[embodiment] some notes on exercise-induced bronchospasm

[kaberett]

Have a Wikipedia link.

The thing I do not previously remember seeing when reading about this, which is the thing that made me exhale the small oh of relief, was specifically

many will present with decreased stamina, or difficulty in recovering from exertion compared to team members, or paroxysmal coughing from an irritable airway [...] It usually occurs after at least several minutes of vigorous, aerobic activity...

I had established to my satisfaction that the trigger on Sunday was spending about 90 seconds at or above a heart rate of 160 bpm (by the watch) while also anxious and Out In The Real World. (I can sustain that heart rate longer on an exercise bike without setting off The Thing.)

And: yes. The thing is that suddenly a bunch of things I would be able to do if I hadn't Set This Off are now impossible, and everything's harder work, and everything's more tiring, for... probably about two days.

Which is what doesn't match up; typical timelines as given by AAFA:

• Resolve within 30 minutes to 1.5 hours after stopping exercise
• Symptoms usually do not return if you continue to exercise within 1 to 3 hours

Some people will have a second wave (“late-phase”) of symptoms 4 to 12 hours after stopping exercise. Late-phase symptoms are often less severe and can take up to 24 hours to resolve.

Because, er, no, symptoms persist for a solid 48 hours, without complete resolution, and without the refractory period. They do decrease rapidly in the first half hour after stopping exercise, though, and steadily thereafter in the absence of further exacerbations, though the threshold for subsequent exacerbations is lower during that period, but... that's still overall a much better description of What's Going On With Me than I'd ever previously seen actually written down, which is its own flavour of significant relief.

I am also finding the high prevalence in athletes very interesting: I'd noticed, over the past couple of years, that as I gradually got fitter things that used to set me off... didn't, any more, in the virtuous-circle mirror of the deconditioning in my early 20s resulting from trying to avoid Ever having an episode (because I didn't understand what was going on, or how much worse it might get or how dangerous it might be, and the drugs didn't help, and it hurt to breathe for days). But -- the athletes thing makes it sound like exercise-induced bronchoconstriction is actually fairly widespread in us-as-a-species given sufficient exertion; elite athletes by definition will be routinely pushing the absolute limits of what humans in general and their personal bodies can do; altogether this seems to add up to corroboration of my intuition that I will if I go carefully likely be able to keep increasing what I can do without tipping myself over into an attack. I expect I'm more prone to it than most people and I expect I'll always be more prone to it, but -- that doesn't mean I can't keep expanding the scope of my possible.

(Is this coherent? Unsure; I'm tired and have been failing to get around to writing any of this up since last weekend, but I'm about to be Extremely Busy for... a while... so if I don't at least write the sketch up today I'm concerned it will evaporate again. So. Here's the sketch.)

Comments

[madgastronomer]

You probably already know this, but the 48-hour effects sound like post-exertional malaise.

[rugessnome]

not helpful to you, but the aspect that the air not warmed by the nose is thought to possibly be a lung irritant makes me think I should consider looking more into assessment for EIB, although the suspect symptoms have mostly only ever happened a few times when I tried to jog in cold weather--I got somewhat wheezy and while not completely continuous, couldn't stop coughing.

but then I used to feel very bad when I tried running much at all before I learned to pace myself, and I'm not sure now what of those symptoms were respiratory...

[ewt]

This makes sense to me!

Also: elite athletes are more likely than the general population to notice limits on what they can do after an acute episode.

[ewt]

I would be interested to know the prevalence in wind instrument players and singers.

[batrachian]

Saaaaaaame. For, you know. Reasons.

[cesy]

Interesting!

[enismirdal]

Oh, that's interesting. For me, the big trigger is aerobic exercise in cold air. Don't really get it in warm weather, but winter jogging...yup, that'll be me coughing for the rest of the day. I occasionally wonder if I should do something about this but then decide that I've been like this for at least 30 years so I guess that's just how it is (and my periods of "let's do some jogging again" are generally short-lived). If it actually stops you from doing stuff you want to do, and persists more than a few hours, I can see why that is very bothersome.

FWIW I'd say the coughing for me lasts probably 4-6 hours. But I haven't tried having a second period of exercise after the first as exercise is poo so why would I do it twice.

Your other post about the fluids is interesting. I wonder if I should try having a big glass of water before jogging...

[beckyc]

That makes a lot of sense!