Exercise can bring on asthma attacks


DEAR DR. DONOHUE: At age 35 and in the wintertime, I decided to get into shape. I joined two others in daily jogging. Things went well until the end of December, when I started to cough while jogging. Sometimes the coughing was so bad that I had to stop. The coughing cleared enough to allow me to resume running, but it didn’t go away entirely. One of my buddies thinks I have asthma. Could that be? I thought asthma was something you got in childhood and that it came from allergies. — L.F.

ANSWER: Your friend sounds like he’s on the right track to me. An asthma attack is a sudden narrowing of the airways (bronchi) along with the production of thick mucus in the airways. Both the constriction and mucus make the movement of air into and out of the lungs difficult. Coughing, chest tightness and wheezing are signs of asthma. Wheezing is a high-pitched, whistling sound made by air passing through constricted airways.

Asthma appears at any age. Half of all asthma patients are adults, and many of them developed it later in life, not in childhood.

Breathing cold, dry air is a known asthma trigger. Your symptoms fit well into exercise-induced asthma.

The only way you’ll find out what’s making you cough is to have a doctor examine you and to take breathing tests. If you do have exercise-induced asthma, you can still run and you can still run outdoors. When running, breathe through your nose to warm and humidify the incoming air. I know it’s hard to get enough air through the nose when you run. If need be, wear a face mask or wrap a scarf around your mouth and nose and partially mouth-breathe. If the doctor confirms the diagnosis of asthma, inhaled medicines before exercise can prevent an attack, and other inhaled medicines can abort an attack, if need be.

You really must get this matter settled. Asthma is only one of the causes of coughing due to exercise.


DEAR DR. DONOHUE: You recently told an 80-plus man that yardwork was a good form of exercise. I have always heard that raking and shoveling were bad for the heart at any age, surely for the elderly. — D.D.

ANSWER: Hang on a minute. I looked up that letter and my response.

The man was 86 and wanted me to write about the value of household chores as exercise. He mentioned raking leaves as being an example. Nothing was said about shoveling snow or dirt.

I started off with the usual caveat that he should first get his doctor’s approval. I do that for any older person who wants to exercise.

Raking leaves is about four times more strenuous than sitting quietly. That’s enough exertion to qualify as beneficial exercise but not excessive exercise.

Shoveling heavy snow or dirt is a different story. Every winter, emergency-room doctors prepare for the influx of heart attacks that occur after the first snow. Shoveling snow (or dirt) is demanding, too demanding for most people of age 86. Many would tell men and women over 50 not to engage in such arduous labor without first knowing their hearts are up to such a challenge.

Your point is well-taken. Unusually hard exercise should be approached with respect and caution.

DEAR DR. DONOHUE: The first thing my son does when arriving home after his basketball practice is drink a glass of chocolate milk. His grandmother thinks I shouldn’t let him. She thinks chocolate milk is a poison. What are your thoughts? — W.A.

ANSWER: I have to confess to a personal bias. I loved chocolate milk as a kid, and I still do. Some nutrition experts share your grandmother’s misgivings.

Eight ounces of whole chocolate milk has 208 calories, 8 grams of protein, 25 grams of sugar and 8.5 grams of fat. That’s a bit of a sugar load, but not an extreme one. It also has 280 mg of calcium, a mineral hard to find in other foods. A recent study compared chocolate milk and a sports drink in their ability to restore body fuel reserves, and chocolate milk won out. I find nothing wrong with your son’s chocolate milk.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.