Breathing Easy with Asthma as an Outdoorsperson

August 14, 2018

I’m an outdoorswoman. My first hikes were enjoyed from a pack on my parents’ backs, and I haven’t slowed down since. Paddling, rock climbing, mountain biking, skiing, and long-distance backpacking are all second nature to me now. So is doing it all with asthma.

26 million other Americans live with asthma, too. As an outdoor leader, it’s something that I have to actively manage for myself and for anyone in the group I’m traveling with. But there are right ways and wrong ways to do it. And with asthma so prevalent in outdoor pursuits today, complacency about managing it may be a growing danger.

Photo by Paula Champagne.

Historically, beyond establishing that one’s asthma won’t be life threatening or incompatible with the activity at hand, the conversation has rarely gone further. But I find that the more information I can collect from my fellow asthmatic participants, the more smoothly our time together will go. It’s often promoted as best practice to check-in with any asthmatic member of your group before setting out to establish whether their symptoms are controlled and what (if any) medications are used to prevent/treat symptoms. That’s a good start. Here are some useful follow-up questions:

Can you explain the nature of your asthma? What triggers your attacks?

  • Where in your pack will you be carrying your medications in case you should need assistance getting them?
  • What other techniques do you like to use to prevent attacks (like warming up in the parking lot, or setting breathing rhythms for yourself as you move)?
  • What do the warning signs and symptoms of an asthma episode look like for you?
  • What have other people done in the past that has made you feel most comfortable in dealing with your symptoms?

One routinely used strategy positions the hiker with the slowest pace at the front of the group. It’s not an approach I endorse because it can have the negative effect of singling out that group member—especially when they might be struggling. Many hikers, upon becoming aware that they are the slowest member of the group, will move considerably faster than a safe pace for their ability simply to avoid the feeling that they are holding the group up. Ultimately, this can create more problems for an asthmatic hiker than it cures.

Instead, take the opportunity to adopt an inclusive group management strategy from the get go. When I’m leading a group, I strongly prefer to work my way towards the back, or at the very least to the middle of any group I am leading, so that I can model effective pace, keep an eye on how everyone is coping, and chat with each person in turn. I might also ask another member of the group to act as leader. This can be especially useful if you find yourself with a participant whose self-assuredness as an outdoorsperson risks straining the group dynamic: now they have a specific job to focus on (setting a manageable pace for everyone in the group), and you have entrusted them with an extra task in recognition of their advanced skills.

Keep an eye on the member of your group with asthma just the same as you would keep an eye on every other member of the group. If they aren’t exhibiting any symptoms, then they’re probably doing okay. If a member of your group does have an asthma attack, or begins to experience symptoms, keep follow these three steps:

  • Stay calm. Not being able to breath is stressful and makes a person feel anxious. If you lose your cool, too, then you’re bound to make the situation worse.
  • Prevent the rest of the group from sitting around and staring. If you need assistance in caring for the person experiencing an asthmatic episode, ask one or two specific people. To the rest, suggest drinking water, having a snack, taking a bio break, or even working to identify a nearby plant or bird—whatever it takes to convey to folks that best way they can help is not to make a spectacle of their group member’s distress.
  • When the asthma symptoms have cleared, have a candid conversation with that person. Are they comfortable to keep going? Is there anything they’d like you to do differently moving forward to help prevent further discomfort? Agree on a way for them to alert you if anything changes, then move on. When someone tells you that they are well enough to continue, it’s time to trust them and carry on.

Happily, having asthma hasn’t kept me from pursuing adventure. As an outdoor leader, it also doesn’t have to change the dynamic of your groups. With a little planning and forethought, everyone can breathe easy!

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Lisa Schott has worked for AMC over the past 10 years as an instructor for the Teen Wilderness Adventures program, an educator and coordinator in the A Mountain Classroom program, a winter caretaker in the huts, a winter naturalist at Pinkham Notch Visitor Center, and currently as the leadership training assistant. She lives in the White Mountains, where she can be found hiking, mountain biking, and exploring with her husband and their dog.

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