When to take salbutamol?

[Junglechicken]

I know this is a strange question from a life long sufferer but at what point does everyone take their rescue inhaler? What got me thinking was if my GP asked me at the moment how often I take my inhaler I would say I wheeze a few times a week. However there are times when I feel chesty, PF drop and cough but I don’t take my blue as I’m not wheezy. That’s the case at the moment. On paper I feel a GP would say we should lower your steroid inhaler dosage as you are “well”. However I feel that my Seretide dose keeps the wheeze at bay and lowering it would cause problems. Any thoughts most welcome

JC x

[EmmaF91 Community Ambassador]

Your rescue I haler should be taken when you feel symptomatic (be that wheeze, SoB, cough or ‘just’ tightness) or when your PF has dropped. You only need 1 of these for it to be a sign to take your reliever. If I waited til I was wheezing I wouldn’t be alive (having gone straight to silent chest with no wheeze at all... and only minutes away from intubation by the time I got to the hospital). Not everyone wheezes and the blue is there to relieve any symptom. The idea being if you catch/treat the issue early it won’t escalate plus flags up issues easily for the docs (cause using too much and needing too many pumps etc) Hope that helps

[Junglechicken in reply to EmmaF91]

Thanks Emma. That does make things a lot clearer. In that case I think I might need to see GP after all. I feel chesty most days at the moment.

[WindsweptRissa]

I agree with Emma, feeling tight chested, short of breath or coughing more are all asthma symptoms, as is night cough and your peak flow dropping, and you should take your reliever inhaler. If you are experiencing any of these symptoms on a regular basis then your asthma is not controlled and the aim should be to get control of your asthma symptoms so that you rarely need to use your reliever inhaler. If you don’t get control of your asthma the chronic inflammation in your lungs can lead to more problems later on. Wheezing is only one asthma symptom. When I was younger I used to wheeze loudly but feel relatively little discomfort, now that I’m older I rarely wheeze, and even then it can only be heard by the doctor with a stethoscope, but I feel far more discomfort. Also my peak flow is no longer a good indicator of how I’m feeling.

[Junglechicken in reply to WindsweptRissa]

Interesting that you talk about your PF not being reliable. My PF is a little better today but I actually feel more wheezy.

[WindsweptRissa in reply to Junglechicken]

Peak flow is mainly affected by constriction in the large airways. In my case I also have small airways disease so peak flow only shows half the story. So, generally speaking, although changes in your peak flow are a good indicator of asthma severity your symptoms are just as important.

[WindsweptRissa in reply to WindsweptRissa]

Just to add. If your asthma is controlled you should normally have no symptoms and it should not interfere with your daily life. If you are having daily symptoms then you need to act as long term uncontrolled asthma can cause permanent changes to your lungs.

[Junglechicken in reply to WindsweptRissa]

I wish I could explain that to the GPS at my surgery. I’m usually dismissed as having anxiety due to the fact my peak is usually in the green (it can fluctuate wildly at times) Over the summer I went private to try and get some resolution and treatment. My specialist put me on a lot of new medication that my GP is trying to take me off as “most” asthmatics don’t take it. Medics don’t seem to understand that my asthma was severe as a child and the severity can reoccur in later life. Have to say after my last attack I saw an amazing GP at my walk in centre. He was so concerned and said even though my PF was over 80% the fact that I’d had an attack was evidence that I wasn’t right. So want him to be my regular GP. Thank you for your advice x

[Wheezycat]

Interesting! I am bad at remembering to take my salbutamol, even when it makes sense, and occasionally I have had to be reminded. But I am slowly learning. I have discovered it can be a way to reduce coughing, but still I mostly forget. And these days I get wheezy and breathless most times I walk anywhere, unless I walk pretty slowly. As for my preventer I am on SMART regime. According to the leaflet I am supposed to take one-two puffs twice daily, but it is rare for me to go down to one. Occasionally I have tried when my pf has been good and all else feels fine but it has never lasted more than 3 days at most. It is that thing to remember that it is not all about wheezing, isn’t it! For me it is mostly about remembering to take my cough more seriously, as I have been prone to coughing always, so I often ignore it....not good!

[Junglechicken in reply to Wheezycat]

Yes. I have a recording of myself aged about 3. I just coughed most of the way through it. I asked my dad about it and he said that was perfectly normal for me at that age. It was part of my asthma symptoms. It was quite sad as I was trying to sing a song but I could only sing it in sections as I had to stop to cough. Having said that I was very good at picking up where I left off!

[Wheezycat in reply to Junglechicken]

I was probably not quite that bad, rather when an infection or something triggered it that it lasted a long time! Always has done. I was never diagnosed with asthma, though it was likely an indicator for the future. (It was a very long time ago.) I remember the time my grandmother tried to make me a hot drink that would help - it was whole spices like cinnamon, cloves, cardamom and allspice boiled in water with sugar! Delicious! I am sure it made me feel better though I doubt it stopped the coughing.

[Yellow75]

I think you have to know your symptoms. I have a distinct type of cough which usually indicates that I'm starting an asthma episode so I take at that point now. I also take if chest suddenly feels tight.

[Clairebear35]

my asthma has only recently seemed to be under control so only take my rescue inhaler as and when I need it, but the moment I’m ill with a cold etc or I move into the amber I have to take 2 puffs every 4 hours