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Asthma/Should I be concerned?


I am in an odd situation.  I am 33, and had respiratory troubles as a baby and toddler.  At the time I was not diagnosed with anything as the Dr. said I was too young for a diagnosis. (so I'm told anyway) My family fell away from professional medical care shortly after that and I seemed to outgrow the worst of my distress.  
At 17 I had a fairly serious attack that I suspected was Asthma, but only had access to a school nurse without my parents finding out, so didn't get a diagnosis then either, though she did get me an albuterol inhaler on the down low but I couldn't get it refilled & haven't used it since that one ran out.
Since then I've run half marathons & a marathon, so I'm not in ongoing distress, though my wind has always been the greatest limiter - never my muscles.  Three weeks ago I had a similar attack.  It has been 16 years since my last serious distress of that kind. I thought I would have to call 911 but recovered on my own.
I have some seasonal allergies that I control with loratadine but use it only occasionally.  I live in a very rural area, and work indoors in a medium-sized city.  I have a cat.  I grew up around heavy cigarette smoke, but am not around it anymore.  My first attack was indoors, with heavy smoking, during an athletic event.  My second was after a light 3 mile jog, but I was fine during the run - the attack came right after.  The weather was cold, but not the coldest I'd run in.  I ran the next day and was fine.
I know I need to see a Dr. and get whatever this is figured out.  I don't want to be afraid to exercise.  But with no existing medical history, I'm concerned about what conversation to have.  And I know that an appointment will leave very little time for conversation.  What, other than asthma, should I be talking to a Dr. about?  What information is relevant?  How can I get the most out of this visit?  Should I even be worried about attacks that come years apart? I appreciate any help you can offer.

Hello D,
  To begin with, the history you provided was excellent, and that you should begin by providing exactly that to the physician.
I would suggest a full lung workup, because the smoking exposure had as a child. There is not a single version of asthma, so each individual needs to be approached as such. Cigarette smoke is a common trigger for people with and without asthma. This is due to the irritant nature of the chemicals in cigarettes. You may also have an allergic component that plays a role in this also. And finally, you may have it's called exercised induced bronchospasm (EIB). This is usually a delayed response reaction from exercise, and commonly due to very dry air and lack of hydration prior to working out.
  I'd suggest to be properly evaluated by either a pulmonary specialist or an allergist just to get to the bottom of what's taking place with you. Then, with that information being known, you can now learn about how you take control of the situation, rather than being controlled by the situation. There would be three parts to your treatment. First, is educating yourself to the aspects of this lung disorder and understanding preventative measures in avoiding situations that compromise lung function, for instance, staying away from anyone who smokes, or environments were smoking is taking place. Second, athletically, is starting to do fluid loading an hour before your exercise activity, and continuing to drink fluids during the activity. And finally, is where appropriate, the use of asthma medications to reduce the risk of an attack occurring, and prevention for the future, as well as treating an actual attack.

Hope this helps to guide you. Once clarity is made, feel free to get back to me so I can provide you with educational resources to take better control.




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Marc Rubin, RPh Asthma Educator


I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.


Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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