Sunday, November 3, 2013

WTFitness: Running with Asthma

Hello all! I was originally planning on using my extra hour to sleep in, but I sprung out of bed fresh as a daisy today and wanted to blog instead. I'd like to talk about something that I'm have unique experience with, running with asthma.

I have asthma. Allergy induced and exercise induced. My airways close up quickly in reaction to several different triggers. I can't do much about the allergens, but I am able to work on the exercise triggers. I grew up thinking that my chronic illness prevented me from being able to run. I had to use an inhaler in PE class at school, which kids made fun of me for, or I could go inhaler-less and sound like Darth Vader, which would also lead to kids poking fun. In any event, running was never a fun thing for me to do and I would avoid it whenever possible.

Dang, look at that sexy waist belt/fanny pack. The amazing shirt I'm rocking is from the folks over at Asthma Sense who run an amazing blog sharing stories of people with asthma and offer tips on living with the disease.
Only when I started training for my 10k this past year was I able to condition my body and disease to handle the task of running and get to the point where I could finish a 6.2 mile race with a smile.

What is asthma?

Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children.

To understand asthma, it helps to know how the airways work. The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. This makes them swollen and very sensitive. They tend to react strongly to certain inhaled substances.

When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways.

This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed.

Sometimes asthma symptoms are mild and go away on their own or after minimal treatment with asthma medicine. Other times, symptoms continue to get worse.

When symptoms get more intense and/or more symptoms occur, you're having an asthma attack. Asthma attacks also are called flareups or exacerbations (eg-zas-er-BA-shuns).

Treating symptoms when you first notice them is important. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can be fatal. (text from NHLBI)
Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms.

What does an asthma attack feel like?
First off, it's kinda scary. Your airways don't feel swollen, but you can tell that they are. When your airways thicken, it feels like you're breathing through a straw. You feel like can't get enough air into your lungs, your blood isn't as saturated with oxygen, your muscles and brain start to feel slowed, I normally start to panic a little at this stage.

Side note, when I was little and went to the doctor, I would have to use a peak flow meter which measures your lung capacity. I also had a peak flow meter at home. You blow into a tube and the volume of air that you exhale is measured. If I was experiencing asthma symptoms, the volume of my exhale would be about half of normal.

How do you treat asthma?
Thankfully, I've never had an attack bad enough to warrant going to the hospital, but I have been "lucky" enough to use a nebulizer a handful of times. It's a device that kinda reminds me of a hookah pipe (a total asthma trigger, btw) and allows you to breathe medication for a few minutes. I remember this stuff tasting really gross and I hated it every time I used it.

This was the model of nebulizer that was popular when I was a kid, they look really different now. They used to call this one "the peace pipe".
Asthma can be treated in a few ways, the most popular is with inhalers. There are some that are daily use inhalers that deliver preventative meds, steroid inhalers that are used when someone is going to be exposed to a trigger for short periods of time (I would use these as a kid during "bronchitis season"), and rescue inhalers which are to be used immediately at the onset of any attack symptoms.

I've gotten more used to my rescue inhaler over the past 15+ years I've been using them. I still dislike using them in public because of the looks I get from strangers. I've explained to more than one person that the device I'm using is a prescribed medication and not some fancy new method of doing illegal drugs.

Holy moly... I had completely forgotten about the Aerochamber until writing this. The aerochamber is a spacer chamber that allows the asthma medication to mix with air before being inhaled. I used one of these as a kid but now I just use the inhaler which is the grey part on the end of the aerochamber in this photo. Photo source
On the rare occasion that I'm caught without an inhaler (it does happen from time to time), I can prevent an attack by stopping the activity that's triggering the symptoms (normally running or jogging), start moving slowly (adjust to a walking pace), lace my fingers and place my hands behind my head which seems to open up my airways and lungs and get me just that little bit more air volume, and start breathing slowly and deliberately with 4 counts in and 8 counts out. The "timed" breathing helps in a few ways, it forces me to concentrate on my breath and it causes me to calm down if I'm starting to get panicky.

One of the best pieces of advice that my doctor gave me was to use my rescue inhaler a few minutes before starting an activity that I know will trigger my asthma. In many cases, it has prevented symptoms from showing up when I'm running.

What is it like to run with asthma?
Totally f*cking awesome. It's something I never thought I would be able to do. I had to start slowly by running and walking in intervals, but my walking intervals got shorter as I kept on with my training plan. Soon, I was able to run 3 miles without stopping, then 4 miles. Then I was able to run a hilly 3-4 mile loop that I've never been able to complete without walking before. Then I ran 6.2 miles at Crissy Field in San Francisco as part of the Women's Health Run10Feed10 and raised $230 to help feed children in schools.

Running with asthma is as much a mental thing as it is physical. It's about knowing your symptoms, what you can live with (being a little short of breath), and what means you need to stop. It's about being able to budget, if you're going out for a run and you start experiencing symptoms 1 mile in... you have at least 1 mile to get back to your starting point, can you make it back? Is it worth pushing for another mile and then having 2 return miles?

What are some good training plans?
I've had awesome experiences with the Couch to 5k series and with the training plan put out by Women's Health Magazine that was specifically for the 10k race I ran.

What about you? Any asthma sufferers out there reading? How do you exercise with your asthma?

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