Exercise-induced Asthma

WHAT YOU SHOULD KNOW:

• Exercise-induced asthma, or EIA, is a condition where your airway swells and becomes narrow. Your airway is made up of many tubes that carry air in and out of your lungs. Exercise includes doing sports or other physical activities. EIA may occur in people with or without chronic (long-term) asthma. EIA is thought to occur when your airway cools and dries up due to breathing fast during exercise. Doing heavy exercise in a short period of time may make you have EIA.
  
  
• Coughing, chest pain or tightness, trouble breathing, and wheezing are the most common signs and symptoms of EIA. To diagnose EIA, your caregiver will ask what your symptoms are and what activities cause your symptoms. He may ask about your health, and your family’s medical history. He will check for other conditions that may give you breathing problems. You may need breathing tests and exercise tests. Treatment may include resting and taking medicines such as anti-allergy medicines, bronchodilators, and steroids. With treatment, your EIA may be prevented and you may be able to exercise without any problems.

AFTER YOU LEAVE:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
  
  
• Allergy medicines: These medicines, also called anti-histamines, can treat allergies which may be causing your breathing problems. Taking these medicines can decrease your risk of having EIA.
  
  
• Bronchodilators: These help open up the air passages in your lungs, and let you breathe easier. They also help stop your symptoms from becoming worse. You may take these before you exercise and before your breathing problems appear. Bronchodilators can be taken by mouth (swallowed) or inhaled (breathed in).
  
  
• Inhaled steroids: Steroid medicine can help open up your air passages so you can breathe easier. These medicines also decrease swelling in your airway. Do not stop taking this medicine without your caregiver's OK. Stopping on your own can cause problems.
  
  
• Leukotriene antagonists: These medicines can decrease swelling in your lungs. They may stop you from having more wheezing or shortness of breath. They may also stop your attacks from lasting for long periods.
  
  
• Mast cell stabilizers: These can prevent your lungs from having more swelling.

Follow-up visit information:

Your caregiver will check how well your treatment is working. You may need to visit your caregiver more often if your symptoms are very bad. Your caregiver may add more medicines to relieve your symptoms, or remove them when you get better. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Inhalers:

Your medicines may come inside small devices called inhalers. An inhaler gives your medicine in mist form which you can breathe into your lungs. A metered dose inhaler (MDI) is one type of inhaler. This is a small tube shaped device which holds liquid asthma medicine inside. Your caregiver may tell you to use a spacer with this inhaler. A spacer is a large tube which holds the mist before you breathe it in. This helps you get the right amount of medicine more easily. An MDI with spacer also decreases your risk of side effects, such as hoarseness, mouth yeast infection, and hacking cough. Ask your caregiver for information on how to use your inhaler correctly.

Peak expiratory flow:

Checking your peak expiratory flow (PEF) helps you know if you need medicines before doing certain activities. It also tells you if your EIA is getting better. You may check your PEF before exercising or doing sports. You can quickly treat your EIA if your PEF reading changes. Always use the same peak flow meter. Buy the same brand if you need another meter. Ask your caregiver for more information on peak flow meters and how to use one.

Physical activities and EIA:

You can do physical activities and play sports even if you have EIA. Exercise is important because it helps keep your body healthy. If you keep your asthma in good control, you can exercise and do sports. Sports and activities that cause heavy, fast breathing are more likely to cause EIA. Examples of these activities are heavy running and cold weather sports such as cross-country skiing and ice skating. Some good sports and activities for people with EIA are walking, weight lifting, bicycling, and indoor swimming. The following may help you prevent EIA when physically active:

• Breathe through your nose. This lets the outside air get warm before reaching your airway. Do deep breathing to help open your airway.
  
  
• Cover your mouth and nose when exercising outside in cold weather. Wear a scarf, mask, or other clothes to keep you warm. You may also use breathing masks or breathing filters to help warm the air you breathe in.
  
  
• Do warm up and cool down exercises. Do light exercises, such as walking or stretching before doing heavy exercise or physical activities. Cool down for at least 10 minutes after heavy exercise. If you have been running, walk for at least 10 minutes to cool down. If you just ate, wait for two hours before exercising.
  
  
• Exercise in clean, warm, and humid air. Exercise in areas with clean and warm air, such as indoor arenas. The air around indoor pools or arenas can be controlled, and made warm and humid. Swimming pools, ice rinks, and indoor arenas have increased amounts of chlorine and other gases in the air. If chlorine gas triggers your EIA, you may use an outdoor pool. Avoid doing physical activities outside during the afternoon and evening when air pollution is highest.
  
  
• Rest. Do not exercise if you feel any signs and symptoms of EIA. Stop training and do not exercise when you have a lung inflection or flu. After being sick, you may need to rest for about 2 to 3 weeks before exercising again. Visit your caregiver and ask him when you may start exercising again.
  
  
• Talk to your caregiver about medicines you may take before exercising. You may take medicines before doing exercise or physical activities to prevent EIA. If an allergy is causing your EIA, ask your caregiver if you can take medicines to treat your allergy. Use your medicines exactly as ordered by your caregiver and follow directions on the label carefully.
  
  
• Watch for early signs of EIA. Know the signs and symptoms of EIA before you have a very bad asthma attack. Watch out for them while you exercise. You can use a peak flow meter to measure how well you are breathing before and after exercising. A peak flow meter is a small tube with a measuring scale or meter (like a ruler) on the side. It can help show if you are breathing OK or if your EIA is getting worse. A lower peak flow reading may be an early warning sign of EIA. You can treat yourself quickly and prevent the EIA from getting worse when you know these signs.

Other ways that may help prevent exercise-induced asthma:

• Eat a special diet. Caffeine, found in coffee and other beverages, can help loosen your tight airway. Eat a lot of fish, or foods high in beta carotene and lycopene. These may help relieve your symptoms or prevent EIA. A diet low in salt may also help. Supplements, such as vitamins C and E, and fish oils, may also help prevent EIA. Talk with your caregiver first before adding vitamins or supplements.
  
  
• Protect yourself from having an infection. Stay away from people who have colds or the flu. Ask your caregiver if you should get shots to help prevent the flu and pneumonia.
  
  
• Stop smoking. Tobacco smoke has chemicals that harm your lungs. Stop smoking or avoid being around people who smoke. Ask caregivers for information on how to stop smoking if you are having trouble quitting.

For support and more information:

Having EIA can be hard for you and your family. Learning more about your condition can help control your EIA. Join asthma awareness groups or a support group with other people who have asthma. Contact the following for more information:

• American Academy of Allergy, Asthma, and Immunology
  555 E. Wells St, Suite 1100
  Milwaukee , WI 53202-3823
  Phone: 1- 800 - 822-2762
  Web Address: http://www.aaaai.org
  

• Asthma and Allergy Foundation of America
  8201 Corporate Drive, Suite 1000
  Landover , MD 20785
  Phone: 1- 800 - 727-8462
  Web Address: http://aafa.org
  

• National Asthma Education and Prevention Program
  National Heart, Lung and Blood Institute
  National Asthma Education and Prevention Program
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/about/naepp/
  

CONTACT A CAREGIVER IF:

• You have increased wheezing, trouble breathing, or coughing.
  
  
• You have problems that may be caused by the medicine you are taking. These include shakiness, trouble thinking clearly, pounding or fast heartbeat, or upset stomach.
  
  
• Your medicines do not relieve your symptoms like they used to.
  
  
• You have questions or concerns about your condition or medicines.

SEEK CARE IMMEDIATELY IF:

• You are so short of breath that you have trouble walking and talking.
  
  
• You have trouble thinking or you pass out.
  
  
• You have very bad pain in your chest.
  
  
• Your chest and neck are pulled or sucked in with each breath.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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