<p>My 16 yo daughter is a talented swimmer that suffers from exercise induced asthma and allergic asthma. She is getting discouraged because her asthma in interfering with her performance at meets. Additionally, this winter she had asthma attacks at two meets that turned into bronchitis. </p>
<p>She has two caring doctors, an allergist and a pediatrician, that have been trying to help us manage her condition. We seem to have the allergic portion under control but the exercise induced continues.</p>
<p>Right now she is using an albuterol inhaler as a prophylactic before races. Sometimes it works, sometimes it doesn’t. She uses a symbicort inhaler twice a day for her allergies and takes a daily zyrtec. We also just started immunotherapy.</p>
<p>I know many athletes suffer from asthma and compete successfully. I do feel guilty about letting her continue to do something that doesn’t seem to be good for her health. Wondering if other CC’ers have dealt with this.</p>
<p>I was going to suggest a pulminary doctor also. It wasn’t til I took my daughter to a pulminary doc that my daughters asthma got under control when she was first diagnosed. I really felt the allergist and pediatrician did not have a handle on it. My D is currently 13yo plays club and AAU basketball year round and has found that if she has a cold or other respiratory issues she needs the allbuterol before a game or practice. We have also found that if she gets a cold (or other respiratory issues) that if it is anything other than mild we need her to start using the allbuterol and maybe pulmicort otherwise it turns real nasty fast. I think each kid is different. We haven’t had to see her in years (no need) but if you live in the Boston area I highly recommend Dr. Suzanne F. Steinbach, MD. She was at Boston Medical Center.</p>
<p>Second the recommendation for the pulmonologist. But makes sure the pulmonologist is familiar with the unique issues of athletes. There are certain classes of drugs athletes are not permitted to take during competition season. </p>
<p>Boy who lives 2 doors down has exercise induced asthma that interfers with his athletic performance. During 8th grade, his mom took him to three different asthma specialists before she found one familiar with the demands of high performance athletics and who could effectively manage his symptoms. She started with a local doctor, then finally took him to an out-of-state national asthma clinic.</p>
<p>(BTW, her search paid off. Her son–whom I drove to high school daily for 3 years–was highly recruited D1 athlete and was first alternate for his sport during the 2012 Olympics.)</p>
<p>I have exercise induced asthma and it was always an issue until I started using Advair. Now I rarely use the albuteral rescue inhaler. I was never an athlete and even now that I have my asthma under control I still can’t exercise to the point of breaking a sweat without a feeling of panic which I think happens because I hear my mother’s voice in my head yelling, “Don’t run! Stop running-- you’ll have an attack!” Of course when I was a kid half a century ago there were very few asthma meds.</p>
<p>Thank you for the responses. It sounds like it’s time to research pulmonologists. Unfortunately we live in a small town in the Southeast. We have a Mayo Clinic about two hours away so I will check there first. If there isn’t anyone promising there the next step is a five hour trip to Atlanta.</p>
<p>Finding the right treatment protocol really helps, but the problem is real and won’t go away even though it can on the whole be managed. One of my kids has a version of this.</p>
<p>One of the pulmonologists we know well swears her athletes seem to do very well with Sodium Chromium inhaler, which surprised her, as it generally is not as effective as the “stronger medications.” I agree that a pediatric pulmonologist would be a good person to add to your D’s medical team. Good luck! National Jewish Health also has a Lung Health line, where you can call toll free and speak with a respiratory nurse. They will also consult with docs from other states and countries about difficult cases. They have been very helpful for me and my family in dealing with our many respiratory health issues.</p>
<p>By the way, once you get a good pulmonologist, the patient doesn’t necessarily have to be seen all that frequently to have good care. It may take a few visits initially, but once things are under good control, they can taper to once or twice/year. It is worth it to go further to find a great pulmo, who is used to working with athletes, as they sometimes respond differently to treatment.</p>
<p>I was diagnosed when I was 10 and have it very severely. In high school, I had a difficult time climbing stairs to get to classes even with medication. I’m also very active now as an adult, and I love to be, but the asthma does make it difficult. I would never imagine not participating in my athletic activities because of my asthma, just as I would never imagine not climbing up stairs or walking up hills anymore because of my asthma. It isn’t an option to just be sedentary to avoid the attacks. If her doctor is okay with her continuing to compete, I wouldn’t feel guilty about it at all. Exercise and team sports are great for her, even with asthma in my opinion as long as her doctor agrees.</p>
<p>I have tried all kinds of inhalers and nothing has really helped me significantly except Maxair, which has been discontinued. I’ve done serevent, advair, symbicort, ventolin, proair, singular, the list goes on… I like the suggestion of a pulmonologist. I’d never heard of those until just recently when I was researching this for my own situation, and it sounds like it’s the next logical step if the allergy/asthma specialist isn’t cutting it.</p>
<p>I have read that there are specific problems related to the chlorinated air for asthmatic swimmers that can really cause a lot of inflammation and trigger attacks. The swimming itself is good for lung function, but you should ask the pulmonologist if the prolonged exposure to the chlorine could be causing problems.</p>
<p>Chlorine was a strong trigger for my wheezing and can indeed be a strong lung irritant. Used to have to Pre-treat with pseudo ephedrine before swimming in chlorine.</p>
<p>I was wondering about the chlorine too. Maybe have your daughter follow her usual protocol (using her inhaler first, etc.) but then have her exercise in a gym or outdoors and see if it’s any different. It may still happen, but not as severely.</p>
<p>My D had exercise induced asthma but only if she was out in cold air.</p>
<p>My H uses Advair, and I use Asmanex so we can use our rescue (albuterol) inhalers less. It works better for him, but I don’t like the “taste” of Advair.</p>
<p>My youngest will experience asthma like symptoms due to her diet, especially anything with high fructose corn syrup. If she drinks soda, the next day if she has any game or running to do, she will have to use inhaler. I started to see the pattern trying to figure out what the trigger was. </p>
<p>It may not be the cause entirely, but removing the offending items has eliminated the issue completely.</p>
<p>Asthma is one of the first symptoms to appear with a high fructose corn syrup allergy, according to MayoClinic.com.</p>
<p>samiamy - I have never heard of the corn syrup issue. Thank you for mentioning it. I recently read a study that said fast food may also contribute to asthma. It definitely seems like there is an inflammation connection. We have had her allergy tested and she is highly allergic to many environmental triggers - grass, trees, etc.</p>
<p>The allergist told me that some people believe that exercise induced asthma is reaction to something (I can’t remember the specific thing) that is released by the cells during exercise.</p>
<p>She does have a problem at pools that don’t manage their chemicals well. Often in the middle of a multi day meet the pool manger will add too many chemicals to compensate for the increase in children. It is extremely frustrating for her. If my eyes are burning just sitting in the stands I know she will not swim well.</p>
<p>We live in the South and she practices outdoors year round. It’s great for chlorine sensitivity (lots of ventilation!) but not so great for her environmental allergies.</p>
<p>Thank you all for your thoughtful responses.</p>