I have written before of my struggles with Exercise Induced Asthma. It has been an issue for me in every race that I have run, on many long runs, and frequently during speed workouts. Here is a little history of my struggles with and triumphs over, Exercise Induced Asthma.
May 1996: I was running a 10k in Yucca Valley. It was shortly after Alan and I had met, and he was going to pace me to a PR. He did that, but I don’t remember the last 2/10 of a mile because I was so seriously oxygen deprived that I passed out at the finish line. While I never coughed or wheezed, I was not getting enough oxygen to fuel my muscles, and it took me over two hours to fully recover. For a while I couldn’t even lift my arms up. On a happier note, I did finish second overall and first in my age group.
Later that same week while on an easy run, I had my first incidence of a full blown asthma attack. I coughed, I wheezed, I cried (it’s very scary and emotional if you don’t know what’s going on) which made it even worse. Because my mother had suffered from asthma all her life, I figured out what was going on, made a doctor’s appointment and got my first inhaler.
December 1996: I ran my first marathon, in Honolulu. Starting about mile 16 in the race, I started having problems breathing and began using my inhaler. It slowed me down considerably, but I finished.
1997: My doctor tried a variety of medications. At one point, I was using three different inhalers and a pill that I took daily. It did help, but that’s an awful lot of meds.
1998: I created a holster in which I could carry my asthma inhaler. After seeing a woman using a similar one at a race in San Diego (it was a gift so she didn’t know where it came from), I used the belt loop part of a flashlight holster with a big paper clip. The inhaler fit perfectly and was easily at hand whenever I needed it. I should have patented it and gone into production. I was asked about it at every race I ever did.
June 2002: The first marathon I ever dropped out of because of my asthma, Rock and Roll in San Diego. You can fight through a lot of things, pain, tiredness, but you really need to be able to breathe, and I couldn’t. I also dropped out of the same race two years later. The only races I’ve ever dropped out of for any reason.
2006: After a knee injury slowed my times and I just got tired of fighting the asthma, I ran my last marathon. For the next few years, I continued to run and race, but never trained at a very high level. I still had the asthma problems during races, but they were infrequent enough so that I stopped taking all the preventative medications and just stuck with my rescue inhaler (albuterol).
2013: With renewed enthusiasm for running, I decided to train hard with a goal of running a sub-2 hour half marathon for the first time in years. That meant adding speed workouts back to my schedule and running longer and harder. It also meant the return of the asthma. Alan (who suffers from asthma too) had been having great success with montelukast, which is the generic version of Singulair. I decided I wanted to try it as well, and after multiple allergy and other tests given by my doctor, I picked up my first prescription.
In my first race while using the monelukast, I still had a few issues. I think one of the problems is that I was taking it in the evening before bed. I should have taken it in the morning, a couple hours before the race. Hindsight is 20/20, but I will know this for next time.
What is Exercise Induced Asthma?
If you cough, wheeze or feel out of breath during or after exercise, it may be more than exertion that is the cause. If you feel tingling in your extremities, dizziness, or like you are breathing through a straw, you may be experiencing Exercise Induced Asthma. Even if you’ve never had any breathing issues in the past, EIA may be causing you to slow down, drop out, and begin to wonder if exercise is all it’s cracked up to be.
Having Exercise Induced Asthma does not mean that you should stop exercising. On the contrary, exercise helps to strengthen your entire cardio pulmonary system, and proper treatment of the condition can help keep you active, whether you are an elite level swimmer, an age group runner, or a weekend warrior.
Symptoms of Exercise Induced Asthma
Some of the symptoms of Exercise Induced Asthma include coughing, wheezing, shortness of breath, tightening in the chest, fatigue during exercise, and poor athletic poor performance. These can happen during or after exercise. Many people don’t realize they have EIA because they think the symptoms are their body’s response to exercise.
My personal symptoms start with a feeling like tingling in my extremities. I always think that they feel like they are not getting enough oxygen. I start to feel weak and my body suddenly needs to slow down. If I try to push through, I feel like the continued lack of oxygen will cause me to faint and even feel like I have encroaching blackness in my peripheral vision.
As asthma attack can be a life threatening occurrence. Get immediate medical help if your symptoms continue to worsen even after using a rescue inhaler or if your symptoms continue after you are finished with your workout.
Causes & Risk Factors
While no one really knows why one person suffers from EIA while another doesn’t, some things that increase the likelihood of an attack include cold, dry weather, air pollution, high pollen counts, chemicals (such as chlorine in a swimming pool), and having a cold or other respiratory infection.
Again, my personal experience is that warm, humid climates make it more likely to have an attack (contrary to everything I have read, but have heard from others). I also have difficulties at high altitudes, especially during the adaptation period. And while I will occasionally have an EIA attack during shorter, high intensity exercise, I seem to have more problems during lower intensity, but longer efforts.
Those who have asthma that is triggered by other causes are more likely to have EIA, as are children, smokers, and high intensity exerciser (like runners).
So what is an athlete to do? For many people, a couple puffs from a quick relief inhaler such as Albuterol is enough to control symptoms. These are called bronchodilators and can help open the airways during an attack as well.
If a bronchodilator is not enough, speak to your doctor regarding the medications that are available to prevent asthma attacks. This type of medication is taken on a daily basis to help reduce inflammation and keep your airway open.
In order to prevent an EIA attack, several things are known to help, including a long warm-up of 10 minutes or more, trying to breathe through your nose, covering your mouth in cold dry weather, and if allergens cause you to experience EIA, avoid them as much as possible (maybe skip a workout on a high pollen or pollution day).
Don’t stop exercising. As I mentioned, exercising improves your lung function, so it is an important factor in the control of asthma symptoms.
Remember, I am not a doctor! If you are experiencing Exercise Induced Asthma symptoms or feel like you are having difficulties breathing during exercise consult your own physician. While I researched the topic, I am speaking from my own experience and yours may be completely different.
Pulse Oximeters and Exercise Induced Asthma
A pulse oximeter is a simple, non-invasive devise that measures the oxygen saturation level in your blood. It is a small electronic device that clips onto your index finger and radiates infrared light into your finger. Oxygenated blood and non-oxygenated blood absorb light differently, and the pulse oximeter can measure your blood saturation level by calculating the difference between the two. Commonly used in hospitals, the pulse oximeter is used to measure how effectively your heart, lungs, and circulatory system work together.
Athletes may wish to wear a pulse oximeter during strenuous workouts to monitor their oxygen levels. Healthy individuals generally have a oxygen saturation level of 97-99%, though any level above 92% is generally considered safe and normal. People with chronic lung conditions such as asthma or COPD, or people recovering from an illness could also benefit from wearing the pulse oximeter. If you are planning to exercise in polluted areas or high altitudes, checking your blood oxygen levels before exercise could help you plan your workout.
I was recently given the opportunity to review the Health-Ox Fingertip Pulse Oximeter. The Health-Ox is a small, convenient pulse oximeter that gives you instant and accurate pulse and oxygen saturation levels. It comes with a lanyard and a protective rubber cover to make it easier to use during exercise.
I tried out the Health-Ox in several ways. Of course, when I arrived I immediately clipped it on and was happy to see that my levels were pretty good.
I also used the Health-Ox at the end of my workout on a humid day. In spite of feeling like the air was thick, I was happy to see that my oxygen saturation level was just fine.
I also tried the Health-Ox during two more strenuous workouts. One was a trail run in the hills with the cross country team. Though I wore it while I was running, I didn’t get a picture until the end of the workout, but my levels were just fine throughout the run.
I also wore it during a short tempo run. Ironically, even though the purpose of the run was to test the Health-Ox, I forgot to get a picture either during or after. But again, my oxygen saturation level was 95%.
The Health-Ox is not just for use during exercise. It can also help monitor oxygen saturation levels in children or adults with chronic asthma or other pulmonary diseases including COPD. Monitoring your oxygen levels can warn you that an attack may be imminent, even before you feel the symptoms.
I found it light and convenient to use. While I won’t carry it with me on every run, I will use it to monitor myself during higher intensity workouts.
Do you suffer from exercise induced asthma? How do you deal with it? Any suggestions that I missed?
Edited to remove the expired giveaway information.
Disclosure: I was given a Health-Ox Fingertip Pulse Oximeter in exchange for my honest review. I was not compensated in any other way. All opinions are my own.