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Exercise is an important part of health for anyone, but it is hard and can be discouraging if you have exercise-induced asthma. I have alpha-1 antitrypsin deficiency (AATD), which has made it difficult to do physical activity my whole life. But even though AATD is genetic, there is still a chance for many people to be physically active and enjoy it if we look at it right.

As a young person, I knew I had issues with exercise. I could not keep up with my peers in physical activities. I had to ask my family to stop when we would go on hikes so I could catch my breath. I later became more sensitive to perfumes and aerosols.

When I was 25 years old, my brother was diagnosed with AATD, so I got tested and discovered I had it as well. It often manifests as lung disease, even among those who do not smoke because we don’t have the protection of the alpha-1 antitrypsin protein.

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However, I was able to work out for long periods when I focused on my endurance. If I kept sipping on my water, I could do a 5k in 40 minutes in college. It took months of preparation and friends supporting me to, but I did it.

Read more about experimental therapies for AATD

Mine is not the story of many patients with AATD. Sadly, many of us have had trauma to our lungs and perhaps some think our lungs have been damaged to the point that minimal exercise is possible. Frequent respiratory infections or even the type of asthma I have is enough to put someone out for a whole day, if not more.

Recently, my doctor challenged me on this. With all the appropriate therapy, increasing my exercise time to 30 minutes per day brought my forced expiratory volume (FEV1) up substantially. I was only doing 10 minutes of exercise per session 3 times a day. Those 10 minutes were as hard as I could push myself. But I knew in the past I had been able to do so much more. The limitation was getting pretty depressing because I love being able to do what I want for more than 10 minutes at a time.

I asked my doctor what my options were, and he believed it was primarily due to the asthma, so he suggested using a rescue inhaler before exercise. I had heard of this before but hadn’t had much of my own experience with it. He suggested doing 10 minutes with the rescue inhaler breaths, then trying 11 minutes the next day, then 12, and so on, until I got to the maximum time per session possible. So I tried it and found that even though the fatigue was still there after the exercise, I could breathe more easily than usual.

Read more about AATD epidemiology

So, encouraged by that progress, I continued, and I am not yet up to 30 minutes per session, but I am looking forward to seeing what progress I can make in the coming year. With this shift in my focus from what I can’t do to what I can do, my attitude also shifted. I found myself enjoying exercise again.

Knowing that I am making progress is an amazing feeling. I highly recommend finding goals and not starting other projects until they are completed. Starting small, I find, things are easier to accomplish. There is a dopamine release that comes when I accomplish a goal. It doesn’t matter if it is a small or large one.

I think it helps all of us have a happier day when we know that doing what we want or need to do is most likely not going to kill us. It’s like that with exercise-induced asthma. We can get into a bad rut when we can’t breathe because we did something like trying to clean the house or take a walk, but if we have a little goal to accomplish with our inhaler, it can mean the world to us. It can even help us live longer. That’s important for a lot of patients with lung issues, and the many therapies available to us now are making that more of a possibility.