Q&As: your health and cycling – respiratory
Short of breath
Q I have been diagnosed with the beginnings of emphysema. Already hills make me puff and pant, but a friend mentioned an aid used often to enable asthmatics to breathe more easily, deeply and efficiently – perhaps Breathe Easy? Can you help and offer any other advice? I am a non-smoker.
A Emphysema, along with chronic bronchitis, is nowadays usually referred to under the term COPD (chronic obstructive pulmonary disease). COPD is often but not always attributable to smoking and relates to damage to the lungs which causes symptoms such as coughing and breathlessness.
Although COPD can cause similar symptoms to asthma, the difference is that there is no permanent damage to the lungs in asthma, and COPD tends to occur at a later age. Spirometry (a breathing test to measure lung volume by blowing into a machine) is used to help diagnose COPD and assess its severity. This can usually be performed at your GP surgery.
There is no cure for the damage already done to the lungs by COPD so treatment is aimed at improving symptoms and preventing further deterioration. In smokers, the most effective way to do this is to stop smoking.
There are a number of inhalers which may be effective in alleviating your symptoms including bronchodilators, to open up the small airway passages in the lungs, and steroid inhalers. Other treatments include medicines to reduce mucus stickiness, antibiotics and steroid tablets to treat exacerbations and chest infections.
Continuing to exercise is important to maximise your lung capacity, and cycling is a good way to do this. You may be offered a pulmonary rehabilitation course where you are taught exercises to improve your breathing.
I’m not sure which breathing aid or device your friend refers to but I suspect that in your case inhalers will be the most useful treatment. Most GP practices have a nurse who specialises in COPD and asthma. It would be a good idea to discuss your treatment with them if you haven’t already done so.
Dr Matt Brooks
First published in the October/November 2012 edition of Cycle magazine.
Q After strenuous cycling, particularly in chilly weather, I sometimes develop a wheezy cough that lasts for a week or two. I have no other symptoms of illness, and even the cough seems to abate when I am cycling. I’ve visited my GP who said my health was good. I blew into a device to check my lung capacity and was told there were no abnormalities. Should I be worried about the cough?
A Without knowing your age it’s difficult to say, because there’s quite a number of complaints that can bring on a cough in older people.
One of the most likely explanations for a wheezy cough is asthma. This usually starts in childhood or early adult life. Although asthma can develop later in life, other causes of a wheezy cough become more likely with increasing age.
In asthma, there may also be symptoms of breathlessness or having a tight chest when the cough and wheezing are present. Normal spirometry (breathing tests to assess lung function and capacity) does not necessarily preclude asthma.
If asthma is suspected, you may be offered a trial of an inhaler to see if this helps. Your GP may also ask you to measure and record your peak flow rate (blowing hard into a tube called a peak flow meter) several times daily to look for a pattern suggestive of asthma.
Other causes of a wheezy cough can include a chest infection or hay fever (even in non-asthmatics), and COPD (chronic obstructive pulmonary disease, usually in older people who have smoked).
Asthma is often diagnosed without further investigation but, if the diagnosis is unclear, it may be necessary to do tests such as a chest x-ray to rule out other causes. Your GP will be able to help decide whether these are necessary.