Asthma: It’s that first breath that always seems the worst.
The chest tightens and the airways spasm. A cough, a wheeze and an attack.
Especially when it’s exacerbated by the cold of winter, asthma is a discomfort for some and a medical issue for many.
Almost 19 million American adults have adult-onset asthma, a chronic lung disease that inflames and narrows the airways. About 90 percent of them — and about 10 percent of the general population — periodically suffer a related condition called exercise-induced bronchoconstriction, in which someone running or doing other strenuous exercise suddenly struggles to be able to breathe, with little or no warning.
It’s understandable that adults with these conditions — and there are more all the time, due partly to poor air quality and other environmental factors — may find some types of fitness to be an arduous endeavor that ultimately won’t be worth the effort.
But experts say that knowledge of both conditions is improving and, in consultation with physicians, it is possible for sufferers to exercise and maintain an active lifestyle.
“Ten percent of Olympic athletes have asthma, so asthma won’t stop individuals from high functionality,” said Albert Rizzo, chief of Christiana Care Health System’s pulmonary and critical care medicine section in Delaware and senior medical adviser for the American Lung Association. “With medication, they can go a long way.”
In fact, exercise can have beneficial effects on people with asthma symptoms. “Exercise and staying fit is recommended with asthma, whether it is adult-onset or exercise-induced,” said Lisa Gilmore, former director of the National Capital Asthma Coalition and webmaster of the Washington information resource DCAsthma.org. “Asthma is very controllable, if you’re following the asthma guidelines and taking medication as needed.”
Those guidelines, which come from the National Asthma Control Initiative, include using inhaled corticosteroids, assessing the severity of your asthma to determine what types of treatment are needed, developing and using a written asthma action plan, making regular follow-up appointments with your physician and trying to control environmental triggers. Some triggers are easy to control, such as smoking, while others — for example, dust and mold in work spaces — might be a little tougher to manage.
Though asthma, especially in children, sometimes seems to disappear on its own, it generally cannot be cured. But it can be effectively treated, with knowledge and careful management.
“For adult asthmatics, it doesn’t tend to get better, but it doesn’t have to get worse,” said Janna Tuck, a Missouri allergist and spokeswoman for the American College of Allergy, Asthma and Immunology.
Jill Selman, a high school teacher in Montgomery County, Md., had her asthma under control with medication when she began running six years ago. But three years ago, her symptoms flared up in a major way.
“I could barely run a minute anymore. A lap was hard,” Selman said. “But my awesome allergist at Rockville Asthma and Allergy encouraged me to exercise and run. My doctor said to do it long-term; helps expand my lung capacity.”
So she kept running. And slowly but surely, she was able to train for October’s Marine Corps Marathon. “The training went great. I could run 16 to 21 miles with no problem,” Selman said. Even when a bacterial infection called cellulitis appeared on her leg just 10 days before the race, she didn’t give up. She ran — a little slower than she’d hoped, but she finished.
Selman wants to run the Marine Corps Marathon again, this time as part of a charity campaign, working with kids who have disabilities. Thanks to Selman’s allergists, her asthma is controlled, with low doses of medication and allergy shots once a month.
An important tool in managing these types of asthma is recognizing the specific triggers that set off coughing, wheezing, or trouble breathing. Rizzo said that for those with exercise-induced bronchoconstriction, “if you know your initial potential triggers when you go about exercise and know how to manage them, that’s all you need to do.”
