Hi guys anyone out there on more than 6 puffs a day in ventolin, seems to be a concern of my gp

[Mickeyboy2020]

Ventolin usage

[twinkly29]

It will be a concern of your GP because needing more than that in a whole week should be a cause for their concern.

What else are you on? Have they suggested anything different?

The idea is to be controlled on preventer medication (which actually reduces underlying inflammation) so that reliever medication like ventolin is not required or is rarely required (this medication doesn't treat the inflammation caused by asthma, only the surface symptoms).

Edit: just realised that you're at RBH. Can't actually believe that certain hospitals who think they're the bee's knees when it comes to asthma don't actually impart such information!

[EmmaF91 Community Ambassador]

Using more than 3 doses for vent a week means that you’re not controlled, so if you’re needing 6 puffs (3 doses as 2 puffs = 1 dose) every day it shows that you’re not controlled and probably need your maintenance meds escalating. Hope this helps

[Mickeyboy2020 in reply to EmmaF91]

Hi I’m on flutiform 2 puffs twice a day, 9 mg pred daily and I get an infusion once a month at the Brompton hospital They showed no concern when I was there last on 30/12

Breathless when walking upstairs or hills or exerting myself ( builder)

But can play 18 holes of golf or an hour and a half vigorous badminton and no problem

[EmmaF91 Community Ambassador in reply to Mickeyboy2020]

That’s a weird drug combo, so I’m not surprised GP is querying vent use. Usually if you’re on a MAB you’re on most (if not all) add ons - LAMA, LTRA, etc etc, maybe regular ABx or theophylline, a different preventer regime (stronger or an additional inhaler) etc etc etc. So your GP is maybe thinking ‘can we control vent use by retrying a standard treatment?’

In my experience some tertiary hosps don’t actually care about what’s happening at home (esp once you’re on a MAB unless it’s to possibly take the MAB away) - my old tertiary literally saw no issue when I was suddenly (and unusually) needing multiple nebs a day. They believed they shouldn’t give plans or advice on when to get help etc.

You have to remember some of these hosps are used to people who have 2hrly nebs as standard, so they won’t necessarily comment anything if it’s 6 vent puffs in 24hrs. I don’t think it’s right, and ‘good’ tertiary hosps (like my current one) are a lot more focused on comparing you to you and getting full controlled, compared to ‘well you’re better off than Julia over there, so I don’t really care’.

It’s why I feel like people should keep all teams (GP, local team and tertiary team) in the loop cause GPs see what you’re dealing with at home and as they don’t have the ‘so and so is worse so this is fine’ going on (you are possibly the ‘worst asthmatic I’ve ever seen’ - literally heard that a couple of times at GP practices 😅) so they care about getting you controlled day to day, whereas tertiarys have the meds but don’t see the impact of your asthma so can have a ‘here is drug, you are fine’ attitude. Local is a good in between (as they see how bad/frequent admissions are). Ofc this is assuming 1-2/3 are good and you get on well with them 😅

So if your GP is concerned and thinks something might help, it’s worth a try!

[Mickeyboy2020 in reply to EmmaF91]

Thanks for info, I will talk to consultant at Brompton later this month and let you know what he says This new drug I’m having infused doesn’t seem to be doing anything, I’ve mentioned this the last 4 months I’ve attended but they insist

1st injection I used to have monthly ( mepolizibub) worked great for 10 months then stopped working, after a 4 month gap new one ramilizibub never really made a difference.

Feel like I was better off back on the steroids 20-25 mg daily before all this

Although they were not having much effect as I was told I was getting immune to them

Thanks