Asthma sufferers don't need to curtail exercise

Exercise is a common trigger for people who have asthma. And for some, exercise is the only time that symptoms of respiratory distress appear.

Health experts believe people with exercise-induced breathing problems — and we're not talking about people who huff and puff because they're out of shape — are especially sensitive to changes in air temperature and humidity.

As many as 80 percent of the 20 million Americans with asthma have exercise as one of their triggers. But a "good part" of the athlete population do not have asthma and experience wheezing, coughing and shortness of breath only when they exercise, and even then, maybe not all the time. Fortunately, treatments and preventive measures can curb the problem without curtailing exercise, which is crucial to health, according to Dr. Max Testa and exercise physiologist Carrie Petteys, both of The Orthopedic Specialty Hospital.

And that's the topic of Saturday's Deseret Morning News/Intermountain Healthcare Hotline. They'll take phoned-in questions about dealing with exercise-related dyspnea, including asthma and other bronchospasms, from 10 a.m. to noon. The number to call is 800-925-8177.

Someone who needs longer to warm up than teammates do may have exercise-induced asthma. Running the second split of a marathon faster than the first can be an indication, too. They also watch for concurrent conditions like seasonal allergies and sinus infection, which may point to asthma.

Testa says differences in how people breathe when they're active and when they're resting make a difference. Breathing through the nose warms and humidifies the air to match that in the lungs. But during exercise, air comes though the mouth, and that colder, drier air hits the lungs, which can trigger an attack. Cool-weather sports or those that require continuous activity, such as long-distance running, basketball and cross country skiing, are more apt to trigger attacks than short-burst activities like walking or swimming, he said.

Still, if it looks like a duck and acts like a duck, it might be a camel.

"There are an increasing number of people, especially young teens, female, especially soccer players, who are treated for years with an asthma inhaler and have no improvement," Testa said.

That's because they're actually suffering from a vocal fold dysfunction that causes a spasm when they breathe fast or deep. They improve when they are sent to a vocal therapist.

"It's important to differentiate, because you don't want to give an asthma medication to those who don't need it," he said. "And it won't work."

The shortness of breath also may be induced by lung disease or heart disease or some other cause. And there's no way to treat it without figuring out what it actually is, the two agree. "You need to do a full investigation," he said.

While exercise is a trigger, it is not to be avoided, Petteys said. "There are plenty of studies to show that increased fitness level — cardiovascular fitness — helps to decrease the severity of symptoms with asthma and exercise-induced asthma. Children and adults need to increase their levels of exercise."

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Tomorrow: Dealing with it

E-mail: lois@desnews.com