Question:
Several weeks ago I was diagnosed with exercise induced
asthma based on my description of symptoms during exercise
of chest tightness and "burning lungs" that builds during
the first 10-30 minutes of effort. (Is there a standard
term for this "burnt" feeling in the lungs? It feels like
what happens if you exercise very hard without warming
up on a really cold day). However, I don't experience any
"wheezing" except that when it gets really severe there
is some shortness of breath.
I was prescribed an albuterol inhaler, 2 puffs 30 minutes
prior to exercise and 2-4 as needed with instructions to
supply the physician feedback after a week or so. On my own
I also got a peak flow meter (MiniWright) to monitor things.
As it turns out, my doc is away for a few weeks and when he
returns I'd like to be able to ask him some reasonably
informed questions.
I still get these symptoms during the early part of a
workout even with the albuterol but perhaps not as
bad as without (?). I expected that while I'm symptomatic
during exercise that I would see decreases in my peak flow
but this does not appear to be the case. In fact, my
peak flow does not seem to vary all that much, most of
the time within about 5% of what I would call the median,
and very seldom much less. Using albuterol does raise
the peak flow somewhat but not by much more than several
percent. Severity of symptoms seems unrelated to peak flow
readings.
Have I misunderstood the purpose of the PFM and it's
monitoring function? If the symptoms of EIA are not
always related to flow problems how else do you determine
if you are medicating it properly?
Also, is it common for the symptoms above to be greatly
diminished after the first hard efforts? I.e. after the
first half hour which includes some intervals of moderate
effort with (kind of scary) symptoms the rest of the ride
or run is good and can contain periods of significant
effort with only a hint of symptoms. Is that the albuterol
at work or is that just the way that EIA can be?
Answer:
->Asthma And Allergy FoundationSeveral weeks ago I was diagnosed with exercise induced
asthma based on my description of symptoms during exercise
of chest tightness and "burning lungs" that builds during
the first 10-30 minutes of effort.
Exercise induced asthma and peak flow meter (kinda long)
Several weeks ago I was diagnosed with exercise induced
asthma based on my description of symptoms during exercise
of chest tightness and "burning lungs" that builds during
the first 10-30 minutes of effort. (Is there a standard
term for this "burnt" feeling in the lungs? It feels like
what happens if you exercise very hard without warming
up on a really cold day). However, I don't experience any
"wheezing" except that when it gets really severe there
is some shortness of breath.
I was prescribed an albuterol inhaler, 2 puffs 30 minutes
prior to exercise and 2-4 as needed with instructions to
supply the physician feedback after a week or so. On my own
I also got a peak flow meter (MiniWright) to monitor things.
As it turns out, my doc is away for a few weeks and when he
returns I'd like to be able to ask him some reasonably
informed questions.
I still get these symptoms during the early part of a
workout even with the albuterol but perhaps not as
bad as without (?). I expected that while I'm symptomatic
during exercise that I would see decreases in my peak flow
but this does not appear to be the case. In fact, my
peak flow does not seem to vary all that much, most of
the time within about 5% of what I would call the median,
and very seldom much less. Using albuterol does raise
the peak flow somewhat but not by much more than several
percent. Severity of symptoms seems unrelated to peak flow
readings.
Have I misunderstood the purpose of the PFM and it's
monitoring function? If the symptoms of EIA are not
always related to flow problems how else do you determine
if you are medicating it properly?
Also, is it common for the symptoms above to be greatly
diminished after the first hard efforts? I.e. after the
first half hour which includes some intervals of moderate
effort with (kind of scary) symptoms the rest of the ride
or run is good and can contain periods of significant
effort with only a hint of symptoms. Is that the albuterol
at work or is that just the way that EIA can be?
!-- start answer -->Peak flow is pretty good at detecting narrowing of the larger airway but
doesn't work well for the smaller airways. You need a much more sensitive
device for that (spirometry) and it may not be worth the expense and hassle.
Thus you may not show much difference with Albuterol. "Generally" a 15%
change is noteworthy but not always the case.
More indicative is wether it makes exercise go better. Your feedback makes
it sound like it isn't helping much. Make sure you are reasonably hydrated
before exercise. Dehydration will make it worse. If there is an
asthma/allergy component then something in the environment where you are
exercising may be compromising the issue. Possibly change location or
exercise to check it out. Warm up very slowly. Give the body a chance to get
accustomed to the load.
If you are expanding your "boundries" and pushing aerobic fitness you may
just be hitting your own personal wall. Anyone will get that lung burning
feeling if pushed harder than they are used to. Increases should not be more
than 10% of current load per week
Lastly, it could be a cardiac issue. You need to take a look at your age,
family history, weight, nutrutional status, all that heart disease stuff and
possibly run this by the physician as at least a remote possibility. If the
heart can't pump it the feeling will be the same in the lungs.
Asthma and Allergy Foundation of America-WA Branch
