evan938

Finally decided to talk to my doc about what I consider a high average HR while cycling. I've had rides 3-6 hours long with an AVERAGE of 173+. If i can stay in the low 160s on a ride, I'm thrilled, but it seems to me like it's still high. I'm not a doctor, so I decided to check with one.

From the research I've found and talked to my cousin who is a nurse, it seemed like my asthma might be of some reason for this. Consuming less oxygen leading to my heart having to do more work. I found some threads on here and talked with a couple members who said that a combination of Advair and Singulair really helped them.

I went in Monday to see the doc, they did a test of hemoglobins (he said it carries oxygen, and if off, might need an iron supplement), did an EKG, and a breathing test.

Came back, said hemoglobins and my heart were both good, said my breathing was "eh" (and did the "so-so" hand motion. LOL), but I kind of figured as much with my asthma.

He gave me a sample of Flovent, 110mcg, 2x daily, and said to follow up next month to do another breathing test and see if I've improved.

Has anyone tried this, and if so, did it help? Most of the threads I read mentioned albuterol (ie, rescue inhaler), advair, singular, and a couple mentions of xopenex. I don't recall seeing anything on flovent, but maybe I just wasn't looking hard enough.

I'm really hoping this lets me breathe better, recover faster (takes me A LONG time to get down from 190+ on a hard effort to even mid 170s), and either keep a lower heart rate for the same efforts I'm putting out now, OR, let me perform a little better for the numbers I'm pushing now.

cmonasco

I have allergy and exercise induced asthma and I have been taking Singulair and Flovent for years but I started taking them before I started cycling semi-seriously. I can not comment about the Flovent improving cycling performance but I can say that the Flovent, combined with Singulair, has been extremely effective in controlling my asthma. The flovent does help a ton with my asthma during exercise.

waterrockets 

I have EIA too, and I have been pre-treating with albuterol with much success. I tried a free sample of Advair too, and that was awesome, but requires daily doses, where albuterol I can just take when riding in cool dry weather, and not worry about it much other than that.

evan938, it sounds like you have more of a chronic type of asthma, so it may be that my experience with albuterol is not useful. I'd go with what the doc suggests and take it from there.

ericm979

I have allergies and EIA. For me, asthma limits my HR. I can't go really hard because I can't get enough air. I could hit higher HRs before I got middle age onset asthma.

FL_MarkD

Same here, middle age onset asthma and especially Exercised Induced Asthma. Tried several things and for me a pre-treat with albuterol and a daily Singulair (now in generic and cheaper) works well. Singulair also helps with allergies which definitely add to my asthma problems so it is a good fit for me.

Everyone is different so work with the doctor and ask to try different options.

Good luck, I know how much I hate to cancel a ride due to an asthma attack or have to ride real easy as the group I am with rides into the sunset....

Mark

evan938

I should've mentioned, I have an albuterol inhaler, and I have tried using it before a ride, and actually feel worse than not using it. when I use it, I almost feel like my chest is tighter, and I can't get in as deep of a breath. it's wierd.

Eric - that's how I feel being limited. If I put in a hard effort, hill, sprint, etc (just fun, hard pulls on group rides, I don't race), I run out of air FAST...LONG before I run out of legs. theres a small hill here we like to ride, i can go into it at a ~150 HR (theres a slight dip down and then after it bottoms out the hill starts), and within 45 seconds of trying to hammer up the hill, be at 190+

Depending on how I'm doing and my tests go when I go back next month, I'll discuss the singulair with him. I wasn't aware of the allergy aspect. I know I've got allergies to something, but no idea what. lol. I get nasal congestion when seasons change from warm to cold and cold to warm.

so, I just happened to see this on bronchodilators - https://en.wikipedia.org/wiki/Bronchodilator. says it will increase airflow to the lungs, and lists long acting as
Long-acting bronchodilators include

• Salmeterol (Serevent)
• Clenbuterol (Spiropent)
• Formoterol
• Bambuterol
• Indacaterol

The flovent is fluticasone, which i see is a corticosteroid. advair is both fluticasone and salmeterol, with the salmeterol being a bronchodialator.

Now I'm no doctor, but it sounds like some sort of bronchodialator drug is what i'd really need to be able to open up those airways and get more oxygen is.

Who knows. I'm thinking out loud at this point. I'll discuss next month. I'd really like to get it figured out before spring gets here so I can get my body used to whatever I may be on and get a good jump on this season

Carbonfiberboy 

Yep, do what the doc suggests or get a referral to a pulmonologist. My wife is chronic and uses Advair. I have it sometimes and use Flovent daily with a hit of Serevent before a competitive ride. All these are in diskus form which I highly recommend. You are correct about the HR. Both sides of the heart beat together.

The thing to do is to get a peak flow meter from your doc or buy one. Mine is made by Personal Best, if that's any help. Add a line to your workout journal and record your peak flow every morning. I blow 3 times and take the average. It's a small thing - you could put it in a jersey pocket and see what you're blowing if you feel not so great.

Edit: Many health plans won't cover these drugs or cover only a small percentage of them. We use a Canadian pharmacy which has been great. Your doc can recommend one.

evan938

Where did you get yours from? i found them online, but would rather buy something like that local. I checked CVS's website but don't show it there. maybe its in store and just not listed there? it looks cheap enough that it wouldn't be a bad idea to have one and track stuff at home myself, vs just a 30 day difference with the doc. this could at least show progress on a daily/weekly basis

DGlenday

Interesting! I'm on Advair, which does not seem to have a generic.

I just did a Google search comparing the 2, and they seem to be very comparable. I'm seeing my pulmonologist tomorrow and will ask him.



Anyway - not trying to hijack the thread. Back to your regularly scheduled programming...

SempreCycling

I was born with asthma and grew up with severe asthma attacks my entire childhood. I couldn't even laugh hard or it would throw me into a severe asthma attack. But as I got older the asthma started to get a little better (actually got better after smoking for a few years). I quit smoking and still had asthma, though it was not as severe.

Gradually it started to wane when I got into my thirties, and was only coming around when exercising (EIA). My doctor recommended albuterol one hour before exercise, but I found that raised my heart rate too much and I didn't like it. I stopped taking it, no steroids, nothing. I just kept exercising and pushing as hard as I could before I would hit the threshold of an attack.

Now at 35 (36 in spring) I have virtually no asthma left at all. I can max out my heart rate and not have an attack. I don't know if I just grew out of it or it was just conditioning myself by pushing it did something. (It's more likely that I grew out of it).

I always thought I would have asthma for the rest of my life. It's really weird to have a disease your entire life that drastically affects your breathing, and then for that disease to just go away is quite amazing. I always worry that it will come back one day in force.

Carbonfiberboy 

My doc gave it to me. Tracking is a big help. You can see results when you change things, start to get sick, have bad air for a few days, etc.

evan938

well, after 4 weeks on it, doses almost religiously as instructed (twice a day, morning and nights, only missed a single dose), went back to the doctor today for another breathing test...results? no improvement at all.

specialist is up next. yay.

fstshrk

Please follow the instructions of your physicians. Having said this, also get a second or a third opinion. Asthma, especially exercise-induced-asthma is one of those overdiagnosed conditions and the physicians are very quick to dispense prescriptions that end up needing to be taken life-long. Based on your description here, I think you may have both a fitness and a climbing technique issue. Did you try shifting to a bigger cog in the back and lowering your cadence and powering through some of the climb?

Best of luck in your endeavors and please get a second opinion from a well-respected specialist in your area.

evan938

That one hill is just an example. I can get up to a 190hr and feel like im going to explode just getting to my turn at the front of the group for a 19mph pull. I then get to the point where I know i'm hurting, drop off to get to the back, and still cannot recover. I can't ever seem to get to the point where I feel like i can get a good breath in unless I drop off the back and keep a 13-15mph pace for a couple minutes

below are a couple recent rides that i've done that leave me hurting, short of breath, fatigued, during a good portion of the ride...i wouldn't be quick to say its NOT a fitness issue, but I feel that i've stayed active enough over the last year i should be performing better than i am. I've gotten a little over 4k miles in the last calendar year (maybe closer to 45-4700 with trainer "miles") which i know doesn't touch what a lot of you guys do, but i also dont think its anything to scoff at for my first real year cycling.

https://connect.garmin.com/activity/280056542 - avg 165
https://connect.garmin.com/activity/277337156 - avg 169
https://connect.garmin.com/activity/274608801 - avg 169
https://connect.garmin.com/activity/266718333 - avg 169
https://connect.garmin.com/activity/263777667 - avg 171

and these aren't even fast rides or rides with any climbing/elevation change. barely 1k' on the "hilliest" routes. 16-18mph averages.

trust me. if theres anyone that doesnt want to be on medication, its me. but at the same time, i've gotta be able to breathe. it's an integral part of this sport. sadly, i've had asthma my whole life, it's been well documented. i thought i grew out of it as i became an adult, but i've realized it's actually that i just did so little cardio activity that i didn't have to worry about it. lol.

edit - for fun, here's a couple other rides towards the later part of last year...

https://connect.garmin.com/activity/242051360 - avg 177, 19.7 avg
https://connect.garmin.com/activity/240307418 - avg 174, 17.0 avg
https://connect.garmin.com/activity/228715182 - avg 175, 18.5 avg

ClydesMoose

I'm on Symbicort after nothing else worked for me. Its been a godsend.

dkoernert

+1. I have EIA and I was taking Symbicort 2x daily when I first got back into cycling. I now only have to take it 1x a day, meaning one refill lasts me months. I haven't had to use a rescue inhaler since I started it.

rpenmanparker 

but I only have asthma symptoms (as mentioned by someone else) when streuously exercising in cold, dry air. Never had to medicate asthma in any other situation. As mentioned above it takes the form of inability to get enough oxygen no matter how fast and deeply I breathe. (Someone explained to me this is really not quite correct. The real problem is getting rid of the CO2. Whatever, it feels like not getting in the oxygen.) If your problem is this specific symptom, I think the corticosteroid (albuterol type) inhaler is the best bet.

Robert

evan938

so, i figured i'd update this. im not sure if anyone cares, and at the same time, i hate leaving a thread hanging incase someone else might be looking later down the road.

so, today i finally got in for my appointment with the allergy/asthma specialist, and oh what an appointment it was.

found out quite a few things. my deviated septum (broken my nose 3x in my youth, 5, 11, and 13 years old), is still completely ****ed. i had surgery around age 16ish, and apparently according to the doc today, its still horrible. he said at the top its curved one way, and the bottom the opposite. like an "S", just not as sharp of turns. awesome

my sinuses are jacked up. he said they're full of "yellow", which i assume was just to save me from the medical mumbo jumbo i wouldn't understand.

got an allergy test done. first one in my life. found 11...yes, 11 allergens. they said it was unusually higher than most people. they did the test on my back first, then on my arm which is supposed to be a better testing site. confirmed them all. trees, mold, ragweed, dust, and cats and dogs. wow. the funniest/worst/ironic part about this is, i have a cat. in fact, the thing sleeps on top of me for about an hour once i go to bed, then he jumps don to sleep on the vents. lol...but, it doesn't ever seem to bother me like i always thought allergies would affect someone...i dont sneeze around him, no dry/itchy eyes, no coughing, etc. i know a girl and when she comes into my house, within 1/2 hour, shes sneezing, eyes start to get it, etc. totally not me.

so he said that the allergies inflaming my nasal passages would in turn inflame my airways, or something to that effect (im still trying to remember stuff as best as possible from a nearly 3 hour appointment).

so, i've got quite a few things to do. gotta keep my bed sheets clean and washed in allergy reducing detergent every 1-2 weeks. easy enough.

gotta start doing a nasal rinse with i believe Mupirocin in the mix to clear out my sinuses. im not thrilled with this by the sounds of it...water up the nose doesnt sound fun at all, but i gotta do something.

got an Rx for an antibiotic. Doxycycline i believe is the antibiotic

also got an Rx for generic Singulair, Budesonide, and Xopenex. he said the Xopenex is a different type of albuterol which should keep my heart from racing like albuterol can do. he said when i turn in the Rx, insurance is probably going to deny it at first then the doctors office will have to appeal it and it will take an extra day or so...ive waited this long, i can go another couple days.

i've also gotta go get some bloodwork done in the next couple weeks.

fun times. it sounds like a lot, but hopefully i can adapt to it quickly, and even more, i hope i start getting some relief and stop running out of air so quick any time i try to put out any effort, be it cycling, jogging, etc.

jdon

same

jdon

Rescue inhalers are no longer recommended with Symbicort. At least by Canadian authorities. Symbicort is supposed to do the job on its own.