May is Asthma Awareness Month–and this coming Tuesday is World Asthma Day. After spending a couple days together in the SF Bay Area last week, Steve and I got our networks to send out some questions, and did a very unstructured Q&A videocast to hopefully get some light shed on asthma, our thoughts, and hopefully teach some people a few new things about this disease.
exercise induced asthma
Over the last few years, I have made friends with too many people who live with diabetes to count them all. These people have become my friends, both online and in real life [and some currently online and ABOUT to become real life friends!] and through Twitter and their blogs, I get a small glimpse into their worlds of living and thriving with a variety of types of diabetes. When I was searching for a Fall race to do, the Run for Diabetes in support of the Canadian Diabetes Association grabbed my attention and didn’t let go. Thanks to my generous friends who helped me not only raise but shatter my fundraising goal, and thank you to anybody who has supported me in the physical activity endeavours in the past couple months! With tribute to Jay, we unofficially called our team “Good Things Run on Insulin!” and got to throw the phrase around and tell the story to a couple people today, which was super awesome.
My friends Sam, Danielle and Julia joined me today, and they were so much fun to race with. We got up at 6 AM (can you say early? I work at 10 AM tomorrow and 7:30 AM for the rest of the term, and my body is going to have no idea what to do with getting up at that hour), got ready, and drove across the city to the beautiful park where the D-run was being held. We preceded the race by visiting the bulk of the booths set up, where the people from Virgin Radio gave us free shirts, and tweeted and facebooked about us (this was the first time I told the Good Things Run on Insulin story!)
Love the tutus and the t-shirts – its team Good Things Run On Insulin! #RunForDiabetes pic.twitter.com/lIgRQRMr
Left to right: Sam, me, Julia and Danielle
Photo Credit to Virgin Radio
YES!
The actual race got rolling a bit late, and in the time we were waiting, literally seven people asked for pictures with us and our tutus. It was a little crazy (stay tuned for those, I know the Diabetes Association has a couple, as do the pharmacy people, as does the Manitoba Runners Association).
Come on guys, I’m ready to go over here!
Finally, after a lengthy walk to the starting mat, and some sort of siren-esque interlude as the gun, we were off!
Being a walker in a race is awesome, but awkward. People cheer you on, but all the runners run past you all the time, and the half-marathoners have triple-lapped you, and et cetera. Also all the runners are super hardcore, obviously. Here’s some footage of the race, except minus the parts where we had to say thank-you four hundred times when people commented on the tutus. It’s super short, because video-ing is kind of distracting from the task at hand and such.
You can’t see all the names, but you can clearly see that there are way, way too many people in my world who have diabetes.
My first chip-timed race! Results TBA!
How could you not want to walk in this? [Running Room! Want to make a deal and you can use this?]
Hmm… maybe the view literally took my breath away and it wasn’t asthma? 😉
Aside from some of the usual muscle-related off and on pain, my legs were totally awesome this race (and they’d be good now if I hadn’t stopped moving!). My lungs, on the other hand, were just true to the pattern that’s developed. I tried a new plan of attack on this walk, and it mostly worked until the last couple kilometers, and I was still able to amp up a run across the finish line at the end! Today’s plan involved a neb treatment (a bit less than a 5mg vial of Ventolin–I got sick of doing the treatment, okay?) at 6 AM, the usual meds with an increased Symbicort dose to 2 puffs instead of 1 (I upped the Qvar to 3 puffs instead of 2 a couple days ago). Then, two-plus (with the delay) hours later I took two puffs of Ventolin from the inhaler. Since my asthma is the most trouble after an hour, or 5.5K-ish, I took two more puffs of Ventolin and two of Atrovent early into the second lap. The pattern of the last longer walk held true, and over the rest of the second half, I think I averaged 1 puff of Ventolin per kilometer, but I didn’t start feeling really short of breath until we started kilometer 8, which was good! I need to stop trying to make sense of this exercise induced asthma pattern, but I really want to understand it so I can treat it better! (Really, I am doing all I can be, which sucks) I really feel that it’s taking me an excessive amount of Ventolin to get through these longer workouts, and I am not super okay with that. To prevent any rebound-flares later on today and to quell the dyspnea already developing, I did another neb when I got home. (The night of my first 10K, I had a really hard time breathing and if it wouldn’t have been for having access to a nebulizer at home, I would have had to go to the ER. Crossing my fingers that I don’t have a repeat of two years ago!)
I had Gatorade at the first station (which I after realized was stupid because why the hell would I need Gatorade by the first stop) but it was also way too strong. I stuck with water for the next few (because cold water > the water from my bottle), threw back a few sips of Gatorade (which Julia described as Mr. Clean. Thanks, Julia ;)) and ditched over half of that one, and stuck to the gross water bottle the rest of the race. I tried the homemade gel at about 7.5K, I think. It worked really well, but it was just too freaking sweet. My pre-race nutrition was also crap, because it involved exactly two bites of some random protein bar that came in the race kit, and about four sips of some almond milk smoothie thing (complete with a carb count on the table! 11g per serving, y’all! I was actually surprised that was the only carb count sign I saw, considering Good Things Run on Insulin and all).
Finally we rounded into kilometer 9, where my friends refused to leave me to go run the last kilometre (I told them to go because I knew pushing myself any harder would be no bueno, but they’re just awesome and told me that we were all finishing together). Halfway through the crowd of people, we kicked into a sprint to the finish line about two-hours after we started, where were unceremoniously handed our medals over (there’s something about when they put the medal around your neck, you know?) to put on ourselves.
Post race
We walked around for a bit, because when you stop moving is when you start to hurt. A guy gave us funeral home branded water (like “Good health choice doing that race! Now, time to think about when you die! Ouch?) Found the bathroom that had no line by the point we crossed the finish line (it had a huge line pre-race because the porta-potties were still being put up, so we stood around until the Gotta Go guy was gotta gone. Also we had nothing better to do but stand there and dance, really–I’m sure even with the dancing we stood around less time than if we’d have waited in the bathroom line).
Subway had a booth with free sandwiches and yogurt parfaits, so we went and ate free food and sat on a bench overlooking a similar view to this, where Julia ran away from wasps while we had snacks and then headed for home!
I was happy to be a small part of making a difference today. With charity races, the making a difference is two-fold: the difference in yourself in not only working to keep your body healthy through training and racing, but in your thoughts in how you perceive the good things that these non-profits are doing for people, AND in bringing much-needed funds and support to these organizations that do so much to help ALL of us live the best possible life we can have! I can go out there and have all the fun I want, but it’s not as meaningful if I’m the only one benefiting from it. Just as a Canadian discovered insulin, my hope is that Canada can be an equally big part in finding a cure–and supporting those living and thriving with diabetes while they wait.
Things are looking a bit different around here! I won a copy of Standard Theme for WordPress by 8BIT from Chris from Canada, so thank you to both parties of that awesome partnership! I am in LOVE with Standard Theme so far! Next on the round of thank-yous is my friend Andy Darnell (also a Standard Theme user) for pointing me in the direction of Pixlr so I could make that snazzy header up there. I’ve been without Photoshop since I got my Mac over a year ago, and was doing limited projects using trial versions (I am a student, read: I am cheap). So there we go! Site looks different thanks to a bunch of awesome people!
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Yesterday Danielle and I did a long training walk in preparation for the Run for Diabetes on Monday. I will be completely honest and say that this was one of the hardest walks I have done, and I am hoping things go smoother on Monday. For the first two kilometers, I had some pretty bad pain in what i’m going to assume was my tibialis anterior on both the right and left shins and some of the flexors of my right foot. I’m really unsure what the deal was, and I am really hoping that it doesn’t resurface on race day. I stretched it out the best I could around the 2K mark, and it didn’t bug me too much more for the next 7K. I obviously have some biomechanical oddities going on here with the discrepancy between my right and left legs, but it should really be nothing I haven’t adapted for by this point in my life. Kilometres 3 through 5 were fine.
Kilometres 5-9 were brutal right up to the end, and I am hoping that there’s enough adrenaline coursing through me on Monday to have a slight beneficial effect. Once I hit 5-plus K/an hour-ish (slow? yes.) my lungs simply don’t feel okay anymore, and from kilometers 5-9 I felt like my breathing was just all screwed up [I even stopped at one point to see if that would help get things back in check]. This could be caused by a variety of things (more demand on my muscles = increased respiratory rate = increased inhalation of particulate matter in the air [aka “air crap”]; increased drying-out of the airways [obviously NOT helped by any degree of dehydration, which I was experiencing yesterday] . . . the list goes on). So, of course, I’m always trying to figure out what’s going on inside my lungs and how I can possibly mitigate it on Monday. I shot off a quick what gives! e-mail to my friend Steve, who’s a respiratory therapist who has severe asthma, and is an all around badass[matic], explaining the experience to him. Within this sentence conveys one of the many reasons this man is among my favourite people:
Hi Ms Lovely,
I think you’re having these problems because you’re an ASTHMATIC.
Damn it!
So, yeah, I just about killed myself laughing at his response. (And thanked him for the diagnosis.) He went on to say that it’s probably some degree of air-trapping caused by the prolonged exertion. [To get a better idea of what air-trapping is, take a deep breath and exhale only half of it. Inhale again on top of the air that’s stuck in your lungs. Repeat. That. Or go read Steve’s post about it.]
Anyways, so kilometers 5-9 included taking the inhaler multiple times to take the edge off of the dyspnea. It’s not preferable, and obviously I wasn’t stopping to take the Ventolin it’s not like I was giving my lungs a break to let it get in there and start working before continuing the assault. However, using the inhaler 3 times in 4 kilometers [six puffs — two of those right at the end] may have helped fend off any delayed stuff and certainly helped at least a bit during that last expanse of time on the trail.
So what am I going to do differently race day?
- Pre-medicate with a neb treatment as opposed to 4 puffs of the inhaler. Getting the bronchodilators where they need to go is super important.
- Somewhat prophylactically take the inhaler immediately when I start having issues breathing, not letting them escalate any. Will it help? Who knows.
- Light warm up with some stretching pre-race time-dependent.
- Carbs/protein, little if any fat to slow down the digestion thing. I’ve got some Gatorade Prime chews [and have fingers crossed for some free Gu!]
- H-y-d-r-a-t-e.
The last one is important. I was definitely experiencing some dehydration during this walk, and that is obviously not performance enhancing.
And is likely the reason that the consumption of 1 litre (aka 32 ounces) of fluid followed within the next half hour at the Starbucks we ended up at, and then I didn’t feel awesome.
Really, I couldn’t loose too much fluid in an two hours and fifteen minutes, right?
Apparently my body is not so cool with ingesting that much fluid at one time. But, I mean, it otherwise felt awesome to be drinking cold things [even after a refill in an en-route hotel bathroom, the water in the Dasani bottle was not cold. And also, screw the myth that cold water isn’t good for your body–about 12 seconds on Google with the more reputable sites will tell you otherwise.] [Also I got a wicked headache last night. Dehydration induced? Possibly. Things i only figure out in retrospect.] [Bracket ;).]
So I learned some stuff. Also I iced my legs for the first time ever [both anterior/posterior and some slight lateral], and they actually don’t hurt basically at all today, though they feel a little tired, so there is something to be said for that. Exciting. #kinwin. Etcetera.
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Finally, THANK YOU to everybody who has chosen to give generously and support the Canadian Diabetes Association through my fundraising page! I set that $200 fundraising goal feeling ambitious, and many of my amazing friends stepped up to the plate right away. Whether the contributions were simply to support my efforts or from a deep passion for the amazing work the Canadian Diabetes Association does for Canadians with diabetes, I am thankful that the money goes to support research and care of people with diabetes in Canada. The fun I’ll have at the walk is a bonus.
How not to train:
- Miss a month of workouts for no good reason. Sometimes there are reasons. Sometimes there are stupid reasons, but those are still reasons. Kind of. No reason at all, though, is the stupidest reason of all to miss an entire month of workouts. And, from July 18th to August 18th, I did just that.
- Register for a race. Forget to use that race as motivation. I go into so many races with the mindset that I am going to rock training for the race. That I am going to train to be able to do the race distance comfortably, rather than dragging myself across the finish line.
- Let previous goals slip.
- Nutrition is a goal that I’ve been trying to build on slowly, or else I know I overwhelm myself. Part of nutrition is not only ensuring I’m eating proper things, but now includes that damn iron supplement that makes me feel yucky. However, in order for me to be able to exercise properly, my body needs to be able to transport oxygen to my muscles. And what’s responsible for that? Hemoglobin. Iron. Boom.
- Asthma. I am good at taking care of my asthma when it needs to be taken care of. I’m good at the morning and evening inhalers. I am not so good at doing the evening inhalers on time on weekdays, or the morning inhalers on time on weekends. This is not a huge deal, but it DOES have an impact on how I feel in those spans of time. I am also not doing so well at taking my Atrovent regularly. I need to get it in my head that when I am exercising, i need to be taking my Atrovent four times a day so that I feel good and want to keep doing it.
- Regular training. I need to once again focus on the fact that anything is better than nothing. If take half an hour and slide a few kilometers in, if I take ten minutes and do some yoga, if I take 3 minutes and do some push-ups. It all adds up.
- Active choices. I got a new bike in the Spring. Part of the hope with the new bike was that I would ride to/from work. I didn’t think that goal through well, as it worked fine in the spring but when summer hit I realized getting to work all sweaty and gross would not be awesome. Once again, that is only an excuse, as
- Make a training plan–ignore it. I made a beautiful, colour coded, training plan for this race. Had I followed it, I would have built up to 10K slowly and easily over about six to eight weeks. Instead? I have a passionately-exercising binge for the last two weeks following the race. If nothing else, I hope this is getting me back in the groove for when school starts again.
- Be unaccountable. During the July/August exercise lapse, I probably told myself at least three times a week I am going to exercise today. I didn’t. I did not make the choice to hold myself accountable to my decision by putting that decision into action. The hardest part of exercise is often putting on my shoes and getting out the door/on the trampoline/to the gym.
I have an amazing, beautiful community of people around me to help keep me accountable. However, I have to rely on myself, and I have to let this amazing community know what my ambitions are so that they can hold me accountable. Even if I simply tweet my plans to work out, it is that much harder to back out of those plans because I know that somebody read it, and later that night somebody could shoot me an @ reply saying: “Hey, how was your workout today?” — “I didn’t work out” is an awkward answer. Making an excuse is an awkward answer. “It was awesome, I felt so much better after!” is not an awkward answer. Even if I am only going out for a ten minute walk, even if that does not spill into longer than ten minutes, I can almost guarantee that even if it is short, it will still be sweet, and I will still feel better after.
Race training has not gone well. That does not mean the race will not go well. So long as I don’t get as sick as I did following my last 10K, I am okay (two years ago I did my first 10K and I had a ridiculous asthma flare that evening, and had I not been fortunate to have a nebulizer at home would have required intervention, read: an ER visit. Put that in the awkward category!). Tuesday I did a 7K training walk, needed my inhaler at about 5.5K and again when I finished, but had few residual symptoms. I am hoping this is the case on race day pending I post-medicate as well. Mostly, though, I know I can handle the asthma. I just need a better idea of how I’ll handle the rest of the distance that I know my body is not adequately prepared for because of being a master in How Not to Train.
The ultimate in accountability though is having a training partner to get out on those long walks with. Because it’s not like you can get lazy and go home early when someone is out there slogging through that same distance with you. Tomorrow is practice 10K day, and I am going to accomplish that with Danielle. One week until race day.
I’ve rocked the fundraising. I’ve kicked up the training in the last week. I’ve gotten my head in the game. Now I’ve just gotta get myself out there and make it happen.
For April 2012, I’m taking another shot at completing the wegoHealth Health Activist Writer’s Month Challenge. Like BEDA, or Blog EveryDay April, the aim of #HAWMC is to complete thirty health-related blog posts in thirty days. With finals and a road trip, it’ll be a tough go, but I’m going to once again try giving it my best shot . . . And hopefully complete it this time!
Health Time Capsule: Pretend you’re making a time capsule of you and your health focus that won’t be opened until 2112. What’s in it? What would people think when they found it?
Twitter – My Twitter account, as it stands now, is very health-focused, but also very diverse. Because I have asthma, I obviously follow many people with asthma [but not as many as I’d think considering 10% of Canadians have asthma]. I’d say I might even follow more people with diabetes, type one, type two, or LADA, than I do people without diabetes. I follow people with cystic fibrosis, people who have or care for people with severe food allergies, fitness and nutrition bloggers, physical activity and health organizations, people with a host of other chronic diseases such as Crohn’s and lupus, the list goes on and on. And of course, I follow a bunch of accounts that have nothing to do with health at all.
School – I often forget to really appreciate all that university has done to amplify my focus in regard to health knowledge and current topics in health. My favourite courses thus far have been Physical Activity: Promotion and Adherence, Issues in Health and Adapted Physical Activity, because of the desire to encourage and implement positive health-related behaviours to as many people and special populations as possible. My focus thus far is always chronic disease or disability and physical activity, from a physiological, psychological and sociological perspective, so many of my courses have been able to tie into that passion.
Asthma – The first Ventolin inhaler, the one that started it all. The huge Mini-Wright Peak Flow Meter I got about a year after being diagnosed would have to be included, because it’s so ugly. I then moved forward to a little green TruZone meter and since then, a digital. The first beat-up AeroChamber. The nebulizer. And of course, the bottle from my first course of prednisone. The chronicles of the constant inhaler switches and doctors visits in my first few years with asthma. Conversation snippets from friends far away, like Natasha, Elisheva, Steveand many more, and pictures of meeting my friend Rona in Chicago who I met through the (smallish) Twitter asthma community and has been a huge supporter for many years. A shot of the Second Cup where Dia [who not only is a badassmatic, but a kinesiologist working in adapted physical activity] and I met in Real Life for the first time. Amazing people who I never would have met if I didn’t have to live with chronic disease.
Exercise – In this I would have to include many conversations with Steve above on how to figure out making the exercise/asthma thing work. Steve has been a huge supporter of mine over the years since my asthma diagnosis [hello, the man finished multiple Boston Marathons on far less than half his lungs. So badass]. I’d throw in the first pair of Saucony shoes that made me a convert. An UnderArmour shirt which made me a convert to the tech-shirt side permanently. The encouragement of so many amazing people on Twitter. The discussions on exercise and chronic disease via e-mail with Jay–along with his constant motivation to focus on the Good Things. And of course, my Team Asthma.ca t-shirt and the support of the Asthma Society of Canada in my crazy projects [like the TeamAsthma-based Intervention Project for Promotion and Adherence] and endeavours in advocacy through physical activity. My motivational dailymile friends. And finally, my Fitbit, which makes me increasingly intentional about my physical-activity choices throughout the day. Because the truth is, if I didn’t have asthma, I wouldn’t have met Steve, and I’d still probably be sitting on my ass :].
Perspective – The blog posts and journal entries that encapsulate transformation in my own thinking and attitude towards living with chronic disease. Because in this journey, it all comes down to choice, and the road that it took to get me to the place where I realized that it came down to my thoughts. With this, finally, I would enclose my personal mantra:
Perspective is crucial, positivity is essential, and ignorance is a curable disease.