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Training with asthma \ COPD

kingrollokingrollo Posts: 3,148
Ive been concerned about my asthma for a while - my peak flow readings vary between 240-360 - never more than that. As a 54 year old geezer of my weight and height I should be hitting 600...

Went to see GP - expecting her to dismiss my concerns out of hand - as I don't have asthma attacks and it only really effects me when going up steep hills. But she booked me in for bloods tests and a chest x-ray - she said she was looking for lung damage and inflammatory markers - Im guessing I am being checked out for COPD.

Either way my lungs are pretty censored ! - any ideas how best to train with asthma \ copd - my theory that I can't stress my body enough because the lung restrictions kick in as I begin to push hard - should I push through it ? - or could this damage the lungs further ?

Any advice welcome

Posts

  • napoleondnapoleond Posts: 18,633
    Do you currently take an inhaler?
    Twitter - @NapD
    Strava - Alex Taylor (sportstest.co.uk)
    ABCC Cycling Coach
  • kingrollokingrollo Posts: 3,148
    napoleond wrote:
    Do you currently take an inhaler?

    Yes the standard blue one (reliever). and a flutiform (preventer)
  • napoleondnapoleond Posts: 18,633
    May be worth a review, symbicort works wonderfully well for me. 2 in one.
    Twitter - @NapD
    Strava - Alex Taylor (sportstest.co.uk)
    ABCC Cycling Coach
  • kingrollokingrollo Posts: 3,148
    napoleond wrote:
    May be worth a review, symbicort works wonderfully well for me. 2 in one.

    Thats seems to be the trick - if you can get it under control then you can train normally. But I have either asthma that doesn'r respond to inhalers or as I suspect there is something else restricting my lung capacity
  • napoleondnapoleond Posts: 18,633
    See what the doc says. Hopefully it's not copd! If not, ask them about trying symbicort.
    Twitter - @NapD
    Strava - Alex Taylor (sportstest.co.uk)
    ABCC Cycling Coach
  • redvisionredvision Posts: 2,670
    I suffer terribly with asthma, and have done since i was about 10. My peak flow is currently higher than its been for more than 2 years, but at 300 is still much lower than it should be for someone in his mid 30s.

    Fortunately i have a great gp and asthma nurse who see me on a regular basis to try to keep on top of the condition. I used to find that cycling and swimming always increased symptoms, but finally after lots of trial and error the current medication seems to be doing the trick (salbutomol and Sirdupla). Weirdly i never had any issues when running, apart from on very cold days.

    What i have found to be crucial is to make sure i take the inhalers every morning and night, and at least 20mins before any exercise. Even missing one dose makes a huge difference. I also find my breathing is much better when i train without a full stomach.

    I really feel for you because i know what you are going through, but if the chest xrays come back clear then just keep working with your gp/asthma nurse to find the right medication. You will get there.
  • I had asthma for years , eventually it became less of a problem , my breathing and chest function improved after stopping eating all dairy products. there are plenty of milk alternatives and vegan cheese etc. google some vegan sites to get ideas. nothing to loose trying it.
  • Mikey23Mikey23 Posts: 5,306
    Similar story here. Asthma from a very early age and taking whatever meds were fashionable at the time finishing with the blue sabutamol inhalers. Did a visit to the asthma clinic about 3 years for extensive tests which proved conclusively that i was not asthmatic but that i had COPD. Was given steroids but stopped taking them and now have no meds at all with no issues. In fact i feel better than i ever did. Used to run for years and had to have a puff before every run just in case. It became a superstitious thing. My personal thoughts are that surgeries have been earning brownie points for years in diagnosing asthma to the extent that anyone, anywhere at any time who got a bit wheezy was stuck on asthma meds for life and came to depend on them. Which got to about half the population. Nowadays there is a concerted effort to get people off asthma meds and COPD is the way to go. No way of proving this of course but...

    As far as my cycling is concerned there has been no effect whatsover. I tend to go out most days and have done some quite strenuous sessions with no problems. My lung capacity, like yours is way below what it should be and this with my age and loss of muscle mass means that i cannot keep up with the fast whippets. But i am pretty good for my age and do what i can to the best of my ability...

    Hope that helps OP
  • kingrollokingrollo Posts: 3,148
    Mikey23 wrote:
    Similar story here. Asthma from a very early age and taking whatever meds were fashionable at the time finishing with the blue sabutamol inhalers. Did a visit to the asthma clinic about 3 years for extensive tests which proved conclusively that i was not asthmatic but that i had COPD. Was given steroids but stopped taking them and now have no meds at all with no issues. In fact i feel better than i ever did. Used to run for years and had to have a puff before every run just in case. It became a superstitious thing. My personal thoughts are that surgeries have been earning brownie points for years in diagnosing asthma to the extent that anyone, anywhere at any time who got a bit wheezy was stuck on asthma meds for life and came to depend on them. Which got to about half the population. Nowadays there is a concerted effort to get people off asthma meds and COPD is the way to go. No way of proving this of course but...

    As far as my cycling is concerned there has been no effect whatsover. I tend to go out most days and have done some quite strenuous sessions with no problems. My lung capacity, like yours is way below what it should be and this with my age and loss of muscle mass means that i cannot keep up with the fast whippets. But i am pretty good for my age and do what i can to the best of my ability...

    Hope that helps OP

    I went out with a club for the first time at the weekend - went with the slow group, quite suprised that I was one of the older people there ! - a paltry 13.5 average over 60 miles - with 3700 ascent !

    I just don't know know how you train - you can't stress you body like a non ashtma/copd (or even someone with controlled asthma) so I feel I am riding more than training - you just can't go hard
  • Mikey23Mikey23 Posts: 5,306
    13.5 average over 60 miles with 3.7 k climbing is not too shabby in my opinion. If this is your current baseline then you have much in the bank already. As well as your steady miles you could add in some hill reps or some fartlek at a speed that is slightly higher than comfortable. If its too much then back off. As long as its enjoyable.

    It depends really what you are trying to achieve and how quickly you want to get there. Sit down and plan a long term goal and short term steps to get there. I aint a medical expert but i dont think you can damage your lungs if you dont do anything stoopid. My asthma nurse told me that she has several COPD people on her books who are good athletes. I was a bit shocked when i was told i have it but it doesnt worry me at all. I know i will never be as quick as the 20 year olds but i enjoy riding with them when i can!
  • I believe COPD disgnosis is technical and can be done via spirometry, and there is a broad spectrum of suffering/disability.
    Good that you've got a GP looking into all possibilities e.g. long term inflamation - of asthma type left untreated can be a cause.

    As someone who has lungs on the borderline of being defined as having COPD.
    BTW spirometry has me definite without asthma meds and almost not with regular preventer (Fostair - which BTW is recommended as treatment for COPD as well as asthma - hopefully preventing further damage/progression).

    Anyway, there's nothing saying you can't stress the body as a normal 'athlete'. However, I would take extra care of following body signs early signs of cold etc.
    'weaker' lungs like mine seem to be more prone to infection, which in turn can be a reall pain to clear.

    AFAIA exercise is recommended to retard COPD progression.

    Opps: re read OP post. I do understand the restriction on lung being the limiting factor, potentially affecting training. I've often thought that. However, it's hard to seperate different aspects of cardio vascular system. For e.g. I bet your heart will be up when you train 'hard'.

    Keeping on top of the best lung function you can get and training with that is what you can do! Best of luck!
  • kingrollokingrollo Posts: 3,148
    O/P Here.

    I took an antihistamine last night. My peak flow hit a new high of 400? - any theories on why ?
  • napoleondnapoleond Posts: 18,633
    kingrollo wrote:
    O/P Here.

    I took an antihistamine last night. My peak flow hit a new high of 400? - any theories on why ?

    Asthma triggered by allergies
    Twitter - @NapD
    Strava - Alex Taylor (sportstest.co.uk)
    ABCC Cycling Coach
  • kingrollokingrollo Posts: 3,148
    napoleond wrote:
    kingrollo wrote:
    O/P Here.

    I took an antihistamine last night. My peak flow hit a new high of 400? - any theories on why ?

    Asthma triggered by allergies

    So it most likley is asthma not copd ?
    I can't be popping anti h on a long term basis though ! (can i ?)
  • Mikey23Mikey23 Posts: 5,306
    I think better to wait for the medical experts than rely on our collective ignorance methinks ;-)
  • napoleondnapoleond Posts: 18,633
    Mikey23 wrote:
    I think better to wait for the medical experts than rely on our collective ignorance methinks ;-)

    But I AM a medical expert. I'm an internet keyboard warrior don't you know.

    But yes. See what the doc says. It was just a suggestion about the allergies triggering it which would be an explanation for antihistamines assisting.
    FWIW during summer months unless I keep on top of a ton of hay fever meds as well as my inhaler my asthma is horrendous.
    Twitter - @NapD
    Strava - Alex Taylor (sportstest.co.uk)
    ABCC Cycling Coach
  • kingrollokingrollo Posts: 3,148
    napoleond wrote:
    Mikey23 wrote:
    I think better to wait for the medical experts than rely on our collective ignorance methinks ;-)

    But I AM a medical expert. I'm an internet keyboard warrior don't you know.

    But yes. See what the doc says. It was just a suggestion about the allergies triggering it which would be an explanation for antihistamines assisting.
    FWIW during summer months unless I keep on top of a ton of hay fever meds as well as my inhaler my asthma is horrendous.

    Im the opposite - The cold damp brings out the worst in my lungs. I come into my own May, June, July (by that I mean I sometimes average 15 mph !)
  • 964cup964cup Posts: 1,359
    1. Get a referral to a proper specialist from your GP.
    2. Get an allergy test to understand what your triggers are.
    3. Review your meds. I'm on Symbicort (and also Mometasone nasal, Montelukast and Omeprazole). YMMV.
    4. Chart your PF on waking, 30 mins after each meal, and before sleeping. Keep a food diary and look for correlations.
    5. Get a lung function test. You need to know what the limitation is - capacity, muscle, airway remodelling, bronchoconstriction, obstruction. Are you producing?
    6. If it's mucous obstruction, learn clearing techniques - your specialist should have physio support for this. You also need to find out the cause(s); make sure you get tested for mycobacteria as well as other infections.
    7. If it's constriction, ask to try a course of oral prednisolone. Side effects are unfun, but you should be able to find out what your unconstricted max PF is. That gives you a target (and usually some relief); it will also help inform dosage and selection of inhaled steroid. Note that combined therapy (Symbicort, Serevent etc) is thought to work better than using separate inhalers, and you will in any case be better with LABA + steroid than FABA + steroid.
    8. If it's muscle, get breath training - you need to engage your diaphragm and learn to breathe properly. This is a good idea anyway.
    9. Capacity is a training issue to the extent that it can be improved. Again, physio support.
    10. Obstruction if not mucous needs proper investigation - X-Ray/CT/PET. Same for constriction that's not relieved by oral steroids.

    I am not a doctor. GPs, while they are doctors, are rarely properly competent to deal with asthma and related conditions. A good specialist will be light-years ahead of them, but you'll need to be demanding as they tend to be taken up with emphesematics rather than boring old asthma. If you're in London, then Loebinger at the Brompton is very good (if brusque to the point of rudeness). Pallav Shah at the same hospital is brilliant, but you may not be ill enough for him.

    FYI my unmedicated PF (and my PF when ill) is about the same as yours (300-350). Medicated and uninfected it's about 600, ultimately limited by airway remodelling.
  • kingrollokingrollo Posts: 3,148
    964cup wrote:
    1. Get a referral to a proper specialist from your GP.
    2. Get an allergy test to understand what your triggers are.
    3. Review your meds. I'm on Symbicort (and also Mometasone nasal, Montelukast and Omeprazole). YMMV.
    4. Chart your PF on waking, 30 mins after each meal, and before sleeping. Keep a food diary and look for correlations.
    5. Get a lung function test. You need to know what the limitation is - capacity, muscle, airway remodelling, bronchoconstriction, obstruction. Are you producing?
    6. If it's mucous obstruction, learn clearing techniques - your specialist should have physio support for this. You also need to find out the cause(s); make sure you get tested for mycobacteria as well as other infections.
    7. If it's constriction, ask to try a course of oral prednisolone. Side effects are unfun, but you should be able to find out what your unconstricted max PF is. That gives you a target (and usually some relief); it will also help inform dosage and selection of inhaled steroid. Note that combined therapy (Symbicort, Serevent etc) is thought to work better than using separate inhalers, and you will in any case be better with LABA + steroid than FABA + steroid.
    8. If it's muscle, get breath training - you need to engage your diaphragm and learn to breathe properly. This is a good idea anyway.
    9. Capacity is a training issue to the extent that it can be improved. Again, physio support.
    10. Obstruction if not mucous needs proper investigation - X-Ray/CT/PET. Same for constriction that's not relieved by oral steroids.

    I am not a doctor. GPs, while they are doctors, are rarely properly competent to deal with asthma and related conditions. A good specialist will be light-years ahead of them, but you'll need to be demanding as they tend to be taken up with emphesematics rather than boring old asthma. If you're in London, then Loebinger at the Brompton is very good (if brusque to the point of rudeness). Pallav Shah at the same hospital is brilliant, but you may not be ill enough for him.

    FYI my unmedicated PF (and my PF when ill) is about the same as yours (300-350). Medicated and uninfected it's about 600, ultimately limited by airway remodelling.

    Cheers - I will pick my way through those.
    Chest X-RAY and bloods tomorrow.
    Ive got the birmingham 100 in a couple of weeks - don't really want any changes before that.
  • napoleondnapoleond Posts: 18,633
    Good luck :)
    Twitter - @NapD
    Strava - Alex Taylor (sportstest.co.uk)
    ABCC Cycling Coach
  • Mikey23Mikey23 Posts: 5,306
    @964cup... respect mate. You know what you are talking about!
  • kingrollokingrollo Posts: 3,148
    Good news my x-rays and bloods came back all clear - so its asthma not copd.

    GP was reluctant to do spirometry as she said I don't have COPD. (Not sure about this myself)

    After a bit of pushing she agreed to try me on symbicort - will see how that goes ?
  • lostboysaintlostboysaint Posts: 4,252
    I'm yet another asthmatic on this forum and like most on this thread I've had mine well under control with inhalers but my GP clearly took a far more pro-active approach to getting the type and dosage right before leaving me well alone. Now that they've dismissed COPD you need to keep giving them grief until your asthma inhaler type and dosage is allowing you to achieve PF readings that are at least somewhere near normal. Your preventer inhaler should do just that and, if your dosage is correct, mean that you shouldn't require the reliever inhaler at all.
    Trail fun - Transition Bandit
    Road - Wilier Izoard Centaur/Cube Agree C62 Disc
    Allround - Cotic Solaris
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