As a first step in preventing an asthma attack, it’s important to treat and prevent hay fever (allergic rhinitis) and sinusitis, if applicable.
Another step is to get your exercise-induced asthma under control, if this is a problem.
1. Treating allergies and sinusitis
About three quarters of people with asthma also have allergies of the nose and sinuses. Because the lining of the nose and airways are inter-linked, hay fever-related inflammation has to be treated. If your allergies aren’t managed well, chances are that your asthma isn’t controlled either.
Hay fever may result in the following problems – all of which could decrease asthma control:
- Trapped fluid in the sinuses (this can lead to sinusitis)
- Ear congestion and infection
- Swelling of the sinus linings
Using a steroid nose pump
Examples: Avamys, Beclate Aquanase, Beconase, Budeflam Aquanase, Clenil Aq Nasal Spray, Flixonase, Flomist, Flonase, Inflanase, Nasacor, Nexomist, Omnair, Rhinocort, Rinelon, Spec Budesonide
If you’re using a steroid nose pump for hay fever, make sure you use it every day without fail to improve your asthma control. Follow the below steps in sequence and practise the technique until you get it right:
- Shake the bottle and blow your nose.
- Hold your head in the normal, upright position.
- Place the tip of the nozzle in one nostril.
- Hold the bottle at a 45-degree angle.
- With the nozzle in your nose, aim for the outer corner of your eye.
- Give a spray into the nostril, breathing in slightly through the nose. Don’t sniff too deeply.
- Bend down with your head, facing your toes.
- Remain in this position for at least 20 seconds.
- Repeat steps 1-7 for the other nostril.
- If two sprays are required per nostril, then repeat steps 1-8 for the second spray.
- Don’t blow your nose for 15 minutes.
Keep a watch out for symptoms of hay fever (e.g. frequent sneezing and itchy eyes) and consult your doctor as soon as possible.
2. Preventing exercise-induced asthma (EIA)
Exercise-induced asthma differs from “normal” shortness of breath that you experience when you’re unfit.
Exercise-induced asthma symptoms such as a tight chest, a dry cough, difficulty breathing and difficulty talking in sentences occur as a result of limited airflow to the lungs. These symptoms usually present about 10 minutes after the start of or after vigorous exercise.
The vast majority of people with exercise-induced asthma have underlying, persistent asthma. They’re considered to have uncontrolled or poorly controlled asthma. If you have to limit your activities in any way due to asthma symptoms, talk to your doctor.
High-intensity and endurance sports are more likely to induce asthma than sports that are less intense and which require lower endurance levels, e.g. swimming, shorter runs, walking and cycling. But this doesn’t mean you can’t play rugby, hockey, squash or other high-intensity or endurance sports.
Exercise-induced asthma symptoms occur more commonly and are more intense when inhaled air is cold and dry.
Exercise action plan
Do you have asthma? Then follow this action plan to participate in sports:
Step 1: Exercise regularly
- Don’t avoid exercise.
- Adjust the intensity of the exercise to accommodate your fitness levels.
- Warm up properly before you exercise.
Step 2. Manage your medication
Step up your controller therapy to achieve excellent off-the-field control and, if needed, add extra reliever puffs before exercise.
Your controller therapy should be taken every day. If you have well-controlled asthma and you still experience exercise-induced asthma despite taking your controller therapy every day, two puffs of reliever therapy taken 15 minutes before exercise will help to control your asthma for 1-2 hours.
Combination inhaler therapy (a single inhaler containing both a controller and a reliever) may also be a good option.
Discuss all these options with your doctor. No matter what type of exercise you prefer, you should be treated adequately to enjoy unlimited activity.
Reviewed by independent healthcare consultant Prof Praneet Valodia and pulmonologist Prof Elvis Irusen, Head of the Division of Pulmonology at the Faculty of Medicine and Health Sciences, Stellenbosch University. October 2018.