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1. How long have you been on advair? Have you been on it for 8 months? If you have problems with the powder, tell your Dr. and ask him about going on Flovent and Serevent spray with an aerochamber, it's a little less hard on your lungs and the aerochamber keeps the flovent from settling in your mouth too much.

2. I had much the same symptoms, with a few differences. 'twasn't my throat that ached, (though thanks to anatomy training I tend to think of my throat as having ended before my vocal chords,) but I would get a burning, aching sensation in my trachea. Another difference, after swimming 20 meters, I would tend to become breathless. The running on land thing, though, is a much less fluid (if you'll pardon the inadvertent pun) and much more forceful motion; since you are fighting gravity, it's much more work to run. Any other feelings that grip you while you're panting? For example, I have a huge excess of gunk in my lungs to cough up after I run, in addition to the inability to take a deep breath or to exhale one fully. I end up breathing very small, very high tidal volumes, and my vital capacity changes. I can't exhale fully without coughing.

I'm not sure what kind of effect sleeping would have on it. I don't know what to tell you as far as that goes.

To your doctor's credit, it DOES sound a lot like exercise-induced asthma. I found that taking Ventolin would help sometimes, but not all the time. I also found what you found about the advair (I take symbicort, a similar preparation) helping more in the beginning. It seemed to have much more of an effect.

The bars-thing, unless by 'a lot of time' you mean every single day for hours at a time, I wouldn't worry too too much about. If your doctor suspected cancer, he probably would have had you go for a bronchoscopy to rule it out. Doctors tend to be rather nervous about the possibility of missing a cancer, and if they suspect one, they tend to jump on the tests to rule it out right away.

Talk to your doctor about a methacholine challenge. An exercise challenge might work too, but the methacholine challenge is pretty definitive. You start by taking a simple blow-in-a-tube lung test, then inhaling a solution that has an irritant effect on asthmatic lungs. If you are asthmatic, even exercise-induced asthmatic, this solution will make the muscles around your airways tighten up a fraction, that fraction being measureable by comparing the lung test taken before and after you take the methacholine. It works on this principle; since most peoples' lungs lack this hyperreactivity, it is practically unique to asthmatics.

If you don't react to that concentration, they try a higher one. It's also a method to see how severe asthma is -- if you react to the teeniest tiniest bit of methacholine, your asthma is relatively severe, or would probably require daily medication. If you don't react and don't react and don't react until the higher concentrations, chances are your asthma is pretty mild. It's not 100% for sure for sure, as there are other situations that can make people have airway hyperreactivity, but they tend to be rather easily differentiated from asthma.

The lung tests will give you a better idea as to whether this is a lung problem or not. I'll bet considering your heart history, your doctor won't think it's a heart condition, but the important role for you here is to get your doctor to tell you what HE THINKS.

The biggest thing that happens with doctors and patients is that doctor suspects something and patient has no idea what's going on. If you come in there armed with a little information (like how you think it'd be a good idea to check out a pulmonary function test with a stress test or a methacholine challenge since the advair isn't working for you very well) and asking him if it could also be a heart condition. It might not be a pre-emptive symptom to a heart attack, but your friend is right, lots of cardiac problems manifest themselves first in difficulty in breathing.

Don't settle for dismissive answers, tell your doctor you are worried about this. Anxiety is known to exacerbate both heart problems and asthma. Some people get air-hunger feelings simply from anxiety; if no other cause could be found for your breathless attacks, that's something I might suspect, but it wouldn't be my first suspicion because of the way you react to exercising in dry air and moist air.

I'm going with your doctor on this one. If it turns out to be asthma, tell him the powder bothers you and makes you cough. It's more of a pain in the ass to take the drugs as two seperate MDIs (multi-dose inhalers) but it's also a lot easier on your lungs, comparatively. (Lots of people have problems taking powder inhalers, so you're not alone.)

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