exercise induced asthma???? (Read 62 times)

I ran a 1 mile race last night and wound up violently coughing after finishing. It felt like I had some sort of throat irritation that I just could not clear. The coughing was making me gag. I went to urgent care, mainly because it seemed to make sense to see a medical provider while this was happening vs after the fact. By that time, about 90 minutes later, I was still coughing, but not quite as constant or as violent. Urgent Care made a diagnosis of bronchitis based on a chest x-ray. I questioned the PA about taking antibiotics since I had no symptoms prior to the race, no fever and would prefer not to take antibiotics unless absolutely necessary. She said, well, could be exercise induced asthma. Assuming the covid test comes back negative (whcih I am since I'm fully vaxxed, have no exposures and the coughing ended), now what? Is this a follow up with primary care? I've seen an allergy doc a few years ago, follow up with them? Do nothing and see if it happens again?

I had something happen after a 5k about 10 years ago, that was in bitter cold conditions, the cough was more dry and it went away after I drank some coffee.

Antibiotics are not indicated in bronchitis.  Did you get an albuterol inhaler out of it?  Prednisone?

 

It would be completely reasonable to follow up with your primary care provider.  That visit may wind up with a referral to an allergist or pulmonologist.  Or it may simply result in a recommendation to use the inhaler if needed and watch for any recurrence.

 

How are you feeling today?

Yes, got an inhaler out of it. By the time the prescription was filled (about 10pm) and I used it, the coughing had pretty much gone away. I have a steroid prescription, I dind't fill that one.

I'm feeling ok this morning, my throat feels raw, I assume from the coughing. Resting heart rate is up about 6 bpm per Garmin.

I often have coughing spells after short, fast races. I think lots of people do - "track hack", you know.  I imagine it's a form of exercise-induced asthma.  In your case, it was more severe than usual, and might be something to monitor, but I would choose "Do nothing and see if it happens again" for the time being.

I often have coughing spells after short, fast races. I think lots of people do - "track hack", you know.  I imagine it's a form of exercise-induced asthma.  In your case, it was more severe than usual, and might be something to monitor, but I would choose "Do nothing and see if it happens again" for the time being.

There was someone who ran the prior heat to me who was having coughing spells and I heard her mention it felt like she couldn't clear her throat.

 

I agree with this. I would not bother to see a doctor at this point. I have asthma, and take a hit from my inhaler before every run. Sometimes I'd probably be OK without it, sometimes not, but it's especially needed if I am going to be running fast. I take extra hits before races of any distance. An all-out short track race would be a worst case scenario. You do plenty of fast interval workouts and have not seen this, so hard to believe you have a major issue that needs to be treated. You just pushed things over the limit. Maybe don't do all-out short track races, but if you must, take your inhaler first, now that you have one.

I already had one, I wound up waiting past my bedtime for an identical one. I had considered taking a puff  from the old one when I got home instead of urgent care, but thought it made sense to see the medical professional while I had symptoms. Main reason I can think of for seeing primary care is for what to do once these inahlers are empty.

I am fine with short intervals. I have more issue with any form of tempo or longer (like 4+ minutes) at 5k-ish pace. I want to slap anyone who calls tempo comfortably hard, because there is nothign comfortable about it, even at a much slower pace than shorter races project.

 

Well, of course it's your call. Maybe there's some peace of mind involved there too. But those inhalers have something like 200 puffs in them, so it could be a long time before they need refilling. I'd personally wait to bring it up till another visit e.g. annual physical, but that's also in part because I'd have to pay for the office visit till I hit my deductible. 

Ah yes, the joys of insurance. I have the "gold" plan, so office visits are a very reasonable $25 co-pay. When I had pnuemonia, the many doctor's visits cost less than the DNS & deferal fees on races.

 

 

I am fine with short intervals. I have more issue with any form of tempo or longer (like 4+ minutes) at 5k-ish pace. I want to slap anyone who calls tempo comfortably hard, because there is nothign comfortable about it, even at a much slower pace than shorter races project.

That actually does sound like me when my asthma is flaring up.  Anything harder than a certain effort level for longer than about 2 minutes gets very very hard.  When my asthma is under control, tempos are great.

Coughing after mile races is normal, and not in itself a sign of asthma.  Did it take you a lot longer than others to catch your breath after the race?  That was one of my early signs of asthma - most other people would be breathing normally about 2 minutes after crossing the finish line of a 5K, while I'd still be struggling to catch my breath.

If you note continued incidents, I would think it would be worth getting checked out by a specialist - either a pulmonologist or an allergy/asthma specialist.

It's also worth seeing if the albuterol inhaler makes a difference - that's one of the classic tests for asthma - "reversibility" (i.e. does albuterol improve things).  My asthma was diagnosed after an "albuterol challenge" test - I breathed into a machine several times to measure lung capacity, then inhaled a ton of albuterol.  Then I breathed into the machine some more.  The difference between my before and after was pretty big - big enough to support a diagnosis of asthma.

Sometimes I produce copious amounts of phlegm when running. I don't know if it's from unknown allergies or throat irritation. The sticky phlegm also results in hacking and coughing, which last beyond the run. Sometimes the coughing comes first, then the sticky plegm.

Just something else to explore beyond asthma.