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ABPA and greenwood forest

Question
I would like to ask about a relationship between ABPA and a walking in the greenwood during autumn time. I’ve had CF and last years I‘ve acquired also ABPA treated by prednisolon and anti IgE medication (Xolair). Sometimes when I am walking in the greenwood forest I wake up for dry cough. Is such walking in this area dangerous for me or leaves aren’t a problem?
I want to ask about swimming. I regularly go swimming in the swimmingpool. Recenly I read some informations about swimming and asthma. Can swimmming support worsening of my ABPA. Is there some relationship between swimming and asthma? Thank you very much. Ingrid.
Answer
Dear Mrs. Ingrid.
In Slovak republic ABPA is not treated with anti-IgE /Xolair/ medication, therefore I suppose you have two diagnosis – CF and asthma bronchiale with elevated total serum IgE level.
Walking in autumn in greenwood forest may in some conditions provoked worsening of ABPA. Rotten leaves are potential source of allergens /fungi esp./, that may provoke immune status. Activation of your ABPA in such conditions should also be taken into account. It is important to regularly control clinical and laboratory status of your ABPA. Physical activity is recommended but optimalization of environment is convenience where it is execute.
Exercise is absolutely a good idea for people with asthma. It keeps us long time healthy. Exercise can also improve asthma, but in some cases bronchospasm may be induced. Most studies show that it can help patients with asthma to breathe better. Swimming is a good choice because it is less likely to cause asthma symptoms than other types of exercise. But in few studies, children, who swam as infants in chlorinated swimming pools, were more likely to have asthma later in childhood. It appeared that the chlorine may have damaged the lining of the lungs. You should look for a pool that is well ventilated and cleaned. Bigger risk than a own swimming pool are for CF patients public places like showers, toilets, wet corridors. They may be a source of germs esp. Pseudomonas aeruginosa.
It is also important to regularly monitore your asthma.
Best wishes Branko Takáč
12.01.2009