Sore chest upon exercise

I was diagnosed with asthma May last year. I am on symbicort SMART regime 200/6 2 in the morning and 2 at night. I am on the SMART regime as the GP felt that more appropriate as I had pneumonia 3 times last year. I have salbutamol for dire emergencies. I've never had an asthma attack and although I have slight difficulty in wood smoke/high polken/cold/very hot my asthma is quite well controlled (I take my inhalers without fail)

I walk 6 miles daily for the school run. Nearly 2miles of it is a steady incline. I take my time up there, never going very fast because it becomes uncomfortable.

At nearing 4pm this afternoon while we were on the walk home my daughter gotstung by a wasp and reacted quite badly to it. I needed to get her home quick for antihistamines. This meant going hard on the hill part of the journey. My thoughts weren't for me or my breathing but I was uncomfortably fast breathing. Since then my chest felt inflamed and sore as I breathed. At around 7.30pm I took 2 puffs of symbicort as I am on the SMART regime and the soreness has very nearly subsided.

I am now confused as whether my inflamed feeling sore chest is down to exercise induced asthma and whether the right thing was to have the symbicort (as I know it isn't for exercise induced asthma). I also wonder if anyone else has had a sore inflamed feeling chest after exercise with asthma and whether in your experienced opinion what has happened tonight warrants asking for a GPs appointment tomorrow.

Any help in understanding what has gone on would be very much appreciated.

13 Replies

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  • I'm interested in any other responses to your post as it is a problem I suffer with as well.

    Your treatment (I do have Montelukast as well, and 200/6 Symbicort) and problems echo mine. I was diagnosed with asthma after a very nasty bout of flu left me with a persistent cough and breathlessness. If I walk at my own pace and rest when needed, I can get by each day, if more slowly than I'd like! You sound far more able and fitter than me with all your walking!

    However, if I have to rush at a fast pace for say 10 minutes or more, or if I have to walk up perhaps 60 steps at quick pace without stopping, or an incline at fast pace (usually dictated by someone else's pace or a time deadline), I pay for it afterwards, for even up to a couple of days.

    My chest will feel uncomfortable; my heart rate will be higher for a few hours; and my breathing rate increased for a few hours too.

    I will need to use my Symbicort in the Smart way several times that evening, and the next day or two with a sense of breathlessness, and need to be very sedentary, and tightness and discomfort in my chest/lungs to the point of a pain that I might associate with the beginning of a chest infection, but it then wears off and my breathing settles down and I don't need the Symbicort other than my standard twice-daily doses.

    I think the inflammation comes because I am having to breathe cold air far more quickly, usually along with a stress-trigger of deadline anxiety, plus a sense of anxiety because I feel air-hungry, breathless and unfit...

    I am waiting for an appointment with the Respiratory Consultant to ask about this, what her opinion is, and whether a 2nd inhaler (Spiriva?) might allow me to move more quickly and for longer without having to pace myself so much. I was playing tennis previously, but now have to rest after a few minutes- thank goodness for understanding friends!

    Did the Symbicort help noticeably? I find it does, but is needed again a couple of hours later; so unlike normal. Symbicort under the Smart system is used as a reliever as well as preventer, so to me that is an appropriate use of it, to help relieve the inflammation. I find steroids really do help stop the coughing and breathlessness.

    It probably is worth seeing your GP in case there is anything further s/he can do for you, or give you an explanation and put your mind at rest. Another idea might be to phone the Asthma UK's Helpline on 0300 222 5800 (Mon - Fri; 9am-5pm) to speak to an asthma nurse specialist.

    Let's hope the two of us can get some help to cope with this better!

  • Thank you so much for your reply. To just not be alone is helpful but I am so sorry to read that it effects you to the point of having to take a slower life.

    I still feel a bit sore and feel it's tired and lack lustre in my chest.

    I chose not to have a car after the pneumonias. My lungs are damaged somewhat and I wanted get moving to improve my capacity but I'm not a fast walker at all. I get the time pressure issue too. I try to compensate by leaving plenty of time and no issue would have me pushing myself like today other than the welfare of my little ones. I have frightened myself though and my heart rate hasn't really calmed down yet.

    Thank you for taking the time for replying. Even though the issue is a rubbish one, at least we're not alone in it.

  • I too have similar issues. I ended up on Symbicort after several months of struggling following a viral chest infection. Eventually I ended up last year in hospital for a few days. Since then I have also been put in the SMARTregime, and just now, as it happens, I am a bit confused. More of that further down. I, too, struggle with walking fast, especially uphill. On one occasion, Christmas Eve last year, I even fell over. Admittedly I did stumble, but felt faint before, and had that chest burning sensation, and not being able to breathe out easily. I was walking with someone else who is a fast walker. Since then I dread walking in groups or with some other people, but I have also got better at saying I need to walk at my pace. Afterwards? Yes, I would also suffer a bit, but not so much now as I avoid it happening in the first place, at least when I can. Hygge’s situation would have me rushing as well. I hate that chest feeling, though!

    Just now I am having my first cold since my asthma shenanigans in 2016, and I am a bit shocked how quickly it triggered my asthma. It doesn’t feel too bad, but then I have a track record of not noticing. My peakflow tells a different story. I am now also on prednisolone, so sleep is not easy to come by just now. Thus I notice more in the night when things aren’t so good. I am desperate to keep on top of it, so I don’t end up in hospital again, and so I have been taking Symbicort as per SMART regime.

    However, today, on advice of Asthma UK nurses I spoke to one of our GPs as I was unsure how far I can take my additional Symbicort use. Confusingly he told me I should not be taking Symbicort as and when, although that is how it is written up, but instead increase my am and pm dose, and otherswise use salbutamol. This is not what it says in the instructions, not what I was told, so I have decided to take a middle path, use both Symbicort and salbutamol if I am worried about going over the limits.

    Has anyone else had this experience?

  • Hi there, exercise can be a trigger for almost everyone with asthma. And it is now believed that there is no such thing as exercise induced asthma, it is just a trigger for lots of people. Who are otherwise relatively symptom free. Anyway the jury is still out on this. So as part of that research I am having an assessment at the Royal Brompton hospital today to see how quickly I have an attack during exercise. I am a runner, and I have quite bad asthma. I am a bit worried about it as I have had to stop using all asthma drugs for 24hours. I think they will get me to run on a treadmill and measure how quickly I have an attack. And do spirometry before and afterwards. I am hoping to get a better idea of how best to use Ventolin on long runs.

    The RBH are doing a study about exercise and asthma.

    If you can contact your doctor, I would ask about using your Ventolin prior or during exercise. I know this is a different protocol for those on the smart regime.

    I always use my rescue inhaler before and during exercise

    Or you could give the Asthma U.K. Helpline a call.

    R

  • From what I know of my asthma and my younger son's asthma, I would say that different asthmatics respond differently to exercise. There is no doubt that my asthma is exercise induced. Taking ventolin before aerobic exercise (often recommended) has almost zero impact on my condition. Contrast that with my asthmatic younger son who has always been able to participate in sports involving quite a lot of running (hockey), without much in the way of problems (though he always has his inhaler with him in case).

    I would almost argue that the fact some (apparently) non asthmatics also have a bad response to exercise is irrelevant. Let's consider another example: quite a high proportion of the general population will react in some way to dust - it will act as an irritant if it gets inhaled in to the lungs. You don't have to be asthmatic for that to happen. But that doesn't mean it should be dismissed as a major trigger for lots of asthmatics.

    I'm always astonished (not to mention a little envious) of asthmatics who are able to do running. I can remember giving myself an asthma attack when I was eleven years old when I got involved in a game of tag in the playground. That just happens to be what my asthma is like.

    I'm actually reasonably physically fit. I certainly am not overweight and I eat a very good diet. A recent blood test done to check my nutrition came back with very good readings for everything except Vit D (which is much more to do with exposure to UVB). I do a ballet class every week (which my lungs can cope with because the aerobic exercise element of that comes in short contained bursts). Likewise my lungs were able to cope with gymnastics. But a game such as netball - well that could be asking for trouble:-).

  • Aha, so this really isn't that uncommon!

    Risabel59 - good luck today for your test at RBH, I hope it helps you with your ongoing running.

    Going without my meds for 24 hours would not suit me - and I'd pay for day's afterwards 😱

  • No, it's not uncommon. The only reason I'm not really answering the original post is that although my asthma is definitely triggered by exercise, I'm not on the Symbicort SMART regime. There is no doubt that if my asthma is triggered by exercise - walking fast uphill will do it - taking ventolin will help to bring it back under control (though nothing like as quickly as the old IntalCo used to even if I did end up with a splitting headache after using it - but that's no longer available).

    As someone who really does have to be careful when it comes to certain forms of exercise, I've often wondered why exercise induced asthma occurs. One of the most interesting answers I've heard came from a medical professional (a retired consultant who happened to be a brilliant medical generalist) when I asked the question of him. His reply started with it wasn't really known (this was twenty years ago, but I rather suspect things really haven't changed that much) but he also offered his own theory (and he stressed it was his own personal opinion). He wondered whether it was connected to a problem with the autonomic nervous system - a chemical imbalance perhaps. That would, of course, tie in with the fact that people other than asthmatics can get symptoms. That said, I stand by my argument that just because non asthmatics can have a respiratory problem arising from exercise does not mean that the term exercise induced asthma is false. Some asthmatics clearly can have quite a severe asthmatic response to particular types of exercise.

  • Sorry you are struggling abit and hope your daughter is ok.

    I have a very similar issue myself, where I don’t feel too bad asthma wise but my chest gets so sore. Just earlier this year I was really struggling with it and any form of exercise was causing it to flare up. It’s worth raising it with your GP as they may want to do a few extra checks just in case. After seeing my gp a few times my preventer inhaler dosage was increased and 4 puffs of ventolin to be taken before exercise, with the same again after if I need it. Since these alterations I have been able to do a lot more so it’s definitely worth raising the issue with gp or asthma nurse.

    I would be interested to know why we are getting this symptom, without the expected asthma ones.

    Hope you get it sorted soon :)

  • Thank you all for your feedback and understanding.

    Today has been much better but I'm avoiding SMART in favour of ventolin before the hill leg of the journey. I've never really joined the hill with exercise so never looked beyond fitness. This morning I was able to relax when breathing. It felt calm and clear.

    Interestingly, with my asthma, my chest is always clear, no wheeze really but I have so many triggers that make me feel uncomfortable and not very confident being out and about. Maybe exercise is another.

    I'm still learning about my condition in terms of how it is for myself but I will be bringing up whether SMART is appropriate for me because without a wheeze and clear chest but so.many daily triggers I need to learn more about so many steroid hits in a day.

    Thank you

  • You have to count the anxiety and fear you experienced when beating by a was which plays a major role in asthma flares up, it probably come back to normal after a few days. It is always advisable to seek the advice of a GP. Unfortunately I have not used Symbicort long enough to advise you properly.

    Hope you get better soon!

  • That is such a good point laburito1. I was worried about DD as she had never been stung before and I didn't know if she was going to have a reaction other than tge 20p sized welt. I was also on the back bridlewsys away from any passing help and DD crying with the pain of the sting. It was definately a stressful time... I now carry water and antihistamines. Ah being a Mum!

    I was sore after the 3pm hillwalk yesterday but this morning I feel almost back to normal although I am on 3x symbicort and I have been using ventolin on the hills. This afternoon we're getting the bus up and i'll rest over the weekend. I'm having difficulty getting a doctors appointment as I'm not in an emergency state but if I feel I need tge ventolin next week I am going to have tontry to persist.

  • Well done! I'm going to try the Ventolin in preventative mode as well before any required yomping, and see whether it helps.

    I have finally managed to rebook my repeatedly cancelled Consultant's appointment (which I have been waiting for since May), which may happen early November.... or not. I'll report back if I learn anything useful after that!

  • I just wanted to let you all know that I have been to the doctors as the pain slowly got worse. I have crackles on my lung and a chest infection. I had 3 chest infections last year which all turned to pneumonia. Having had the P jab last week (with the flu jab) the incident with the wasp happened the day after. I just didn't put the soreness down to a chest infection.

    The doctor assures me that I couldn't have contracted a chest infection from the jabs but I've been clear for 9 months, have those jabs and fall ill the day after.

    Just thank you all for your help and support. Please have hope that it doesn't develop into pneumonia. Pretty please.

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