Managing my asthma

It’s taken me 15 years to feel like I have some control over my asthma. This is how I do it – maybe it will be useful for someone.

Disclaimer: I’m not a doctor, I have no experience other than my own. Asthma affects people differently – trying something like this could literally kill you. If you choose to do it, be careful, and make sure you always have your inhaler with you

Step 0: Get as cardio fit as possible

When I first met my wife I was in the best shape of my life – not too much body fat, and a decent amount of muscle. I ate well and lifted weights a lot. But I did almost no cardio and my asthma, although much better than when I was fat and inactive, still wasn’t great.

A few years later (after I’d let marriage, kids and work eat into my gym time ;)) I had little muscle or cardio fitness. My asthma was quite bad. I started the Couch to 5K program and felt like I was going to die. But by the time I could run 5km (combined with the steps below), my asthma was almost non-existent. I could go months at a time without using a preventative or an inhaler.

(For a whole swag of reason I’ve slackened off on my cardio over the past few months and am paying for it now. Step 0 is as much a reminder to myself as anything else).

So get fit. It makes everything else work a whole lot better.

Step 1: Exhale

Although asthma seems to effect everyone differently, the most common advice you’ll find is to ensure you exhale fully. I’ve read scientific stuff about excess carbon dioxide exacerbating the restriction of your airways, but the why doesn’t really matter.

I can almost on-demand give myself an attack by intentionally not exhaling properly.

If I can stay calm (see step 2) I can usually control an asthma attack by forcing myself to breath slowly, shallowly and exhaling as much as possible. Breathing in through your nose and out through your mouth is a handy way to help do this.

Step 2: Stay calm

This is the hardest part. I don’t know about you, but I freak as soon as I feel an attack starting. I’m minutely conscious of my breath, my heart rate rises and I just want to gulp air in as fast as possible. All of which just makes things worse.

You have to train yourself to not freak out. In part I do that by not taking Ventolin straight away. I get it out, take the cap off, then sit with it in my hand and try and relax myself. But my brain is already in panic mode so it’s pretty hard to control.

You’d be surprised how far you can go. I admit to being kinda stupid on a few occaisions, taking it to the point of being dangerous. When I was running I would get furious at being held back by asthma attacks, so I decided to run through them. I really wouldn’t recommend this – getting light-headed and seeing stars and still running is pretty stupid. But in a way finding out how far I could push myself was quite valuable.

Ideally though, you want to practice building your resiliance without putting yourself in (as much) danger. Which brings us to …

Step 3: Stop breathing

To control the fear, you need to expose yourself to the trigger, preferably in a controlled, relatively safe way. Ever since I’ve had asthma holding my breath for more than a couple of seconds kicks my “OMFG I’m going to die” reflex into action. So that’s what I practice doing.

The best way I’ve found to practice is kneeling on all fours, exhaling as much as possible, sucking my stomach as hard as possible towards my spine, and holding it for as long as I can. With your stomach sucked in it’s very hard to sneak in accidental cheat breaths.

I usually last around 10 seconds. By the 5th rep I’m clawing the floor and praying for the end. By the 10th I’m usually somewhat calm, though the end can never come quick enough.

Messing with your breathing can bring on an attack so make sure you have your meds with you if you do something like this.

You can also try swimming, although I’m not sure if that’s more or less disturbing. The combination of exercise, water, and controlled breathing has certainly been enough to scare the shit out of me. The nice thing is, if you can relax into it you can gradually increase the strokes between breaths (or just reduce the stroke rate). You can’t cheat-breath when your head’s under water.

And then…

So long as I keep practicing holding my breath, I am usually able to stay calm when I do have an asthma attack. That lets me properly concentrate on my breathing. 95% of the time (when I’m fit, probably 75% when I’m not) I can control the attack without medication, breathing my way through it until it passes.

I’m not sure if it’s causal or coincidental, but not using meds seems to drastically reduce the number of attacks I have. The more quickly I reach for the Ventolin, the more regular the attacks.

Doctors

Doctors have told me that it’s best to take Ventolin as soon as you feel the attack starting. I’m sure they’re completly correct. You’re not going to die from having Ventolin a little earlier than you needed it.

But it’s a shitty way to live, especially when I can control and reduce the attacks without a huge amount of effort.

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