I was told not to take any of my normal meds the morning of the test, and to avoid chocolate and caffeine. Because of this, I took my first workout that included fast running in about four months into the gym and did it on the treadmill. I was still wheezing quite a bit by the time I hit the final mile, and I felt confident that I had junked up my lungs pretty well for my appointment.
The test was quite a bit different from the "blow into this tube" test that I've taken at the allergist's office. I was connected to a big machine that was hooked up to oxygen and maybe something else, and I did a series of breathing tests while attached - big breath and blow out hard, lots of little fast breaths, holding my breath, etc. The tests weren't just testing lung function, but instead were testing many little things like how much oxygen was absorbed from my lungs into my blood, the actual capacity of my lungs, and my rate of inhalation and exhalation. After the first round of tests, the technician hooked me up to a breathing machine that pumped high-test albuterol (magic breathing medicine) into my lungs for about five minutes while she frowned at the big string numbers the machine spat out. Once the albuterol was in, I repeated the round of tests.
After all of this was done, I had a normal work-up - height (5 feet 5 & 3/4 inches, annoying), weight (don't tell me I just ate lunch), resting pulse (42), pulse ox (99), and blood pressure (100/60) - plus a detailed history of all the things I like to complain about (several pages long). My symptoms, for those who are interested (hi mom!), are most prominent in the summer. After about 10-15 minutes of running, even at an easy pace, I feel a sharp tightness in my chest, right at the midpoint of my sternum. I'll start wheezing pretty hard a few minutes later. Running harder/faster makes it show up sooner. Once running is over, I'll cough pretty hard the rest of the day. During the winter, hard or long efforts won't reproduce the mid-run symptoms, but I will spend a lot of the day coughing. I'm also extremely congested, all the time, despite my allergy meds (Singulair and Allegra-D), living with an air filter machine, vacuuming up puppy hair every day, etc.
I talked to the doctor for a bit and he decided to give me a chest x-ray just to make sure
The good news is that nothing weird is going on. My x-ray looked fine and while my breathing test numbers were bad, they weren't horrifically bad. More "appropriate" when compared to my symptoms. After taking the albuterol, my numbers improved a bit, although I didn't feel any different (except light-headed from all the extra breathing). So other than some standard asthma, nothing weird is going on, I'm not missing a lung or about to collapse because my heart is in my stomach.
The bad news, of course, is that the asthma is bad and isn't being controlled or corrected by the drugs I am on. But that's fairly easy to fix. The doctor told me to stick with the Singulair, prescribed a nasal spray (gross), a maintenance inhaler (AdVair) and a rescue inhaler (albuterol). He said that the maintenance inhaler was the strongest dose of steroids, and he is hoping that settles down all of my symptoms. However, he was also careful to tell me that there are a lot of meds available for asthma and it might take trial-and-error until we find the right one. I've got a month on these drugs and then I go back for another test to see where things are. He said it will probably take 10-14 days before I start improving.
So, I'm encouraged. I've had a rescue inhaler for two years now (prescribed by my allergist after he initially diagnosed me with asthma last year) but have never really felt any relief from it. The pulmonologist told me that could be because of how inflamed my lungs are, and that once the steroids start working, the albuterol may also start making me feel better. I'm very committed to taking everything exactly as prescribed, but I also realize that the period of time it takes for all the drugs to kick in also may coincide with summer coming to a close, which is generally when I start feeling some relief anyway. Sigh.
He also did mention that exercise-induced or aggravated asthma is particularly difficult to deal with here in DC because the air quality is so poor on a regular basis, especially in the summer. I also got a chance to ask him about all the reading I've been doing about dairy as related to exercise-induced asthma. His opinion was that he does not believe, based on current research, that the two are connected but giving up dairy certainly wouldn't hurt me and I was welcome to try it. And if it does make me feel better, to stick with it, but he felt more strongly that treating it with a maintenance drug instead of merely the allergy drugs plus a rescue inhaler was going to help me feel better sooner. I'd call it cautious skepticism but not taking anything off the table, and that might be enough for me to give it a try. My RD buddy told me that it would probably take about a month to feel differently based on dietary changes, so I'm going to think about it some more and then decide. I'm concerned about changing too many things at once, because then I won't be able to easily pinpoint the change that made a difference, but the link between dairy and breathing problems makes sense to me (I am not a scientist so don't listen to me).
I am interested in hearing from anyone who has dealt with asthma as an athlete and how you have handled it. My doctor works with plenty of athletes and told me that it is manageable once we find the right combination (don't despair, little pony!). I'm particularly curious to find out if you think a diet change of any sort (dairy, gluten, meat, oreos) has made a significant difference in your health, so please, drop me a comment and let me know!