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What is asthma really — and should you even be exercising?

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We’ve all heard about asthma and probably know someone who suffers from it  – but do you actually know enough about this common condition? It’s estimated that over 300 million people worldwide suffer from asthma. And when it comes to reported asthma deaths, South Africa is ranked fourth worldwide. Yup, fourth…

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“The tragedy of these deaths is that most are preventable,” says Dr Richard Raine, who works at the Respiratory Unit at Groote Schuur Hospital. “The biggest cause is an underuse of controlling medication… Other factors in asthma deaths include lack of recognition of the severity of attacks and a delay in getting the correct treatment.” A severe attack needs skilled evaluation and shouldn’t be taken lightly.

So, what exactly is asthma?

“Asthma is very heterogeneous [a fancy word for varied, or diverse] and there is no clear biological gold standard that defines it,” begins Raine. What’s more, there is no clear cause for the condition.

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“We know that the airways are chronically inflamed – and that there are a number of factors that influence the risk of developing asthma,” he adds. These factors are vast and varied, including genetic predisposition, airway twitchiness, obesity and a low birth weight.

Environmental factors can also play a role. Allergens such as house dust mites, furry animals, yeast and pollens can leave asthmatics coughing and wheezing. And that’s not even all of it: “Asthma can be triggered by occupational sensitisers (such as latex, flour, spray paint) as well as infections, tobacco smoke exposure and air pollution.”

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With so many possible causes and triggers, it’s easy to see why so many people are at risk. But luckily, with the right meds, it’s easy to maintain a normal lifestyle.

Asthma signs and symptoms 

“The typical features of asthma are a cough, chest tightness and wheezing,” says Raine. These symptoms can be relieved with an inhaler – but a severe attack requires urgent medical attention. In this case, symptoms could include “severe breathlessness, significant distress and marked chest tightness.”

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The person experiencing an attack probably won’t be able to communicate much. Their lips and nail beds will start to turn blue. “Initial treatment of this is high doses of a reliever medication (for example, 10 puffs from the inhaler) while making urgent arrangements for medical attention. Oxygen and more advanced treatment is usually needed,” adds Raine.

The burning question: exercising and asthma…

Here comes the catch. There’s another type of asthma: Exercise-induced asthma (bronchoconstriction), or EIB. “EIB is very common and is found in the vast majority of asthmatics,” says Raine. Again, the cause is not entirely clear. Raine suggests that it can be related to the cooling and drying of the airways caused by increased ventilation during exercise.

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“Running seems to cause it the most. Cycling is more protective and swimming seems to be the sport least affected by EIB,” adds Raine. “[But] there’s no reason why an asthmatic can’t excel at any sport with the correct treatment.”

Note: If you’re looking at competing at a professional level, keep in mind that excessive use of asthma treatment can count as doping. (Looking at you, Chris Froome.) To exceed this limit, however, you’d need to take around 15 to 20 puffs of the inhaler.

Don’t quit

“Even well-controlled asthmatics can develop EIB when playing sport.” All you need is two puffs of the reliever inhaler about 20 minutes before you head onto the field or trails. While exercise can’t directly improve your asthma, increased fitness can delay the onset of EIB. So toss your asthma pump into your gym bag and get out there.

This article was first published on Women's Health SA.

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