The Lung Experiment!

As a follow up to the January Newsletter, I wanted to go into a little more depth on asthma and endurance sports. Along with that, I’m announcing the start of an experiment that will become clearer as you read through the blog.

I have moderate asthma. I kind of feel like I’m at an AA meeting when I say that. “I’m asthmatic…I’ve been clinically diagnosed as being asthmatic for about 18 months now…”

I’ve heard for quite a while that I’ve been “borderline” asthmatic.  When I first started working for Hoffmann-La Roche in Basel, Switzerland, they did a THOROUGH baseline physical as only the Swiss could do…they even did a cool Conconi test for me on the bike. That was back in 2001 before I got all geeked out on physiological testing.  I think that might have planted the seed to be honest.  Anyway, I digress.  When I transferred to the Boulder site of Roche, I had a lung function test every year and every year the occupational health doctor would tell me: “you are borderline asthmatic with these numbers but since you seem so active and have such good numbers otherwise…it’s probably not a big deal”.  I suppose I was in denial and never wanted to think that I was somehow “defective”.  So, I never went to the doctor for a follow up. Fast forward to 2010…I had been living in Indiana for two years and THIS year, my allergies were KILLING me.  They had gotten so bad that it interrupted my sleep…I HATE to lose sleep.  I started self medicating with what my niece called the “ghetto inhaler”.  I used Primatene® Mist. It worked a little and then I gave in…”I have good insurance…just go to the doctor, goofball!”. 

So I make an appointment and see the asthma/allergy expert in town.  We have a discussion.  He gets a little history on me.  When we talked I recalled how I used to get bronchitis A LOT as a child.  I HATED that medicine…tasted like bananas.  He guessed that back in the 70’s asthma was not diagnosed as easily as it is nowadays.  I suppose there is some truth to that.  During my research, I’ve discovered that there is accumulating evidence that postnatal infections, in particular viral infections, down regulate Th-2-cell domination (that is T-helper lymphocytes)and diminishes the subsequent risk to develop atopic, or “allergic” asthma (Howarth PH. “Is allergy increasing? Early life influences.” Clin. Exper. Allergy 1998; 28, 2).  Just as a reminder, atopic asthma accounts for 90% of the cases (Holt PG, Sly PD. “Breaking the nexus between asthma and atopy” Med. J. Aust. 1998, 169, 54).

Well, we do the lung function test and it came back pretty clear that I had asthma. It was so “low” that he told me if someone had come in and he ONLY knew their lung function number, he would have expected them to be short of breath just talking to him.  I on the other hand, came in hyper and talking like crazy.  He jumped right away to put me on Advair and ProAir®.

Next we did the allergy test…oy!  Long story short, if it pollinates, I’m allergic to it. Not such a good thing when you’re living in the Midwest. One striking observation…considering where I live, I had ONE test show up VERY positive on the food allergies. When I asked the doctor which one that is, he told me “Corn”.  CORN?!?!?  I eat corn all the time, I’m not allergic to that!  He went on to tell me that if you’re EXTREMELY allergic to corn pollen, it will show up as a food allergy during the test.  Wow…and I currently live in corn field heaven.  That helps explain why the asthma finally hit a level that I had to do something about it.  Thanks Indiana!!!

We went on the Advair treatment and things improved almost immediately. I could breath better than I ever had before.  It felt great!  We spent some time tweaking the treatment and even experimented with adding Singulair to see if that would help.  It didn’t and at least this doctor agrees that if it isn’t having a positive effect on lung function…don’t take it.  So now, I take Advair twice a day and Flonase once a day. After all of this work, we STILL only have my FEV1 value 78 - 79%.  The FEV1 is your Forced Expiratory Volume and is a measure of the amount of air you can forcefully exhale in one second.  The lower threshold of “normal” is 80%.  I’m SOOOO close to that and it pains me to no end to not get it above that 80% value.

And the discussion begins…I talked to the doctor about some other “holistic” means to help improve my lung function.  I ask the doctor if adopting an “anti-inflammatory” diet could help.  I was actually a little surprised HOW dismissive he was to even consider this.  

It is now well established that asthma is an inflammatory disorder of the airways in which the release of mediators from activated mast cells and eosinophils play a major role. These processes are orchestrated by T-helper lymphocytes through the actions of cytokins associated with the Interleukin-4 gene cluster. The inflammatory process results in endogenously generated oxidative stress that contributes to tissue injury and asthma symptomatology.  Exogenous oxidants also exacerbate existing asthmatic manifestations. Modulation of this oxidative stress may contribute significantly to the reduction of asthma symptoms.  In MY mind, an “anti-inflammatory” diet is worth exploring.

There have been a lot of great reviews on asthma, oxidative stress and diet. (Greene LS “Asthma, Oxidant Stress, and Diet” Nutrition, 1999, 15, 899; Misso NLA; Thompson PJ “Oxidative stress and antioxidant deficiencies in asthma: potential modification by diet” Redox Report, 2005, 10, 247; Riccioni G, Barbara M, Bucciarelli T, di Ilio C, D’Orazio N “Antioxidant Vitamin Supplementation in Asthma” Ann. Clin. Lab. Sci. 2007, 37, 96).

So, the experiment…my next visit with the asthma doc is on April 5^th, 2012.  For the next 77 days, I will adopt an anti-inflammatory diet.  “WHAT is that???”, you may be asking…

·         I will cut out all simple sugars. Sugar is a good carrier of Reactive Oxygen Species (ROS) and has been attributed to the distal neuropathy problems of diabetics. These ROS elevate the oxidative stress the body is exposed to and exacerbates any inflammatory response. 

·         Although I am not clinically allergic to gluten, there has been a lot of research on the spectrum of “gluten sensitivity” and its role in inflammatory diseases.

I figure that I have two and a half months to see if I can break through that 80% ceiling I’ve been under with that FEV1 test.  I’m sure that is just like looking at the numbers on a scale to assess your “fitness” but I’m hoping that this experiment will get me off this lung function plateau and bring me to a higher ground (in the words of the Red Hot Chili Peppers). 

I’ll be sure to keep everyone posted with more regular blogs as I head down this path.

In good health,

Mike

January Newsletter