Exercise induced asthma

Hi All

I'm new to AUK having been diagnosed with exercise induced asthma just 1 week ago. What a surprise! I ran the london marathon last year and then turned 40 and since then my body has decided its just had enough.

I have to say its hit me pretty hard. At first I just noticed breathlessness when doing normal every day things, like going up the stairs. I work in the NHS and was talking to a nurse who noticed that I got breathless when talking for long periods. So a trip to my GP who said they didn't think it was asthma. My spriomertry result wasn't the usual for asthma. They gave me ventolin to try which did nothing.

I left it as I felt like a pest keep going back to the GP and then after a respiratory infection i ended up seeing a consultant who, after an exercise test, diagnosed exercise induced asthma and has put me on symbicort.

My peak flow ranges between 250 and 320 which according to the readings on here are pretty low. I'm trying to exercise gently bugt does anyone have any advice on how quickly I'm likely to see good results. I'm eager to run the next marathon for AUK. Also anyone esle diagnosed with this late on in life?

Also does this condition make you tired and irritable - or is that just me!

Any support gratefully received...

40 Replies

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  • Hi Catwoman, it sounds like you are really keen to maintain and improve your fitness despite feeling low about your diagnosis - good on you!! I'm afriad I don't have any tips for exercising (I'm sure others will though) but I completely sympathise with the tired and irritable thing - for me that's a lot to do with frequent night symptoms but it's also about accepting your asthma is going to be up and down and take your mood with it from time to time. I find chocolate and wine are helpful! :) Fingers crossed you feel more in control and find exercise easier soon!

  • catwoman, I know just how you feel. I was diagnosed last autumn aged 35, but like yoou, I was active, i run swim and cycle, infact was training for a triathlon later that year, and ironman this, but not anymore.

    I've learnt that I can swim, but need my ventolin before, cycling I need to cover my mouth with a buff to keep the cold air from getting at my lungs, but running 8-10k is just about the limit, at a pace that I'm really ashamed to admit (10K=55mins), despite doing a marathon years back in 2hrs59.

    As you are new, you will have to find out how bad you are, and what medication you will need. you don't say what dose symbicort, but if you are not getting any better after a week or so, then you either have the wrong medication for you or need a higher doseage.

    How long ago was the chest infection? it can take 6 weeks or more to recover from that fully, so again you should not be pushing yourself hard on the exercise front.

    You may find using a volumatic spacer with the inhaler an advantage, it's been shown to help you get more of the mediation into your lungs. I use one, but was not told to, and noticed an improvement.

    the best advice I would give is to try and avoid breathing in cold air, even at this time of the year, and take 1 or 2 puffs of ventolin 10-15mins before you exercise, or what ever you rescue inhaler is, as I see ventolin didn't work for you.

    Chris

  • EIA

    I used to do biathlon and found that although the asthma was bad, if I completed the swim before the run I could cope however if the run was first I then struggled with the swim as the run would muck up my breathing patterns for the swim.... I always found that breathing in cold air was a problem, especially during the winter.

    I always found that taking the ventolin 10-15 mins before the start of the excecise helped along with the ventoin taken as required during excercise often helped. Unfortunaely now unable to do either activities due to asthma/allergies.

  • malawi, did you try running with something over your mouth to prevent the cold air reaching your lungs, I found it helps, but not completely. Swimming is good for asthma, but some pools have a high combined chlorine level or are too hot, ask at your pool for both, the combined chlorine level should never exceed 1ppm and the temperature should ideally be below 28deg. I have virtually chlorine free pool near me, and its good, but another one has more chlorine, but is a lot colder around 26-27deg, and thats fine, so you may need to experiment if thats causing you trouble, also worth a try is the ""sinus rinse"" system, helps to alleviate allergies by removing them from the sinus passages. neilmed.com I've used that to 4 months and no longer use the saline solutions from them, but ordinary sea salt, works just as well, and has made a difference to my life.

    chris

  • Hi Catwoman and welcome to AUK! My mum was diagnosed in her late 40s, after she realised that a lot of the symptoms I described with my asthma, she also experienced. It has taken some time and some trials of different drugs but she is now very well controlled, as I am.

    Please please don't let asthma let you put you off your running - I have just got back from London, having done the marathon yesterday for Asthma UK. I suffer with moderate/severe asthma - nothing like a lot of people on here who are severe/brittle, but I've managed to do it in a perfectly respectable time. It probably took me a couple of years to really learn how to run well with asthma, it takes a bit of adaptation and experimentation to find out what works for you, but you CAN do it.

    I hope to see you in the AUK VLM team next year!

    CathBear

  • talk in shorter sentences, breathe in through nose when talking if possible

    Breathlessness while talking is common, have you tried to speak in shorter sentences (with small breaths in through your nose in between)?

    If you can breathe through your nose while talking (the pause is only slight and people do not notice it) then you are far less likely to be out of breath after talking.

    Laughing and coughing have similar effects (keep breathing through your nose- cough through your nose (keep your mouth closed). Also, sleeping with your mouth open has a similar effect (breathlessness- dry mouth, poor quality and broken sleep).

    If your nose is blocked there are techniques to unblock it and to keep it clear.

    Have you tried to breathe through your nose while exercising?

    If you can breathe through your nose (NB both in and out- every breath) and continue to do so while exercising then your symptoms should reduce. Initially this will also greatly affect your speed but within about 6 weeks or so you should get back to where you were in terms of speed. This will also cause your nose to run so you will need tissues.

    To start with, you would only run as fast as your lungs/nose will allow you to without resorting to mouth breathing. If you cannot get enough air then slow down or if necessary stop but keep breathing through your nose. If you have pushed it too hard then you may need several mouth gulps of air but try not to push it for the first few attempts. If this is causing more than mild discomfort then you will need to slow down further.

    If you are racing or measuring your speed then you should warm up for at least ten minutes beforehand (while nasal breathing) and warm down for at least ten minutes afterwards and do your best not to finish on a sprint. If you sprint finish, then jog around for a further ten minutes to allow your lungs to reduce the rate of breathing slowly back towards resting volumes.

    This method of breathing while you are running results in improving how your lungs feel afterwards and can help your symptoms at rest too (as exercise should). You should also greatly reduce this damage effect and also you should not need a recovery time or a much reduced one. This will mean you could continue this form of exercise for many years to come in a self controlled (by your lungs and nose) fashion.

    regarding triggers, i think that your nose blocks and filters particles out of your body within 15 minutes and those lodged through mouth breathing (breathed in deep into the lungs and with greater force) can remain for 60-120 days.

    The onset of your increased sensitivity/allergy may have been triggered by some event or change in your life or even a particularly bad chest cold/infection.

  • I'd be keen to impress on people that breathlessness whilst talking *shouldn't* be common at all, in fact it can be a sign that your asthma isn't under good control. Having experienced this myself it's not a sensation of not being able to get enough air, it's a sensation that the expiratory phase (combined with talking) is more of an effort, meaning that you have to stop to gasp *out*, not in.

    PS - yes I am a nose breather, not through any conscious effort, that's just the way I am.

  • Breathlessness by talking is common because people talk far too much- even non-asthmatics! (but they are lucky enough to getaway with it).

    People speak in sentences that are far too long, without pauses and are breathing out while doing so (very few people speak when breathing in- your voice isn't really designed to work that way- even if you make noises they are generally less distinct and do not carry).

    The difference in sensation is subtle and I would never have thought it before it being explained to me. I always believed that this sensation was not getting enough air and always dreamed of ""expanding my lungs"" given my asthma and feeling like i wasn't getting enough air. However, i now feel like i am breathing out too much as this is what i believe - funny how the body will experience what it expects to feel sometimes.

    This is the same for coughing where people cough out too much thus generating the need to breathe in too much causing the breathlessness and possible asthma incident. If you cough through your nose (it can be difficult and messy) then the need to cough is reduced in two ways- you irritate the irritated bit a little less (less air over that spot) and also you do not cause the cause-and-effect of breathing out too much thus becoming breathless then short of air and into asthmatic episodes. Just a small technique that works. If you don't get it at first doesn't mean it doesn't work- your technique may need tweaking. And if you cannot do it obviously its not for you.

    Its funny, that if you try it, it actually works. And i have seen this in several asthmatics of my acquaintance and many public speakers. The urge to take a huge gulp of air actually exacerbates this which many people especially asthmatics do before talking. If you try to speak more slowly, in shorter sentences then then feeling of breathlessness is reduced. If you combine this with nasal breathing then this is further enhanced. Proof is in the pudding.

    If you stop the actions (long sentences and too much talking) then you lose the effect (breathlessness). So if you try these tips for talking then you should not feel breathless after talking.

    Cath- you are lucky to be a nose breather- i am too but suffered from a perpetually blocked nose for 32 years. But i never thought that breathing through one nostril could possibly be enough air (and i'm not small - but to compensate i do have a big nose!).

    the feeling that you have to gasp out is usually from trying to hold your breath on the in-breath. This also generates excessive need for air. If I hold my breath on the out breath instead, even if only for a half second i can recover my breathing to normal quite quickly (even after talking which i almost always do while breathing through my nose (a strict habit now but i would get away with it for a while).

    At rest, i have built up the ability to do this from 8 seconds which is reasonable for an asthmatic (actually similar to the figure for an asthmatic international sportsman who learned buteyko too) to over 20 seconds. Each extra 5 seconds results in a significant improvement in quality of life.

    I agree completely that this technique has alot to offer but should be taught by a qualified person. I think that the success rate for people who buy books and DIY it from home is less than 10% but the rate for those who attend clinics and get personal instruction is far higher. I do not think i would have learned successfully from a book or DVD/tape.

    Obviously, medication should only be adjusted by the prescribing doctor.

  • Sorry but breathlessness when you are talking is a sign your asthma is getting worse please please do not think it is normal!

    Butekyo'd your advice is going to kill someone one of these days, unless you are qualified I sugest you stop contra-indicating asthma guidelines - like if you become breathless when you talk you should seek medical advice.

    Cath and other admin I am sorry if this seems like flaming but when you are looking for advice and don't really want to go in although you know you should posting nonsesne like its normal to breathless on speaking is just irresponsible.

    Bex

  • Bex is potentially quite right, albeit forthright in her expression ;)

    Inability to complete sentences in one breath can be a sign of a severe, life-threatening asthma attack, and I'm afraid I'm not happy with Buteyko'd's suggestion that it's a common and ""normal"" phenomenon. I'd have to strongly dispute that.

    I still talk at the same rate and in the same length of sentence as I always have done. I have not changed the way I breathe or talk, but as my asthma has come under control I no longer get out of breath whilst talking. When I have a tickle in my throat and need to cough, I don't end up setting off a chain reaction of bronchospasm.

    Physiologically speaking, if there was any grounding to this theory of mouth-breathing/coughing inducing bronchospasm, then you would even manage to induce bronchospasm in healthy subjects. But that doesn't happen.

    I am very happy to accept Buteyko as a method of reducing asthma symptoms. But ""blinded"" scientific study has shown that, whilst it reduces symptoms and reliever inhaler use, it neither improves lung function values nor enables asthma sufferers to reduce their ""preventer"" medication useage. I think any extrapolation outside of this area is unsafe scientifically and potentially dangerous medically.

  • I am, in turn, gobsmacked by one post and then hugely uplifted by the next.

    Bex - I believe that my correct message board response to your post is ""+1""!

    Cathy's medical info is, as you would expect from a GP - which takes nine years of medical training to achieve - spot on, accurate, and balanced.

    To anyone who is becoming breathless when talking - this is *not* in any way normal, and you should seek medical attention ASAP.

    I will now draw everyone's attention to the terms and conditions of using this message board, and in particular to this one:

    ""be aware that protocols for managing asthma and dealing with acute exacerbations may vary vastly, particularly at the severe end of the spectrum- if your protocol is unusual, please exercise caution and judgment in posting about it to avoid giving others the impression that it is safe for them to behave in a similar way""

    Remember, this applies to both those with severe asthma *and* those with mild asthma. Treatment that works for one person won't work for everyone, and no-one should be posting with claims that it will.

  • What Catwoman said was she became breathless after talking for long periods.

    This is a common occurrance even in non-asthmatics. Watch public speakers after they have been orating on some topic for a while. They look like they have stepped off a treadmill. It also happens asthmatics.

    My suggestion is merely a technique to avoid the effect of talking for long periods.

    If this is unavoidable (for work reasons or other reasons) then those small techniques help to lessen the effect of ""breathlessness after talking for long periods"". Its like an avoidance strategy with triggers. If talking for long periods causes breathlessness then don't do it. Obviously within a controlled and medicated asthma framework.

    Unfortunately it is far too common and as Bex advised below if you become breathless when you talk you should seek medical advice. If you can avoid it and its the only thing (not sure in Catwomans case) that makes you breathless then don't do it.

    Bex, these tips worked for me and i adopted them. They are tips that i learned that helped me to control my asthma. They are good asthma management techniques that have helped many people. The tip to avoid excessive talking causing breathlessness is common sense if this is possible (without affecting your job - the social affects are not excessive). People need to think one breath at a time sometimes (cause this is how we breathe automatically) and even break breathing down to the in and out part. If speaking in a more controlled fashion with shorter sentences helps to stop one becoming breathless, even if this means changing the way one speaks, it surely is accommodatable within ones own personal asthma management?

  • Ten years, Steve, ten years. We grow ever older ;)

  • *sob*

    I feel old.

    Orators do indeed ""look like they've stepped off a treadmill"" after speaking. You also look like you've just stepped off a treadmill if you've just stepped off a treadmill. This is not a joke; all exercise will leave even the fittest person looking ""out of breath"", to some degree or another.

    But this is NOT the breathlessness that Catwoman was describing.

    In this case, a better comparison would be with an orator who has to stop speaking because he/she physically cannot continue. Like the runner who has to stop the treadmill because they can't breathe any more. *This* kind of breathlessness is *not* normal, and it is dangerous to suggest that it is.

  • Buteyko'd, I too am finding your posts increasingly worrying and was about to chip in on your extraordinary 'breathlessness while talking is common' but others have already made the points succinctly and well. As for your advice about avoiding activities which result in breathlessness, that's worrying too. One of the results of having asthma is that people can contract their lives around it, consciously or unconsciously avoiding activities which will produce symptoms. They can, therefore, be under the the impression that their asthma is milder than it really is and this is dangerous. A common finding in asthma research is that patients' expectations of the degree of control which is achievable for most - not all - sufferers are frequently too pessimistic, so very often they are not on the best medication and/or optimal dose. As Cathbear has shown by her success in completing a full marathon, good asthma control means that you do not have to limit your activity. If asthma is reducing one's phsyical activity capacity, the first course of action should be to discuss this with one's doctor or asthma nurse.

    You shoved in a bit at the end of your most recent but one post about only using these breathing techniques under proper instruction and medical supervision. Exactly right. So by your own lights, advising people with asthma sight unseen to try breathing techniques is really not ideal. You have no accurate idea of how severe their asthma is or what other health issues they might have.

  • re: avoiding activities which result in breathlessness

    Cathbear, Kate Moss and myself (and others) will be helping Asthma UK spend the summer telling a whole load of kids the exact opposite!

    asthma.org.uk/go.rm?id=533

  • I have to agree with claire,cathy and peaksteve, being breathless while talking is certainly not normal, and no mater how you breath, it's not going to change anything. I do pilates, and yoga, and both employ different styles of breathing, but I can't honestly say either one is better than the other for my asthma.

    I will agree that we all think that having asthma means we do get breathless, and have the occasional cough, etc, but tend to ignore them and just downgrade the activities we did before, or expect we can do. I know I have thinking about it (re: cathys PM to me). I always ignored the trivial things, but will now thinking about it, make a note of them, and have worked out that I'm only better because i do less and at a lower exertion rate. If i wanted to return to my pre-asthma days then that is not currently possible, so yes asthma affects my daily life constantly, even though I've said it doesn't.

  • My consultant told me this!

    If you get out of breath walking to the post box, up the stairs, down the stairs, walking across the landing or talking on the phone. Your asthma is not happy!

    Use your reliever the recommended dose they tell you.

    If no improvement come and see me or ring my secretary for further advice!

    Breathlessness means inflammation in your airways (basically asthma)

    An asthmatic should be able to walk up the stairs or to the local post box or talk on the phone, if they cannot they are experiencing problems and need to talk to a medical person within 24 hours!

    If you cannot say a sentence 999 now!

    Hope that is a little helpful :)

  • I have done training on public speaking I have been with political party leaders including the all drinking all smoking one after they stepped off the rostrum after giving a speech to conference lasting roughly between 45 mins to an hour long and I can assure they were not breathless, tired yes, gagging for a fag yes but not breathless.

    I am now going to step away from the keyboard before I end up with a ban.

  • I seem to have started a bit of a debate but thank you all for your comments and advice. I think that I should add that the nurse who first said I should go to my GP immediately spotted that it was likely to be asthma - I become quite husky (which my husband quite likes!) and I have never had this before so I can say, without doubt, that my breathlessness is not a usual feature in my life and to be fair it starts after only about 10 mins.

    I'm still learning and find the forum really helpful.

  • Bex, why would anyone ban you from here, were all entitled to our opinion and last time I looked the right to free speech. Doesn't it make you sick to see those who smoke like a train, drink, and stuff them selves with all that unhealthy food, and still manage to have no problems being out of breath or something, while the like of you with more serious asthma, through no fault of your own struggle with even the daily basics.

    chris

  • Hey catwoman, don't worry about it - we like a nice lively debate on here, y'know..!

    Hope you continue to find good, useful and interesting advice and info from here.

    CathBear

  • Woody - I think Bex was more concerned with what she was *about* to say rather than what she had said!

    We know she's a good girl really :P

  • Woody-som, sorry if I caused confusion I was simply saying that if I were not a sane and sensible person I feel so passionatly about dis-information regarding asthma I could use some pretty strong terms, but I becuase I am a good girl really I am holding back :) Anyway I don't like making work for the admins I do too much admin'ing myself to do that.

  • Fully support full involvement where practical in all aspects of life for asthmatics

    Not wanting to rake over old coals, but i have not had the chance to get on the forum for the last while.

    In case it is felt i do not support the great efforts made on asthma kids camps please note that i of course i do (felt like chinese whispers). Well done to all who give so generously of their time and effort. I echo the sentiment to live life to the fullest.

    My advice was never to shrink your activities around your asthma, rather to learn to control your breathing in different situations that will arise. The modification to shorten your sentences actually works to reduce hyperventilation while talking! For me, the buteyko method was the first time i felt that it all made sense to me.

    For someone who has been fit and active all her life and eager to continue this level of activity, Catwoman sounds like she is a hyperventilator who would benefit from learning (from a trained practitioner) the buteyko breathing method.

    There is no attempt on my part to diagnose or otherwise. Obviously this is not possible without seeing someone in person.

    Of course all complementary therapies should be done in consultation with your asthma team (doc/consultant etc). This goes without saying. I can see your point that if someone does this after reading something on this site or on the internet, then i am very afraid for them. Given the serious consequences everyone should exercise caution with everything they read or hear. This goes for all posters and readers, irrespective of their background or training, a particular technique suitable for one may be detrimental to another.

    I do not agree that the trial results show that there is no reduction in preventer medication. The trial numbers are small yet appear to show in Brisbane (being the one i know more about) significant reduction in symptoms, reliever medication (95%) and preventer medication (inhaled steroid-49%).

    This is consistent i believe with other trials, when i googled ""buteyko nottingham trial"" up came a few buteyko sites (that i neither know or can vouch anything for) who may look at the results differently) that showed consistent results indicating reduction in both reliever and steroid medication.

    This point can be argued many ways, as statistics can be shown to reflect the opposite things depending on your point of view.

  • Buteyko breathing is like practising pranayama yoga. The control over breathing patterns is part of helping the mind to feel calmer and then the body to attain a relaxed physical state. This would undoubtedly help any sort of hyperventilatory symptoms which can also run concurrent to the inflammatory state associated with asthma.

    The big difference is that asthma is associated with inflammation – an absolutely physical condition, whether triggered by external influences such as environmental pollution or, to internal processes related to a genetic susceptibility.

    A stable asthmatic will always experience a relaxed state of mind when practising Buteyko.

    However Buteyko breathing is not credited with a demonstrated and permanent long term physical improvement in breathing capacity or lung function such as FEV1 ratios and FVC measurements.

    Nasal breathing will always trap environmental triggers such as pollen and HDM’s better than mouth breathing. What it won’t do is negate ongoing inflammation whether short or long term in the bronchioles.

    That’s why asthmatic world record holders for marathon running – one of the most challenging sports if you are asthmatic - continue to prioritise dual medications related to long acting bronchodilation relief and control of inflammatory processes.

    Supportive breathing relaxation techniques related to Buteyko or similar are helpful although never used as key strategies for asthma control whether at Olympic ‘any sport’ scenario or, for everyday control of asthma symptoms.

    The priority for asthma control if you are a runner would be to ensure you have complete control over symptoms before experimenting with other alternative therapies such as Buteyko, and then only under specialist supervision.

    As one passionate former marathon runner (but can still run half marathons) to another, hope you are feeling better Catwoman!

    Mia X

  • Buteyko'd, people expressed concern because they are aware of the potential seriousness of breathlessness while talking; the appreciation of this seriousness did not come across well in your posts. Had you said something like ""if you experience breathlessness while speaking, please see your doctor or asthma nurse quickly as this can be sign of poor control' and then suggested breathing retraining, under proper supervision, once good control is re-established I don't think people would have been so concerned. Anecdote alert: I recently had conversation with a man who does a fair amount of public speaking and who has a recent asthma diagnosis. He did indeed become hoarse and breathless sometimes during speeches and it was after one of these episodes that he was approached by an audience member (a nurse) who suggested a visit to his GP to check his lung function, which he duly did. After a discussion of symptoms and a bronchodilator reversibility test, asthma was diagnosed but is now under good control. The GP also recommended voice coaching, which has helped as it addresses dysfunctional breathing. As Mia points out, the crucial bit is collaborating with one's doctor/asthma nurse to try to establish good control before recommending breathing techniques. There is an important difference between not having symptoms during an activity because you have good asthma control and not having symptoms because you have reduced levels of that particular activity.

    With regard to the research, you say you are familiar with just one (smallish) study and then go on to say that in any case statistical results from these studies can be twisted to suit different points of view. That is indeed the danger of relying on individual studies rather than the weight of the evidence. That is why those who compile guidelines such as the BTS/SIGN asthma guidelines ( sign.ac.uk/guidelines/fullt... ) have to plough through many studies so that they can identify the good quality ones upon which to base their recommendations. (A relative is involved in the SIGN guidelines for another chronic condition - he has to sift through veritable mountains of research literature.) If you follow the link to the full text of the BTS/SIGN guidelines, you will find the reference to Buteyko on page 37. It concludes that the techique may be used to control symptoms but cites a Cochrane review and four clinical studies which suggest benefits in terms of reduced symptoms and bronchodilator use but no impact on underlying lung function.

  • Reply to Mia

    Reply to Mia

    I am unsure of the purely relaxational state of stable asthmatics while practicing Buteyko.

    There is an element of discomfort due to reducing ones habitual volume of breathing to a lower one that is not dissimilar (by its very nature) to a feeling of suffocating (not getting the habitual amount of air). This becomes more comfortable with time and replaces the anxiety element associated with not getting enough air.

    Although you state that Buteyko is not credited with improving lung function, it maintains it while allowing the asthmatic sufferer to reduce the amount of preventer medication (under supervision etc from doctor) and reducing short term (reliever) use to the bare minimum. This goes hand in hand with a vast improvement in the quality of life and amount of activity tolerated by the asthmatic.

    I disagree with your statement that it cannot address underlying inflammation. Due to the filtering and reduction in amount of trigger inhaled, coupled with the nose expelling them in 15 minutes rather than the 60-120 days that the lungs take to remove the same particles forced deep into the lungs through mouth breathing must reduce the underlying inflammation. It does not however, change the underlying genetic condition but protects it from being activated/ irritated.

    It has proven to be useful for many athletes, including international rugby players. I would suggest that your MR.A.WRH (marathon runner, asthmatic, world record holder) has to train far harder as he/she is an asthmatic. In relation to the current men’s MR WRH, I believe that he left an Olympic and World record and consequent gold medal behind him through lack of knowledge of the correct way to breathe. I would expect him to run even faster if his breathing control was further optimised (sub 2 hours or a full 4 minutes faster).

    Buteyko goes far beyond “supportive breathing relaxation technique” and involves key common sense asthma husbandry. If used correctly, it enables you to maintain great control, far improved quality of life and fitness as well as potential to reduce medication under supervision. This allow people to continue running to their ability rather than diminishing their target due to their condition.

  • Reply to Claire O’B

    Reply to Claire O’B's post below

    Point taken Claire regarding the hazard of not getting breathlessness under control.

    In relation to your anecdote, I believe that the gentleman in question would benefit enormously from breathing retraining and should over time and under supervision be able to reduce his medication. This is different from just getting voice training. The danger being that this person will be on medication for asthma, for the rest of his life, that he may not need should breathing control techniques successfully work for him. There is no question of reducing your symptoms purely by reducing your activity through Buteyko. This is true for the retraining period, usually 6-8 weeks depending on fitness and severity of asthma, after which one should be then able to participate as before and actually increase your levels of activity (thus the huge quality of life improvement as well as keeping your symptoms to a minimum). However this is also true for many people who retrain themselves in aspects of their life. You sometimes need to go backwards to go forwards. Tiger Woods, although world number one, was not happy with his swing so he deconstructed it and put it back together better. After a period where his performance slipped, he came back better than ever. In his push to be the best ever, he spotted the small flaws in his game that needed to be addressed. Breathing retraining similarly necessitates a dip in activity levels initially to redress the chronic habit of hyperventilation, before allowing greater performance than before.

    Thanks for the link (but it doesn’t work!) for the sign guide. I still maintain my point that you can achieve any result almost from any studies. The Nottingham Trial, however well intentioned, could not possibly have achieved a successful result. It did have several successful outcomes, one I pointed out already, that 72% of people found mouth taping acceptable, and 2 that there was a reduction in reliever use. Lung function may not have been improved (or ever claimed to be improved under such partial conditions) but quality of life and activity function may have been. There is that example, on the internet, of one of the trial patients, who was astounded at the result of the trial given his own success with buteyko.

    Was it ever considered to go back and re-interview the triallists?

    In relation to the weight of evidence, its very heavy. It is also calibrated to discriminate against non-conventional therapies by its very nature. The absence of longer and larger trials, generally through the cost involved and lack of funding (no downstream revenue only health improvement gains on a national/global level) means that this technique is currently the preserve of the early adaptors (in marketing terms). Eventually, this will dramatically increase and then be far more readily advocated, encouraged and will become the new wisdom. But we all have a chance now to be wise already.

    mayoclinic.com/health/asthm... is a link to the mayo clinic (one of the world’s foremost medical clinics) where they put buteyko as one of the 3 most promising complementary asthma treatments.

  • Butekyo is all very well and I understand that you are promoting it because it has worked for you. However for many of the asthmatics on this forum it is something that doesnt work and if used improperly in a severe attack may be dangerous. I have to say that breathing and oxygenating my body in such an instance is far more useful!

    I also find your excessive promotion of the method insulting and on a par with the people we have come on here marketing magical asthma cures. Sadly for many of us on maximal therapy there is no easy answer. Trust me if I could cure it through breathing exercises I'd be off the pred right away. And my life would be far far more convenient without the need to nebulise 4 times a day.

    Everyone is entitled to their beliefs but I feel it would be nice to show some regard for the fact that it is not a method that can cure everyone, or help everyone. It might be worth taking this into consideration next time.

    regards

    Emma

  • Whatever works for you!

    Reply to Wherrers.

    no intention to cause offence- sorry.

    I am hoping to help - it appears in this case that Soph may have found it useful.

    I also replied to general responses and hope not to overstate things but i may do accidentally in my enthusiasm - not intentional.

    You mention that it doesnt work for you- is it something you have tried?

    If you have can you advise how it didnt work and how you tried it? PM fine if prefer. If prefer not to discuss at all fine too.

    Where you mention on another post (phelgm one) about doing running and vigorous exercise - can you nasal breathe while doing this? What is your reaction to vigorous exercise? Nasal breathing works to keep ones lungs working at the correct level for ones activity. It is also possible to go back to mouth breathing for competitive exercises (although i don't) once one reaches a certain level of control. Its filtration factor and conditioning of the air (moisture and temperature) helps too. It was very beneficial to me and also reduced my allergic response to animals (cats and dogs).

  • Buteyko'd, it's obvious by now that you are rather enthusiatic about this technique but what is missing from your posts is a proper awareness that while some encouraging evidence exists for its use in milder asthma, it is by no means apparent that it is suitable - or even safe - for all asthmatics. (cf my reply to you today on the ""holistic"" thread)

    ""It worked for me"" is a standard response of those promoting complementary techniques but is insufficient to make general recommendations. Personal experience is subjective and can be subject to bias, which is why more robust evidence is preferred to anecdotes. The better quality studies - e.g. the 2006 Thorax paper I cited in the ""holistic"" thread - have found some encouraging evidence in milder asthma but the consensus remains that underlying lung function and inflammation are not addressed. By the way, you can easily reach the BTS/SIGN guideline if you google ' bts sign asthma guidelines' - it's the first result and you can link through to the full text. This guideline is referred to constantly by all medical personnel treating asthma in the UK, so if you are going to discuss asthma control you really should be aware of it.

    Finally, it concerns me to see that the Buteyko Moscow clinic makes statements such as allergy is not a cause of asthma and continues to define all asthma as CO2 deficiency. Furthermore, they recommend buteyko even in severe asthma, without any mention of the hypoventilation/raised blood CO2 that can occur in this condition.

  • Hello Buteyko'd one

    The web ref link immediately below and copied info was published less than six months ago, by a group of medical professionals and respiratory professors. They know a little bit about asthma and some of them suffer from asthma as well.

    Understanding and treating the inflammatory process is key to treating and improving symptoms for asthma control.

    thorax.bmj.com/cgi/content/...

    ‘Breathing training was not associated with significant changes in airways physiology, inflammation or hyper-responsiveness.

    Conclusion: Breathing training resulted in improvements in asthma-specific health status and other patient-centred measures but not in asthma pathophysiology. Such exercises may help patients whose quality of life is impaired by asthma, but they are unlikely to reduce the need for anti-inflammatory medication. ‘

    Hello Catwoman,

    Asthma plus meds can REALLY make me feel irritable at times as well. But please keep on running with the evidence based research meds that work!

  • asthma late in life AND a runner like you

    I've had it for a few years and only realized it when I got really sick earlier this spring. As a runner and a female of 5'4"" and 128lbs, my peak flow should be between 500 and 550. That's your guide. Exercise opens my lungs up for 36 hours after, and I can get a peak flow of 490 or so after I run, and it gradually goes down to 440-460. I use Symbicort 1x per day. I also have found that magnesium, 200mg per day, opens my lungs up by 10% or so which I can measure within the hour on my peak flow meter. Google it and see, it is a natural bronchodilator. I also take 2000mg of Vit C per day, taken as 1000mg 2x per day, to fight the inflammation in my lungs. My asthma is related to sickness, yours is different in that it's exercise induced.

    You are tired because you are walking around without a full set of lungs drawing in 100% of your breath. Until you get your lungs open and the irritation down, your peak flow won't go up to where it should be. Ventolin will only open you up for a few hours but does not treat the inflammation. You need to use your cortisoid inhaler to treat the underlying cause firstly.

    Running helps asthma, as it opens your lungs. I use my Symbicort as I wake, and then if I am running that morning will also use my Ventolin 1x just before I run to open up my lungs. I would have thought that you would have been told to always, always use your Ventolin before you run, especially to prevent an attack such as in your type of asthma. Not all doctors give you the best advice, you have to read and make use of resources, such as this website. Also, talk to others about their experiences. You can run successfully again but you must start treating your inflammation (steriod inhaler for a few months it sounds like to me) AND use your Ventolin before each run.

  • mouth vs nose breathing

    I'm only now reading all of the posts from Buteykd, and am astounded that someone would actually recommend to run with your mouth closed. You have obviously never run competitively, other than to catch a bus perhaps. Human beings were designed to run with their mouths open. Check out any race, of any kind, whether elite or amateur athletes are involved, they all run with their mouths open. It's not just for eating.....

  • Lee: wine & chocolate

    One last musing.....wine sets off my asthma, didn't realize that that's what was happening for a few years. It's the sulphites in wine that is used to preserve and rinse out the bottles. Google sulphites and asthma and see for yourself. Once you really get into finding out about your disease, you can figure out your triggers and do what you have to to get your PFM up to 450-500. You need to get the inflammation down, it won't get better by itself. Never change your meds without talking to a pulmonologist first, however, and it's good to get their advice rather than just the GPs or a nurse (not specialist enough for YOUR needs).

  • re: avoiding activities which result in breathlessness

    ...... and over the next few months, if my asthma allows me, I shall be telling politicians at the Scottish Parliament (on behalf of Asthma UK Scotland) how exercise can be LETHAL to some asthmatics - like me. I do think that it is time that we got back to basics on this post and remember that no two peoples asthmas are identical, that's why it can be so difficult to treat, and even more difficult to diagnose.

    And for Catwoman: Hi there! My PF varies between 600 and just under 290, recently being mostly at the lower end of the scale, and exercise and talking are two of the worst triggers. So be very careful what you do until you are sure that you know your limits, and then keep well away from those limits. Yes, in most cases exercise is beneficial for asthmatics, but in a large minority of asthmatics it's a KILLER.

    Catwoman, you take good care of yourself!

    Kindest regards,

    John

    p.s. It's quarter to two in the morning, my PF is just above 300 making it look like being another long night, and I think that if I exercised now my wife would have to call a VET. ;oD

  • Dannielle,

    Only quickly skimmed your posts, as short on time, but a runner myself, I'm really glad you said that runners have to breath trough there mouths, there is no way in the world I could get enough oxygen into my body if I didn't.

    Will read it all later, may edit this post afterwards.

    Chris

    I agree, exercise is good for asthma, gets the lungs working, shifts and mucus and allows them to move freely, I also take a vitamin C daily 1000mg, but an extra 1000mg in a sports bottle. I saw the difference last winter when I started to do it, and haven't stopped all year. I did personally suffer with the cold air, but have found workarounds, and montelukast has improved things no end. I still remember the Dr telling me even before we knew I had asthma, don't give up the exercise.

  • hi

    not sure if you still come online as this was posted last april, but your symptoms are identical to mine.

    i have always kept fit, gym, cycling etc and i played badminton in a club for years. i then had a break for over 10 years but decided last year to go back and found a brill club near to home, the people there are lovely. trouble was i think i went back into it like i was 25 again (i am 52) and started having problems breathing and got chest infections one after another. i too like you got breathless even walking, anywhere, and when talking. i ended up in hospital with pneumonia. i am now on becotide, serevent and salbutamol inhalers. i am due to see a consultant in april, and hope he can put things right fo me. i tried badminton last night for the first time in a few months and only lasted half an hour, i am extremely sad that i can no longer exercise. i have cancelled my gym membership, i guess i am just feeling a bit sorry for myself now, guess there are a lot worse things out there

  • welcome Catwomen

    Asthma can make you feel tired as takes more out of you,

    make sure you take reliever before exercise and dont over do it,

    Check with your doctor before you start exercise .

    Im new to asthma about 18 months ago.

    You will make lots of friends on here and lots of info ,

    love Glynis xx

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