A breath of air for fitness buffs

Exercise-induced asthma shouldn't take the wind out of working out

April 07, 2002|By Joan Cary. Special to the Tribune.

Joan Pavin thought she was just having another bad day. Ten minutes into her run at the health club, she started wheezing. Her chest felt tight, and she had to slow down.

The good news was that she was running next to an allergist's wife, Shari Sharon, who saw that Pavin was having a hard time and suggested she get medical help.

Pavin, of Winfield, does an hour of aerobic exercise five or six days a week, varying between spin and step classes, kick boxing, weight training and running.

Sometimes she had trouble with wheezing 5 or 10 minutes into class, and sometimes she was fine. She saw Sharon's husband, Dr. Greg Sharon, who diagnosed her with exercise-induced asthma. Sharon is an allergist/immunologist who runs a private practice, Asthma and Allergy Center, in Bloomingdale.

"I feel so much better now. But I feel like I was robbed," said Pavin, 43. "All of that time when I was struggling, I could have made it easier. My comfort level when I work out has changed dramatically since I found out what's been causing my problem."

Exercise-induced asthma, also known as exercise-induced bronchospasm, occurs in about 10 percent of the population, and in more young people than old, Sharon said. Typically, 7 to 10 minutes into a course of vigorous exercise, the person with EIA begins wheezing, coughing and feeling tightness in the chest. Generally after 20 minutes of rest, he or she feels better.

People with EIA have airways that are sensitive to sudden changes in temperature and humidity, especially when breathing in cold, dry air or allergen-laden air. During strenuous exercise, people tend to breathe through the mouth, allowing the cold air to reach the airways without passing through the nose, which warms and moistens the air. The airways may react with a spasm that induces the coughing and wheezing.

People with EIA may have an attack while running to catch a bus or train in winter or while jogging outside in the cold air, Sharon said. Some may experience EIA only during allergy season.

EIA often shows up between the ages of 5 and 18, although some people may not develop EIA until they are in their 20s or 30s. "It can occur in non-allergic patients, but it is more likely to be in people who have bad allergies," Sharon said, adding that the problem also may develop after an infection, sinusitis or over stimulation of allergies. It should not be confused with being out of breath from being out of shape. A person with EIA does not feel fatigued or experience muscle aches and pains, Sharon said, while pointing out that heavy breathing is not the same as wheezing.

"If it comes to the point where you are huffing and puffing and have to stop what you're doing, change your exercise, stop or limit your sport, then it has to be treated," Sharon said.

Although there is no permanent cure for EIA, there are ways to help prevent an attack. A warm-up period before exercise may reduce the tightness in the chest. Drink lots of water. Exercise in a warm environment, and if you run outside, wear a mask.

If you are sick with a viral infection, lay off the strenuous activity, said exercise physiologist Susan Strickland from Central DuPage Hospital's Wellness Center in Wheaton. "If you have a cold or respiratory infection, you may find that you get exercise-induced asthma," Strickland said. "Skip that day or lower the intensity of your workout."

Those suffering from allergies and people taking a lot of aspirin or who are on medications for high blood pressure or heart problems also are more likely to suffer from EIA, Sharon said. Hard exercise also may stimulate EIA.

How do you differentiate between EIA and asthma? Sharon said EIA patients are generally better after a 20-minute rest. An asthma attack can go on all day or stop and reappear 5 or 6 hours later. EIA will not reappear. People also can be born with asthma but not with EIA. Anyone who thinks they may have any kind of asthma should see a doctor for tests.

As for the causes, running is the exercise most likely to bring on EIA, and swimming is least likely to cause it, partly because of the warm and humid atmosphere of the pool. Sports that call for strenuous periods of energy, such as sprinting, basketball and soccer, may trigger EIA episodes, he said. Soccer often is worsened by spring and fall's high pollen and mold counts. Those who suffer from EIA may want to switch to exercises that can be done at a steady pace such as walking on a treadmill, bicycling indoors and swimming during allergy season, Strickland said.

Once patients are diagnosed with EIA, they can learn to recognize the symptoms and stay away from things that might precipitate an attack. Since her diagnosis, Pavin takes a prescription medicine each morning to reduce inflammation of the airways and carries a bronchodilator or inhaler with her for extra help if she needs it during exercise class.