Lots of exciting stuff

I’m writing this in my new home state, TEXAS!
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I had an interview for the job on Tuesday in the week when I last posted.  On Wednesday, they called to say I got it!  I flew home on Sunday, packed up all my stuff, and left early Friday morning.  I drove down with my dad and got into Austin late Saturday night.  And then I started work Monday morning!  The job I am in right now is a contract position for a year, but I have an interview set up on Tuesday for a full time position in a different group within the company.

I am living with my brother and sister-in-law for now until I find my own place.  They live in a house with a guest bedroom that I have taken over.  They’ve been out of town for weddings the entire time I’ve been here so I’ve had the whole house to myself.  I’m going to start looking for my own place next week now that I’ve gotten a better idea of what the different parts of town are like.

One of the best parts so far about being in Austin is the weather.  It’s been in the high 80s every day and I love it!  Yesterday, I went for my third run since the half marathon (a month ago).  It didn’t go so well but it felt good to be out running again.  It is crazy how quickly my breathing deteriorates when I stop running.  I think if I start running regularly again I will get better soon.  I just have a hard time slowing myself down to the point where my chest won’t start getting tight.  When you ran a half marathon not too long ago it feels a little strange to barely be able to run two miles.

Now that I know my schedule I can add training back in!  I just have to find where I like to run around here.  There are sidewalks everywhere which is great but the one area I have run so far is on a somewhat busy road.  I don’t like having to wait for the crosswalk or breathing in all the exhaust fumes.  I know there are great trails to run on so I’ll have to check those out in the next week or so!

Now it’s time to decide what to train for.  I sort of wanted to train for a faster 5k at first.  Alex wants to do a half marathon in Jan or Feb so I am 95% sure I want to do that.  And then Drew and Alex’s friends were talking about training for a marathon and since I can’t turn down a challenge I think I might end up doing that.  I don’t know when or where they were thinking but since it is on my bucket list to do a marathon I might as well! I did sign up for a Blacklight 5k in November but it is one of the fun runs so I’m not worried about training for that.  As long as I start getting back into the swing of things again I should be fine.

I also started looking up yoga studios which I think will be important this time around so I can stay injury free.   I didn’t do such a great job of stretching and a regular yoga class could make sure that will happen.  I’m going to try to find one either close to work or close to the house.  If I could walk to the yoga studio from either, that would be perfect.

Anyone have any recommendations for yoga studios in Austin, TX?

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What it is actually like to run with asthma

Since I have asthma, running was difficult when I first started.  I started by using running/walking intervals to slowly build up my endurance.  I know I have to push myself if I’m going to get stronger.  The difficult part is knowing how far I can push myself to keep improving without triggering an asthma attack.  I don’t mind being out of breath every once in a while but I prefer to avoid triggering my asthma.

Regular shortness of breath: If you start working out harder than your fitness level can handle, you are going to get out of breath.  Your body needs you to breath deeper and faster to meet the higher oxygen demands for whatever your activity is.  If you took a break, you would be able to quickly catch your breath.

Asthma attack:  When you have an asthma attack, you may feel like you are short of breath but there is more going on.  During an asthma attack, it actually becomes physically harder to breath.  The bronchioles bringing the air from your mouth to where the oxygen is absorbed become inflamed and thickened and mucus starts building up.  Air gets trapped in the alveoli, which are basically air pockets where oxygen is transferred from the air into the body’s cells. If you take a break from activity during an asthma attack, you won’t be able to quickly catch your breath.  You are going to need a rescue inhaler to relax the smooth muscles of the bronchioles to make it easier to breath.

What the bronchioles look like with and without asthma.  Imagine how much more air you can get through the one on the left compared to the one on the right.

What the bronchioles look like with and without asthma. Imagine how much more air you can get through the one on the left compared to the one on the right.

Having asthma my whole life, I have learned how the sensations of the experiences are different.  I can’t quite put it into words but asthma from allergies feels different to me than asthma from exercising.  Both of those feel different from the point in running where I need to focus on my breathing.  Knowing the subtle differences had been helpful in keeping me safe while I exercise.

While I run, I pay special attention to not push myself over what I like to call “the edge.”  It’s a feeling that I get when I am running harder where I know that if I don’t back off I will have an asthma attack.  I start to get a sense of overall tightness in my chest, sometimes with a more acute feeling.  For me, this usually happens when I sprint or run uphill.  Once I cross over “the edge,” the only thing that will make me breath normal again is my rescue inhaler.

This is probably why I haven’t liked running with anyone yet.  My pace is pretty slow and anyone I have run with (ok, there have only been two people so far) has tried to push me to go faster without understanding the delicate balance I have to maintain.  I would rather run slower and finish than try to run faster and have to stop immediately.

When I first started running, I used interval training to alternate between a steady run and walking.  I gradually increased the running time while decreasing the walking time.  With that base level of fitness, I am now able to go out and just run.  The half marathon training plan I am following doesn’t include intervals for speed work.  I am fine with that now because I think the distance challenge is enough for me.  I am able to go at a steady pace that feels comfortable on my lungs for all of my runs.

In the long run, I know I am going to have to face hills and speed work head on if I want to keep improving my respiratory health.  I might through a few sprints into my easy runs while I keep training.  Once the race is over (and I let myself relax for a while) I am going to switch it up by trying to bring down my 5k time.  As tough as it will be, I think it will be so worth the challenge.

What health challenges do you face while running or exercising?  How do you adjust your workouts around that?

The Rundown on Asthma

Asthma can be a frustrating and sometimes frightening condition to live with.  It doesn’t have to be if you have it well managed.  If you are going to be running and have asthma, I highly recommend you meet with your doctor first!  You can discuss treatment with your primary care physician but may need to see an asthma specialist.

When I go to see a doctor, I like to know what to expect and have some background knowledge about what they are looking for and what treatment could be.  Asthma will be evaluated based on severity and level of control and then assigned treatment based on those two factors.

First up… severity

It can be classified as intermittent or persistent.  If it is persistent it can be mild, moderate or severe.  To figure out your classification the doctor will consider how frequently you experience symptoms, how often it causes you to wake up at night, how often you use a short-acting beta­2-agonist (SABA) for symptom control and if it interferes with your normal activity.  They will also look at lung function measures like your forced expiratory volume, forced vital capacity and peak expiratory flow. 

Next up… level of asthma control

It will either be well controlled, not well controlled, or very poorly controlled.  The same factors are considered for level of control as in severity.   An “Asthma Control Questionnaire,”  “Asthma Control Test,” and “Asthma Therapy Assessment Questionnaire” are also used to judge level of control.

Finally… stepwise treatment approach

You should be placed at a treatment level depending on your severity and level of control.  Then you can step up if needed or step down if possible and asthma has been well controlled.  The following treatments are the preferred treatments, although some alternatives are available.

  • Step 1: For intermittent asthma, you should be prescribed a SABA as needed.
  • Step 2: With persistent asthma, you should be prescribed daily medication to maintain proper control of your symptoms.  The first step for persistent asthma is a low-dose inhaled corticosteroid (ICS).
  • Step 3:  The next step up is a medium-dose ICS or a low-dose ICS with a long-acting beta­2-agonist (LABA).
  • Step 4:  The next step up is a medium-dose ICS with a LABA.  If you reach this level of care or higher, you need to see an asthma specialist.
  • Step 5: The next step is a high-dose ICS with a LABA.
  • Step 6:  The last step is a high-dose ICS with a LABA and an oral corticosteroid.
  • Rescue treatment for all: SABA as needed for symptoms, possibly short course of oral corticosteroids for exacerbations.  If you are using the SABA more often, you should let your doctor know because you may need to step up your treatment.

All this information (and more of the details) was found on a handy table prepared at the University of Michigan.  The full guidelines and more can be found at the National Heart, Lung, and Blood Institute.

What I Wish I Knew- Running With Asthma

Now that I’ve been running for a year, I’m going to share some things I wish I would have learned a long time ago about running with asthma.  

  1. The doctor is your best friend.– If you have asthma and aren’t working with a doctor to make sure it’s controlled, you need to drop everything you are doing and make sure you get seen ASAP!  Whether you have allergic or exercise-induced asthma, there is something to be done.  There are rescue inhalers for emergencies and maintenance inhalers for daily use.  Your doctor will figure out the best plan for you.  Since I started allergy shots and using a maintenance inhaler, my lung function improved dramatically (as seen in my pulmonary function tests) and I rarely use my rescue inhalers now!
  2. Stop the excuses.– I am still working on this one but for the longest time I let asthma be the reason I didn’t really exercise.  Something finally clicked last summer and I realized that running was exactly what I needed to make myself feel better.  Since then I have been running rain or shine and don’t let myself skip runs because of asthma.  I’m always amazed at what I can do when I ignore my excuses and run anyway. 
  3. Cut yourself some slack.– While you shouldn’t let asthma stop you from starting or from pushing yourself, it is important to remember that asthma might give you some limitations.  You won’t be able to go as fast or as far at first, but that’s ok.  My favorite saying is that a 14 minute mile is just as far as a 7 minute mile.  When you put the hard work in, you should be proud of all that you accomplish.
  4. Make it work for you.– The only way you will keep up running is if you can keep it enjoyable.  Do the type of workouts you like to do (while still challenging yourself).  If a piece of advice you heard is just frustrating you, adjust it until it works.  With asthma, breathing is an especially import part of running so I tried to find advice on that.  When I started running last year, I tried to follow a pattern of 4 steps per inhale and 3 steps per exhale.  Trying to follow this pattern exactly left me out of breath and feeling defeated.  When I’m running now, I use the basic principle of the advice by focusing on my breathing and using my steps for timing.  This time, I let it happen as it needs to throughout my runs, whether that means longer or shorter breaths.
  5. Always be prepared.– Get enough sleep.  Drink enough water.  Eat healthy.  Keep your inhaler prescriptions filled and available.  Any time I have had a truly bad run has been because one of these things was not being done.
  6. Know your environment.– The last thing I wish I would have learned is to consider what conditions you will be running under.  I didn’t realize how much the cold would affect my breathing so I was not prepared for how much harder it would be to train in the winter.  Other adverse conditions include extra muggy summer days, high pollen counts, and poor air quality. Plan to run a different time, day, or place so there will be no problems!

This past year of running has been so rewarding.  Some of the lessons were learned the hard way but how great I feel now makes it totally worth it.  I would love to hear other tips and advice people have for running with asthma!  (Or breathing techniques that non-asthmatic runners are using!)