Expert: Marc Rubin, RPh Asthma Educator - 11/7/2010

Question
hi i have exercise induced asthma and have tried many different medicines. my peditarian is sending me to pulmonlogist. i was wondering what do i expect at a pulmonologist ? what will they probably do ?

Answer
Hi Ashleigh,

The first test they will probably perform is a lung function test called spirometry. You will be inhaling deeply, then blowing out as fast and hard as you can, for as long as you can. They will repeat this at least two more times to get two results that are very close. Then they will treat you with an inhalation treatment to see if they can increase the air volume, and repeat the spirometry again. If there is an improvement of greater than 200ml air volume and/or 12% improvement, you have reversible airway disease: asthma.

The next testing that should be done is skin testing, to determine if you are triggered by allergens: pollens, dust, mold, pet dander, etc.
About 80 to 90% of people with exercise induced asthma (EIA) are also allergen induced. If these skin tests all turn negative, your condition is then primarily triggered by irritants: fumes, ozone, smoke, viruses, etc.

They will also interview you about your home/school environment. Pets, smokers, fireplaces that are used, has the home been checked for mold, etc. They should also ask you about your quality of sleep.

From this information, as well as other tests that may be run, a plan is put in place to bring you under control. Planning includes:

-fluid loading, to begin, if possible, 1 hour before exercise, and continuing throughout,
-proper warming up and cooling down
-monitoring your lung function with a peak flow meter (an inexpensive tool to measure airway resistance), before, during and after exercise, and doing treatments if necessary.
-developing an "Asthma Action Plan" worksheet for you to follow based upon your performance.

The more information they glean, the better they can plan with you as to how best resolve the issues. Keep in mind that 15% of Olympic athletes have asthma. Success is based upon knowledge and working hard. But never foolishly put yourself in a position of danger by ignoring warning signs. You can achieve great things. Just with asthma, the road is longer and more challenging.

Best of success!

Sincerely,

Marc