One chance moment can change your life.

For me, it began with an inkling – a tiny spark that has now burned for nearly two decades. Two decades of meeting my fears head-on. Of working with medical professionals. Of putting myself into uncomfortable situations. And of working to manage my exercise-induced asthma which, for all its might, couldn’t keep me off the mountain.

For years, I thought I couldn’t run. I couldn’t climb summits. I couldn’t do all the things that I so yearned to do. Because I had exercise-induced bronchoconstriction (EIB, the preferred medical term) that robbed me not only of my breath, but of my dreams of standing atop tall mountains. Until I decided it wouldn’t.

And if that sparks an inkling in you, then maybe this moment, right here, is your moment.

In short, exercise-induced asthma (EIA), now more commonly referred to in the medical community as exercise-induced bronchoconstriction (EIB) occurs when you experience asthma symptoms during or after exercise. While I also have mild chronic asthma, it’s important to note that even non-asthmatics can experience EIB.

Notably, I have mild asthma. It is scary but asthma can be much worse than mine. In fact, when I’m healthy, my numbers are completely normal. It’s when I have a virus or do extreme athletic events that I struggle – and even then, it’s usually after the summit day or an endurance challenge that my asthma symptoms kick in. The pre-work has helped reduce those symptoms tremendously. (I’ll get into that pre-work, below.)

Understandably, everyone experiences exercise-induced asthma differently. According to the Mayo Clinic, some of the most common symptoms to watch for include:

• Coughing or wheezing
• Shortness of breath
• Chest tightness or pain
• Decreased stamina and/or fatigue during exercise
• Poorer-than-expected athletic performance
• Prolonged recovery time after exercise

And while these symptoms sound pretty standard, especially if you have chronic asthma or have previously experienced other respiratory issues (including the Virus That Shall Not Be Named).

Real talk: I was a college athlete who couldn’t run long distances. I shied away from big athletic endurance events, even though I wanted to participate. And, while I had hiked all of my life, I was cautious to climb the big mountains with high summits (14,000+ feet). All because of my EIB symptoms. I was that person: the one who had the will but didn’t think she had the way.

Turns out, I was wrong. Now, I can run 15, 20, even 30 miles. I love doing a couple of big events per year. And oh boy, do I climb mountains.

It’s hard to pinpoint a starting point to my EIB journey; after all, I began experiencing symptoms as a teenager.

When I finally realized that my symptoms extended beyond my asthma, I went to the doctor. You know, as you do… Except, I learned that most doctors will recommend, if you’re suffering, to no longer do that activity – or even to try it. The problem was, I wanted to run the ultra-marathons and climb the big mountains. I wanted to try. I didn’t want to sit out on my favorite activities.

The next stop was my allergist. Unfortunately, they didn’t know how to help, either. That is, they didn’t know how to help me achieve my goals. My allergist’s advice: Don’t go to high altitudes with cold air, don’t do endurance challenges, don’t climb tall mountains. A wall of don’ts.

My response: I don’t think so.

Of course, I don’t begrudge these medical professionals. They’re doing their jobs and trying to keep me safe, albeit from myself and my goals. Their job is to help manage and minimize my symptoms, not to encourage me to do the things that could exacerbate them.

Now, it was truly on me to find a way.

So many people – myself, at one time, included! – think they can’t do something because of asthma and/or EIB.

Turns out, one chance moment can change how you think. It can even end up changing your life.

My moment happened while watching a reality show. Over 18 years ago, I found myself watching an episode of Discovery’s Everest Beyond the Limit that featured Ed Viesturs, the godfather of mountaineering, as an Everest guide for the show.

Anyway, Viesturs was on my TV, encouraging and coaching a mountain climber to summit Everest as he battled with asthma.

Turns out, that mountain climber was Mogens Jensen, who would become the first asthmatic to summit Everest without supplemental oxygen. It was the first time that I had witnessed someone with asthma doing something like that. It was also my first inkling: maybe there’s something here; maybe I could climb high peaks, too.

This set me off and running – metaphorically, if not physically (yet). I went down a rabbit hole of research and while I often ran into dead ends, sometimes I didn’t. Those didn’ts changed my life. And I hope they can spark change in yours, too.

The very first step is to understand how asthma and EIB affect you.

And so, if my first step was to understand my body, then the second was to do my own research.

EIB Is Still Not Fully Understood

Doing your own research is not advice I’d always give: For so many things in this world, the true experts have already done the research – and published it.

The problem with EIA and EIB is that there really hasn’t been much research: Though exercise-induced asthma was first recognized as a condition in 1960 and the term EIB was coined in 1970, over 50 years later, there is still a “lack of awareness among physicians and the general population.” Especially EIB at high altitude.

In other words, my allergist and my specialists weren’t equipped with the tools or knowledge to help me. So I had to help myself.

Medical Interventions

As I said, my research began. To start, I began seeing a pulmonologist, who helped me identify the medicines, schedule, and rescue and maintenance protocols that would help me the most. I had to find a doctor that wanted to help me climb instead of telling me I shouldn’t do it.  I take all my meds, as instructed.

In my case, it’s a combo of allergy meds and asthma control, plus oral steroids in a would-be emergency – usually, after specific conditions, ex. the cold air and low oxygen conditions on a mountain that induced a cough. (Notably, thanks to the prework I do – diet, maintenance, and an inhaler – I’ve never had to take steroids during an event or climb. But knowing they’re there, just in case, is a safety net.)

We also bumped up my daily maintenance inhaler to a longer-lasting form with an inhaled steroid, to better manage my day-to-day, and when I am prepping for a major event or to go out of the country, my doctor pre-prescribes an anti-inflammatory oral steroid. I know the warning signs and will take these meds, if needed.

I know myself, understand my goals, and consider my health.

Under the medical supervision of my trusted doctor, Dr. Tasneem Bhatia, I also started nebulized (inhaled) glutathione, a natural supplement shown to control asthma symptoms, including in cases of EIB. Dr. Taz treats me and supports my climbs; she has been one of my doctors for 13 years and is now very well-known (and deservedly so!).

Bottom line: Diet, maintenance, and my inhaler have enabled me to control my asthma. And I always have my rescue inhaler (albuterol) with me during training, climbing, and endurance challenges, as this is probably the most important thing for controlling my EIB! It’s like carrying an EPIPEN® if you have a food allergy.

An Anti-Inflammatory Lifestyle

Dr. Taz also suggested that my asthma and EIB symptoms could lessen when I stick to anti-inflammatory foods and behaviors. Turns out, she was right!

Because yes, research has shown that an anti-inflammatory diet can help in mitigating asthma symptoms. In my case, this means eating things like eating kiwi, keeping my sodium levels healthy, reducing my intake of sulfates, and getting enough vitamin D. I am also sure to pack in plenty of vitamin C-rich foods, as they’re a good source of the antioxidants (ex. beta carotene) that may help reduce lung swelling and irritation (inflammation). Plus, they taste great!

I’ve also made some lifestyle changes. For example, I know that cold air is my #1 trigger (see step 1: know yourself). So, whenever possible – granted, it’s not always possible but it is sometimes, and those sometimes matter – I wear a simple layer over my face, to protect against the cold air. This small adjustment has saved me from serious fallout, on many an occasion.

Additionally, I’ve sought out other training aids, as well: I’ve trained with a Hypoxico machine – at Elemental Altitude out of Atlanta, they’ve seen asthmatic athletes improve their endurance in this way – which has conditioned my lungs to do well at higher elevations.

And I’ve practiced the breathing techniques from Dr. Trish Smith, who helped get me through my first 29029 event in Utah. Not only was there high altitude and cold air, but there was also smoke from fires during the entire event. An asthmatic’s nightmare.

General Management and Treatment

Beyond the protocols, lifestyle changes, and training, there’s some standard medical advice when it comes to exercise-induced asthma and EIB. Because, while it is still challenging to find any information about asthma and mountaineering (or EIB while mountaineering), there have been some advances over the last two decades.

According to the Mayo Clinic, the current medical advice to manage and control exercise-induced asthma and EIB includes:

1. Medication: Bronchodilators, especially short-acting beta2-agonists (e.g., albuterol), can be used about 15-20 minutes before exercise to prevent EIB symptoms. Long-term control medicines, such as inhaled corticosteroids, can help generally manage the underlying symptoms, as well.
2. Warm-Up and Cool-Down: Before you begin any form of exercise or activity known to induce your EIB, begin with a gradual warm-up and then, end with a cool-down period. This can help reduce the severity of EIB symptoms.
3. Control the Environment: If possible, exercise indoors during very cold or pollen-heavy days. If you’re a swimmer, pools with lower chlorine levels are ideal, as high levels of chlorine have been shown to exacerbate EIB symptoms.
4. Practice Breathing Techniques: Breathing through the nose (as opposed to the mouth) can help warm and humidify the air before it reaches your lungs, which in turn can help control inflammation.
5. Know Your Limits: Understand and recognize your body’s signals. If you begin to experience EIB symptoms, even after all due preparations, don’t be afraid to take a break, rest, and, if needed, use your inhaler.
6. Long-Term Control Medications: As mentioned above, if you have chronic asthma and EIB, speak to your allergist or pulmonologist about adjusting or changing your long-term control medications, such as inhaled corticosteroids, leukotriene modifiers, or others, to better manage your symptoms.
7. Regular Check-Ups: Speaking of your medical care, it’s essential to maintain regular check-ups with a healthcare provider, to monitor and adjust your treatment, as needed.

Nearly two decades ago, a chance moment of TV viewership sparked a major change in my life. Today, all these years later, I’ll be the climber meeting Ed Viesturs on a mountain!

It’s interesting where life takes you. If you had told me 18 years ago that I’d be climbing Aconcagua in Argentina with Ed Viesturs, I would have said, “Only in my dreams.” Turns out, a great doctor, a lot of research, medical intervention, and a huge dash of determination and grit can make dreams a reality.

Conquering my EIB – deciding to control it, rather than let it control me – is a lot like summiting a mountain. Years ago, the first time I climbed to the top of Half Dome, I remember wondering who in their right mind would want to do that – to grab their lifeline and move their feet, one step at a time, for an agonizing 45 minutes to climb 400 vertical feet… after backpacking for 6 days in Yosemite and hiking all morning through the dark to even reach the base of Half Dome.

Turns out, it’s me. I’m that kind of crazy. Because we can’t let the negative thoughts win. We can’t give up before we’ve given it a try. And we can’t let others make that choice for us, either.

If I had given into my fears – my very real fears, given how terrifying exercise-induced asthma can be – or listened to my first doctors, I would still be that college athlete who wasn’t a great runner, that wannabe ultra marathoner who couldn’t go the distance, that would-be mountaineer who couldn’t summit the peaks of my dreams.

Instead, I am an endurance athlete. I am a mountaineer. I am someone who can do almost anything I set my mind to. Just as I learned so much on the mountain, so too do I learn every time I do something challenging, every time I stand up to my doubts – and every time, I come home with new lessons learned and new ideas.

We all have many “whys” when we set a goal and stick to it. So my challenge to you is, set a goal. Discover your why. And tackle your fears. Go to your doctor. Try out an anti-inflammatory lifestyle. Learn some lung-oxygenation and breathing techniques.

Who knows? It may not take 18 years for you to have your full-circle moment. But even if it does, from the other side of the decades, I can tell you it’ll be worth it.