By Dr. Paul Ehrlich
Every parent worries about whether their kids get enough exercise, and they are right to do so. Parents of kids with asthma worry especially. I recently talked with a journalist in Minnesota who wondered if I could name any athletes who could serve as role models for asthmatic kids, and being from the home of Lake Woebegone, she was particularly concerned about cold-weather sports. I directed her to the Asthma All-Stars, which list a number of cold weather athletes, most notably Kristi Yamaguchi, the great figure skater, and representatives of almost any other sport you can name. Unsurprising to allergists, the list is heavy with swimmers, including Mark Spitz.
In fact, there is nothing exceptional about winter athletes who wheeze. They suffer from exercise-induced asthma. Gretchen Reynolds, a NY Times blogger, wrote a year ago, “Exercise-induced asthma has been diagnosed in as many as half of all elite cross-country skiers and almost as many world-class ice skaters and hockey players. It’s far more common in winter athletes than in those who compete in the summer, although nearly 17 percent of Olympic-level distance runners have been given the same diagnosis.”
In our book we have a couple of suggestions regarding what to do before exercising outdoors in cool weather, one that involves medicine and equipment and one that does not.
Simply take a few laps in a warm gym before going outside. The
flow of air in and out of the airways cools the lungs before they warm
up again with exercise. If an asthmatic goes directly from warm inside
temperatures to cold outside temperatures, the shock causes bronchospasm. It is better to gradually pre-cool the airways with an indoor
warm-up so that the contrast will not be so great.
The other is to take Proventil or another beta-agonist spray
twenty minutes before exercise to prevent bronchial spasms and to
wear a facemask of the kind used by carpenters to trap and prewarm air, then engage in a normal warm-up. Studies have shown that rapid cooling of the airways followed by re-warming causes coughing in some and wheezing in others. Warmed and moistened air will minimize this response, which is why asthmatics have few wheezing problems swimming in pools, where the water is continually evaporating.
Another medicine that is also effective before exercise is cromolyn, which has been in medicine cabinets since long before the medicine cabinet was invented—it is derived from an Egyptian root.