General Discussion Triathlon Talk » constriction of airway especially while training / swimming Rss Feed  
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2011-06-05 3:49 PM

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Subject: constriction of airway especially while training / swimming
I am a 54 yo female triathlete, 2x Ironman finisher, 9 solid years of endurance building and base. Beginning in February I experienced marked decrease in breathing endurance especially while swimming. Felt like my lungs were constricted, preventing air from coming in- went from swimming 1,500 yards non stop to barely getting 100 yards in before having to stop for breath. No fear of swimming, water or open water swims- that has always been easy for me. No history of asthma. Running endurance dropped signficiantly (from 6 mile runs in 58 min to eeking out 2 miles in 23 minute before having to walk). Continued to try to train through these issues, with continued decrease in edurance, energy level and stamina, dry unproductive cought and tight feeling in base of neck in windpipe area

Went to doctor for complete blood work up, EKG, Chest x-ray- all came back excellent. Pulmonary doctor next- heard wheezing, maybe some residule bronchitias..did not call asthma yet or even exercise induced asthama but put me on Dulera 2x day, Albuterol before exercise and a dose pack of prednsione. Only very slight improvement- cough went away. After being on steriod for 5 days, I had first tri of season and lungs constricted immediately into 1/2 mile swim -unable to get good breath and had to side stroke whole distance.

I am completely frustrated, mad that no improvement. Swimming has always been strong for me- I have no fear or anxiety of open water swim so this is not stress related.

Anyone else dealt with this type of respitory issue and if so, what did you find that helped? Will see pulminary doc again in week. Try new inhaler? Can't believe I felt absolutley no improvement from the steriod Prednisone!
Hate this!!!!


2011-06-05 9:49 PM
in reply to: #3533450

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Subject: RE: constriction of airway especially while training / swimming

It does sound like excercise induced bronchospasm (asthma). Could even be allergies -- is this seasonal? Does it occur in multiple venues?

The inhaler should do the trick. The albuterol literally opens up the air passages. The steroid keeps inflammation down and you really won't see any immediate effect from it. It is more used on top of albuterol. Like I said albuterol opens up the airway passages, then the steroid keeps it open. The steroid alone won't do much, plus it takes quite some time to even kick in.

By the way, albuterol and most products in inhalers cause a marked increase in heart rate -- like 20bpm. Tell the doc you're an athlete and wish to have an inhaler that won't increase the heart rate. There is a drug out there called levalbuterol, or Xopenex that does not increase heart rate. The dulera is a long acting mediation which basically does the same thing the other 2 medications you were prescribed do.

Best bet - see if you can take the inhaler on the swim somehow and huff on that.

Good luck, keep us posted



Edited by flashpoint145 2011-06-05 9:52 PM
2011-06-06 12:06 AM
in reply to: #3533450

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Subject: RE: constriction of airway especially while training / swimming

That's good advice he suggests, and worthwhile following.

May I also ask you where your is HR running versus your exertion levels on the run and bike? As a long time triathlete I developed the same symptoms a few years ago.

2011-06-06 7:01 AM
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Subject: RE: constriction of airway especially while training / swimming
flashpoint145 - 2011-06-05 9:49 PM

There is a drug out there called levalbuterol, or Xopenex that does not increase heart rate. 

Except that it does, and it does at almost the same amount as albuterol.  And for a much higher cost.  It's marketed as causing less tachycardia, but if you review the literature, it's the difference of a few beats/minute and not substantial enough to justify its use overall albuterol generally.

2011-06-06 3:08 PM
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Subject: RE: constriction of airway especially while training / swimming
Thanks for the suggestions. Unfortunately, the Albuterol has not helped, nor has the Dulera and no noticable improvement while on the Prednisone. Went back to pulmonary today and was given Symbocort to try am, pm. I first noticed the breathing issues end of Feb during a swim. It happened very suddenly, as in, two weeks before could swim 2,000 with no breathing issues and the next swim could barely get 100 yards in before I had to stop at side to get my breath. I have no history of astham, very little allergy issues in the past. Its very strange. Today, 2 days post olympic (almost) distance tri my airways still feel very constricted and cough is back. Will go through exercise breathing tests on stationary bike - hooked up to all kinds of monitors and recorders. Otherwise from this lung/bronchial/airway constriction/whatever it is - I am the perfect specimen of health! Low resting heart rate, low blood pressure, all blood work excellent.
Breathing is an issue on all three disciplines- swimming, biking and running. Most noticable on the swim (of course) then next on run (which really cuts into my endurance) and while on the bike cannot stay aero long- have to come up to try to open airways.

I'll report back after Friday tests....
2011-06-06 7:51 PM
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Subject: RE: constriction of airway especially while training / swimming
HR during training, and time to rise and fall to normal pre and post exercise?


2011-06-08 12:42 PM
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Subject: RE: constriction of airway especially while training / swimming
DerekL - 2011-06-06 7:01 AM
flashpoint145 - 2011-06-05 9:49 PM

There is a drug out there called levalbuterol, or Xopenex that does not increase heart rate. 

Except that it does, and it does at almost the same amount as albuterol.  And for a much higher cost.  It's marketed as causing less tachycardia, but if you review the literature, it's the difference of a few beats/minute and not substantial enough to justify its use overall albuterol generally.

 

Damn drug reps!

2011-06-21 6:40 PM
in reply to: #3535431

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Subject: RE: constriction of airway especially while training / swimming

This may sound crazy- but have you seen a cardiologist? I have heart valve damage and have no symptoms now whatsoever. However, he has told me that my damage is pretty severe and that when the symptoms start it will most likely be very sudden like you describe. The number one symptom he told me to not ignore is shortness of breath. He said I'd notice it exercising first and then with just regular activity. He doesn't want me to wait though if I start noticing it with exercise. Now, mine is from previous radiation treatments but mitral valve prolapse is fairly common and can worsen rather quickly. Just a suggestion. The tests you've mentioned so far I don't think would pick up MVP or any other heart valve/ heart congestion issues. It may be worth a visit to a cardiologist. 

Keep us posted and good luck,

Shelly

2011-06-22 9:46 AM
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Subject: RE: constriction of airway especially while training / swimming
I can't help you at all,, but I can say that I wish you a quick & complete recovery soon!
2011-06-22 10:26 AM
in reply to: #3533450

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Subject: RE: constriction of airway especially while training / swimming
Thanks for all the suggestions and info. Had a cardiopulminary stress test a week ago. My numbers were excellent- V2O max 140% above predicted, Watts 180% above, all numbers 40% above for my age- in other words, I have a very fit, very well trained body, and heart...with the excpetion of very irritated bronchial tubes. What we believe happened is I had a bout of bronchitus in the winter months (Jan/Feb) which I did not seek medical treatment for (true- I got sick, felt like crap for several days, gutted it out filling myself with Vit C, Zinc and over the counter stuff- all in the name of saving money from going to doctor believing I could ward it off myself) and my broncial tubes just got really irritated and when I continued to ram up my training, they just did not settle back down to normal this time. So my excellent pulmoniary doctor believes I will get better- it just will take a bit of time. In the mean time, I have gotten some improvement with the symbacort inhaler. My swimming is coming back a bit- still cannot do flip turns like I used to and I am relearning to breath just on one side (I normally do bi-lateral breathing) when I race to get more breaths.

This is just one of those examples that the body is not invinciable and despite being a very fit, very healthy athlete, there are just some parts of the body that take longer to recover and much as I hate to admit it- aging is a factor- recovery at 54 is not as quick as it was at 45 or younger...learn to adapt, never give in and keep on keeping on!
2011-06-22 10:30 AM
in reply to: #3533450

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Subject: RE: constriction of airway especially while training / swimming
oh yea, final diagnosis is exercise enduced asthma. As I hit the anerobic zone my air flow closed down some and he could still hear some wheezing.


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