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3398Re: [HR100] safe and effective inhaler use for asthma

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  • Deb
    Feb 5, 2014
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      Yum... Thanks for sharing Betsy!  ( my first finish, I think it was a ( mostly) green placenta.  ) 

      Sent from my iPad

      On Feb 5, 2014, at 1:06 AM, Betsy Nye <betsynye@...> wrote:


      Hi HR Runners: )I cough up green burgers after every 100 miler!It is a good thing as long as it is green

      Sent from Yahoo Mail on Android

      From: eric <thebeave7@...>;
      To: HR100@yahoogroups.com <hr100@yahoogroups.com>;
      Subject: RE: [HR100] safe and effective inhaler use for asthma
      Sent: Tue, Feb 4, 2014 6:42:56 PM


      I agree with many of Bruce's points. At least from your initial description it sounds more like Accute Mountain Sickness (AMS), or altitude specific related issues rather than exercise induced asthma which tends to be more transient and associated with chest tightness/shortness of breath even if not moving. Not to mention exercise induced asthma (EIA or EIB) is more related to stress in general; hard pace, cold temps, hot temps, altitude can be a trigger too, but its not specific to altitude. 
      I've gone through some similar symptoms to Bruce and am trying to see if albuterol will help manage it, jury is still out as it does not help all cases. I've also had AMS and it is a different feeling and something that for me was only alleviated by returning to a lower altitude, where I could still exercise just fine. Here is an interesting article about exercise induced asthma that I picked up a few months ago when I was learning about the symptoms and treatments specifically for athletes (which I'd like to think we are).

      In short its probably best to just work with your Dr, and if they think its exercise induced asthma it doesn't really hurt to try an inhaler when symptoms arise (as Bruce described). If it doesn't work, well just discontinue it and try other avenues to manage the symptoms.

      Eric Lee

      "Climb the mountains and get their good tidings."
      -John Muir

      M.S. Cell & Molecular Biology

      To: HR100@yahoogroups.com
      From: lonerunman@...
      Date: Tue, 4 Feb 2014 10:07:21 -0800
      Subject: Re: [HR100] safe and effective inhaler use for asthma


      Howie - I am in a similar situation as you, living at sea level and having mild asthma that comes occasionally and unpredictably. After getting caught early in my running career with asthma symptoms, I always run/race with a salbutamol inhaler just in case my lungs act up. I have never been hospitalised, but have come close once, and I do not want to go through that experience again. My chest tightness can come and go on its own, but I take a puff when the tightness is sustained for 15+ minutes, or immediately if it gets worse. I will repeat as needed, but have never had to do more than 5 puffs. I am not concerned with dosage when I am having trouble breathing - the salbutamol will work by then or it will not, so there is no point blasting so much as to overdose but on the other hand I am not going to hold back if there is some benefit, either. Anyone with first-aid training will tell you that a patent airway is the primary concern in treatment!

      That said, from your description above it occurs to me that perhaps what you have experienced may not be asthma, but a reaction to altitude and some mild pulmonary edema. Again, I have had similar experiences racing at altitude at Hardrock, Leadville, Bighorn, and Jemez. Altitude will manifest itself in a number of nasty ways, including a total weakness in the legs, light-headedness and disorientation, and chest congestion. The weakness and light-headedness has, in my experience, been temporary and generally alleviated by dropping to a lower altitude (general lack of fitness and fatigue notwithstanding). The chest congestion, on the other hand, has happened to me during a race but more frequently after I have finished (almost like the actual exercise mitigated the problem). I have been hit with distressed breathing immediately after a race, where salbutamol administered with a mask for ~30 min made no difference. I have also had a delayed reaction up to a day later, when my chest tightens up with no alleviation with my inhaler. In both these situations, the symptoms only dissipate once I start coughing up chunks of firm green phlegm. This is an entirely different experience than the strict asthmatic reaction that I get. 
      I would also note that this particular problem happens most notably when I am not acclimatised to altitude, i.e., going directly from sea-level home to a race site. If I spend time at altitude getting used to it, the chest problems are significantly reduced or non-existent. For Hardrock in particular, I have found that being there a minimum of a week prior to the race makes an enormously positive difference in how I feel, with much better outcomes in breathing, performance and cognitive ability during the race. 

      I am not a doctor, but I run a lot and these are my experiences and the strategies I have learned to cope with how I am affected. Besides preventative acclimatisation, I don't know of a better way to clear the altitude-induced edema other than time. I carry my asthma inhaler all the time, and will use it when I get sustained chest tightness to the point where symptoms subside or it is evident that the drug is not making a difference. 

      I hope that helps you figure out what is affecting you. I guess my overall point is that it may not be typical asthma but something altitude-induced instead, and you may need to look at alternative coping strategies to help. 


      On 4 February 2014 02:11, <hbreinan@...> wrote:

      Does anyone have any advice/guidelines on using albuterol inhalers during the run?  Does it help?  Do your docs let you take any more than the recommended daily dosage?  My history below indicates I will probably have breathing trouble during day 2 at HR.  Needless to say, I live at sea level.  

      I started developing asthma in HR100 2011 early in morning #2 climbing up Bridal Veil at about 80 miles.   I didn't have an inhaler as this had never happened to me in an ultra before, even pacing at HR.  No problems running downhill... only on the ups.   Death breathing really hit on the climb of Grant Swamp... from the very bottom, even at a very slow pace I could barely move.  I had no further episodes in my running until my Leadville qualifier this year.  I finished fine with almost no symptoms - I did take one puff from an inhaler climbing Powerline as I thought I might just be starting to sense a little something coming on.  Either it was a false alarm or the albuterol took care of it as I continued strong to the finish.   But sleeping in the car afterward (about 27 hours after the start) I had severely labored breathing.  I did not fully recover until several days later at home.  I had my breathing tested at my allergist about 36 hours after the race and my numbers were horrible.  So I escaped the death breathing in the race, but still it showed it was poised to get me... if I had gone on for more than 24 hours it probably would have.     

      Thanks for any advice or thoughts,
      Howie Breinan

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