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EIA meds and related

 
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Anonymous
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PostPosted: Tue Aug 14, 2007 1:18 pm GMT +0000    Post subject: EIA meds and related Reply with quote

All my asthma meds have room temp storage requirements which I am frequently violating as they travel around in my cycling bag. Is this decreasing their lifespan or effectiveness? If they are in my bag, they are there when I need them. If I have to bring them into work, I might forget them and not have them on a weekend and a cooler every day just to put some drugs in seems like a real pain. But you know how hot a car can get.

Also, I can't find anything that really works well enough to stop some bad wheezing for extended anaerobic efforts ... like 2-3 minutes. Especially when it is humid. Is that just taxing the system too bad or should I pursue other drugs? Like right now I have 2 hits of proventil and 2-4 of intal. I don't know what a reasonable expectation is .. no issues or just that they are minimized.

I know I'm so much better than before but when hot on a chase and having what seems like less lung function is discouraging. Especially when having to back down just to get the wheezing to go away (but then I'm fine).
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The Bike Doc
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Location: Corpus Christi and Warda, Texas

PostPosted: Thu Aug 16, 2007 4:23 pm GMT +0000    Post subject: Reply with quote

KnobbyToes:

I will have to give you the quick answer now but will get back with more details later as I am covering a busy in-patient service at the hospital.

The high temperatures may cause your asthma meds to break down and become ineffective. Your asthma can be brought under much better control with daily preventative medications of the inhaled corticosteroid class. They are safe and may be used in all collegiate, Olympic, USA Cycling, and UCI sanctioned events provided you have your physician fill out the necessary paper work. Get a referral to a Pulmonologist for an evaluation of your asthma and recommendations. You will find your need for pre-exercise albuterol markedly decrease and even go away completely with the propper preventative medication.

I will visit more on this topic when I get caught up at work.

By the way, I am a Pulmonologist, so this is right up my ally of expertese.

Thanks,
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Anonymous
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PostPosted: Fri Aug 17, 2007 12:12 pm GMT +0000    Post subject: so... Reply with quote

Even if you only have EIA some sort of daily med is better?

Any recommendations for docs in Austin?

Thanks Doc!
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The Bike Doc
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PostPosted: Sat Aug 18, 2007 7:11 pm GMT +0000    Post subject: Reply with quote

KnobbyToes:

Yes, even if you "only" have symptoms when you exercise you still have asthma. The reason I use quotes around "only" is that it is highly likely that you may be having other asthma symptoms and you may not be aware of them. When you get a cold, do you get tight in your chest and/or have some wheezing? Do you get a tight cough that last for 2-3 weeks after the head cold symptoms of runny, nose, congestion and post nasal drip resolves? Do you cough if you laugh hard or when you get around perfumes, arosoles of smoke? I consistently find that in patients who "only" have exercise induced asthma that there are other asthma symptoms such as these lurking in the back ground; it is just the individuals have gotten use to them and think that is normal, but, in reality it is not.

You deserve to have normal functioning lungs and you can achieve this. The underlying pathology that causes exercise induced asthma as well as other forms of asthma is airway inflamation. Bronchodilators shuch as Albuterol, Maxair, Proair, Xopenex to name just a few do nothing for airway inflamation. In fact, it asthma therapy is soley bronchodilator therapy, the long term picture of the asthma is no improved and in fact can deteriorate. However, when inhaled corticosteroids are added into the daily controller therapy the effective anti-inflamatory action on the airways leads to dramatically improved long term asthma control. Asthma symptoms triggerd by exercise, upper respiratory infection (colds) and other triggers are markedly reduced or even eliminated when inhaled corticosteroids are used on a routine basis. Death rates from fatal asthma attacks have been shown to be reduced by 10 fold and hospitalizations have been reduced 5 fold with low dose inhaled corticosteroids taken twice daily. Inhaled corticosteroids in low to medium dose do not have systemic steroid side effects. They can be used safely and as I have already mentioned are approved for use in all athletic competitions when the prescribing physician fills out the appropriate paper work.

When I use to practice Internal Medicine and Pediatrics in Giddings and LaGrange, Texas (before I became a Pediatric Pulmonologist), I often used the Pulmonologists at the Austin Diagnostic Clinic. You may want to see if one of them can get you in for an evaluation in the near future.

Thanks,
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PostPosted: Mon Aug 27, 2007 3:41 pm GMT +0000    Post subject: Reply with quote

I have had pretty severe, chronic asthma my whole life and it kept me from doing just about everything aerobic for most of my life. About 2 or 3 years ago I went to a pulmonologist in San Antonio who educated me quit a bit and got me started on Advair (a daily corticosteroid). Over time, this drug has almost completely taken control over my asthma to the point now that most days I simply cannot attribute my physical limitations to asthma anymore. And I almost never use the inhalers now. If I do its more preventative than anything. Occasionally, if I feel like asthma may be an issue for a race, i take Prednisone tablets for a couple of days leading up to the race. I can tell I still have asthma but it is dramatically minimalized now.

I know I must sound like a commercial but Advair has changed my life! Believe me, as an attorney who represents consumers I would not be inclined to plug the pharmaceutical industry.

The good Doctor's advise (go to a pulmonologist and get on a corticosteroid) is what I did and it worked for me.
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The Bike Doc
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PostPosted: Tue Aug 28, 2007 5:30 pm GMT +0000    Post subject: Reply with quote

drichman:

Thank you drichman. I, too, have asthma for most of my life and had to abstain from rigorous sports and activities all my childhood and adolescent years. Once I got on inhaled corticosteroids, I found out what normal breathing was able to take up bicycle racing. What a difference it makes being able to breath without feeling tight in my chest, coughing or wheezing when I hammer hard.

If you still have some break through symptoms with racing, talk with your Pulmonologist about a step up on your Advair dose. You should not have to take oral steroids just before racing when your symptoms are well controlled.

Thanks again,
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