resuming exercise

Dear Doctor,
When would it be safe to resume intensive aerobic interval training exercise,  considering:
a) I stopped exercise for 2 weeks due to an asthma attack
a) My age is 50 years
b) I get episodes of NSVT, most probably due to mitral valve prolapse, with otherwise normal echo
Thanks,
Malan

[David Tinkelman, M.D.]

It would be safe to resume intensive aerobic interval training exercise, only after you can be assured that the current status of your airways closely approaches that seen when your asthma is optimally controlled; that is, after the acute airway inflammation and the hyperreactivity associated with your asthma worsening have completely subsided.

Parameters to make this assessment would include clinical status, peak flow measurements (PFM’s), pulmonary function tests (PFT’s) to be compared with those measured at baseline and a physical examination of your lungs that reveals good volume clear breaths sounds, without wheezing.  Your feeling that your breathing has returned to baseline normal is important but should not alone, be relied upon to make the decision to return to your full exercise program.  In addition, even should all the preceding be favorable, it would be wise to resume exercise with a low-level program and increase it over 1-2 weeks, in a stepwise fashion, every 2-3 days.  If still unsure that all is well, check with your asthma doctor.

Other testing that might help to confirm that your airways have returned to their normal state could be, the measurement of exhaled nitric oxide (NO) or the performance of what is called a methacholine challenge.  NO is not available for clinical use in all medical clinics and the methacholine challenge is a bit burdensome.  Both, probably unnecessary if the parameters mentioned in the preceding paragraph are decidedly normal/negative.

Good luck

[ill13632]

I also have MVP and asthma and have vomiting/nausea with exercise and have nausea and difficulty breathing during the day.  
I read that exercise is good for the MVP

[malan]

Thanks very much, doctor, for your detailed reply. Unfortunately, at my place of residence, I don't think I would be able to undergo all the tests you recomend. But I shall follow your advice and build up slowly.