Try holding a straw in your mouth and pinching your nostrils shut. Breathe only through the straw "until you start to panic" from an insufficient supply of air, said registered nurse Susan Ross.
"That's what it's like to have asthma," she said. "It's a horrible, terrifying feeling to have."
Ross, a clinical adviser for the Minnesota Department of Health's Asthma Program, was among a group of asthma experts who attended the Minnesota Youth Ski League's ski swap and expo Saturday in Bloomington. They were there to share information with coaches and young athletes about how those with asthma can stay safe during cross-country skiing or other sports.
An asthma attack causes lung tissues to swell. Mucous production increases, "like a sticky glue in your lungs," said Ross, who has asthma herself. Muscles tighten around airways, further constricting them.
Asthma need not interfere with participation in sports, said Dr. Charlene McEvoy, medical director of the Asthma Center at HealthPartners Specialty Center, who spoke Saturday.
"Asthmatics can be great athletes — there's no reason why not," she said. Middle and high school students with asthma participate in youth sports at about the same rate (56%) as kids without asthma. "A good chunk of Olympians have asthma."
On the other hand, its potential risks should not be underestimated, Ross said.
The Department of Health has developed a free, 35-minute interactive training course on its website to teach coaches how to recognize and respond to symptoms of an asthma attack. "If you're coaching a youth athlete, we want you to take the course," said Kelly Raatz, the department's asthma communications and program planner.
In 2017, there were 55 deaths from asthma in Minnesota. Just over half were age 65 or older; eight were under 35. A year earlier, asthma led to 18,200 emergency department visits and 1,900 hospitalizations in the state.
One of every 14 children and one in 13 adults have asthma, McEvoy said, although severity levels differ. Some people can manage the condition on an as-needed basis, taking a puff from an inhaler containing albuterol to relieve wheezing and shortness of breath. Those with more serious cases should take regular medication, an inhaled steroid mixed with albuterol, and also carry an albuterol inhaler for quick symptom relief.
Coughing, wheezing, difficulty breathing, tightness in the chest or a sudden inability to keep up the pace signal a cautionary level of asthma problems calling for puffs from an inhaler, followed by an oral steroid if symptoms continue. Extreme difficulty breathing, trouble walking and talking, lips or fingernails turning gray or bluish are signs of an asthma emergency requiring immediate quick-relief medication as well as a call to 911 or a visit to an emergency room.
The experts at Saturday's event could not recall hearing of anybody dying while playing youth sports, but many sports — including swimming, soccer and mountain biking — involve conditions that can aggravate asthma. Cross-country skiing presents a risk because aerobic exercise and cold air are among asthma triggers. Others can include allergies, viral infections, scented products and pollen.
Athletes should warm up and use an inhaler about 15 minutes before playing, McEvoy said. Cross-country skiers should carry an inhaler with them, keeping it under clothing so it doesn't get too cold. Wearing a scarf or mask over the mouth can also help by moistening air before it enters the lungs.
