An old question re ventolin

[Wheezycat]

I know this has been asked before, but I am far from clear.

I rarely use my Ventolin except when ill, as it generally doesn’t occur to me, even when a good idea. Just this season I should be, and should have been, using it far more often as I have a significant issue with walking outside. But I haven’t. I am now telling myself to do it. However, I don’t feel immediate relief, more a gradual improvement, or things not getting so difficult, and so I can’t tell if there is any active ingredient in it. Just now I have been trying the floating method to know, but I see it is regarded as unreliable. So how do you know when it is empty? What do you do? Tips would be welcomed. (I have started the route of sorting my walking breathlessness out with my asthma nurse, in case you wonder, so greater use of Ventolin is a stopgap solution.)

[K8ty25]

I hear you. I also rarely use my ventolin and also have breathlessness walking. I have been referred to see the respiratory physio at the end of Feb and hopefully they can help with this. I never pre use ventolin as my symptoms are usually very quick in onset. I will be fine one second and gasping the next and it's not always a consistent thing. Ie one day I will walk to the car and be fine the next day I will need to rest and use ventolin to do the same walk.

As far as telling my canisters are empty. I am a bit paranoid about this as when I get ill suddenly I can empty a ventolin pump quickly, so I usually carry two newish ones in my bag. Plus a couple of 'on the go ones' dotted about. It sounds over the top but I like to know I have them to hand. I usually detach the canister from the plastic holder and shake this next to my ear. It takes a bit of practice to be able to tell the difference but it works for me. When I started doing this I shook a new one straight out of the box and then compared to one I was using to feel/hear the difference. It's not 100% reliable but I'm not sure how else you can do it.

I really wish they would put a little counter on the back of them like the fostair inhaler has. It would save a lot of time and probably cut down the number of inhalers that get discarded when not fully used.

[Albertdog in reply to K8ty25]

How do you obtain extra supplies of "newish ones" - feel I need more than one per month as is my ration now. This cold damp weather does me no favours.

[K8ty25 in reply to Albertdog]

I'm not going to lie it's not easy. I have to plan carefully and it's a combination of things. I have great Asthma nurses who are willing to help as long as I let them know I need help and can often top up things like ventolin.

If I know I am coming to the end of a canister I order it with my repeat medications. I have also phoned my GP in the past to explain why I have requested extra.

And if I have been having a very bad time I usually end up in hospital which means before I got here I will have used a reasonable level of my home use ventolin. So when I get discharged I usually ask if I need any replacement medications so I can ask for a new ventolin that way.

[Wheezycat in reply to K8ty25]

For now I have plenty of backup, for me it is about knowing how to spot it going empty. I have now had various suggestions, and they all have merit, but none are perfect. Oh, well!

[K8ty25 in reply to Wheezycat]

I don't think there is a perfect method. Just a combo of things that after trial and error will work for you

[Wheezycat in reply to K8ty25]

Exactly my thought! I brought up a child with asthma, in the days when everyone mostly used Ventolin rather than increase preventers if there was a problem. So I was in charge of the Ventolin etc. Somehow I managed it then. I have to have faith I can do it now as well.

[Philgn in reply to K8ty25]

don’t know your age and if you ever smoked but you describe what I experienced of late, ventolin didn’t help as it was COPD that did for me, I have never experience a rapid total can’t talk or walk with asthma, although I have been hospitalised hundreds of times with Asthma, Now got to learn how to cope with COPD,

[Wheezycat in reply to Philgn]

Yes, it needs checking. If have had a bit of a struggle every winter for the last three years, but this year even though it is warmer, it feels worse. I am lucky I never developed a smoking habit, even though everyone smoked when I grew up. Plenty of passive smoking!

[Hidden in reply to Albertdog]

Hi, I went to see my doctor and asked him if I could have a spare one to leave at work in case I left my inhaler at home one day. He prescribed me another one so I always have a spare one now.

I re-order a new one on line as soon as it allows me to do so whether I need it or not. My surgeries system allows you to add a note to a request where you can explain why you need something.

Hope this helps.

[Wintersbite]

Hi I only use ventolin as I am allergic to all the proventers and the salbutolmol inhaler as another person said in their reply to tell if the puffer is full or almost empty you do have to put it to your ear and listen for how long it takes to hit the other side the longer it takes the emptyer or lower the inhaler is if you can't hear anything moving your probably inhaling the fumes that's left behind and need a new one which should feel heavy compared to your old empty one. The ventolin is a relivor not a proveter so if you need to take it due to issues with asthma depending on what your asthma nurse and gp has told you to take then remember to try and calm your breathing and during deep and slow breaths take x puffs it can feel like it takes a few minutes to work but if you know that it's going to be an issue you can take depending on your health advice before you do your walking and again later on if needed as it will be already working for you before you go out into the cold. I have just moved to a hilly area and at the moment I also have to carry around with me my ventolin in my bag which is not a normal thing for me to do and the cold don't help so hopefully you keep your chest area warmer and hot drinks will help your asthma when out so treat yourself on your walk it's the steam from the drink all this will help you with your asthma management. Good luck

[Wheezycat in reply to Wintersbite]

I can use preventers, and do, and I always carry my Ventolin with me. I can have a need for it suddenly that I hadn’t expected, so I don’t leave the house without it. It seems the listening way is the way forward. I need to learn to hear the differences.. Better start practicing straight away.

[Wintersbite in reply to Wheezycat]

Unfortunately yes listening is the best way to know maybe a good idea would be to ask your asthma nurse to help you hear the difference between a new inhaler and an old /empty one until you get the hang of it on your own also if you are not sure any pharmacy should be able to help you with letting you know how full your inhaler is by doing the shake to hear test just explain to them that you don't know as you are learning how to tell but your not sure and could thay assist you if you are worried it may be empty have a full backup with you and Mark them in use and new or something. Hope this helps

[Artforever]

Two things I've done to help, first date the canister (not the plastic tube) use a permanent marker pen and when you suspect it's running out use the float test. I did recently because I suspected it wasn't working and yes it floated.

[Wheezycat in reply to Artforever]

Yes, the float test is probably as good as any other method, though when tested it has been said to be unreliable. Perhaps a combo of weight, shaking and listening and float test would be the way to go.......and to date the canister.

[emmasue]

When I was in hospital last, they suggested that I use my Ventolin more (I also use Fostair and Spiriva). I was under the impression that I should only use it when I was ill. Now I use it whenever I feel breathless. I've been a lot better since September with only one chest infection. Will see how it goes. I don't think the doctors and the nurses help because everyone says something different so we end up confused as to what we are supposed to be doing.

[Wheezycat in reply to emmasue]

I agree.

However, part of me also just find it hard to believe I will really need it. ‘ Or is it my fault as I am unfit (struggle just now going for walks due to this very issue), or am I just imagining it, or even if it was there yesterday, surely today it won’t be. And, finally, how will I know if I take Ventolin before going.....even if that feels better, perhaps that is because I don’t need it’. All of this is rubbish, and what I should do for now is just take it before going out at all. I decide that and then I still don’t do it.........go figure! Anyway, yesterday I again took the decision to use it each time BEFORE I go out. Now I just need to stick to it. Wish me luck.

[emmasue in reply to Wheezycat]

I know that I am unfit, but I am unfit because I keep getting ill. I used to walk three miles minimum until I got the flu nearly two years ago. I just can't do it now. I wish I wasn't unfit, but every time I push myself I get worse. So at the moment I am just pacing myself and limiting my activity. I have been more stable, but I in order to be healthier, I need more exercise. It's so difficult so I know where you are coming from. We judge ourselves most harshly. Try to be kind to yourself. xxx

[Wheezycat in reply to emmasue]

Interesting! The last two years I have felt let out of a prison once we got summer weather again, and then I have been able to walk quite some distances. Winter, though, especially this year, five minutes outside can floor me! Not always, but too often for comfort. I have become fearful of going out. So I am testing taking Ventolin before I go out, and I do think it helps. No three miles, but at least a bit further than our local Coop, about 4 minutes away.

[Hidden in reply to emmasue]

I can relate to what you say as I used to be very fit by regular walking every day until my Asthma got worse and the cold weather took hold. I was stuck as going out made my Asthma worse and i started to get lazy.

I then decided to follow the advice of my brother in law who has used an exercise rowing machine for many years and swears by them. They are certainly one of the few exercise machines that give you a full body workout and are called low impact as all your joints move naturally when using it.

So I investing in a rowing machine and which now sits in my conservatory. I put the radio on and use it everyday if possible and are slowly building up my time on it each week. I make sure I do not overdo it and on bad asthma days I leave it alone.

I could not see any alternative as I wanted to exercise but didn't want to have to go to a gym and this way I can do my own thing at my own pace regardless of the weather.

The initial outlay may be a problem, I bought a very good machine at £450 but there are a lot more cheaper models out there, however I decided this was a long term investment and should last me a minimum of 10 years. It also folds up and can be wheeled out of the way when I need the room.

[Wheezycat in reply to Hidden]

I have a small cross trainer and I have now rigged it up with an old bicycle basket with a cushion in it. That means I can rest my tablet there to watch something that helps me cope with the sheer boredom of it all. Rowing machines are not so good for me due to my knees.

[Hidden in reply to Wheezycat]

Hi Wheezycat, I like the name.

I have problems with my knees and back but have been ok on the rowing machine up to now, but still taking it easy and not going for an Olympic sprint.

I listen to the radio when I am rowing but a good idea to rig up your tablet, I'll have to look into that.

[Wheezycat in reply to Hidden]

Years ago I was specifically warned against using a rowing machine because of my knees. They get worse if I bend them sharply.

[Blue-Breeze]

I do date mine and keep a record of what I use.. the latter mostly was proof that I needed at first but now I just continued my asthma diary.. I had not heard of the float test before so that is something I will try too. Always learning on here.

[emmasue in reply to Blue-Breeze]

I too keep a record of when I use my Ventolin. It also helps to record it because you are not supposed to use more than 10 puffs in 4 hours. I am trying to keep on top of my symptoms. I think it's helped. x

[Blue-Breeze in reply to emmasue]

My last in stay they put me on the Smart system. Confusing me as it's that first not ventolin. Ventolin with lower PF...if that makes sence?

[Wheezycat in reply to Blue-Breeze]

No, not sure what you mean. I have been on SMART for years. It is a preventer and long acting bronchodilator in one. It has worked well for me, and it allows you to vary the amount due to how you feel. I liked that. Now due to a different reason I have recently gone to a different inhaler, which is still on trial for me. My struggle with my own failure to notice - or pay attention - to when I need Ventolin. And then I get massively breathless when I go walking outside.

[Blue-Breeze in reply to Wheezycat]

It's all new to me. The CNP said to use Smart more and not ventolin. I can use my blue inhaler if my PF drops below 300 along with regular symicort till I'm back to personal best.

Just means I now carry 2 inhalers my bag.

[emmasue in reply to Blue-Breeze]

The Smart system is probably why I wasn't using my Ventolin enough. I was using the Symbicort instead. However, I am now on Fostair so I need to use the Ventolin more. However, when I first went on Fostair, the GP told me to increase the Fostair when needed. The consultant wasn't pleased and said no, I shouldn't be increasing the Fostair. This is where conflicting practitioners giving conflicting advice doesn't help.

[Wheezycat in reply to emmasue]

Aha! It all sounds much the same for me. I have just changed from Symbicort to Fostair, though I never found Symbicort so helpful for those out of the blue moments.

Fostair seems to ‘hold’ my asthma as well as Symbicort did, with half the amount of steroids! However walking outside has become worse and worse. It might be fine when warm - it was the last couple of years - but this winter it is doing my head in!

I wondered how you manage with Fostair? As it is still on trial, so I haven’t yet raised it. I have been ordered to up my Symbicort to double the amount the minute I feel a tickle from a cold starting, but can I do the same with Fostair? Etc. Al, these questions! (And how do you travel abroad if your inhaler must not be in temperatures above 25 degrees. We tend to travel simply so I can see this could become an issue. Whoops!)

[emmasue in reply to Wheezycat]

A lot of questions! I was told not to up my Fostair dose if things get bad. It's not the same as Symbicort. I am to use my Ventolin instead. As with the temperature, I'm not sure, but I had my Fostair in America this summer and it gets hot there, but I guess it was air conditioned in the house. I didn't bring it out with me except for the trip to and from the airport. You could ask Asthma UK or your Asthma nurse. They may know. I do think the Fostair is better than the Sybicort. I'm not sure why. I was really bad in August/September, but since then I've been fairly stable until a chest infection last week. Will see. Good luck. x

[Wheezycat in reply to emmasue]

Yes, I am due to have contact with my AN in a couple of weeks, then I will have questions.

There are cold bags for inhalers, but if you travel as we have been known to do, it could be difficult to chill the cold blocks again. We went to Toledo a couple of years ago, late summer, and it was 42 degrees. We stayed in a B&B, but from memory no fridge. Etc, etc, etc. Still I am sure it can be worked out, and we have no plans just now.

[emmasue in reply to Wheezycat]

Let me know what the Asthma Nurse says. Good luck! 😊

[Blue-Breeze]

I tried Fostair at the begining it gave me terrible cramp. My Sympicort was changed to MDH so I could use it in aerochamber and that too gave me terrible cramp and headache. My GP changed it back to powder.

[Wheezycat in reply to Blue-Breeze]

I am also very prone to cramp, always have been. With Symbicort the dry powder inhaler, it did get a bit worse, but I have just sort of learned to live with it.......except mildly cursing under my breath when it kicks in. With Fostair metered inhaler it is no different, but it seems a good inhaler in other ways.

I have found that Ventolin works better for me in acute moments than Symbicort. That could just be me.

[Wheezycat in reply to Blue-Breeze]

Now that I am three weeks into Fostair I have found my cramp has eased a lot, but then of course the strength of the steroid is half of what I used to take. I still get cramp, but nothing like as much.

[Blue-Breeze in reply to Wheezycat]

I was put on Fostair when I was first diagnosed had terrible cramp. After reading a lot on here though of the benefits with allergy types which mine has turned into, I might suggest I try it again.

[Wheezycat]

Thanks for responding. The problem is if I try to decide by shaking/listening/floating /assessing the weight it would still be largely a guesstimate.

[Kitty2823]

When I shake my venteolin it tells me how much. I always carry my inhaler with me when I go outside. I clean my venteolin once a week

[DollyDutchGirl]

My hospital consultant (an associate professor in respiratory medicine) suggested that I take two puffs of Ventolin immediately PRIOR to the Fostaire 200/6 and Spiriva in the mornings - plus, two puffs of Ventolin immediately PRIOR to the Fostair 200/6 in the evenings....this really does seem to have helped me a lot. However, there are still occassions when I need to use the Ventolin during the day. He has just suggested that I try adding Montelukast into the mix to see if that helps complete the asthma control picture for me......

[Gareth57]

Hi, have you tried the Ventolin Accuhaler? I have found it more pleasant to use, more effective because you get a double dose in one and it has a counter so you know when its getting empty, win win 👍

[Wheezycat in reply to Gareth57]

No, I am far from sure my gp would prescribe as I suspect it is more expensive. Besides, I have had an issue with one DPI, and this one might be another one.