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Medical Forum / Diseases and Disorders / Asthma / March 2004

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Exercise Induced Asthma

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mmv - 22 Mar 2004 01:36 GMT
Does anybody have any information on how this type of asthma is experienced
and what might be done about it. I think I have a bad case of it. I've had
asthma since my childhood. It was always more or less under control, and I
could even do sports.
But since the last 5 years I have started to suffer from cramps and spasms
in my lungs when I do sports, e.g. running. The cramps really make breathing
very difficult and painful. It is not like a normal asthma attack or
anything, it is pure pain in the lung area. Unfortunately there is not much
infromation about this available, especially not on the form I experience
Meghan Noecker - 22 Mar 2004 09:14 GMT
>Does anybody have any information on how this type of asthma is experienced
>and what might be done about it. I think I have a bad case of it. I've had
[quoted text clipped - 5 lines]
>anything, it is pure pain in the lung area. Unfortunately there is not much
>infromation about this available, especially not on the form I experience

Yours sound a bit different than what I experience, but I usually
avoid them, so I don't experience them very often.

I only have exercise induced attacks for two reasons - trying to
exercise too hard for my conditioning level, or when I am already
experiencing other risk factors.

So, for exercising too hard, this is when I try to do too much, and my
heart rate jumps out of control, and my breathing follows. I get
exhausted immediately, and I gasp for breath. Not an attack that
requires medication, but I must stop and rest. I used to fail in
exercise programs until I learned to go at a slower pace and back off
when I felt the heart and breathing rates speed up too quickly. Part
of my problem is that my throat is smaller than typical, so my peak
flow on a good day is lower than most people's normal. So, my lungs
have to work harder to produce the same level of oxygen.

Now, the other kind, caused by a mixture of factors *does* require
medication. This usually means bad allergies at the time, or hot humid
air, or very cold dry air. Any two of these factors will produce an
asthma attack. So, I can be sleeping in a hot humid night with high
pollen and wake up with a full attack.

Or I can walk to work on a cold dry day at my normal walking pace and
have a full attack. Technically, it is considered exercise induced
since I don't get the attacks simply standing out in the cold. But the
constriction by the cold, *and* the increased need for oxygen (because
of the walking) can bring on an attack.

On cold days, I wear a scarf. It keeps the air moist, and prevents it
from being cold dry air. If I am having allergy problems, I tend to
walk a little slower if I am "aware" of my breathing. (That means I am
entering my personal risk zone). If it is hot and humid, I do not
exercise outside, only inside with a fan, cold drinks, and an easy way
to control the situation. While I love rollerblading, I will not do it
if it is humid, or my allergies are acting up.

By avoiding the combinations, I can avoid attacks, and I have been to
go many months at a time without an attack.

I'm not sure about your cramps and spasms. It sounds like you are
physcially more active and pushing yourself harder. It could be the
same gaspy feel I have when I can't breath. But it might be something
different.

Have you been to a doctor recently? It could be that something has
gotten worse. Does an inhaler help when this starts up?

Meghan & the Zoo Crew  
Equine and Pet Photography
http://www.zoocrewphoto.com
Richard Friedel - 25 Mar 2004 11:01 GMT
> >Does anybody have any information on how this type of asthma is experienced
> >and what might be done about it. I think I have a bad case of it. I've had
[quoted text clipped - 5 lines]
> >anything, it is pure pain in the lung area. Unfortunately there is not much
> >infromation about this available, especially not on the form I experience

To
„Meghan & the Zoo Crew  
Equine and Pet Photography
http://www.zoocrewphoto.com"

Well, since you are paying such attention to body sensation, you might
be interested in my asthma philosophy.  It is on the basis that asthma
is a definite phenomenon, which may be secondary to some basic disease
that weakens the chest. O r it may occur without any apparent
predisposing cause. Asthma may be considered as similar to lower back
pain, in the case of which somebody someday may find a disease
condition at a molecular or biochemical level, but for which muscle
training in a fitness studio is, at least in Germany,  accepted as a
sound remedy. In other words, the standard approach checking through
all details of the nerves etc. and concentrations of substances and
concentration ratios, though appearing logical, may be like looking
for the proverbial needle in a haystack.  This may also apply for
asthma.  As Carl Sagan told us, it is as well to spin an alternative
hypothesis.

Many sources point to the diaphragm playing an important role in
asthma and in breathing. Oriental techniques attach great importance
to its descending to an imaginary  point (tanden or hara in Japan,
tantien in China) an inch or so below the navel. With martial arts
this notion has been accepted in the West. Western medicine is however
based on what a doctor can measure scientifically with instruments.

My philosophy is minimum reliance on examination with  instruments and
maximum reliance on direct body sensations and the development of
breathing techniques to get a kick out of them.

The work of Dr. Erik Peper in California (see
http://www.i-breathe.com/thb12/Incentiv.htm) proclaims asthma to be

1)    firstly a spasm of the bronchi which can be overcome not only by
drugs as almost everybody learns at school these days, but   also by
breathing and relaxation techniques, and

2) a lack of normal diaphragm activity, which would overcome the
spasm.

By concentrating on relaxing the bronchi, maybe by combining a yawning
effort with an inhale and simultaneously causing the abdomen to
balloon out a person can with patience get to the stage that he is
actually breathing by such a ballooning effect.  A true breathing
sensation takes time to develop. See Peper's figure 1: the less the
strain in the upper chest, corresponding to spasm, the greater the
volume breathed in.  See  also figure 5 on "Learning inhalation volume
awareness". One trick to get a diaphragm sensation is to inhale though
the mouth with a finger placed between the lips to provide a graded
resistance.  Another is to wrap a length of Theraband around the
abdomen to get an abdomen rather than a chest awareness for breathing.

With time I found that the downward movement of the diaphragm in the
course of time gives rise to a sort of kick like in pelvic floor  or
kegel training. The airways are relaxed and there is a kick like with
a shot of reliever spray, but hopefully without any addictive effect.

As an advanced exercise there is bhastrika (a part of yoga) as one
form of the breath of fire. One breathes as quickly and as
energetically as possible through the nose concentrating on diaphragm
action for around half a minute, while being careful not to start a
phase of hyperventilation. This is similar to huffing as recommended
in orthodox asthma and bronchitis treatment but is much more
intensive, and is considered one of  main yoga tactics for asthma.
Another approach to strengthen the diaphragm is "laughing yoga" of Dr.
Madan Kataria.

I've tried to stick to safe techniques which have some backing and
they seem to work with me excellently. I'm  pleading for is more
caution about accepting treatments based on biochemical intricacies.
It seems likely that the body of a healthy person adjusts itself to
deal with abnormal airway constriction.  This mechanism should be
identified. Regards, Richard Friedel
Meghan Noecker - 26 Mar 2004 12:22 GMT
>I've tried to stick to safe techniques which have some backing and
>they seem to work with me excellently. I'm  pleading for is more
>caution about accepting treatments based on biochemical intricacies.
>It seems likely that the body of a healthy person adjusts itself to
>deal with abnormal airway constriction.  This mechanism should be
>identified. Regards, Richard Friedel

I'll have to look into it more, but I'm not sure if would help me. My
asthma is caussed by a combination of allergies and small airway. I
didn't have any asthma problems until I was 19 and went to Mexico for
3 weeks to visit a friend.

I had major allergies there and awoke the next day unable to breathe.
They gave me an inhaler there, but when I got home, I went to a doctor
here for the official diagnosis. They determined that my throat is 30%
smaller than typical for my body size. This makes sense to me as I
have always had trouble swalloing pills - they hit the back of my
throat and I cough them up.

As long as I don't put together the combinations of
exercise/cold-dry or hot-humid/allergies, then I am fine. I can go
months without an asthma attack, and I have not had a true, out of
control breathing attack on over 5 years, maybe 6 or 7, it has been so
long. I have only felt the need to use my inhaler this past December
after a bad cold that got into my lungs. And I had to get a new doctor
as my old one had moved away at least 5 years earlier, and I had no
current presciption.

I don't think there is anything I can do about my small throat, so I
just avoid the factors which cause the problems. My allergies are
mostly controlled now, and the air temp/quality thing isn't a big
issue in the Seattle area. It rarely gets that bad in either
direction. And it just means I can't run or go rollerblading. I can
still walk and do normal stuff in it.

Meghan & the Zoo Crew  
Equine and Pet Photography
http://www.zoocrewphoto.com
Richard Friedel - 27 Mar 2004 11:32 GMT
> >I've tried to stick to safe techniques which have some backing and
> >they seem to work with me excellently. I'm  pleading for is more
[quoted text clipped - 34 lines]
> Equine and Pet Photography
> http://www.zoocrewphoto.com

Yes your unalterable constriction due to the permanently undersized
throat (medical term?) might be a bar to rollerblading or other
comparable exertion.

Remember however that some people (see John Douillard's popular book
"Body, Mind and Sport") extol the virtues of being able to run with
the mouth closed.  This takes some time to get used to and since it
does not seem to be just a question having a large enough pipe but
also of reflexes (which are not considered) the whole idea might be
unhealthy. I guess breathing through the mouth for exertion acts by a
reflex   See discussions on running newsgroups, where breathing thru
the nose is of interest owing to air pollution.

In some pre-Columbian American civilizations, reputed for their
sadism, youths were trained to run with their mouths full of water,
which they had to keep in as a proof that they did not cheat by mouth
breathing.

On the more general point of breathing exercises for asthma, judging
from my experiments on myself, tests on recommended methods, theories,
copious Internet mining etc. etc it does seem that there are two
aspects  of being short breath (SOB).

1 The peakflow reading relied on by a doc which does not distinguish
between bronchitis or any cold on the chest and asthma on the other
hand.
2 The asthmatic type, which is so crippling and drives people into
fits of hyperventilation and to medication (see recent research done
by Andrew Binks).

My experience is that, for folks without high blood pressure problems
and stable asthma at least, some yoga exercises such as breath of fire
(bellows breathing) with a concentration on getting the diaphragm to
go as low as possible lead (at least with time) to a ummy and
vitalizing feeling. There may be no change detectable with spirometry,
but the SOB is turned off.

Even if your small throat is be a limiting factor unable to be changed
in any way, breathing slowly (pursed lips breathing, see also
http://www.ohiou.edu/isarp/conf_00/papr_19.htm) during an inhale is a
valuable tactic to stave off  an attack.  Regards, Richard Friedel
Meghan Noecker - 28 Mar 2004 08:48 GMT
>Yes your unalterable constriction due to the permanently undersized
>throat (medical term?) might be a bar to rollerblading or other
>comparable exertion.

Actually, I can rollerblade most of the time without any problem. I
just can't do it if the air is really cold and dry or really warm and
humid. Not much of a problem in the Seattle area.

If I know my system is already down (recent asthma attack or
something), then I won't go or will only do a little bit. But most of
the time, it isn't a problem. I don't know why, but rollerblading is
like walking to me, something I can do easily for a fairly decent
distance without any problems. I can even race for a quarter mile or
so at my fastest speed before slowing down. I feel good, and I love to
do it.

>Even if your small throat is be a limiting factor unable to be changed
>in any way, breathing slowly (pursed lips breathing, see also
>http://www.ohiou.edu/isarp/conf_00/papr_19.htm) during an inhale is a
>valuable tactic to stave off  an attack.  Regards, Richard Friedel

Hmm. I do the pursed mouth breathing during exhaling when I feel my
breathing is labored. I have never tried it for inhaling.

Meghan & the Zoo Crew  
Equine and Pet Photography
http://www.zoocrewphoto.com
Richard Friedel - 30 Mar 2004 06:44 GMT
> Hmm. I do the pursed mouth breathing during exhaling when I feel my
> breathing is labored. I have never tried it for inhaling.

Sorry about my mistake.  Hope no one was misled.  RIchard Friedel
 
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