't need to be factored into being controlled or not controlled when considering your ICS + LAB2A dose (Symbicort). Keep taking Peak flow readings daily and continue chronically using Symbicort until advised to step down therapy according to your physician (asthma is reversible).

Asthma guidelines suggest using a rescue dose when PEFR is < 80% of your personal best; <50% calls for a corticosteroid (systemic/per oral) taper of 40-60mg/day prednisone equivalent.

asthma is not reversible its a lung disease. while you can have less triggers and less attacks and even get to where you no longer need meds does not mean it can be cured. because some day you can have an asthma attack later in life that could be deadly.you cannot outgrow it either but you can have less to no symptoms of it. you can strengthen your lungs sure but its nothing that will go away completely.

CharlieBeansmomTracey · December 2015

rbiss wrote: »

Thanks guys. I won't be doing any cardio until I see the other doctor. I feel great today, but I am not taking peak flow readings or anything. The other doctor didn't mention this or keeping an asthma diary which really upsets me (part of the reason why I am switching). Another question, is the peak flow measurement a rolling personal best? I would assume that after a steroid dose I would have a good number and if I loose more weight this number would get better. So does the 50% off personal best adjust when the best number keeps getting better? I guess this number stabilizes eventually.

the numbers will improve with prednisone(which should only be taken a short time and not with the symbicort either). but some days you will have good peak flow numbers and others you may not as for losing weight for some that may not make a difference.for some the numbers may stabilize once their asthma is under control,but for others they may not. I would also get tested for allergies and see a lung specialist. sometimes people are diagnosed with asthma and its not asthma(copd,heart valve defects can mimic an asthma attack which I have both asthma and the defect,another cause can be stongoloids(parasites),heart failure,etc).if you dont see an asthma specialists then find one. they can be lots of help.as for ending up in the hospital twice under a doctors care. its not always the dr's fault. they prescribe what they think will work and it may not work for everyone and not all drs will suggest the peak flow,diary,spacer or any of those things.if you want to do those things that is up to you. if you think your current dr is not up to par then switch.

Bella0531 · December 2015

I take Advair daily and also use my rescue before/during bootcamp every day (1 puff before class, 1 more before the very last exercise - which is usually something that really gets you breathing hard like sled pushes, sprints, burpees etc...). It seems to work pretty well.

I spent all of last year trying to figure out how to make myself a runner without having to stop every quarter mile wheezing like a 90-year-old smoker. I tried different combinations of inhalers and dose timings, different levels of running intensity, perfectly flat courses...nothing worked. I'm just not destined to be a runner.

Asthma and Cardio

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