The key to exercise or sports participation for anyone with asthma is to prevent the process that leads to airway narrowing. Traditionally, a bronchodilator is prescribed for use before exertion. This medicine is usually given by a metered dose inhaler (MDI) and a spacer. The bronchodilator works by relaxing muscles that surround the airways. When they are relaxed, the muscles can't squeeze the airways, and the airways stay open. Although this seems to work to some degree for many people, a bronchodilator before exercise may not be the most complete treatment because a bronchodilator does not treat inflammation. The swelling and mucus in the airways, therefore, can still be a problem. The bronchodilator before exercise treatment plan also does not cover the possibility of spontaneous exercise that is common among children, such as running outside to play ball with friends or racing to catch the school bus.
It is likely that many people who only have asthma symptoms with exercise have a low level of inflammation in their airways. In other words, their inflammation is not enough to cause symptoms while their bodies are at rest, but they do come on with exercise. These individuals may also experience mild symptoms during other times of biological stress, such as when they catch a cold. If this low-level inflammation exists, there may be long-term consequences as well. Some asthma researchers believe that constant inflammation can cause permanent damage to the airways. No studies have yet been done, however, to find out if there is long-term lung damage in people with asthma whose symptoms are brought on only with physical exertion.
The possibility of low-level airway inflammation raises this question: Should people whose symptoms only occur with exercise take a daily anti-inflammatory medicine? This therapy would decrease or eliminate the inflammation. Daily anti-inflammatory therapy would also allow for better tolerance of spontaneous exertion. It might also increase their breathing capacity more than if they used only a bronchodilator before exercising. Consider Scott's situation:
Whenever ten-year-old Scott exercised, he coughed, wheezed, and had chest tightness and shortness of breath. He had occasional wheezing in the spring, but otherwise he had no symptoms or complaints. He used a bronchodilator when springtime symptoms appeared. As a competitive swimmer, he also used it before swim practice and team meets.
Halfway through the swimming season, his doctor suggested that Scott try an anti-inflammatory medicine, even though he had no symptoms. After a few weeks, his coaches noticed that Scott was swimming several seconds faster. Scott also became aware that he was able to swim faster for longer distances. His parents, however, did not renew the prescription for the anti-inflammatory medicine because Scott seemed better. Two weeks after stopping the medicine, Scott's times fell back to where they were before he started the medicine. Scott also noticed the change and asked his parents if he could restart the anti-inflammatory medicine. Within two weeks of restarting the daily therapy, Scott was again swimming faster.
While daily anti-inflammatory therapy might improve the athlete's performance, there is the increased cost of daily therapy in both time and money. Different health care professionals treat asthma differently, and each individual with asthma is unique. If your child has asthma symptoms when exercising or playing sports, talk to your doctor or nurse practitioner about whether a daily anti-inflammatory treatment is right for your child.
Before Exercising
If a bronchodilator is prescribed for use before exercise, it must be taken at least fifteen minutes before the exercise begins to be as effective as possible. A long, slow warm-up, such as easy running or swimming, before the actual practice, game, or event begins, may also decrease symptoms during exercise. In cold weather, wearing a scarf or trying to breathe through the nose during the early part of the exercise may help as well. Quick-relief medicines along with any necessary delivery equipment should be available during and after the exercise in case symptoms do arise.
Young athletes with asthma may still seem to have symptoms even though therapy is being used. If symptoms occur when they are using only a bronchodilator before exercise, then it may be a sign that airway inflammation is present. Adding a daily anti-inflammatory medicine may decrease symptoms. If they are already using anti-inflammatory therapy and symptoms continue during exercise, a stronger medicine may be needed. Sometimes if a child with asthma has a cold, is having problems with allergies, or is having a mild asthma flare, then the airways will be more sensitive and symptoms during exercise will occur more readily. Limiting exercise on these days may be necessary.
What Others Adults Should Know
Coaches and gym teachers should be aware that your child has asthma and should allow him or her to stop, rest, or take quick-relief medicines if symptoms occur. Hopefully, this can be done without bringing too much attention to a child with asthma because it can affect self-esteem or cause embarrassment. Coaches and school nurses should know how to administer the medicines if necessary. Give a copy of your child's asthma management plan to coaches and teachers and review it with them.
Conditioning
Despite adequate therapy, shortness of breath with exercise may continue. This symptom could indicate a lower level of fitness, which can be remedied by physical conditioning. Children and teenagers who were less active when their asthma was not well controlled have usually limited their exercise in general. Their muscles are therefore not used to the sustained demands of, for example, a competitive game of soccer, fast-break basketball, or a long, uphill hike.
Some children and adults with asthma develop a sedentary lifestyle from an early age and may be overweight. But gradual physical conditioning that builds increased strength and endurance can have life-long benefits not just for their lungs but also for their entire bodies. Young athletes will sometimes need to be patient and condition their bodies by gradually increasing their degree of activity until they can participate to their full potential. Hgh facts, articles, and news on HGH, weight loss.
