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Today doctors are touting exercise, not rest, for asthma patients.

April 11, 2005|Jeannine Stein | Times Staff Writer

Debbie Kyle couldn't understand why she felt so winded and out of shape during workouts. She was in her early 20s and fit, but still couldn't run on the treadmill without feeling short of breath. Feeling discouraged, she stopped exercising altogether.

"I felt like it was work, and I wasn't enjoying it," recalls the 25-year-old student from Northridge.

Twenty pounds later, and struggling with allergies, she saw a doctor who diagnosed her with asthma. But instead of telling Kyle to hang up her running shoes, he encouraged her to start exercising again.

The conventional wisdom today for children and adults with asthma is that in most cases, exercise can lessen their severity of symptoms and often help reduce their medication.

Exercise-induced asthma affects about 80% of those with allergic asthma, says Dr. Robert Eitches, assistant clinical professor of medicine at the UCLA David Geffen School of Medicine. Symptoms, which include coughing, wheezing, a tightness in the chest and shortness of breath, can be triggered by breathing faster and through the mouth, which occurs during exercise. The air that's breathed in is usually dryer and cooler than air inhaled through the nose. Other factors, such as pollution, pollen and colds, can also worsen symptoms.

Decades ago, doctors recommended rest, rest and more rest for asthma patients, resulting in generations of children who grew up staring out the window watching their friends play.

"There is something generational," says Eitches. "Older people especially were told as children to be quiet and stay in bed and wait it out."

That's what happened to 65-year-old Jaycie Ingersoll during her childhood in San Antonio, Texas. "When I was growing up, resting was the deal" for asthma sufferers, she says. Asthma and bronchial infections caused her to miss school and playtime. Although symptoms subsided during her teens, the Los Angeles real estate agent says they returned when she went through menopause.

About 20 years ago a nutritionist suggested she try walking to ease symptoms. It worked. "I would feel better, no matter how awful I felt in the morning," says Ingersoll, who also stretches, practices yoga-style breathing exercises and swims during the warmer months. She's stopped using most of her asthma medications, except for an occasional spray of albuterol, a drug that relaxes and opens air pathways in the lungs.

As with Kyle, without proper diagnosis people may assume they're out of shape and stop exercising altogether. Parents who don't recognize symptoms may think their child isn't trying hard enough at sports. Says Eitches, "Too often you see kids playing soccer and the father says, 'Shape up!' because he doesn't know his kid has asthma, but he's coughing a lot. The typical asthmatic goes from being a forward in soccer to being a halfback to ending up as the goalie, or dropping it altogether."

This can set up a vicious cycle, says Dr. Guy Soo Hoo, a pulmonary critical care specialist with the VA Greater Los Angeles Health Care System in West L.A. "You don't feel well, so you exercise less, and then you get to the point where you can hardly do anything." A sedentary lifestyle often leads to obesity, which can also worsen asthma symptoms.

But cardiovascular exercise can help alleviate problems, adds Soo Hoo. "When cardio endurance improves, you can deliver more oxygen to your muscles," he explains. "You can go further before becoming starved for oxygen. You need to breathe less to do the same amount of work, and the body becomes more efficient."

In recent years, Olympic and professional athletes have begun to speak out about their battles with asthma, becoming important role models, especially for children. Among the ranks are track star Jackie Joyner-Kersee, Olympic swimmers Debbie Meyer and Amy Van Dyken, champion figure skater Kristi Yamaguchi and NFL running back Jerome Bettis.

Even with proper diagnosis and medication, many people don't know how to exercise properly, and drop out after doing too much too soon. "Don't expect to run a marathon right away," says Eitches. "Do it slowly and work up." He also advises anyone experiencing an acute episode of asthma to refrain from working out until they are healthier.

Also, stretch and warm up before working out, and try some nasal breathing exercises to "get the lungs ready for physical activity," he says.

Because cold air can trigger an asthma attack, morning exercisers might do better indoors. If high pollen counts and smog trigger symptoms, avoid outdoor workouts at peak times as well. Swimming is often advised for asthmatics, because the air that's breathed is moist and warm.

Since Kyle started exercising five months ago and using an inhaler, she says she has more energy. "Daily errands used to tire me out, but I can do everything now. It's not a problem."

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