My Experience With Exercise Induced Bronchospasm

Last updated: August 2017

A story I’m proud to talk about is how I conquered exercise-induced bronchospasm (EIB). As a kid, I was not able to exercise much and even had a doctor’s excuse to skip gym class in high school. Today, I exercise all I want. Here’s my story how I beat EIB.

My airways are inflamed, and this makes them hypersensitive to asthma triggers, one of which is exercise. This is exacerbated when I exercise in cold air, like when I used to ski with my brothers.

Behind my parent’s house are a lot of hills, some steep and some not so steep. We would make cross country trails through the woods and open fields, and then we’d make trails up and down these hills. It was fun, although sometimes it caused bronchospasm.

While my brothers continued having fun, I’d have to use the ski poles to lean on while I trudged home, shoulders high, weary, as I struggled for air.

On the way home I incessantly puffed on my inhaler, and when I got home, in the warm indoor air, used my nebulizer. These efforts were useless, as there was a refractory period after exercising when my asthma was not responsive to rescue medicine. So what I had to do was wait it out; tough it out.

These episodes were sometimes so bad that it would take all of an hour for the inflammation to settle down and for my breath to come back

My doctor knew how much albuterol I used at times like this, and he was fine with it. Well, he wasn’t fine with it, but he knew how bad my asthma was, and he trusted my judgment with my medicine, being that I had severe asthma and all.  I greatly respected him for that. He knew I was the exception to the rule.

As you might imagine, this sort of discouraged me from sledding and skiing, at least for a little while. Usually, after enough time elapsed, I’d forget, or my brothers and I would make plans for making new trails, and I’d participate in the fun. Sometimes I did fine, while other times my asthma flared.

I usually was able to play baseball, and I was thankful for that. Swimming I could do, although sometimes the chlorine got to me (still does). Basketball was out. Gym class was out, and my doctor wrote a note saying, “This boy has severe asthma and cannot participate in gym class.” This I didn’t mind so much.

I did take an inhaled steroid every day to control my asthma. I took Vanceril, and then Azmacort, but at that time doctors prescribed a low dose four times a day. At one point, because I needed a higher dose, I was prescribed 8 puffs 4 times a day of Azmacort, and Lord knows I missed many of those puffs. I would feel guilty for missing doses, especially when my asthma got worse. However, turns out I was not alone.

In the late 1980s, researchers observed most asthmatics were missing doses, and this resulted in worse asthma control. So, they had pharmaceuticals put a higher dose in each inhaler, and they prescribed it twice a day. Studies confirmed this was equally effective, and just as safe, as prescribing a low dose four times daily.

But it would be a few years yet before my doctor caught on to the new trend. In fact, it was nearly ten years later when I was prescribed Flovent. I only required 2 puffs twice daily. It was nice because I just took my puffs before brushing my teeth in the morning and before bed.

Add to this is the fact that each new inhaled steroid, I think, is a little stronger than its predecessors. The combination of a stronger steroid plus taking it only twice a day resulted in much better asthma control, and not just for me but for all

I did take Serevent for a time, although it made me too jittery, at least the inhaler version that was initially available. I took it off and on with minimal success. In 2002, however, I was introduced to Advair, and that was what I needed. Since then, I have been able to exercise whenever I want, so long as the temperature is greater than 52 degrees Fahrenheit.

I came up with 52 degrees by experimenting. If I run when it’s cold, as in the winter, I still have EIB symptoms. However, when it’s less than 52, I exercise indoors, where it’s warm, and where the air is at least somewhat humidified. This works great, allowing me to exercise like a normal person.

The reason cold air still irritates my airways is because, I think, even the Advair isn’t able to get rid of all the inflammation. Some is there all the time, and it is very sensitive to cold, dry air. It’s also sensitive to viruses and allergens like dust mites and mold spores. So, as long as I avoid them, and so long as I exercise in warm air, I’m usually fine.

I have tried pre-treating myself with albuterol, although that doesn’t seem to have much of an effect. Singular works for some, but not for me. What I do do is pace myself when exercising. I usually start out slow for about three minutes, and then I run. I pace myself, but I run. Sometimes I do interval training, and sometimes I jog for distance.

I am a witness to how far asthma wisdom and medicine has advanced. Just in my short lifetime, I have gone from unable to exercise to able. It’s kind of neat when you think of it.

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