Firefighter Recruit with Asthma

[phoenix99]

I am currently in Stafford County, VA's Firefighter 1 class and I have mild, exercise induced asthma. I can do a lot of strenuous activity with no problems, I exercise regularly and I do not have to use my inhaler. However, since we started using our SCBA to perform search & rescue, firefighter rescue and the maze I have had 4 asthma attacks in a week and had to use my inhaler as both a preventative measure and for these attacks.

I can walk briskly with the SCBA on just fine, but as soon as I get into a crawling position I immediately start having a hard time breathing and have an asthma attack. I am not claustrophobic and I could crawl around in the maze all day with just turn out gear on. It doesn't bother me at all. Everyone immediately says "I bet you panicked because of the close quarters". It's not only in the maze that this has happened. It first happened during search & rescue and firefighter rescue drills. Anyone with anything similar? I have had to drop the class as the asthma created a medical liability. I am staying on as the Class Historian - taking pics, video etc. and I'm very happy and grateful my Lieutenant offered that option to me. I will be going to the Dr. and trying to strengthen my lungs to re-take the class in the future. Any help any of you guys can give would be awesome...help a sister out! I have wanted this since I was a kid!

[Drjmilus]

I found this book, and it's amazing:

Close Your Mouth : Buteyko Breathing Clinic Self Help Manual

By Patrick McKeown

It's a book on breathing exercises to re-teach you how to breath. It works for Asthma, Hay fever, and Nasal Congestion. It's white, paperback, with a mouth on the front/center. YOu can have it delivered to your house from Amazon for about $17.
http://www.amazon.com/Close-Your-Mou.../dp/0954599616

I have been recommending it to my patients for 3 years now. Here's how I found it: I had my nose, cheekbone and brow crushed, shattered, and broken (respectively). As you might imagine, I had 5 surgeries just to look almost normal. But my sinuses had been imploaded. After the 5th surgeries, and a year to heal, I still couldn't breath through it. I had chronic SOB, even though I am in really good shape, and I had night mares that I was sufficating! I even got tested for sleep apnea. I had never snored before in my life- and suddenly it was stopping me from sleeping! I saw someone I had not seen in a while, and they noticed I was yawning, sleepy, stuffy, nasally and breathing through my mouth only. They recommended this book to me. I thought they were nuts, but I was ready to try anything! It's only 139 pages. I read it in 1 day, started the exercises, and in 3 days, my sinuses were clear. I do the exercises in the car when I am driving and in the morning at the kitchen table while the coffee brews. And I feel great... better than I had for 3 years... no SOB... no nightmares, no decongestants...

I started recommending it to my lacrosse players who had asthma... and any of my patients with asthma, apnea or allergies. And they all LOVE it!

So- go buy it. Then write me back when you feel better...

Dr. jen
www.fireagility.com

[phoenix99]

I really appreciate the fact that you took so much time to reply to my issue. I unfortunately had to drop this particular class until I can get the asthma under control. I have made an appointment with my doctor and I am sticking with my class as the Class Historian - taking pics, video etc. I am so thankful that my Lieutenant is such a great guy and offered me the opportunity to remain a part of the class. I will be signing up for EMT classes and I will try to get my lungs in good enough shape to re-take Firefighter 1. I will definitely buy this book and read it. I'm up for anything! Thanks so much again! I'll let you know how it works out.

[edpmedic]

I read an article on Dieselcrew.com today, dated Oct. '07 about exercise induced asthma, by Frank DiMeo. I'm not sure of his medical background, or lack thereof. He paraphrases a section from the NSCA strength & conditioning manual, in regards to exercise induced asthma. He advises that the bronchconstriction is triggered by cold, dry air, coupled by mouth breathing. He also advises that nasal breathing both warms and moistens the air, which I'm sure you are already aware of. It would seem that the air from the pack, coupled with hyperventilation, could be triggering your bronchoconstriction. Perhaps nasal breathing will help. If you need more tidal volume, try breathing 4-5 breaths through your nose, then one deep breath through your mouth. I hope Dr. Jen's recommended reading has solved your problem.

[edpmedic]

Also, try breathing ladders, to condition yourself against hyperventilation. Take a weight(I use 95# hang squat cleans), do one rep, take one breath. Do two reps, take two breaths, 3/3, 4/4, etc. When you reach failure reverse the cycle. Aim for a progression to 12-15 reps, before adding weight. When you do each set, do not pause between reps to take extra breaths. You can, however, breathe as you like during the set. Between sets, if you hyperventilate, you cut down your rest period. If you properly control your breathing, you increase the rest interval, and can increase your work capacity. Be sure to choose an appropriate load to balance muscular fatigue, and oxygen debt. This should assist you in controlling hyperventilation while encapsulated.

[phoenix99]

Thanks for the info on the breathing techniques and exercises. I will definitely be working on this so I can get back in the fight. My chief, classmates and instructors have all been a great help too. Thanks again!

[Drjmilus]

EDP medic's advice is very sound. Especially note what he (she?) said about mouth versus nose breathing. The book will be great for you, because it is a road map to training yourself for nose breathing, and for $17 it's cheaper than one inhaler, right?

I sure hope you get what you are after- health, and a great career!

Thanks for your input EDP medic. I like to learn from all that you all have to say!

Dr. jen

[LADDER2EKU]

I'm from Stafford. Do you mind if I ask where you are a member?

[edpmedic]

EDP medic's advice is very sound. Especially note what he (she?) said about mouth versus nose breathing. The book will be great for you, because it is a road map to training yourself for nose breathing, and for $17 it's cheaper than one inhaler, right?

I sure hope you get what you are after- health, and a great career!

Thanks for your input EDP medic. I like to learn from all that you all have to say!

Dr. jen

Thanks for the complement, espacially considering where it's coming from. I'm a 31 y/o male, beginning recruit school as a firemedic at Fairfax county Va next month. I had some SCBA experience with my former employer, as a paramedic.

[phoenix99]

EDP medic's advice is very sound. Especially note what he (she?) said about mouth versus nose breathing. The book will be great for you, because it is a road map to training yourself for nose breathing, and for $17 it's cheaper than one inhaler, right?

I sure hope you get what you are after- health, and a great career!

Thanks for your input EDP medic. I like to learn from all that you all have to say!

Dr. jen

Thanks Dr. Jen and EDPMedic for all your advice. I am determined to do this!

[phoenix99]

I'd look into whether you'll be cleared for employment. Or is this academy part of a recruit program and you go right to work with the dept? A lot of cities will label you "unfit to work" if you are diagnosed with asthma in a physical prior to being employed. Just cover your bases and good luck.

It's a volunteer recruit class. I am going to go EMT and work on getting the firefighter later on when I am able to breathe and crawl with the SCBA. Thanks for the advice guys!

[Drjmilus]

First, I recognize that asthma can be a terrible and even deadly problem. BUT: I also see more and more people (especially kids and athletes in my world) told they have asthma, and given inhalers. They say the kid has exercised enduced asthma...

I am a former collegiate athlete, CSCS, and sports coach and have had countless times when I simply played/ran so hard that I completely overwhelmed my respiratory tract. I became hypoxic. In the 80's, I stepped out of the game a caught my breath. I went back in when I could breath again.... once my body caught up with the oxygen demands I was putting on it. Nowadays a doctor syas, "You have asthma" at the drop of a hat and prescribes meds. What if the kid is just out of shape and playing harder than their body can handle? Could he/she not train harder to bring their VO2 max up? That's what we did. It sounds like CYA to me...

Food for thought with cases like the above mentioned... his doc prescribed it, but the long term implications could be more than just CYA.

I see the point that in some cases, it's a REAL threat, but I also know that the "incidence" of astham has multiplied in the last 20 years. Hmmmm...

Never stop training!
Dr. Jen
www.fireagility.com