For physiology studs only..

yoga crna · Apr 12, 2006

My guess would be exercise induced asthma. Here is an abstract that explains the physiology. I am anxious to hear what others may think you have. Very interesting and thanks for making us think.

Yoga

1: J Allergy Clin Immunol. 2000 Sep;106(3):453-9.Related Articles, Links

The mechanism of exercise-induced asthma is ...

Anderson SD, Daviskas E.

Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, Australia.

Exercise-induced asthma (EIA) refers to the transient narrowing of the airways that follows vigorous exercise. The mechanism whereby EIA occurs is thought to relate to the consequences of heating and humidifying large volumes of air during exercise. In 1978 airway cooling was identified as an important stimulus for EIA; however, severe EIA also occurred when hot dry air was inspired, and there was no abnormal cooling of the airways. In 1986 the thermal hypothesis proposed that cooling of the airways needed to be followed by rapid rewarming and that these two events caused a vasoconstriction and a reactive hyperemia of the bronchial microcirculation, together with edema of the airway wall, causing the airways to narrow after exercise. The osmotic, or airway-drying, hypothesis developed from 1982-1992 because neither airway cooling nor rewarming appeared to be necessary for EIA to occur. As water is evaporated from the airway surface liquid, it becomes hyperosmolar and provides an osmotic stimulus for water to move from any cell nearby, resulting in cell volume loss. It is proposed that the regulatory volume increase, after cell shrinkage, is the key event resulting in release of inflammatory mediators that cause airway smooth muscle to contract and the airways of asthmatic subjects to narrow. This event may or may not be associated with airway edema. The osmotic and thermal theories come together by considering that inspiration of cold air not only cools the airways but also increases the numbers of airway generations becoming dehydrated in the humidifying process.

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rn29306 · Apr 12, 2006

Yoga you are awesome. As one poster said, I hope to be able to meet such a role model at some point at an AANA event.

Thanks again.

susswood · Apr 12, 2006

I am no phys stud.... but my first instinct was exercise induced asthma. I think this only because my husband gets it, so I see it from time to time..... and it sounds similar.

London88 · Apr 12, 2006

Without looking at any studies the first thing that came to mind is was it cold where you were jogging? cold air that is less than adequately humidified can cause narrowing of the bronchioles. Pretty much like Yoga said exercise induced asthma.

Pete495 · Apr 12, 2006

I agree with the exercise induced asthma. I also wonder if the altitude had anything to do with a decreased o2 intake. doubt it however, since you said you were running down hill. I wouldn't worry about the heart rate. I'm sure it did go that high. Not every theory is totally physiologically sound.

I have exercise induced asthma, and everytime I exercise, esp. after not having done so for awhile, such as a run that you described, I get congested w/ chest discomfort and coughing for a day or two. If you continue to exercise routinely, it usually goes away. If you're like me, and are very busy in between exercise periods, and are losing exercise time because of school, then you get it a lot.

good post though.

rn29306 · Apr 12, 2006

Without looking at any studies the first thing that came to mind is was it cold where you were jogging? cold air that is less than adequately humidified can cause narrowing of the bronchioles. Pretty much like Yoga said exercise induced asthma.

No, infact it was a rather warm day in GA. Good pointer though.

NephroBSN, BSN, RN · Apr 12, 2006

Allright guys. All you physiology masters pay attention. I need an explanation of what happened to me when I was in my early 20s.
DISCLAIMER: To the moderators, please don't can this thread. I am not seeking medical advice as this was a one-time occurence and I got a checkup soon after. All checked out OK. I AM NOT SEEKING MEDICAL ADVICE, just a physiological explanation.
Early 20s, better than average shape and build, but certainly not marathon runner shape (I guess as you will soon see). There is a place in Georgia called Kennesaw Mountain. It has a hiking trail up the mountain and then a paved road that circles the mountain all the way up, about 2 miles in distance. It is quite a steep road. I put on a very quality heart monitor and basically ran down the paved road as fast as I could. For 2 miles. Suprisingly it was not that hard, just put you feet in front of you. During this, I passed a car traveling down the road. No lie.
My HR peaked at 209 BPM which violates the 220 - your age formula.
Sustained HR in 180-195 range the trip down.
Afterwards for 3 days, anytime I took a more than normal, resting tidal volume breath an inspiratory wheeze developed and I had an irrestible urge to cough. Needless to say, this was worse than my nagging GF ever was.
I would assume I gave my self a stress test at that time. Never did I feel any CP or discomfort. I probably created a very large consumption / supply deficit because I was not breathing that hard (running down a hill ain't rocket science, just go with gravity) with such a high HR. But like I said, never any CP or discomfort.
Any takers on the cough and wheeze?

With my eyes closed. Exercise induced asthma..

Got any difficult one's??? :lol2:

Sorry this really was pretty easy.

rn29306 · Apr 12, 2006

With my eyes closed. Exercise induced asthma..
Got any difficult one's???
Sorry this really was pretty easy.

Not too hard after multiple people came up with it huh?

I will give you the benefit of the doubt and say that you are a pro.....Now only if we can get you to tough out a 30 guage needle and quit lying and telling people that you are allergic to lidocaine when you really aren't.

Just a thought. :nono:

NephroBSN, BSN, RN · Apr 12, 2006

Not too hard after multiple people came up with it huh?
I will give you the benefit of the doubt and say that you are a pro.....Now only if we can get you to tough out a 30 guage needle and quit lying and telling people that you are allergic to lidocaine when you really aren't.
Just a thought.

I didn't read the other answers BTW...I happen to have EIA too. That might be why it was easy.

Lidocaine hurts me. Who are you to decide what I am allergic too.

Pain is in the eye of the patient not your's.

BTW did you mean gauge ??????????????

BTW why doesn't the RED CROSS use lido before sticking me to get my blood??????

rn29306 · Apr 12, 2006

I didn't read the other answers BTW...I happen to have EIA too. That might be why it was easy.
Lidocaine hurts me. Who are you to decide what I am allergic too.
Pain is in the eye of the patient not your's.
BTW did you mean gauge ??????????????

That still does not make it an allergy....At what point might you realize that?

Sorry for the incorrect spelling. I've been up since 0500 giving 6 patients anesthesia.

NephroBSN, BSN, RN · Apr 12, 2006

That still does not make it an allergy....At what point might you realize that?
Sorry for the incorrect spelling. I've been up since 0500 giving 6 patients anesthesia.

It makes it an allergy if I say it is.. I also don't like the effect I got from Percocet I list it as an allergy. Some time I might not be able to speak. I don't want lidocaine under my skin.

I've had anestheologist start my IV's, yes I have terrible veins, and they didn't use lido.. Said I don't want to cover up what veins you do have.

I had 17 sticks when I was in the hospital for DVT before I got a triple lumen placed.

I didn't like it when the ACU nurse just decided on her own to give me idocaine without asking me. I dont' like needles. One is enough for me.

And when I had the central line placed the surgeon used the spray.

Get some sleep...

We use 15 guage needles, two of them, three times a week on our patients all without lidocaine.