It is like I am not using the inhaler

[Jonathan_C]

Morning all. I have exercise-induced asthma/bronchospasm. I also have a heart condition and until I was 41 (I am now 45) I thought the asthma was a symptom of my heart as it only flared up during certain exercise. So although I am in my mid-40s I am still very new to this condition. Since diagnosing asthma correctly I have tried a beta agonist and because of my heart, I switched to ipvent (Ipratropium bromide) - both have worked for me.

Over the last few months, I have lost some fitness due to injury and travel but not completely. I live in Cape Town so it is winter now.

The last few times I have jogged (in the morning, in the cold) I have used the inhaler but I have felt like I have not been using it. This morning the furthest I could run was about 600m before I felt my chest tightening. I took two good sucks of the inhaler about an hour before I set out. In total, I covered just over 5km, but very slowly. It is even worse when I jog in the gym, and I think the trigger there is the air conditioning.

Six months ago I could run 6 km with one or two stops. Given my current fitness levels, I would expect to be able to run 4km without any issues, but that isn't happening.

Is this normal? I thought it was the winter conditions, but it wasn't much better when I went jogging in Uganda a few weeks ago.

I have a heavy bag (boxing) and do quite hectic interval sessions on that and don't have any problems.

[d2read]

Hi, Jonathan,

Who diagnosed your asthma and on what basis? Have you had any allergy tests?

I’m not a physician, so please check with your doctors, but I am wondering if any of these things might be factors (I’m certain your asthma doctor — an allergist or pulmonologist — will know/be able to determine answers).

1. Perhaps you need a different asthma inhaler, and/or to use it closer to the start of your exercise (20 minutes). Many of us have to try different formulations before finding the optimal one for us.

2. Perhaps you would benefit from a low-dose of daily inhaled corticosteroids. Two puffs/am-pm and it can make a terrific difference for many people.

3. Is it possible that you have some other condition, other than asthma, like emphysema? There are tests to help differentiate.

4. You said you are in Cape Town and it’s winter — what is the air quality like? What time do you normally jog? Where?

5. You mentioned problems inside the gym - could there be a problem with mold levels there? If so, perhaps that’s one of your triggers.

It’s really critical that You and your doctor identify your triggers and come up with a treatment and PREVENTION plan tailored to your case. It’s also vital you have an emergency plan and know what to do when, in case you have a sudden flare while out jogging alone.

Good luck, and please let us know how you are.

Debbie

[Jonathan_C in reply to d2read]

Thanks for these questions. The air quality is good in my hood! I think the issue is an underlying subclinical virus of some sorts.

I wrote a while ago that I get sick when I exercise too much and I think that is caused by this subclinical bug/virus.

On Saturday I had an active day watching my son play rugby and other rugby games (but nothing more strenuous), on Sunday I went for a mild hike with the dogs and yesterday I went for a jog - this morning I woke up with a sore throat and headache. It seems that is too much for my body at the moment. It is a cycle that is repeating itself now in a predictable way: if i push myself for more than two consecutive days I feel sick. This explanation makes sense of the way i feel when i exercise - if i walk up one flight of stairs I am ok, but up two it becomes a problem. If i hike its ok, but not if I jog and so on.

I sound like a real moaner! I apoligise for that. I will get over it!

.

[d2read in reply to Jonathan_C]

No apologies necessary. I have serious asthma (and was one of the babies that wasn't supposed to survive in the '50s & '60s) that became critically worse through exposure to toxic mold (in the wall cavities of my flat, never in the outer area where it could have been seen/treated. Aftera decade of getting steadily sicker with few doctors taking it seriously, my health was largely wrecked with 60mgs of corticosteroids (prednisone) a day for 18 months. Then we discovered I also have hypereosinophilic syndrome -- and now e-asthma and e-emphysema. So no need to apologize for moaning.

Seriously, go see an infectious disease specialist if this has been going on a while, and don't be too quick to dismiss the symptoms.

Let us know how you are doing.

Debbie

[Jonathan_C in reply to d2read]

Hi Debbie

Thanks for your concerns and suggestions. I came to this forum as I am on another HealthUnlocked forum which discussions atrial fibrilation. The problem I reported in my original post is actually because I am back in atrial fibrilation, but was not aware of it.

So i am fully healthy, but my heart rate is wonky. I will be fine!