Dispelling the myths of exercise and asthma

Mark W. Millard, MD

A 16-year-old boy comes into your office and says he needs inhaled albuterol. He wants to play soccer but becomes short of breath when he is out on the soccer field. He currently uses the drug once a week during exercise, and he tells you that his albuterol keeps him from being so short of breath. When you listen to his chest, it is clear. His history includes no complaints of wheeze or cough; he has had no emergency department visits, hospital visits, or even sick days related to asthma. How would you proceed with this patient?
With the paradigm of adolescence revolving around sports, it is not unusual for children to come into a primary care office with shortness of breath related to exercise. Right now, 20% of all children enrolled in the Dallas Independent School District have a history of asthma or current symptoms. Yet it is important to clarify the role of exercise in asthma and to dispel some commonly held misconceptions about exercise and asthma. This article deals with 3 such myths: that asthma stops patients in their tracks, that patients are "allergic" to exercise, and that managing exercise-triggered asthma requires specialized help.