Q: My teenage son had a second spell of bad breathing during a school basketball game. Even when he stopped playing, it felt like somebody was sitting on his chest. Could this be due to asthma?
Dr. Bassett: Your suspicions might be warranted, particularly if your son has a history of allergies and asthma. Exercise-induced asthma or bronchospasm (EIA or EIB), can be present in more than one-third of those with seasonal allergies and in up to 90 percent of those with chronic asthma. With EIA, coughing, chest tightness, shortness of breath and/or wheezing generally occur within three to eight minutes of strenuous exercise.
Low stress exercise, such as walking, jogging and golf, or fitness involving short bursts, such as biking, baseball, football, volleyball and weight training, tend to be better tolerated by those who have EIA. Swimming is also a good option because of the humid, warm conditions. Less optimal choices include soccer, long-distance running and basketball, due to their prolonged and intense activity level.
Some of the key elements for successful exercising with asthma are: an adequate warm-up and cool down; avoiding strenuous outdoor fitness at high risk times, including days with an ozone alert, high pollen count or cold, dry weather conditions; and pre-treatment prior to exercise with a prescription “rescue” inhaler. A peak flow measurement taken before and after exercise and lung function tests performed by an allergist can help to confirm an EIA diagnosis and the proper treatment.
Dr. Clifford Bassett, an allergist and asthma specialist, is the Medical Director of Allergy & Asthma Care of New York (www.allergyreliefnyc.com; Twitter @allergyreliefny). He is also on the faculty of NYU School of Medicine and Cornell University Medical College in New York City.