Allergies and Asthma

As I posted a couple days ago, I have hypothyroidism. Unfortunately that isn’t the only medical issue I have. I also have bad allergies and asthma. My asthma is mainly triggered by allergens but I also have a bit of exercise induced-asthma.

Of the 32 pollens in the standard prick test, there’s only 4 that I’m not allergic to. I’m off the scale for grass and sage brush. That’s why I put in my profile for Race Across America that I was worried that some farmer cutting his hay in Kansas would trigger an asthma attack. Last year while doing the RMCC 400k brevet, I went by a hay field where they were cutting hay and could feel my lungs shutting down. I struggled through the last 80 miles of the ride and ended up going to the ER after I finished. My peak flow, which is a measure of how well you can exhale, was only 30% of predicted at the ER. Even when I feel I’m breathing well, I’m only 80% of what is predicted for non-athletes. Athletes are typically 120-130% of predicted.

I take a lot of medication to keep me breathing reasonably well. I take Zyrtec, an anti-histamine, every night. I also take Singulair at night. Morning and evening, I take the inhalers Pulmicort and Serevent and the nasal spray Nasonex. Before exercise I use another 3 inhalers. They are albuterol, Atrovent, and Intal. I also get allergy shots once a week and a Xolair shot once a month. A couple of these require a therapeutic use exemption for use as an athlete. I don’t really expect to be tested with what I do but I’d rather have my form on file with USADA than risk it. I also had to provide RAAM with documentation before racing.

Every race I’ve done that has been at least 24 hours long, I’ve had trouble with asthma except for the Adirondack 540 last year. I think that was partly because it rained a lot the first day and night of the race and also because I changed how I took my medication. In long races my asthma doctor also has me periodically take the 3 inhalers I normally take just before exercise in addition to the medication I take once or twice a day. In the past I had tried taking as much of it at one time so I wouldn’t have to deal with taking medications too often. At the Adirondack 540, I decided to try spreading out my inhalers as much as possible. For example I normally take 3 puffs of Pulmicort twice a day but during the race I took 1 puff every 4 hours. Instead of taking the albuterol, Atrovent, and Intal at the same time, I spread them out. My thought was that at times I was low on protection from the medication and by spreading it out I’d be more evenly protected. I really do think it made a difference.

Based on those results, I came up with a medication plan for RAAM. In addition to all the medication I normally take, I got a pneumonia vaccine since people have dropped out of RAAM in the past because of it. It ended up taking Jure Robic out this year and it was thought that Kenny Souza was suffering from it when he stopped for over 7 hours in Durango. The only time I really had much trouble with breathing was on the climb into Prescott. I think what triggered it there was that because of the dryness of the desert I had blood draining out of my sinuses into my throat and it was irritating my air passages. I took albuterol, Atrovent and Intal and stopped for about 20 minutes and then improved enough to get back on the bike.

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Tags: allergies, asthma, cycling, RAAM, Race Across America

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