What should I do to prepare for the test?

• Make sure you get a full night’s sleep prior to the test.
• Avoid a heavy breakfast just prior to testing.  A light meal is fine.
• Avoid any use of caffeine for at least 12 hours prior to your test.
• Bring clothes and shoes to run in.
• We ask that you do not exercise the day of the test.
• If you are sick, please call the office to determine if you should still come in to run.

Should I take my regular medications before the test?

If you are being sent for testing in order to confirm or refute a diagnosis of exercise-induced asthma, and you have been taking medications for this (with the diagnosis presumed), call our office and we will inform you if, when and how to discontinue your medication prior to the test.

If you already carry a diagnosis of asthma and are being sent for testing in order to determine if exercise is an additional trigger, or to determine if your current treatment is effective, then you should continue all medications up to and through the test as you would typically take them.

What will happen during the test itself? When you arrive, we’ll review the procedure with you beforehand.

1. Prior to running on the treadmill, we’ll obtain a set of lung function values to establish your baseline prior to exercise, by having you breathe forcefully into a tube.
2. Next, you will be fitted with a mask and backpack to hold the equipment required for testing.
3. You will then be asked to run on a treadmill for a brief period of time at a relatively high intensity to reproduce your symptoms.  You will be breathing through another tube that measures your inspiratory and expiratory breaths, and your heart rate will be monitored as well.
4. Following your run, you will either
   • be taken next door to see Dr. Porto who will then perform a nasal scope to determine if you have vocal cord dysfunction
   • or you will perform the breathing test that was used to determine your baseline, at three-minute intervals for up to 20 minutes, or until we are able to document a significant decrease in your ability to exhale.  If there has been no documented change by 20 minutes, the test will conclude.
5. Your referring physician will receive a copy of your test results within 1-2 days of the test.

Practical Tips for Management of Exercise-Induced Asthma

Following are some tips for minimizing the symptoms associated with your exercise-related asthma.  These should not be considered a substitute for advice or treatment recommendations provided to you by your physician but should supplement your overall treatment plan.

1. Condition yourself aerobically.  Improving your physical conditioning will reduce your body’s need for ventilation at a given level of exercise.
2. Try an active warm-up period prior to actual competition.  40-50% of people with exercise-induced asthma symptoms experience a “refractory period” after exercise is started, where symptoms spontaneously decrease between 30 minutes and two hours from the start of exercise.  Some suggested pre-activity routines:
   • Warm-up exercise for 15-30 minutes, with 10-20 minutes of rest prior to actual activity.
   • #7-30 second wind sprints separated by 2 ½ minutes of rest.
3. Minimize the exercise you are doing in cold, dry air environments.  When this is not possible (when exercising outside), consider the use of a scarf or face mask to facilitate air warming.
4. Breathe through your nose when possible.
5. Cool down from exercise gradually.  Sudden changes from high-intensity exercise to static activity can magnify symptoms.
6. Hydrate well around exercise to minimize airway dehydration.  Basic hydration guidelines include:
   • 12 ounces of water/sport drink two hours prior to exercise.
   • 12 ounces of water/sport drink 30 minutes prior to exercise.
   • 6-8 ounces of water/ sports drink for every fifteen minutes of continuous exercise.
   • Weigh yourself (minimally clothed) before and after exercise.  Any weight loss is strictly water loss.  Replace fluids at the rate of 16-20 ounces per pound lost.
7. Minimize excess salt intake.  Ordinarily, salt intake is encouraged to help maintain body sodium levels.  People with exercise-induced asthma, however, should limit their dietary intake.  Replacement of lost body salts through sports drinks is o.k., but total intake should be less than 1500 mg/day.
8. Fish oils may be helpful in minimizing symptoms.
9. Caffeine may be helpful in minimizing symptoms.
10. There is some evidence that supplementation with dietary antioxidants will reduce symptoms from exercise-induced asthma immediately after exercise.  These include:
    • Alpha-Tocopherol
    • Ascorbic Acid
11. Avoid medications that can trigger asthma symptoms.  Talk to your doctor about this, but these can include:
    • Aspirin.
    • Large doses of Tylenol (or non-aspirin pain reliever) exceeding 1000 mg.
    • Non-steroidal anti-inflammatory medications.  If you have a documented history of allergic reactions to aspirin, do not take Ibuprofen or similar medications before consulting with your physician.

#EIA #Asthma # ExerciseInducedAsthma #exercisetesting