Asthmatic breathing in a ramp test and how to improve

Anyone with asthma check their breathing from a ramp test? I find it interesting how it changes (bottom measurement is before starting tr, middle is right after the ramp before the cool down, toP is after closing tr

Seems interesting how my peak flow is a personal best right after the ramp even though the amount I can blow out in a second is less asking with my functional volume. Then when my functional volume recovers my ability to breath out goes down.

Guessing that is kind of aerobically limiting me. It never really felt that bad so haven’t bothered to use any asthma meds but maybe I should rethink that. Any asthmatics have recommendations on what works well? Thanks

That’s normal for an obstructive pulmonary disease. As the airway is obstructed you need to build up a lot of pressure to expell the air from your lungs and it flows out very fast through the small airway but as the pressure difference decreases you are unable to build enough pressure to expell the rest of the air from your lungs

I’m guess I’m wondering how others have delt with it for balancing drugs and breathing impacting biking. My asthma is not such that there is any danger in not controling it. So then its a matter of how it impacts workouts. Workouts that don’t seem limited by how much I can breath (so threshold and below), would they benefit from a greater FVC and FEV1? Seems like oxygen supply isn’t the limiter so I’d guess no.

The reason for this is the easy treatment for my breathing is a short-scting beta-agonists like Alburerol which would be great except long term constant use of it will cause it to be less effective. So if I use it before all workouts in the long term this doesn’t seem like a good option.

I don’t race so don’t care about banned substances (well, should be legal in the US but don’t care about UCI or WADA or anyone like them.

Ramp tests, TT efforts, or any really hard repeatedly riding over threshold -can- trigger my allergy induced asthma. However I really don’t like how albuterol makes me feel (jittery and weird taste in mouth) and never take it before cycling. Last year I had a couple bad episodes, including one during a 20-minute field test. About 3 hours after that #fail, my wife said “hey, either cough it out or have another cigarette!” Figured it was time for a video appointment with my general practitioner, and he prescribed levalbuterol. But I’ve been too stubborn to try that and just deal with it - which means sometimes I’m wheezing after 10 minutes sucking wheels on Wed worlds and just drop off and do my own thing. This year I started taking generic Claritin a month early, on the first of Feb. Hoping for the best.

Not sure your new drug will be any different

I have suffered from Exercise Induced Ashtma for decades…but it usually only flares up bad in the cold. I would occasionally take a hit on my “bong” (inhaler) when it was cold. Never felt like I needed it on other rides because I was never wheezing.

2 years ago, my new primary care doc had me use a peak flow meter and said I was just wasting my energy by not using my inhaler regularly when I rode. Yeah, I was able to hand on a very fast group ride, but I wasn’t performing at my best. Started using it regularly and it made a huge difference, primarily on early hard efforts in the ride.

What type of inhaler if you don’t mind me asking? Albuterol or cortical steroid or something else?

Does it help for efforts where you didn’t really notice a problem before?

I’ve been doing the preemptive albuterol puffs since I was a kid through football/basketball/running/snowboading/cycling so it doesn’t really bother me. Don’t need it all the time on the bike but will use it any time I expect to go all out.

it will be worth seeing if the adverse effects are reduced with levalbuterol.

I use albuterol.

The only thing I notice a difference on is intense efforts….if I am doing anything up to sweet spot, I don’t use it. Above that, I take a quick hit.

As an example, shortly after I join our group ride, we hit a quick uphill where some of us hit it really hard. 500 meters after the hill is a light that usually stops us. I often found myself out of breath at the light….but would settle back down and be fine the rest of the ride. Once I started using my inhaler before the ride, I completely lost that sensation at the light.

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Have you tried using a spacer or are you using the cheap thing that comes with the medicine? Back when I used albuterol I always used a spacer, it helps get rid of the large spray particles that won’t help in your lungs as they probably won’t reach that far in but will land in your mouth and upper throat which you taste but can also increase side effects. (A large amount of the spray is the larger particles so you are basically decreasing the dose of the drug to your body that causes the side effect while keeping the same dose to your lungs which is what you want) When I was really young it helped me learn the right speed to breath in by avoiding the noise it made when I went fast.

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Guessing the cheap thing. What is a spacer?

Thanks. I guess I was too worried about the meds losing its effect over time. But realized when that happened to me I was also on theodur and larger doses of both before switching to a different doctor who slowly got me off them and got my asthma under better control. But this is also working off memories from elementary school so…

Yeah, I should be clear that I have never had any asthmatic issues in day to day life…it has only flared up on me while exercising, primarily in the cold.

I don’t consider myself to have asthma per se, but exercise-induced asthma.

Same but only in the spring when it’s warm, and I go hard.

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This is my favorite spacer (or when I used it over a decade ago, hope its still as good):
small and compact as meds fit inside it. Not saying buy from them, that was just the first link I found

Spacer use and care - National Asthma Council Australia.

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I’ve only been exercise induced since high school

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Spacers are much less important with the inhalers that are used now. Particle size is much less of an issue. The right kind of spacer can still help for those who have trouble timing their breath with the spray from their inhaler, however.

I wish I could get my asthma under control. Every year it seems to get worse. It gets really bad on CX and races up to about 90min. Even if I don’t have an incident on course, I spend the next couple nights coughing constantly. Then some general malaise sets in and I feel lousy for 3 days.

Now I am even noticing this during/after hard workouts. I’ve had a couple doctors and all they really do is breathing test and meds. Problem is if I do the breathing test when I’m not flared up I’ll score 115-120%.

I have skipped races and workouts because of this. Plus I’ve loss motivation to race knowing how lousy it will be afterwards.

I had that problem till I joined the childhood asthma study that Johns Hopkins was doing. For some reason weekly meetings with two doctors who basically were only dealing with asthma improved how they were treating me… Then later as an adult one doctor tried to scare me into always carrying my inhailer on me cause I might have a major problem, but I ignored them as even the worst asthma attack I’ve ever had was just really annoying and I hardly ever needed the medicine so why always carry it?

What types of breathing tests? No methacholine challenge? Those are fun as its a ramp test where your breathing gets worse in a controlled way. Though they tend to end the test before it really gets challenging to breath

When I had it done they went to 30% reduction. Then because my numbers didn’t start out well I got a lung volume test which is basically sitting in a well insulated sound booth doing weird breathing moves into a tube to measure your lungs. Mine were smaller for my height which explained my numbers.

Though why would they need to test? Do they not trust you have breathing issues?