Exercise Induced Asthma and Fatigue

DeVlaeminck

Not cycling related in this case but thought some of you may have experienced something similar in cycling. I've got a young footballer who has had EIA for 2-3 years and is on a brown inhaler which has stopped her getting asthma attacks.

Previously she would have a bit of an attack - come off - use the blue inhaler and be able to go back on and play normally.

However now she just feels very lethargic and leggy - she looks knackered very easily when previously she was one of the fittest on the team. Could this be asthma connected and if so is there any way to test for it - and if there is how could she access that ? It's been going on a while now so I don't think it's a hangover from a virus - she feels OK in everyday life.

kingrollo

I was told by a respitary consultant that there is no such thing as exercised induced asthma - only controlled and uncontrolled asthma - your scenario indicates the latter imo.

you need to get past your GP and see a respiratory consultant - they will have knowledge and access to inhalers that your GP will not have. you might have a battle with your GP and a long wait for a consultation but worth it ime

Matthewfalle

send her to see her doctor.

end of thread.

kingrollo

ignore the attention seeker.

I have had asthma all my life - feel free to post any questions here.

Matthewfalle

1. well done
2. good for you.
3. are you a doctor?
4. are you her doctor?
5. no.
6. no.
7. tell her to see her doctor.
8. don't pretend to know medical stuff
9. end of thread

mrfpb

Matthewfalle wrote:

send her to see her doctor.

end of thread.

This.

I've got two kids with asthma. Both have had several very hairy moments.

At such times I did not consult an internet forum, I took them to a GP or a&e.

kingrollo

mrfpb wrote:

Matthewfalle wrote:

send her to see her doctor.

end of thread.

This.

I've got two kids with asthma. Both have had several very hairy moments.

At such times I did not consult an internet forum, I took them to a GP or a&e.

Sure - but I don't see why he can't do both.

imposter2.0

As above - some people seem to be assuming that the OP is seeking advice here as an 'alternative' to professional medical advice, rather than 'as well as'. It's possible to do both.

This is a discussion forum, after all - and as such, I don't see why asthma should not 'discussed' on here. If every question was answered by simply saying "go see your doctor/physio/coach/whoever" then there wouldn't be much point in having a discussion forum...

Matthewfalle

kingrollo wrote:

mrfpb wrote:

Matthewfalle wrote:

send her to see her doctor.

end of thread.

This.

I've got two kids with asthma. Both have had several very hairy moments.

At such times I did not consult an internet forum, I took them to a GP or a&e.

Sure - but I don't see why he can't do both.

1. its not his kid
2. he doesn't know the history
3. he doesn't know the family's history
4. none of us are or know the above
5. none of us are resp. specialists
6. the parents need to send the kid to the doctor

slowbike

Matthewfalle wrote:

kingrollo wrote:

mrfpb wrote:

Matthewfalle wrote:

send her to see her doctor.

end of thread.

This.

I've got two kids with asthma. Both have had several very hairy moments.

At such times I did not consult an internet forum, I took them to a GP or a&e.

Sure - but I don't see why he can't do both.

1. its not his kid
2. he doesn't know the history
3. he doesn't know the family's history
4. none of us are or know the above
5. none of us are resp. specialists
6. the parents need to send the kid to the doctor

Wind your neck in ...

then go and do something useful.

To the OP - you're probably already aware - as you're asking on here - not all GPs are the same or give the same advice. It does sound like whatever your athlete is taking, it's not working correctly, so yes, a trip back to the GP is required - if it's a multi-doctor practice, see if one specialises in sports and see them - hopefully they'll have a better understanding of the condition and the effects of sport on it.

mrfpb

Again, I'm with MF. Given the seriousness of the condition and the lack of info on the sufferer, NONE of the advice we can offer is helpful, and could actuakly be harmful.

I'm all for discussion on people's own health issues or training needs, but this NOT the case here.

haydenm

Sounds like her's is working as it should for the most serious attacks but not clearing it completely. I never found that the brown inhaler did anything for me, only in the last few years have they put me onto a pink inhaler called fostair which is fantastic. I very very rarely have to take the blue one now at all.

Given the previous comments I wouldn't recommend this as I'm not a doctor but personally I would take the blue inhaler just before I went onto the pitch to get 100% lung capacity back. I always found that the blue inhaler makes me feel 100% asthma free (aside from the few occasions when I had a proper attack) and the mental side of it is huge. When I felt like my lungs were closing up I would panic and make it worse.

Again, obviously I'm not a doctor so the best you can do is suggest to the parents they speak to the doctor with a different medication in mind? Or get them to condone the use of blue inhaler before exercise if you are worried, I always had 'two puffs when necessary' prescription so I had options to find out what worked for me

DeVlaeminck

Just to follow up.

It is my daughter but she also plays for my team.

She's not had an attack as such for about a year and barely since she's been on the brown inhalerand that was when it ran out and she didn't realise!, she just feels sluggish on the pitch not out of breath so I don't think it's a medical emergency. She does play at a decentish level on Saturdays so seems a shame if she can't play to her potential.

She does have blue inhalers so I may get her to use that and see if it improves things.

I was more wondering if this kind of symptom could be asthma, previously she either felt fine or had a short lived attack. I will get her to go to the docs but it's good to know if we should push for an asthma specialist consultation hence trying to get some wider views as nobody else in my family has asthma.

Thanks for all replies though. .

photonic69

Maybe it's just her growing? I know that my daughter when she went through a huge growth spurt that she was really tired and lethargic, lacking in her usual energy when out on the bike. She did grow about 9cm in a about 3 months which was alarming (and costly)
Also any viruses over the last few months. I've had one that seemed to never properly go and has lingered around in the background for months in my system. Doc says this can happen with some virus types.

Hope she gets her spark back soon. It can be concerning for parents to see their young suffering.

tangled_metal

All of the MFs seem to have given their opinion and seems to be at least half decent advise. The bit about seeing the gp is right the rest is a bit of a d1ick response IMHO. If there's no benefit from discussing health aspects with fellow sufferers as well as doctors then you'd never see self help groups which certainly do a lot of good.

From my perspective it's not just good enough to go to your gp. They're gatekeepers. Most now a little about a lot but among them there will be GPs with knowledge of asthma and sports. It is always better to find out if there is a gp in your area who knows a bit more about sports and asthma. My practise has nobody but when a locum came in be was good because he did sports and was involved in sports clubs on the side.

Another point that's more related to the fatigue. I'm mid forties and a few years ago got diagnosed with EIA/uncontrolled asthma. I doubted it so another visit resulted in getting a peak flow meter and a lot more knowledge. So I know it is asthma. I also trace back my fatigue and reduction in performance on the bike to the same time I first noticed the breathing issue.

I have years of strava times on the same commuting route. So years of travelling on the same road, same time and fame kit. At the time I developed asthma I got a step change in times and average speeds. We're talking consistent average mph for a few years then 2mph slower or more. Right now I've managed the average speed I used to do everyday about 3 times last year. I found it hard all three times.

So what is it? No idea but it's not growth related with me. I've been the same weight and height for 15 years (+/-1 or 2 kg).

If DeV finds out it's asthma related and what is needed (different inhaler for example) then I for one think it's helpful to know and discuss it. Confidentiality of course allowing.

I don't want to pry but the benefits of discussing health aspects related to sport could benefit people greatly. For one this thread is encouraging me that there is really something not right with me. Why? Because a concerned Dad is describing his kids symptoms that seem not too far from mine.

My history is never, ever had any sign if asthma in my whole life until into my 40s. Years of allergy which I think has a factor in my asthma too. My partner has had bad attacks as a kid but that stopped by adulthood. She has in the past few years gone back on blue inhaler for attacks and at certain times of year she goes onto brown inhaler but that doesn't help much.

Asthma needs proper expertise and IMHO the GP doesn't have it. They don't really know much more than the common stuff plus when to send to an expert. DeV's kid needs the expert. I suspect we often have the sense of not wanting to bother the nhs with something that's not really stopping is doing stuff, just lessening our effectiveness in it. But IMHO we should not give in like that. It's not hypochondria just trying to put your kid's health and performance back to where it should be if she didn't have asthma.

Good luck sorting it out.

slowbike

Tangled Metal wrote:

From my perspective it's not just good enough to go to your gp. They're gatekeepers. Most now a little about a lot but among them there will be GPs with knowledge of asthma and sports. It is always better to find out if there is a gp in your area who knows a bit more about sports and asthma. My practise has nobody but when a locum came in be was good because he did sports and was involved in sports clubs on the side.

Exactly as you'd find in all walks of life - generalists in all sorts, eg Accounts, Tax etc - but specialists in a particular part of those broad subjects

Tangled Metal wrote:

Another point that's more related to the fatigue. I'm old and a few years ago got diagnosed with EIA/uncontrolled asthma. I doubted it so another visit resulted in getting a peak flow meter and a lot more knowledge. So I know it is asthma. I also trace back my fatigue and reduction in performance on the bike to the same time I first noticed the breathing issue.

fixed that for you!
Joking apart - we've taken Little SB to the docs - prompted by his daycare staff - as he seems constantly tired plus some other bits.
Docs diagnosis was - at this stage, nothing of concern, it may be glandular fever - which apparently we get 3 times in our life - at LSBs age, it doesn't manifest itself as much - other than tiredness - and they'd not do anything about it - so fair enough, we could have bloods done etc, but TBH, not worth it - yet ...
Not suggesting you have GF - but it's amazing just how many things could be "wrong" without being majorly wrong - which we only notice when we try pushing ourselves. Then the question is - what do we do about it - where do we draw the line? Do we want to be just healthy enough to function effectively? Or do we want to be 100% - then what is 100%? and who should fund the difference?

964cup

I have suggested we have a sticky about asthma on the forum. Here's what I've posted previously:

viewtopic.php?f=40011&t=13084741&hilit=asthma#p20219138
viewtopic.php?f=40011&t=13073053&hilit=asthma#p20010503

TL;DR - Me: not a doctor; medical background; lifetime asthmatic. Advice: sod the GP, get a consultant referral; get the right meds - almost always a combined therapy, not a single inhaler; fluticasone is more effective (in combination) that beclomethasone; don't ignore leukotrine antagonists like Montelukast but they're not a magic bullet for everyone.

New stuff:
There are physical interventions now - bronchial thermoplasty (smooth muscle ablation using heat, with the effect of reducing constriction) and vagus nerve ablation, with the same intended effect. Mostly used in COPD/emphysema but starting to be considered for severe asthmatics. Still very early days and most people can do well on drugs, so I'd be sceptical if a consultant suggested it.

However you do it, it's *really* important to get asthma managed properly when you're young, or you will end up with remodelled airways that permanently limit your peak flow. Speaking personally, this sucks and I wish they'd had the treatments they do now when I was young.

haydenm

TM, I don't know what your prescription is but wonder whether it could be that the brown inhaler does enough to prevent asthma attacks (say 95% capacity) but doesn't open you up to 100% capacity. I certainly *feel* like I can breathe marginally more freely at any point if I take a blue inhaler even if I don't feel like I have proper symptoms to the point of tightening. To all, I would highly recommend Forstair if you don't use it already, it prevents the worst of even my allergy based symptoms which the brown inhaler never did. The switch has coincided with a bit increase in training though so it's hard to say what affect it actually has...

tangled_metal

I only have blue salbutamol. When I asked for another I had a review that the gp told me I could have brown if I needed it and there's other options.

I only went because I was getting a few more attacks and was feeling tired a lot. Perhaps I should very the brown. Autumn is my bad time for asthma perhaps get it for then.

haydenm

I always had a dreadful time as a kid around autumn because of dust on radiators/fungal spores and things. This autumn I went in and said I was taking my blue inhaler ~15 times a day (which I do periodically if it's really bad but not actually having an attack), they all looked panicked and gave me the forstair. Long may it stay on my prescription as it cleared it all up straight away

tangled_metal

Oh! I only took 10 puffs on bad autumn days. That's 5 double puffs. I always got told two puffs per dose. It seems to work OK.

My big thing is a persistent cough. It clears after a salbutamol dose. I found that out 6 months after getting the puffer. I'd had a 4 year cough especially after cycling into work. It's all got a bit tiring so I'm down to at most 2 commuting by bike days instead of 4 days in the past.

Pross

Judging by your signature it seems your daughter is at an age where all sorts of things, physical and stress related, could be affecting her physical performance. Is it a general issue or just when she takes to the pitch? Whilst asking other sufferers whether they've experienced similar issues makes sense as a first step if it is something that has been going on for a while a trip to the GP is definitely the way to go either to get the medication assessed or to see if there might be another cause.

DeVlaeminck

Tangled Metal wrote:

I only have blue salbutamol. When I asked for another I had a review that the gp told me I could have brown if I needed it and there's other options.

I only went because I was getting a few more attacks and was feeling tired a lot. Perhaps I should very the brown. Autumn is my bad time for asthma perhaps get it for then.

The brown has certainly made a difference for my daughter. The real evidence was when she had a bit of an asthma attack in a game and when I got home I gave her brown inhaler and a shake and it was clearly pretty much empty - she hadn't had any episodes since getting it. I think gets is pretty much the minimum dose.

Her peak flow is a bit above average for a 17 year old female but I'm going to get her to blow into it mid game and see what it's like then. Also she's always done a lot of sport so slightly above average may be less than her actual potential, I don't know if doing sport would normally raise it a lot.

DeVlaeminck

Pross wrote:

Judging by your signature it seems your daughter is at an age where all sorts of things, physical and stress related, could be affecting her physical performance. Is it a general issue or just when she takes to the pitch? Whilst asking other sufferers whether they've experienced similar issues makes sense as a first step if it is something that has been going on for a while a trip to the GP is definitely the way to go either to get the medication assessed or to see if there might be another cause.

Yes just when playing sports. I am telling her she needs to go to the GP - she's a bit of the opinion she's not having an attack it can't be asthma - you are right it may not be I am open minded and in a way I hope it's something like a virus that may pass but I'd say with hindsight it's been affecting her for over a year. The thing is it's not so bad she can't play - end of last season I remember saying gave a proper rest over the Summer so I know sort of May time it was an issue.

tangled_metal

I didn't believe I had asthma. I've had allergies most of my life but never asthma. I struggled breathing after a bad cold type bug so went to the gp. Salbutamol helped that but it took another forum thread on asthma which stated that salbutamol doesn't have an effect on someone without asthma. That was a gp who posted on the forum that said that. So I accepted asthma as a diagnosis.

I rarely have the tight chest traditional asthma attack. I get the tickle on the throat and a cough. The salbutamol clears both up. It allows me to clear the phlegm out. It's not this that's the issue. I feel my fatigue and drop in performance that happened with this asthma is the issue right now. It's something I can't identify as asthma.

This is really why I struggle with the idea that I have asthma. It's why I don't get it checked out further. Don't want to waste a GPs time for some seemingly fluffy issue. I'm still getting around and although I can't stay awake straight after getting home, I'm struggling on a half hour commute, etc. it's not really serious.

As to your daughter's problem.! Thought would be diet or asthma or both. Food intake and its timing can have a huge effect on fatigue and endurance. Could something related to food be today of the issue?

awavey

Tangled Metal wrote:

I didn't believe I had asthma. I've had allergies most of my life but never asthma. I struggled breathing after a bad cold type bug so went to the gp. Salbutamol helped that but it took another forum thread on asthma which stated that salbutamol doesn't have an effect on someone without asthma. That was a gp who posted on the forum that said that. So I accepted asthma as a diagnosis.
?

not sure Id go along with that as a diagnosis, but Im not a doctor so the rest of this could be ignored ... but how do you get your salbutamol though ? the brown inhaler is a preventor, its a steroid that cuts the inflammation that causes the airways to constrict, and in theory it should mean you dont need to take any salbutamol at all, if your condition is under control properly.

If at my annual asthma check up,which the NHS do force me to take even if i think its a waste of time for me and the GP, I told my doctor I needed 10 puffs of salbutamol in a week, let alone a day, Id be immediately prescribed stronger steroid treatments,and they would be the kinds of steroids that would get you in trouble taking as a professional athlete.

Ive never felt having asthma made me feel lethargic or lacking energy, its harder to breath for sure when you have a chest infection, and I certainly recognise using a blue inhaler before doing exercise, more as a mental crutch than a physical boost.

tangled_metal

Whatever my real diagnosis should be salbutamol helps me when I have a tight chest due to viral infection/chest infection. It's almost Instant on that case.

It helps me when I get coughing spells occur following cycle commuting, when allergies affect me and first thing in the morning. It's near instant improvement.

I also notice an improvement when I've taken it before exercise when prior to setting off I had no noticeable asthma effects. I've checked this out with a peak flow meter so good chance it's not just my imagination (near certain it's not). I've noticed an increase in peak flow meter measurements following salbutamol use even when I didn't feel like I was having an asthma attack. Basically normal meter readings are not as high as average readings should be for someone like me. After salbutamol it rises to typical levels.

Just looked online for typical peak flow measurements for my age, gender and approx height (actually 6cm shorter than me so mine should be higher still). I typically get 200 units lower than typical measurements for my age, gender and height. I get 440 at most without symptoms if asthma when I should be getting 660 if I didn't have asthma. If I understand the chart correctly. Makes me think I do need a daily inhaler.

navrig2

kingrollo wrote:

mrfpb wrote:

Matthewfalle wrote:

send her to see her doctor.

end of thread.

This.

I've got two kids with asthma. Both have had several very hairy moments.

At such times I did not consult an internet forum, I took them to a GP or a&e.

Sure - but I don't see why he can't do both.

Because someone, who is not suitably trained, may write something which discourages the use of a GP and .........

TBH there is probably not much which can be gained from asking on a forum which cannot be found, more quickly, just using Google and tinternet.

slowbike

Navrig2 wrote:

Because someone, who is not suitably trained, may write something which discourages the use of a GP and .........

.... we're all thick who will blindly follow what some unknown person says on the internet ...

Navrig2 wrote:

TBH there is probably not much which can be gained from asking on a forum which cannot be found, more quickly, just using Google and tinternet.

If you know what you're searching for - yes - if you're trusting of the anonymous poster of a blog somewhere/somewhen ...

at least on here it's a discussion and you can gauge the weight of the information against the persons posting profile - hence anything suggested by MF is just ignored as being tripe.

navrig2

DeVlaeminck wrote:

Pross wrote:

Judging by your signature it seems your daughter is at an age where all sorts of things, physical and stress related, could be affecting her physical performance. Is it a general issue or just when she takes to the pitch? Whilst asking other sufferers whether they've experienced similar issues makes sense as a first step if it is something that has been going on for a while a trip to the GP is definitely the way to go either to get the medication assessed or to see if there might be another cause.

Yes just when playing sports. I am telling her she needs to go to the GP - she's a bit of the opinion she's not having an attack it can't be asthma - you are right it may not be I am open minded and in a way I hope it's something like a virus that may pass but I'd say with hindsight it's been affecting her for over a year. The thing is it's not so bad she can't play - end of last season I remember saying gave a proper rest over the Summer so I know sort of May time it was an issue.

From my experience of having be diagnosed with EIA in my early 20s, I learned that asthma is not a binary condition. It's generally progressive, going from "I can hardly feel it" to a full blown call the ambulance attack. External factors can influence where you are in the spectrum at any given point so a smokey pub wasn't good for me and then add in a load of beer and I could very uncomfortable.

I eventually found out that mine wasn't really exercise induced but allergy induced. Initially fungal spores in a damp Dundee flat then a cat in shared house in Cambridge. Out of those environments the asthma went away and, eventually, didn't come back.

navrig2

Slowbike wrote:

Navrig2 wrote:

Because someone, who is not suitably trained, may write something which discourages the use of a GP and .........

.... we're all thick who will blindly follow what some unknown person says on the internet ...

Navrig2 wrote:

TBH there is probably not much which can be gained from asking on a forum which cannot be found, more quickly, just using Google and tinternet.

If you know what you're searching for - yes - if you're trusting of the anonymous poster of a blog somewhere/somewhen ...

In that case visit a forum dedicated to medical issues even one dedicated to that particular medical issue.

If I want advice on wallpaper hanging I wouldn't come to a Bike Forum........ even tho' someone on the Bike Forum may know a lot about wallpaper hanging. The chances are that a DIY forum will yield more reliable and trustworthy results.