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Asthma Question
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Anonymous
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PostPosted: Fri Jan 20, 2006 11:21 am GMT +0000    Post subject: Asthma Question Reply with quote

Doc,

The list you gave as possible signs of asthma in your post to the pnuemonia question has me wondering. As a child I had asthma which would be brought on by exposure to large amounts of dust. I have since outgrown this problem but a few years ago I started getting an odd rash on my ribs and arms. An asthma/allergy specialist diagnosed it as Uritcaria (sp) and I notice that you mention hives in one of your points. He also tested me for asthma and I showed no noticeable improvement on the exhaling test after using the inhaler. Whenever I get a cold, it seems to go straight to my chest. During races, it never seems like my lung capacity is where it should be and, if the race is particularly dusty, I wheeze and cough for a couple of days after the race until my lungs clear out. Although the coughing with colds is not an issue (other than sleeping sitting up for a few nights), I'm wondering if I am holding myself back during races due to my lung capacity. Do you feel I should consult another asthma specialist to see if I do have exercise induced asthma?

Thanks,

Terry
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The Bike Doc
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PostPosted: Fri Jan 20, 2006 12:00 pm GMT +0000    Post subject: Reply with quote

Terry:

Yes your respiratory symptoms can be holding you back from maximal performance during racing and training. Get thee to a Pulmonologist! (A lung specialist) You have clear symptoms of both allergy and exercise induced asthma. Having normal pulmonary functions does not rule out asthma as many individuals with mild to moderate asthma may have normal pulmonary function tests between flares. Your clear history of exercise and allergy (dust) induced symptoms combined with your past history of asthma makes the diagnosis. You would benefit from a trial of daily inhaled corticosteroids such as Azmacort (triamcinalone), Flovent (fluticasone), Qvar (beclomethasone) or Pulmicort (budesonide) and pre-exercise inhaled albuterol. Visit with your doctor and ask for a referral to a Pulmonologist.

Thanks,
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Anonymous
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PostPosted: Fri Jan 20, 2006 2:23 pm GMT +0000    Post subject: Reply with quote

Doc,

Thanks for the info. I now have an appointment with a Pulmonologist on March 8 which happens to be three days after the Warda race. I have an inhaler of, I believe, Flovent that my doctor gave me last year when I had walking pnuemonia. Between now and my appointment, would you recommend using this inhaler each day and especially before the race?

Thanks,

Terry
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Anonymous
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PostPosted: Fri Jan 20, 2006 7:36 pm GMT +0000    Post subject: Reply with quote

Actually the inhaler is Albuterol.
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The Bike Doc
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PostPosted: Sun Jan 22, 2006 9:08 am GMT +0000    Post subject: Reply with quote

tspitts:

Ask your doctor for an inhaled corticosteroid inhaler such as Flovent to use on a daily basis, even when you are feeling fine. If the prescription provided is a metered dose inhaler (MDI) (Flovent or Qvar) be sure to take it with a spacer such as an Aerochamber, which will maximize the delivery of the medicatoin to your lower airways. If it is a dry powder inhaler such as Advair, Asthmanex or Pulmicort, you do not use a spacer with these devices. Asthma is an inflamatory disease of the airways to the lungs. Using a daily inhaled corticosteroid can significantly reduce the chronic airway inflamation and help prevent asthma attacks. The albuterol taken before rigorous activity can help reduce exercise induced asthma symptoms, but, unlike the inhaled corticosteroids, it will not alter the longterm course of the dease. Only inhaled corticosteroids have been shown to alter the long term course of the disease, meaning reducing the frequency and severity of asthma attacks and improve lung functions. The sooner you start the inhaled corticosteroids the sooner your lungs will benefit.

Thanks,
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PostPosted: Mon Jan 23, 2006 3:18 pm GMT +0000    Post subject: Reply with quote

Doc--

Is there a reason to go to a Pulmonologist vs. an Alergist? I've had allergy problems in the past, but the cold usually puts my breathing on lockdown. I don't have any problems that I perceive when it is warm...
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The Bike Doc
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PostPosted: Mon Jan 23, 2006 3:35 pm GMT +0000    Post subject: Reply with quote

Guest:

I usually refer my patients to a Pulmonologist if one is available. Many private practice allergist still like to use allergy shots for their asthma patients and the data does not support using allegy shots in asthma sufferers. Pure upper airway allergies may benefit from allergy desensitization, but for lower airway asthma, the benefits are not clearly present. Some allergist who are current on the findings of allergy shots and asthma do not jump to giving allergy shots; my experience has been, these are hard to find outside of an academic (University) medical center. If you can find a University medical center based allegist, then you are less likely to find someone who will jump to allergy shots and more likely to treat with the only class of medications that have been shown to alter the course of asthma for the better, specifically inhaled corticosteroids. The Pulmonologists I have experience with are more willing to use inhaled corticosteroids when indicated.

Thanks,
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z0s01
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PostPosted: Mon Jan 23, 2006 3:53 pm GMT +0000    Post subject: Reply with quote

Thanks..I don't need to get a referral to go to one, but I was just wondering. I'll have to check my magic book of doctors to see who is in there.
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z0s01
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PostPosted: Mon Feb 13, 2006 11:29 am GMT +0000    Post subject: Reply with quote

z0s01 wrote:
Thanks..I don't need to get a referral to go to one, but I was just wondering. I'll have to check my magic book of doctors to see who is in there.


Worked out well...what I thought was me being out of shape was exercise induced Asthma. Now I can actually breath clearly on a cold night.
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The Bike Doc
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PostPosted: Mon Feb 13, 2006 2:59 pm GMT +0000    Post subject: Reply with quote

z0s01:

Thanks for the follow-up. I can breath easier tonight knowing I have helped someone else do so. Cool Cool Cool

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PostPosted: Tue Feb 14, 2006 8:34 am GMT +0000    Post subject: Reply with quote

z0s01:

Have you had a chance to see what effect your visit to the pulmonologist has had on your riding yet? During races, I seem to gasp for air right off of the line and have, like you, attributed it to being out of shape. This has caused me to train harder which has resulted in finishes of 7th overall in the last two fall series. What has been frustrating is where everyone around me seemed to get faster, my times seemed to pretty much remain the same even with the harder training and I still don't seem to have the lung capacity I feel I should have. I am just curious since I can't get in to see a pulmonologist until March 8.

Thanks.

Terry
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cmclark
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PostPosted: Tue Feb 14, 2006 2:33 pm GMT +0000    Post subject: Reply with quote

Have you always been this way or did you recently move? I moved from West Texas to the Valley and that is when my exercise induced asthma fired up. I was on inhaled steroid and Albuterol inhaler. It helped a bit. I was always having problems training. Then I raced at Warda one year in the rain. I almost passed out.

I have since moved back to West Texas and all is well again.
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PostPosted: Tue Feb 14, 2006 9:21 pm GMT +0000    Post subject: Reply with quote

tspitts wrote:
z0s01:

Have you had a chance to see what effect your visit to the pulmonologist has had on your riding yet? During races, I seem to gasp for air right off of the line and have, like you, attributed it to being out of shape.


Race-wise, no. I got in right after Tapitio. I saw a speed increase on my usual road ride at the same HR on a cold day. I forgot to use the inhailer before my RR last night and felt the chest close down, made it back to the truck after a lap and it cleared up right after taking a puff.

We'll see how it'll work at Terlingua, especially with the cold start.
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z0s01
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PostPosted: Tue Feb 14, 2006 9:22 pm GMT +0000    Post subject: Reply with quote

Anonymous wrote:


We'll see how it'll work at Terlingua, especially with the cold start.


This was me.
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z0s01
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PostPosted: Tue Feb 14, 2006 9:24 pm GMT +0000    Post subject: Reply with quote

cmclark wrote:
Have you always been this way or did you recently move?


I've been on allergy pills since I was a kid. I never really got into cardio sports until a few years ago, so it wasn't something I really ever noticed...and when I started noticing it, I thought it was a conditioning issue, so I tried plugging through it.
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