Never let it be said asthma is a simple disease. Highly treatable in most cases, yes, but never simple. I learned something about exercise-induced asthma (EIA) this weekend which may be old news to other people, but I’m passing it along, anyway. This article outlines the eight other reasons for sports-related wheezing besides EIA.
Huh.
This is–literally–news to me, partly because exercise-induced asthma is fairly common. In fact, I’ve always been sort of jealous of EIA kids, though not because I think it’s necessarily easy to live with. I’m sure child and adult athletes tire, very quickly, of having to use that inhaler every single time they exercise. But if my daughter has to have asthma, seems like EIA is the best one, what with such a situational and easy trigger to identify.
But according to this article from the 55th Annual Meeting of the American College of Sports Medicine, a fair number of those kids with asthma symptoms during exercise could suffer from these conditions instead:
1. Deconditioning – affects undertrained athletes
2. Exercise-Induced Anaphylaxis – Apparently, all those school gym coaches are wrong. You really can be allergic to exercise, as it turns out.
3. Foreign Body Aspiration
4. Reflux
5. Hyperventilation
6. Psychogenic cough – This one’s emotion/psychology-based.
7. Tracheomalacia – Airway collapse
8. Vocal cord dysfunction – Just what it sounds like
In fact, of the 98 children (142 total in the study) thought to have exercise-induced asthma, only 11 of them did.
Moral of this story? If you or your kid has an EIA diagnosis based on self-reported symptoms alone, it might not be a bad idea to go ahead and ask for a more definitive evaluation.
Thanks for that Amy…Interesting article.Speaking as an adult asthmatic, I agree that there are a lot of non asthma symptoms that can mimic EIA , but while hyperinflation is not the same thing as bronchospasm, it is most definitely a symptom of asthma(at any age) and it can lead to bronchospasm.
So I’m not sure I agree with everything that was said.
I am a very conditioned athlete and I still experience both acute bronchospasm and hyperinflation ( air trapping) but it doesn’t happen all the time.
I think there’s still a lot they don’t know about asthma triggers.
Interesting article….
I once read that all asthmatics have EIA to some degree. I don’t know that the reverse is true… if you have sympoms of EIA, you have the full spectrum of asthma.
I agree with Steve that in athletic endeavors, I only experience asthma systoms occasionally. Although I always experience them above 6-7000 feet.
Oddly, I only seem to experience trapping when I bicycle. Usually around mile 5.
Hmm…thanks, Steve. I figured one of you asthma athletes would know more about this than I do! I did find it interesting, though, to read EIA may be over-diagnosed. If anything, asthma in kids usually involves under-diagnosing.
Asthmagirl,
I buy that. AG doesn’t flare during exercise unless she’s having problems already or if it’s really, really hot outside. As for the altitude–well, you know I’ll find that out in July!
EIA will depend on breath hold at rest and chronic hyperventilation. (all asthmatics chronically hyperventilate) A simple breath hold measurement called the Control Pause will provide some feedback regarding this.
If the control pause is greater than twenty seconds, EIA should not be a problem. If it is less, the exercise will be a problem. Ideally an asthmatic has a very high breath hold of 40 seconds. this indicates no asthma symptoms.
Hmm very interesting! thanks for posting about this. I’m following a running program (walk 6 min, walk 1 min kind of thing) and have noticed that after a hard run – say, up a hill, or after trying a sprint at the end of a run period – my upper chest feels funny – kind of tight. I would never have wondered about asthma before this year, but now I was wondering about it. It doesn’t help that I also have seasonal allergies (not taking any meds) which lead to guck in the back of the throat, so I do sometimes have a few coughs after running.
It’s nothing dramatic but stil lit makes me wonder. I”m glad you posted this article because it brings me back to a balance point – perhaps this is EIA, but it could also be under-conditioning. I’ll ask the doc about it at some point for sure.
also thanks to Patrick – I googled control pause and did one just for fun – came out to about 20 seconds. interesting! Though I’m not hanging my MD degree up on the wall anytime soon
Thanks, Patrick. I think I’ll look that up like Andie did.
And Andie–Well, you know I hope it’s not asthma but glad the link helped. One thing I had to remind myself constantly as I got used to AG’s asthma was that not every cough meant she was flaring. (even though it sure seemed that way for awhile!)