I'm new to this forum, and this is my first post. I've just resolved a problem which I'd like as many as possible to be aware of.
I've been using the Becotide inhaler sucessfully for many years, but a few years ago was advised to use a spacer device for better effect. This was the large two-piece Volumatic device. Around two years ago, I was prescribed a superior form of Becotide called Qvar, which has smaller particles. However this doesn't fit the Volumatic, and requires a different, smaller spacer device called AeroChamber plus. I've been using this for maybe two years, but looking back, hardly noticed that it was losing its effectiveness until a recent crisis.
I'd caught a chest infection (which happens to me about 3 times a year), but even with a course of antibiotics, didn't clear up as it normally does. In fact after 3 weeks,I was getting more and more 'chesty', and had found climbing stairs difficult - which is very unusual for me.
Then in the middle of the night, I realised what the problem was - the AeroChamber wasn't working any more! I immediately stopped using it, and just used the inhaler on its own. I started to feel better within a few hours. A day or two later, I got a new one, and now after three days, I'm almost back to normal, which in may case means I can go hill walking, run for buses, and be otherwise normal.
On reading the leaflet, it says something like 'after a year, you may need to replace the device' - but this isn't emphasised enough in my opinion.
So the point of this post is to warn others of the importance of replacing the device before it ceases to work. I'd be interested to hear of anyone else who has experienced this problem. Unlike the Volumatic, the AeroChamber is impossible to clean properly.
You used a spacer for nearly 2 YEARS without either properly cleaning or replacing it?! Good grief, no wonder it stopped working. I dread to think what state it was in by the end.
Clean spacers regularly (this applies to Volumatics too) - say at the very least once a month. Replace them every six months or so to be on the safe side.
It's perfectly possible to thoroughly clean an AeroChamber; you can remove both ends (unlike on a Volumatic) and soak/wash them in warm soapy water before leaving them to air dry and putting them back on the main chamber.
As you say, yearly replacement IS mentioned in the patient information leaflet that is provided with the spacer. You should really be reading the information leaflets that come with any new prescription items before using them, so that you know this sort of thing in advance.
Yick! You could have been growing things in it too!
I replace my Able spacer at least once a year! and wash it weekly too!
The aerochamber is easy to wash - just pull off the end, warm soapy water and bung it back together when dry.
I used to pop volumatics in the dishwasher but I think that is not recomeded!
My old ones are now in the garden and are used as closhes for baby plants in spring!
Kate
But I DID clean both devices. The Volumatic is no problem to clean, but the AeroChamber is more difficult to do properly, which I assume is why they recommend getting a new one after a year. I've been using the Volumatic for several years with no problem.
I have been using my Aerochamber for about 18 months now and I didnt realise that the info leaflet mentioned possibly needing replacement after 12 months ;but you are right,it does!
-how do you know if it isnt working right though?-no ""whistle""?-or symptoms getting worse as oldgeoff seems to have noticed?-that could be some other cause of course!
I clean the valves on all the different types of spacer I've had by running under fairly high flow tap water, to 'ungunk' them and get rid of the sticky inhaler residue which can block the valve mechanism and stop them working. I then give them a thorough wash all over with hot water and detergent before letting them air dry.
If I'm feeling particularly anal (which, let's face it, I often am) I then sterilize them in a sterilising solution, either a denture one or a baby bottle one - usually Milton baby bottle cleaning stuff as I know I don't react to that. I do this because tap water does sometimes contain an amoeba (Acanthamoeba), although to be honest the only documented disease caused by it has been eye disease caused by people using tap water to clean contact lenses - it doesn't appear to cause any other disease in humans. I just don't like the idea of Acanthamoeba growing in my spacers.
I have to say that out of all the spacers I've had in the past (the Volumatic, the Nebuchamber, the Aerochamber) I actually find the Aerochamber the easiest to clean properly, as it has more parts that are removable. Cleaning it adequately is of course no substitute for replacing it regularly. It's also the most convenient in terms of size - in the days before I carried nebs and O2 with me, it was great because it fitted into a handbag, no problem!
Just one comment on some of the things people have said below - if the Aerochamber whistles when you use it, IT IS BECAUSE YOU ARE BREATHING IN TOO FAST AND NOT USING IT CORRECTLY. You might therefore not be getting the full dose, and also could be putting yourself at increased risk of local side effects such as hoarse voice and oral thrush. If used correctly, it should not whistle. This is clearly indicated in the instructions that come with it. As Steve says, it's vital to read the instructions with any new bit of kit, even if you think you know how it works.
Hope this helps
Em
Dont worry Emily,I realise what the whistle indicates,I was just using that as an example of how you may be able to tell if it wasnt working i.e you could deliberatly breathe in too fast to see if it does/doesnt whistle-would this indicate it isnt working correctly?
I wasn't particularly implying that you didn't know how to use it, bluejam, I was just pointing it out for the benefit of other readers who might have read your post and thought that they were supposed to be making it whistle! I've seen quite a lot of people, both as a doc and as a patient, who come into hospital and are using it incorrectly and making it whistle - and it often doesn't seem to get picked up on by the doctors/nurses on the ward either.
I suppose if you were to deliberately breath in too fast and make it whistle, it would at least prove that the valve wasn't completely bunged up - but I'm not at all sure it guarantees that it is working *correctly*, ie giving the whole dose and distributing it so it goes into your lungs and doesn't deposit on the back of the throat.
Consulting the product literature and website would seem to suggest that there isn't any 100% fool-proof way of determining whether it is working properly - all the more reason to wash it regularly and replace it every six months, as Steve has suggested. It might also be worth asking your GP to prescribe a second one, so that if you do notice any problem with it, or you have a deterioration in your symptoms, you can swap over and quickly tell whether that is the problem.
Em
I agree that the Aerochamber can be very awkward to clean. But it is possible. I have twoone with a face mask and the other just with the mouthpiece.
I know If i am taking an attack and panicing I often have it whistle the first time or two i use it when i am trying to calm down but that sometimes makes me panic slightly more as i know it means it prob won't work!
The whistle has got it the nickname of ""My Flute"" by my collegues at work etc but i have explained to them all its not a good thing and to encourage me to calm so i use it properly! And it does work!!
If you breathe in too fast, even using a spacer the meds hit the back of your throat as they are going too fast to go round the bend.
Think about driving a car! ( car hits hedge!)
Too slow and it won't go deep enough. (Car grinds to a halt and stalls)
Nice and slow it corners the throat and caried on down into the lungs
( car gets round corner and carries on journey)
There is a trainer device call 2Tone which
2 tones if too deep or too shallow and one tone when just right.
Kate
Hi All
I have aerochamber - baby haler and volumatic for my 3 year-old son who has asthma - i use a baby's bottle brush to clean the inside of the aerochamber and baby haler - i have a tommy tippee one that has a fat end and thin end (sorry for ' terminology) - the thin end is great for cleaning where the valve is as it isn't easily removable and the fat end is great for the chamber.
I too am a tad 'anal' about cleaning so use steralising tablets on the brush before i use it to help get rid of any bugs/bacteria.
Hope this helps
Claire
Popped into our local Boots this morning and the pharmacists opinion was that if you were regularly cleaning it and it wasnt cracked or split then it would be ok to use beyond the 12 month period.
To be fair, if you're keeping a spacer in a really good, clean condition, there's no reason why they won't last for quite a time.
However, if you either get free scripts or you use a pre-payment certificiate, there's no real reason why you don't replace them every 6 months.
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