Asthma
Exercise, diet, weight and other lifestyle issues
With the right treatment and management asthma shouldn’t restrict daily life. As well as taking regular asthma medication people use various self-care measures to reduce the symptoms and the risk of further attacks.
Exercise
Everyone knows that taking exercise is very important for general health. In our interviews people talked about taking part in a whole range of different types of exercise, including yoga, swimming, pilates, going to the gym, rugby, football, golf, tai chi, walking and running.
Tomas has had asthma since early childhood and when he was very young he found it difficult to join in with PE and activities, but as he got older he learned how to manage things so that he could take part in sports with his friends.
Tomas has had asthma since early childhood and when he was very young he found it difficult to join in with PE and activities, but as he got older he learned how to manage things so that he could take part in sports with his friends.
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What do you mean mad? [laugh]
Well like angry, was just a bit annoyed at, by the fact that I couldn’t join in at a lot of things because of my asthma.
At school?
Yeah at school.
What about your friends at that time? Did you join in with activities that...
Yeah, yeah
...the others were doing?
Yeah I did. I joined in quite a few things with them. But seems as though I was so young they wouldn’t really understand so it was just, you know, just they generally thought there was nothing wrong. That I was just, you know, just running and getting out of breath for no reason. But I did join in just obviously couldn’t do as much as I would have liked to, just joining in and stop after a while.
And at school did you have to miss schooling around that time when you had your, your attacks?
Yeah at the time I missed quite a lot of school. I mean even now I’ve missed a couple of days but not as much as I used to but I still have days where I just don’t feel right and I feel I have to stay in from anything. So even now I just still get it as well.
You said that the, the attacks became less frequent after the age of ten. If you have to compare how much activity you did before and after ten did you get involved in more kind of school activities and things like that or?
Yeah after my asthma attacks were less frequent I would say I got involved in a lot more. Because I discovered that if I like took my reliever before doing activities then I wouldn’t be out of breath as, as much which meant I could do a lot more of what I wanted to and a lot of different things which I’d never been able to do in the past. So yeah, after ten I would say I did, I done a lot more than before.
What did you want to do before?
Well nothing big obviously because I wasn’t that old but just being able to do what everyone else was doing really at the time. Just being able to join in, in everything else was the main thing.
Like what?
Just you know, just any sport like football or just running around or whatever game we were playing, just anything like that.
Dee feels a responsibility to do what she can to help improve her lung function ‘ It doesn’t have to be training for a marathon or anything like it…..it’s about taking a bit of control’.
Dee feels a responsibility to do what she can to help improve her lung function ‘ It doesn’t have to be training for a marathon or anything like it…..it’s about taking a bit of control’.
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So it doesn’t it doesn’t impede my life. It doesn’t get in the way but I think if you’ve had a really serious asthma attack, you don’t forget the fear factor.
What I’ve learnt is, you can do an awful lot with your own general health if you take a kind of a, if you take and a run and a jump at it and you know for instance that you need to lose a bit of weight or you’d been out of exercise for such a time and take yourself in hand for a month or two and see if you can improve that. For instance, if I, one of the things that would happen to me intermittently is I would be busy at work, I’m neglecting taking regular exercise and then every so often I have to give myself a talking to, go back to the swimming or go back to the yoga. That’ll last for, if you’re lucky, three months as a sort of a regular thing. You feel the benefit of that. You can run up and down stairs easily. You can feel your lung function improving, yeah. Then you go on holiday and do nothing for two week, yeah, then it’s you get distracted with family and things happening and before you know it, six weeks have gone past and you haven’t done any regular exercise. And it’s things like that, I suppose I would kind of think, “Well, what can I do for me first before I.”
Yeah. But no, I’m lucky that I’ve got good health. Thyroid condition is controlled with thyroxin. The asthma is controlled with the drugs, when I need them, and I can go for a very, very long periods of time where I don’t use the asthma drugs at all.
As long as I have the inhalers and the accuhaler with me, nothing. I do feel a responsibility to, particularly as I get older, I do feel a responsibility to put a bit of effort into my lung function. And I’m one of those people who just doesn’t get on with gyms. I can’t, like I just can’t get the gym thing at all. I just get bored. But I like to dance. I like to sing and I like to do yoga and I like to swim, walk the dog, yeah, cycle.
And any of that you can really, in quite a short period of time of taking short bursts of exercise, you can make a really big difference to your lung function. You know, doesn’t have to be training for a marathon or anything like it. So I suppose I maybe that’s the only thing I have come to recognise that without an intervention, without medication there’s a responsibility on me, if you like, to kind of do what I can do. To keep the lungs in good condition. Now the fact that I have to have my preventative and relieving medication with me to do that is that’s just an outcome of the condition. But it doesn’t mean you can’t work on with improving your lung function. I don’t know if that’s ever, I don’t know if anybody’s ever measured what difference it makes to asthma but it makes a difference to your general health. And that can only be a good thing.
So I suppose it’s about taking a bit of, again, it’s about taking a bit of control and a bit of responsibility for it yourself.
John’s asthma doesn’t stop him from being a professional rugby player. ‘I like to think I’m one of the fittest players on the team’.
John’s asthma doesn’t stop him from being a professional rugby player. ‘I like to think I’m one of the fittest players on the team’.
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I don’t think it stops, it shouldn’t stop you doing anything. I think it’s huh I don’t think unless, I can only speak for myself. But I think my grandad who has it a lot, a lot more severely than me. He still swims, he’s still very active. I think you can only, it would be mental thing if it stops you from doing anything, because now you’ve got the inhalers, you’ve got technology to stop it. To make you be able to cope in life with it. So I think, it can be used as an excuse, but you shouldn’t be.
I only think that if, as I say if you’ve got inhalers, if you push yourself then I don’t think it is an issue and I like to think I’m one of the fittest players on the team, cardiovascularly and aerobically. So I just don’t think that it can be made as an excuse and yes, I do have it mild to medium, I wouldn’t say I’ve got a severe case of asthma, but for some of course it may be different. Not everybody’s fit. But I do know people who do have it worse and who are still extremely active so…
Because actually exercise does improve the lung capacity doesn’t it?
Yes, it does. So I think if you exercise and you lead a healthy life then things like sport, they shouldn’t be a no- no for people who have asthma because I feel yes, I pretty much feel that if you do have asthma yes. It just shouldn’t be an excuse really.
Tim thought he was hopeless at sports as a youngster, but after he was diagnosed with asthma in adulthood and had the right medication he started doing sports that he’d never done before. Last year he cycled from Lands End to John ‘O Groats.
Tim thought he was hopeless at sports as a youngster, but after he was diagnosed with asthma in adulthood and had the right medication he started doing sports that he’d never done before. Last year he cycled from Lands End to John ‘O Groats.
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But when you observed your friends, I’m assuming that you …?
Yes, but as I say I just thought I was hopeless at sport. I mean I could never get into the right, well the right, I could never get into the soccer team or …and of course as a result I developed an aversion to sport. Which persists [laughs]. And I never really competed at anything much. I, there was a clue I guess, if I’d been sensible enough to pick it up, that I was pretty good at running a hundred yards, where you don’t need to keep breathing deeply for long periods. You run more or less off stored energy. I was pretty good at that. But nobody seemed to draw any conclusions from that and neither did I.
When I first was diagnosed I did start doing sport that I’d never done before. I started running for instance. And I still do occasionally. I do a lot of walking nowadays. Just within the last couple of months did a cycle ride from Land’s End to John O’Groats, so I can’t be in too bad condition.
That’s quite amazing, yes.
Yes. So I mean it certainly didn’t affect me.
And did you need to use your inhalers at all?
Oh I might have used it once or twice, you know, early in the morning perhaps, just to make sure everything was firing on six, but it doesn’t no, it certainly didn’t prevent me doing anything.
Of course most people are not competing in sport at a professional level, but there are plenty of different ways to fit some level of exercise into daily life. Often people said that they were determined not to let asthma stop them from doing something that they enjoyed and to focus on what they can do rather than what they can’t. Margaret said, ‘That’s the way to beat the beast, it’s not to let it rule your life’. Often people said that when they took regular exercise they could feel the benefits in terms of general health and wellbeing, and in particular that it helped with lung function. One common piece of advice was to take a reliever inhaler before starting exercise, rather than taking it after the breathlessness had started. Getting this advice from a friend changed things completely for Esther.
When she was first diagnosed Esther had a few years when she felt unable to do sports, but she started again when a friend who was a serious runner explained that he always used his inhaler before running.
When she was first diagnosed Esther had a few years when she felt unable to do sports, but she started again when a friend who was a serious runner explained that he always used his inhaler before running.
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And so when you took up running did you have your asthma in mind? I mean what did you think about how that might pan out for you?
I used to run before.
Did you build it up gradually?
Yes. But also, I’d always been a swimmer and a runner, well, I’d run at different points. I’ve always you know, done some form of exercise. And running’s basically the cheapest thing you can do. You don’t have to pay for a gym membership. And it’s nice and quick, because you’re at home and you just get changed here anyway. So I would often walk my daughter to school and then run back, and perhaps run round you know, and then start sort of adding a circuit of the park and then you know, having my shower and get on with my day. And that’s great. You’ve done your exercise first thing.
A lot of people kind of would be frightened I think perhaps if they’ve got asthma of taking up a kind of exercise like that?
Yes, well I have some friends here who are in the running club and really serious runners, and one of them said to me, “Oh,” he said. He said, “I always have a puff before I run.” And I suddenly realised, so what I had been doing, was running and worrying about whether I was going to get wheezy. Well once he told me that, to have a puff before you go, then you know you’re not going to get wheezy and then you can concentrate on the rest. Oh my goodness, it just changed my life [laughs]. So that’s why I can run so well, because I don’t worry about getting wheezy because I have a puff first. And when I was, you know, yes, if it’s really, really horrible, cold wintery coldness, I’ll have two puffs perhaps [laughs]. So I’m just sort of doing prophylactic puff.
Because I understand that actually doing exercise can be, is beneficial because it opens up the lungs and keeps them kind of active?
Yes, it’s better for you to do exercise now, yes, absolutely. Also it’s just better for you because it keeps your weight down, it makes you feel good, it gives you energy, you feel virtuous for some reason.
Catherine has found ways to exercise which suit her, especially swimming and going on the treadmill. She says, ‘I’m fitter now than I’ve ever been’.
Catherine has found ways to exercise which suit her, especially swimming and going on the treadmill. She says, ‘I’m fitter now than I’ve ever been’.
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And as a result my lungs are stronger and I think that’s one of the reasons why I don’t have as many attacks and I control it and I don’t have as many chest infections.
What exercise have you found that you are able to participate in then, that gives you that extra…
Treadmills are great... because then no matter what the weather I can still do walking. Exercise bikes. I like swimming as long as it’s not a particularly chlorinated pool. Sometimes if it’s a very chlorinated … pool, the fumes can aggravate your asthma. But just simple things like gardening can help. If you’re not allergic to pets, walk your dog [laughs] it doesn’t have to be a lot at all.
I think one of the things about asthma that I’ve picked up is, is about lifestyle changes and that ... people find, sometimes find it quite difficult that they have to stop doing …
Yeah.
… things, but I’m picking up from what you’re saying that it’s more a question for you anyway of, of finding other things, just …
Yeah.
... working out what you personally can tolerate …
Yeah.
… or do rather than …
If you …
… stop doing everything.
… yeah, if you sit and focus on what you’ve lost, life’s going to be hell. And you’re going to be miserable as hell. And, because if you dwell on it, you, it’s, you, you will end up thinking, it’s not ruddy fair. But you have to find things that you do like … and that you can do. And it is very hard, and it does take time. But you can get there and you can find a life whether…
I’m not so frightened of my health these days as I used to be. One, because I know I can manage it. I do live on my own and I cope with it.I work full-time. I’m off sick less than healthy people because I manage it. I travel abroad on my own. It’s not going to stop you from having a life, you just have to … find the life that suits.
Mary has severe chronic asthma but has been swimming with friends twice a week for the last twenty years. She has also recently taken up playing golf, and says her friends have really helped her by encouraging her to get involved.
Mary has severe chronic asthma but has been swimming with friends twice a week for the last twenty years. She has also recently taken up playing golf, and says her friends have really helped her by encouraging her to get involved.
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Oh that’s really good.
Which has made an enormous difference.
Because I think people might assume that that wouldn’t be something that you’d be able to do.
Well, you can. You have to learn to do things at your own pace. And everybody else swims up and down, up and down, up and down. I sit up, get my breath back and then swim back again. I can do nearly as much as them, but it takes me longer, because I have to pause.
And what about the chlorine and the chemicals?
Well most swimming pools nowadays haven’t got chlorine in them. I think the chlorine actually now in swimming pool is the top few inches. They put something else, calcium carbonate or something in swimming pools, and it’s that reaction with the air and the top of the swimming pool that causes any chlorine smell.
Are there things that are just totally out of bounds that you really can’t do that you would love to be able to do?
Yes, I would love to be able to dance. I’ve never been able to do that because it takes continued effort. I’ve never been able to run. I’ve never really been able to walk up hills very easily without, you know, dozens of puffs of Ventolin.
But you do still take forms of exercise that you can manage?
Yes, I started to play golf, but now I’ve found that I can only do it if I have a buggy [laughs]. I can do it, because... First I had an electric trolley to pull me up the sliding climbs. You can find things that you can do.
It sounds like quite a good philosophy to focus on what you can do, rather than to worry too much about what things are missing?
Hm. And I think I’ve just been, I’ve been very lucky that I’ve had very good friends that have had the same sort of philosophy, oh well, let’s help Mary do it really.
A doctor explains why it’s important to take exercise if you can, and to know your limits. Using a reliever inhaler before participating in sport or exercise can reduce or eliminate symptoms.
A doctor explains why it’s important to take exercise if you can, and to know your limits. Using a reliever inhaler before participating in sport or exercise can reduce or eliminate symptoms.
Sex: Male
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Swimming is regarded as an acceptable form of exercise for asthma because people are breathing humidified air. And while there is some issues about whether chlorine will exacerbate some people, in general terms the humidified air is, is a help for asthmatics. Breathing dry air often triggers them.
So its understanding what makes, what is right for them and then either avoiding them or developing strategies for managing them. It’s very individual.
It’s a difficult one, because for those who’ve got bad asthma exercise is impossible. They have to walk slowly. They find what you and I would regard as relatively mild exertion as impossible. At the milder end of the spectrum if you like, where people may well find that on their good days they can run miles, and on their bad days, they find that after, you know, walking half a mile, they’re breathless. Then that’s just a matter of understanding taking, you know, preparatory doses of inhaler. People generally know when their asthma’s not quite right. They talk about it in those terms, rather than being able to define it more clearly. And understanding what needs to be done to avoid those situations or at least deal with them, is very individual.
Diet and weight
People we talked to were aware that they were advised to eat healthily, but that their asthma does not require them to follow a special diet – unless they found that food was a trigger. Common food allergies include cow’s milk, eggs, fish, shellfish, wheat products, nuts, and some preservatives and colourings. Alcoholic drinks such as wine and beer can make asthma symptoms appear, and one person said fizzy drinks affected her asthma.
Faisil finds that certain foods trigger his asthma and has tried to cut them from his diet to avoid getting symptoms.
Faisil finds that certain foods trigger his asthma and has tried to cut them from his diet to avoid getting symptoms.
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Do you avoid them completely or would you kind of do it in moderation and see how it goes?
I did sort of cut out milk for a long time. But I think I ended up with a calcium deficiency, so and I think eventually, when I started it just bothered my stomach than my breathing. So then you’ve got that lactose free in the alternatives so I started using that more, because I started going basically with the calcium deficiencies and stuff. So it’s not as much of a problem.
But the rest for example, avoiding, yes, I mean I can avoid having frozen stuff because it always ends to be stuff that’s not good for you in the winter time, so I can sort of live without that. Fizzy drinks I find hard work, because I don’t drink alcohol and I do find that it tends to, I just seem to always have an unsettled stomach anyway for some reason. Fizzy drinks help that in one case but it causes the problem the other way, so it balance… I can be quite annoyed.
Certain wines and beers affect Charles but not all, so he can drink alcohol but just avoids the types that set off his asthma.
Certain wines and beers affect Charles but not all, so he can drink alcohol but just avoids the types that set off his asthma.
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Well I will do actually now, because there’s so many nice alternatives. Therefore I used to drink quite a lot of German wines. We had a neighbour who was German and was also a master brewer, I know this sounds slightly off track, but he was very much into the field of wines, and he said that quite often it’s how they treat the grapes and how they spray the vines which they do with white wines in certain areas. And it’s probably an additive associated with that. And therefore because of that I kept off the German wines and I might go to French or Chilean wines which don’t seem to affect me to the same extent.
I certainly know with beer, that’s another one that certain beers can affect me. You know, I can just take half a pint of beer and I’ll start wheezing and I’m told that again certain places treat their hops in a certain way. And that can, there is obviously an additive there which I’m sensitive to.
Other lifestyle and environment factors
Smoking is especially bad news for people with asthma because it can irritate or even permanently damage the airways, and can also block the benefits of asthma medicines, increasing the risk of an asthma attack.
A doctor explains why asthma sufferers shouldn’t smoke if at all possible. It’s not easy, but there are programmes to help you quit.
A doctor explains why asthma sufferers shouldn’t smoke if at all possible. It’s not easy, but there are programmes to help you quit.
Sex: Male
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Would your advice, what would your advice be, to stop smoking?
Absolutely.
… if you’re diagnosed with asthma?
Absolutely. Stopping smoking is mandatory in my view in asthma. Easier said than done, but of course there are lots of smoking cessation clinics now in both primary and secondary care, and we’re getting better at being able to provide the sort of support that people need to get off what in many cases of course is an addiction. But cigarette smoking is an absolute no, no, in asthma.
Gail gave up smoking several months ago after being a smoker for many years and says since then she’s hardly had to use her inhaler at all. [AUDIO ONLY]
Gail gave up smoking several months ago after being a smoker for many years and says since then she’s hardly had to use her inhaler at all. [AUDIO ONLY]
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Well we’ve been, we’ve been trying on and off for years to give up smoking and I had a stroke five years ago and I should have given up then. But again stress makes you think that you actually need the nicotine to keep going and, and I was getting more and more upset the longer I would try to not smoke. So about, well as I say seven and a half months ago my husband had had another bad chest infection and he said, “I think it’s time to give it up.” And I said, “Well come on let’s do it.” And we did.
We sort of had nicotine patches for three days and stopped the nicotine patches and I haven’t smoked since.
That’s quite an achievement.
It was.
Were you quite …
We were really, really pleased as punch that we, you know, we’d done it. We still go through periods at certain times of the day, when we think oh yes, we can have a cigarette now. And, you know, the normal times that you would have a cigarette. And you get a sort of stressful period, you think I could really do with a cigarette now. And then it goes. As quick as it comes, it goes again. And as I say seven and a half months now, and yes, we’re still not smoking, so we’re really, really pleased.
That is a good thing. So looking back would you say that the smoking exacerbated your asthma?
Yes, I wouldn’t have then. If you’d asked me then, I would have said no smoking has nothing to do with it.
Would you?
I would have said that then, yes.
Why do you think that was then? Was that denial?
Denial. That would have been, yes, it would have been denial definitely. But because of the way my chest is now, then I know definitely that the smoking aggravated it. Definitely.
People whose asthma was triggered by house dust mites, cleaning products and pets, were sometimes able to make adjustments to the home environment to minimise contact with their triggers. This could be difficult when visiting friends with pets.
Dusting and housework can make people feel unwell, and some joked that this meant they had a great excuse to employ a cleaner, or that their partner did the majority of the housework. Margaret’s husband always hoovers the bed when the sheets are being changed, and they have a cleaner to try to keep dust to a minimum. People often thought that it helped to have hardwood floors in their home rather than carpets, and to keep things like rugs and cushions to a minimum.
Catherine explains that it’s important to know your triggers and says ‘you have to keep a clean environment otherwise your asthma will suffer’.
Catherine explains that it’s important to know your triggers and says ‘you have to keep a clean environment otherwise your asthma will suffer’.
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Duvets are not good if you’ve got asthma. Carpets aren’t good if you’ve got asthma. Lots of curtains and cushions aren’t good if you’ve got asthma. If you’re a child, soft cuddly toys no go area. And as an adult that means for me living on my own means having wooden floors, and although I’ve got rugs it means they’ve got to be super clean. Cushion covers have got to be washable. They’ve got to go in the washing machine a lot, if I do have curtains they’ve got to be clean. And that all costs money.
Tim doesn’t have carpets or curtains in his house because they can accumulate dust.
Tim doesn’t have carpets or curtains in his house because they can accumulate dust.
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And what is it about soft furnishings and curtains?
Oh well I guess its dust mites and all that sort of stuff. No matter how clean the place is but it harbours mites and dust and all the rest of it and that does set it off.
I know you said it’s partly a matter of taste, but is it something that you would definitely think about when you were furnishing a house?
Oh yes. I mean, yes, it would be second nature. We wouldn’t, we simply wouldn’t have carpets in the house, and as you can see in this place we’ve got a few rugs and that’s it. You know. And because you can take those out and shake them out. Not that we do often enough, but yes, certainly it’s a direct result of my condition that we do that.
A few people said they felt nervous about travelling away from home because of worries about having an asthma attack in unfamiliar surroundings. Remembering to pack inhalers and making sure you have some knowledge about the local area you are visiting is important. Some people found it helpful to be able to take steroid tablets away with them, with the agreement of their GP so that they had them to hand if needed.
Dee says be organised when you go away on holiday even if you don’t always need your medication, it’s best to have it with you.
Dee says be organised when you go away on holiday even if you don’t always need your medication, it’s best to have it with you.
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