Author Topic: Asthma, exercise and allergies  (Read 1386 times)

Asthma, exercise and allergies
« on: April 10, 2019, 10:24:55 am »
What is asthma? What causes it? Is there an easy way to find out if a diagnosis is right?

Probably a Google session is needed but there's helpful people on here who are great at helping / advising people.

I got diagnosed in my 40s about 2-3 years ago after a tight chest/difficulty breathing overnight. A dose of antihistamines out of sequence helped that night but a doctor's visit straight after led to salbutamol. I read that it has no effect if not asthma. In my case it helps. Not that after it my peak flow reading is much above 400. I'm 6'5", relatively healthy and exercised regularly back then. Less so now. My asthma, if it is that, consists of coughing a lot and excess mucus that can't be shifted. It's not what I knew of asthma. I've had lifelong allergy response to various things such that I pretty much take loratidine year round on and off.

Going to doctors soon to discuss this. I don't feel I'm managing it well. I'm living OK it's just tiring me out.

So oxygen is important, breathing too, but can asthma cause you to tire out? At 6pm I'm dropping off to sleep. I struggle on half hour commute at times. My fitness is dire. Is this what badly managed asthma can do? No hospital visits needed but is this low level asthma or what?

Any views from sufferers or medical people?

Re: Asthma, exercise and allergies
« Reply #1 on: April 10, 2019, 11:05:47 am »
Not getting enough oxygen tires you out.
That is not necessarily from asthma.

Your GP should offer you a test for asthma. The test I've been given consisted of a lung power reading (you blow as hard as possible through a peak flow meter). They then give you salbutamol in a nebuliser and you do the peak flow test again.

If your peak flow doesn't improve, generally they say you don't have asthma. Certainly, salbutamol won't help you.
<i>Marmite slave</i>

Re: Asthma, exercise and allergies
« Reply #2 on: April 10, 2019, 01:40:04 pm »
I've already had one on prescription and two weeks reading before and after. Certainly salbutamol works for me. So is that enough to be certain of asthma?

I've looked on the relevant graphs for peak flow and my age, height, etc I should be 600 to 650 level. At best I'm 450. About 10 years ago I could get 500 to 550. Now 450 after salbutamol.

So in real terms I'm not back at the levels I should be at if I didn't have asthma.

I reckon tiredness is something else. Hereditary since three generations of one side now have this habit of dropping off. Just wish it wasn't happening at a younger age with each generation. Could be lack of sleep of course but the performance drop on my regular commute. About 3 years ago my times changed from 25 minutes to 28-30 minutes. Same route, same time and same traffic. A health check have good results for lifestyle and bloods. Nowhere near type 2 diabetes, cholesterol high in good kind, low in bad kind but slightly high overall (if you don't do the ratios you'd be marked as ready for statins I reckon).

I just wonder if asthma can wipe out your fitness levels if not managed. If not then what could do that? IBS? Got that and coping with the symptoms (OTC drugs are a help).

hellymedic

  • Just do it!
Re: Asthma, exercise and allergies
« Reply #3 on: April 10, 2019, 01:58:52 pm »
It's a long time since I did respiratory stuff but AIUI

Asthma is defined as reversible airflow obstruction; a bronchodilator like salbutamol should result in a significant and measurable rise in peak flow.

There are other conditions that cause irreversible airflow obstruction, like chronic obstructive pulmonary disease. Some COPD is smoking-related, some is not.

Peak flow does not measure inward oxygen transfer or outward CO2 movement; these things will affect how you feel.

I would expect a tall man to have a peak flow of around 600 or more. (Men have a peak flow about 100 more than women and flow increases with height.)

Re: Asthma, exercise and allergies
« Reply #4 on: April 10, 2019, 02:52:36 pm »
The graphs put it at 630 for my height. Never got high and I know how to use the meter since I've been using it for testing materials at work (a rough and ready means to test thin layer air permeability).

Not sure if it's relevant but I did do something called the rock port walking VO2max test. According to my results my VO2max was classed as excellent and well above average for my age and gender at the time? Isn't that related to oxygen transfer? So I should be alright with that.

BTW back then I was a lot fitter but always had this cough that's eased with salbutamol. I get up in the morning and cough for a few minutes. Now a quick double puff and I stop coughing. Turns out the 5 year plus cough was asthma related I guess.

Re: Asthma, exercise and allergies
« Reply #5 on: April 10, 2019, 03:02:35 pm »
I think Asthma in the general perception has changed somewhat.  Adult onset asthma does seem to be much more related to thick tenacious mucous as a cause of the reversible airways narrowing.  i suspect you need a small dose of inhaled steroid as well.

My wife is in a similar situation, diagnosed as adult onset asthma, history of hay fever, allergy to nail varnish and now gluten intolerance.  She has a low peak flow but I have always been amazed that she has a fairly high respiratory rate to compensate.

We now use pillows with hypoallergenic covers and we always take pillows on holiday with us.  This does seem to help.

Re: Asthma, exercise and allergies
« Reply #6 on: April 10, 2019, 03:32:36 pm »
We're synthetic duvet and pillows too. Vacuuming bedrooms must be done in the morning to allow the air to clear. As good as your vacuum is (s class or hepa filter) doesn't matter. Allergic response overnight if vacuumed in the afternoon is still bad despite those filters that supposedly stops the allergens.

My issue is allergic response has got worse in the last 5 years for some reason. Last autumn I thought it was ivy flowering outside our kitchen door. So I cut all flowers off and it still was bad a few years ago when it started to get bad we came home from a two week summer cycling tour in Scotland. We had been nearly allergy free on holiday. Taking the motorway turnoff about 2 miles from home with the car windows open we both started to sneeze. It's something to do with where we live because we can be allergy free or very mild, then off the motorway and it gets bad again.

Until recently I thought asthma was only swelling of the airways causing the restriction. But long ago I read that mucus can do it too. That convinced me it was asthma because it's the mucous cough I've been having for years that my gp used for diagnosis it seems.

Kim

  • Timelord
Re: Asthma, exercise and allergies
« Reply #7 on: April 10, 2019, 03:57:44 pm »
We're synthetic duvet and pillows too. Vacuuming bedrooms must be done in the morning to allow the air to clear. As good as your vacuum is (s class or hepa filter) doesn't matter. Allergic response overnight if vacuumed in the afternoon is still bad despite those filters that supposedly stops the allergens.

IME the filters just mean that you have nice clean allergy-free air squirting out of the vacuum cleaner exhaust to blow the not-yet-hoovered dust around.  Ours exhausts dirt-free but unfiltered air to its left at fairly high velocity to cool the motor, and you have to make sure you work in a left to right direction to avoid disturbing anything loose.  (It makes up for this design flaw by being extremely tenacious.)


Quote
We had been nearly allergy free on holiday. Taking the motorway turnoff about 2 miles from home with the car windows open we both started to sneeze. It's something to do with where we live because we can be allergy free or very mild, then off the motorway and it gets bad again.

This used to happen to me almost like clockwork when I was a child.  We'd spend a blissful couple of weeks in France or whatever, and as soon as we got to the M25 junction a few miles from home, my hayfever would kick in with a vengeance.

I have a similar effect when returning to Birmingham (particularly from Wales, where you get on the train in the land of rain and oxygen, and get off at Mordor Central), but I think that's mostly the pollution.  Trips to London don't produce the same effect.
To ride the Windcheetah, first, you must embrace the cantilever...

Re: Asthma, exercise and allergies
« Reply #8 on: April 10, 2019, 06:43:54 pm »
I'd love to find out the pollution levels near me. You can probably find maps showing it for big cities but small towns and cities I don't think that info is easily found. Anyone got a link? Lancaster area would be interesting.

BTW when my asthma got noticed I thought it might be pollution building up because it was about less than 2 years into commuting. I even researched masks for cycling. Didn't see that they worked for cycling so didn't get one. But now I'm driving more perhaps I need one for the car. Especially because of 4x the pollution in cars or something like that.

We have a miele compact vacuum that pulls the floor up. If we ever put full power up I think it would be like a black hole with the brushes as the event horizon. Certainly the lowest setting pulls the carpet up with any dust. We also have an upright vax that's similar. Then the handheld Dyson v6 or 7 is weaker and actually usable. That just blows waste air onto your hand. 20 minutes charge = 20 minutes use daily in a different area of the house. Means good dust control I think. Although any vacuuming does create a lot of airborne allergens.

BTW the big upright when we first got it used to amuse me the way the exhaust gases could move the curtains from across the room. Like a desktop fan!

Re: Asthma, exercise and allergies
« Reply #9 on: April 10, 2019, 07:09:35 pm »
Enter your postcode for pollution levels , low where I am.

https://www.bbc.com/news/science-environment-42566393

Re: Asthma, exercise and allergies
« Reply #10 on: April 10, 2019, 07:55:22 pm »
I have COPD. Thirty pack-years of Rothmans will do that to a person. It's over 17 years since I quit that rubbish, but I'm left with "Emphysemic changes" in the upper lobes of both lungs, not to mention Alpha-1 Antitrypsin Deficiency which is very much linked with COPD.

In recent years, I've also started to develop a periodic dry, insistent cough that's (a) really annoying, and (b) accompanied by chest tightness; it responds positively to Salbutamol, so the diagnosis was indeed "Asthma". It seems to be provoked by higher intensity exercise, so if it's going to kick off - one or two hilly bike rides will do it.

Prior to last August, the episodes I'd had, had coincided with tree pollen; around April/May time. But last year I had a two/three week episode that coincided with Semaine Federale in August, so basically I have no idea what kicks it off - likely it's more than one thing.

I have relief from it with the Blue Inhaler, and I've just chalked it up to one of the many ways one's body gets its own back for all those indiscretions of youth, as you get older. It's not the age guv', it's the mileage.

Kim

  • Timelord
Re: Asthma, exercise and allergies
« Reply #11 on: April 10, 2019, 08:11:17 pm »
I'd like to attribute my childhood asthma and chronic middle-ear infections to a toomany of pack-years of Rothmans, but I suspect the bulk of the damage was done by whatever knock-off African stuff my parents were chain-smoking before we moved back to the UK and I worked out how to read the text on cigarette packets.

Like so many things in life, it all came to a head one summer evening on Hampstead Heath, and from then on I was an Asthmatic with a capital A.

It got better when my parents mostly stopped smoking in the house[1], and even more so when I left home and got away from the local allergens.  I can still induce a proper asthma attack with strenuous exercise (particularly when combined with cold dry air), but if I stop and control my breathing it goes away, even without Salbutamol.  It's the allergies I have to watch out for, as the effect is cumulative, and the lingering asthma will get me in my sleep (or turn into infections).  Being allergic to both tree and grass pollen isn't much fun, but then neither is being allergic to your parents.  Steroids and antihistamines are my friends.

If I'm not sleeping properly because I can't breathe, I'll certainly be tired and cranky.  But I tend to notice more direct symptoms first (coughing, nightmares, scratching my throat, rhinitis).


[1] I was the child who reeked of smoke and wasn't aware of it in primary school.  I remember getting really upset on the odd occasion that someone would accuse me of smoking, because I hated smoking with a passion and didn't understand why they were accusing me of it.
To ride the Windcheetah, first, you must embrace the cantilever...

Re: Asthma, exercise and allergies
« Reply #12 on: April 10, 2019, 10:24:03 pm »
Thankfully, as far as I'm aware, I was never actually allergic to my parents.  ::-)

Re: Asthma, exercise and allergies
« Reply #13 on: April 10, 2019, 11:45:26 pm »
I was at the doctor's this morning trying to get some intel on worsening rhinitis, mucous and crappy sleep.

Asthma and hayfever are my sister's department, although probably Birmingham's got the air pollution angle covered  >:(

 

Re: Asthma, exercise and allergies
« Reply #14 on: April 11, 2019, 12:23:33 am »
I was at the doctor's this morning trying to get some intel on worsening rhinitis, mucous and crappy sleep.

Asthma and hayfever are my sister's department, although probably Birmingham's got the air pollution angle covered  >:(

I think Birmingham is downright hostile to asthmatics. Whilst clarion was working there last year, he worked a few days, then was off repairing his lungs for a week, then work for a few days, then repair his lungs... It wasn't sustainable.
Quote from: Kim
^ This woman knows what she's talking about.

Re: Asthma, exercise and allergies
« Reply #15 on: April 11, 2019, 07:34:24 am »
I had it quite bad as a child but diagnosis was slow and confusing. Sometimes it was asthmatic bronchitis, others it was bronchial asthma.
Following tests for allergies (which ISTR involved being pricked by multiple needles at once on my arm), all the woollen blankets and feather pillows went. Likewise staying anywhere near cats.
Summers were always bad, especially (in my memory) the 2 weeks every year in Mayo.
It seemed to abate after adolescence and (as long as I stayed away from cats and feathers) was an infrequent problem, well-controlled by salbutamol for the next 30 years or so.
I stopped smoking 2 years and 8 months ago. I also finally started using my preventer inhaler properly a few years ago. The combination of those two has meant that I use my blue inhaler so rarely that it often passes it’s use-by date before I finish it.
Still have to stay away from my mum’s sofa, though: it was reupholstered by a guy who had several cats, and it often sets me off.
I don’t know whether exercise exacerbated my asthma: I think the attacks I experienced during exercise might have coincided with pollen, but I’m not sure.
My peak flow always disappoints the asthma nurse.
L'enfer, c'est les autos.

Re: Asthma, exercise and allergies
« Reply #16 on: April 11, 2019, 08:30:22 am »
I moved up to the same area as my parents at the same time and signed on with the doctors at the nurses appointment after my mum's. Various health checks based on height, weight, lifestyle, etc (off topic but their height gauge only went up to an inch or two shorter than me, how bad is that? I'm only 6'5"of should go up to more than that). Anyway the nurse passed me a peak flow meter and I gave it back with my typical reading on it. She handed it straight back saying, "you can do better than that, even your mum did better!" that really made me feel great. I got a little bit more but it took a bit of psyching myself up and preparing my effort. Still not good but the nurse was at least happy I got just above my mum's reading. She could tell the effort was there. Looking back on that nurse appointment I wonder why she didn't suspect asthma? I hadn't noticed any issues but must have been a low reading.

Right now I'm misusing salbutamol. Before setting off to cycle to work I take a couple of puffs. It's not a preventer but I know it'll be needed on the ride and I'm usually too late to stop and dig it out. Anyway gp visit tomorrow to discuss asthma. Might get given the brown one to take. Last appointment he suggested it might be worth trying at some point. At the moment it's salbutamol and loratidine antihistamines. Seems to be a good combination to me.

Re: Asthma, exercise and allergies
« Reply #17 on: April 11, 2019, 08:33:02 am »
There does seem to be an interesting trend here of people with late onset asthma having relatively low peak flows even with treatment. 

A pubmed search suggests that adults presenting with Asthma, already have more lung damage.
Quote
Pre-existing lung function impairment was more common in older adults.

•Older adults with incident asthma had an accelerated decline in lung function.

Quote
Asthma seems to be more difficult to control in the elderly and older patients with asthma have a higher morbidity and mortality compared to younger asthmatics [3], [4], [5]. A central question is whether asthma is more severe in older individuals, or whether the increased morbidity relates to a combination of long-standing asthma, delayed diagnosis and under treatment, higher prevalence of co-morbidities such as bronchiectasis, general de-conditioning, and life-time exposures to potential noxious factors such as smoking and infections [4], [6], [7].

Asthma appears to have more detrimental effects on the airways of older adults. Older individuals with asthma are more likely to have fixed airflow obstruction at the time of diagnosis, as well as a subsequent accelerated loss of lung function [1], [8], [9], [10]. Moreover, co-existing obstructive airways diseases increase with age, and possibly up to 30% of adults >60 years with airflow obstruction have been estimated to have the asthma and COPD overlap syndrome (ACOS), i.e. a mixture of variable and reversible airflow obstruction and fixed airflow limitation [11], [12], [13].

Full reference
https://www.sciencedirect.com/science/article/pii/S0954611115001237

Re: Asthma, exercise and allergies
« Reply #18 on: April 11, 2019, 10:10:46 am »
These are just my unscientific and perceptional thoughts

Some people has asthma, different things make it worse or better ( that’s the obvious bit)
Some widespread crops ( Oil Seed Rape for example) are recent introductions. If part of our resilience to pollen etc is based in our childhood then we may react to new challenges.
Today’s 50+ year olds are possibly the first generation to exercise fairly hard in our mid to later years. My parents certainly wouldn’t know if they had exercise induced asthma! Now we have 60/70 year olds doing cardiac max intervals.
As we get older, the likelihood of having some sort of medication probably increases. If you read the big folded bit of paper in the tablet box it’s not unusual for breathing issues to be mentioned as a possible side effect.

Just my rambling thoughts, but based on getting older, on more medication and still trying ( less and less effectively) to pin a number on my back occasionally.

Re: Asthma, exercise and allergies
« Reply #19 on: April 11, 2019, 10:24:10 am »
Giropaul, I think a lot of what you say is true, but I suspect that what this paper is suggesting as well may be that adults do not actually have late onset asthma but rather undiagnosed asthma and that they should be treated very carefully to prevent further deterioration in lung function.

Re: Asthma, exercise and allergies
« Reply #20 on: April 11, 2019, 11:51:27 am »
Lung damage does sound a scary thought to me. I had an x-ray last year and the gp saw no problem. It was in response to asthma and the gp was new to me so he asked what I did for a living. I said the magic word "fibre" and within minutes I was referred to go xray department at nearest hospital. Within an hour I'd had it done and a week later called in to gp to get told by receptionist everything was OK. Later gp visit confirmed nothing was showing up on the xray. No damage and more importantly no fibre. No shadows or whatever they're looking for.

Mind you it would not surprise me to find out that xrays aren't the best investigation technique to show up lung damage or fibre issues. I've had other cases of being sent to the easiest / cheapest imaging technique despite the chances are it's pointless. Xray for suspected cartilage damage for example.

hellymedic

  • Just do it!
Re: Asthma, exercise and allergies
« Reply #21 on: April 11, 2019, 11:59:33 am »
My late grandfather developed asthma in his ?70s, having had a lifetime of hay fever and having smoked heavily as a young adult. (He gave up abruptly after a 'dare'.)
I think he initially responded well to salbutamol but deteriorated as time progressed and seemed to look more like COPD in his final years.

Kim

  • Timelord
Re: Asthma, exercise and allergies
« Reply #22 on: April 11, 2019, 12:07:54 pm »
Right now I'm misusing salbutamol. Before setting off to cycle to work I take a couple of puffs. It's not a preventer but I know it'll be needed on the ride and I'm usually too late to stop and dig it out.

I wouldn't call that misusing, and neither would my asthma nurse.  Preemptive salbutamol before exercise to avoid an attack is better than using it to treat one.  Less lung damage.

Which isn't to say that you wouldn't be better off with some other preventative medication.
To ride the Windcheetah, first, you must embrace the cantilever...

Kim

  • Timelord
Re: Asthma, exercise and allergies
« Reply #23 on: April 11, 2019, 12:14:47 pm »
I think Birmingham is downright hostile to asthmatics. Whilst clarion was working there last year, he worked a few days, then was off repairing his lungs for a week, then work for a few days, then repair his lungs... It wasn't sustainable.

It's been particularly horrid this last week-and-a-bit, on account of the weather conditions.  Thick with diesel fumes as soon as you drop off the ridge at the Col de Primrose Hill (or equivalent).

Also the hayfever season got started back in in February(!) - both Gerwinium and I were streaming at the end of the Chiltern Grit 100 - and the oily yellow bastards are in bloom as of this week.
To ride the Windcheetah, first, you must embrace the cantilever...

Re: Asthma, exercise and allergies
« Reply #24 on: April 11, 2019, 01:33:12 pm »
Right now I'm misusing salbutamol. Before setting off to cycle to work I take a couple of puffs. It's not a preventer but I know it'll be needed on the ride and I'm usually too late to stop and dig it out.

I wouldn't call that misusing, and neither would my asthma nurse.  Preemptive salbutamol before exercise to avoid an attack is better than using it to treat one.  Less lung damage.

Which isn't to say that you wouldn't be better off with some other preventative medication.
That's why I've booked a double gp appointment. Gives him more time to listen and actually consider best treatment. I'm expecting the brown inhaler preventer. No idea what thay drug is but my partner has it. She's the one that said I might suit it. Needless to say I refused to try hers. I'm a great believer that no matter what you do not share prescriptions even if you're on the same stuff. I'm ocd about that sort of thing.