Exercising With Asthma The Straw In Your Mouth
The following is only a personal account of living and exercising with asthma. It is not intended to be used as advice either for life-style, exercise-preparation or medication.
This quick blog hopefully strikes a chord with other asthmatics out there. I originally read a blog quite a few years ago and tried to find it and post it. I couldn’t, so I’ve taken the essence of what I remember and put it in my own words with hopefully a few original thoughts. I was hugely inspired by the words this person wrote and I only hope that my memory serves justice to the original write up.
I’ve has asthma for as long as I could remember. In fact some of my most striking childhood memories are of my asthma. The 2 or 3 times a night waking up. The ambulance arriving on the school fields when I had an attack. Sitting in an oxygen tent in hospital. And worst of all, not being able to do sport. This was all in the early seventies. Medication then was obviously not as effective as it is now. I remember when I was very young using a Spinhaler. It was a bit of a faff to use. You had to take it apart, insert capsule, put it back together then slide the blue/grey sleeve up and down to pierce the capsule. Then breathe in. I remember it as being a bit like inhaling talcum powder and not being terribly effective.
Later, (I can’t remember when) I was prescribed Salbutamol under the brand name of Ventolin, a reliever treatment. Salbutamol was introduced as an asthma treatment in 1969 and was found to be highly effective. I wasn’t prescribed it this early, but when I was, I found it to be enormously beneficial. So much so that as the years went by I began to rely on it, not just physiologically, but mentally as well. (See below*)
Then came Becotide. This was a preventer. I never really got on with this and always felt slightly breathless when I did use it. Some of the reported side effects were hoarseness, throat irritation, and unexpected narrowing of the airwaves. (paradoxical bronchospasm). Looking back, it seems I suffered from at least these three. Becotide has been discontinued since 2007. Whether the active ingredient, beclomethasone dipropionate is available in other types of medication, I do not know.
I am now on Symbicort. This contains a combination of budesonide and formoterol. Budesonide is a steroid that reduces inflammation in the body and formoterol is a bronchodilator that relaxes muscles in the airwaves to improve breathing. My asthma seemed to be getting progressively worse as far as exercise was concerned and one of my footballing team-mates mentioned that he was on an inhaler that was proving to be of great help to him. (It didn’t improve his football though, as Symbicort has not improved mine.) This prompted me to go and see my GP and he said that if I was using my Ventolin more than six times a day (which I was) then the asthma was not under control. He prescribed Symbicort and now for the first time in my life I feel as if I do not have asthma. My team-mate is not on Symbicort. His inhaler is purple. That’s all I know, but it does go to show that asthma treatment differs from person to person.
I hated not being able to give it everything during PE lessons. My enthusiasm for sport far out-weighed my ability. Both in talent and the physical. Consequently sport passed me by during my childhood. Not that I’m blaming asthma for my lack of sporting prowess. I’m rubbish at football because I’m rubbish at football. I’m brilliantly mediocre at kickboxing simply because I am distinctly average at it. Since I’ve matured I’ve never used my condition as an excuse. As long as (sporting) expectations are realistic, asthma is not an insurmountable problem. It should not stop you leading an active lifestyle or indeed scaling the peaks of sporting excellence. Paul Sholes, Paula Radcliffe, Jackie Joyner-Kersee etc are inspirational examples.
However, asthma is a serious condition and Exercise Induced Asthma is a real issue. It’s not just exercise that brought my asthma on. Cats, dogs, dust, pollen, all these things contributed to tightness of the chest even if they didn’t trigger a full blown attack.
It’s difficult to really explain what an asthma attack feels like. The only way I can think of describing it is if you take a narrow drinking straw, then do some vigorous exercise whilst trying to breathe only through the straw. But it’s not just shortness of breath. It’s not just the physical, it’s the mental as well. Most people when they play sport get out of breath. Asthmatics on the other hand do not have the luxury of simply taking things easy for a few minutes before things are back to normal. Once an attack takes hold, it usually (or in my experience, always) stays until medical intervention is administered. Just imagine for a second, being completely breathless and knowing that it isn’t going to get any better unless you have your medication. I can’t speak for any other sufferer but just realising I didn’t have my inhaler with me was almost enough to bring an episode on.* Panic and anxiety are symptoms that can stop you getting involved in a sporting event in the first place. And in my case lead to frustration, despondency and sometimes anger at the condition. I remember on occasion, deliberately going out on a run without my medication, setting off at a frantic pace and daring, challenging my asthma to take hold just so as I could rail against it. To keep running and refusing to give in. Of course eventually the asthma won. It always did. But sometimes you have to fight even when you know you are going to lose.
Just going out for gentle jogs may be good for some people. Others need more of a challenge. This is of course true for most of the exercising population, not just asthmatics. The problem for asthmatics is, remaining competitive whilst dealing with EIA. Personally, I had a tried and tested routine for warming up. An easy jog for perhaps 10 mins. Stopping every time I felt I was pushing my luck a bit. If all ok, then I would slow right down, then after a few minutes, start running again taking the intensity up a notch. This stop/start method and slowly ramping up the effort was pretty effective for me. The whole warm up might last 20/30 minutes.
And that was the problem. Going through all of that at the start of a football match or a 5/10k race is just not practical. Was I regularly going to turn up before matches/events and go through all of that? No. Particularly not at the shoddy standard I play/run at. Consequently the first 20 mins of every match I was really just jogging around the pitch and probably not contributing too much. It was always on my mind that for the remaining 25 minutes I’d better have a blinder or find myself getting substituted toute suite. The second half was where my hard earned fitness began to show and I usually managed to finish a match stronger than many of my team mates. So you see, in my opinion, asthma is no barrier to fitness. You just need to manage it in a way that suits you.
Running was and is still a tricky pass time. As would seem obvious, the above warm up is a practical non-starter, unless of course you are a regional/national class runner, in which case you do what is required if that is the standard you run at. I mean, really, how many recreational runners would be willing to go through such a time consuming ritual to run a, let’s face it, an unimportant 5/10k race with nothing except a PB riding on it. However, when you are out with a group it isn’t always possible to go at your own pace and you don’t really want to slow anyone else down. As you can probably guess from this ramble, I am not a hugely competitive person, but many people are. Many asthmatics are. Even if they are not particularly good at football, tennis, running, rugby etc, they quite rightly want to give it their all. This is where I have enormous respect for asthmatic athletes. Imagine once again for a second, that feeling you get when you make that lung-busting effort when you sprint for the line at the end of a distance event. Or that maximal effort you make to reach the ball before your opponent. Think about how you felt. The sickness in your stomach. The burning of your lungs and the fire in your throat. The straw in your mouth. This is how asthmatics feel ALL the time. And yet you carry on. You continue running. You continue competing. This is what makes you stronger than the next person. This is what gives you a mental fortitude that non-asthmatics simply cannot appreciate.
Hats off to all you asthmatics out there who compete. You are not weaker or less able than the next person. In many ways you are stronger.