Inhalers

[misterthomas]

I used Advair (or Symbicort) for 20 years until I finally started getting lung infections. Quit on my own and it cleared up right away. I was using Spiriva also and am now ready to try going without. I am having the eye problems associated with it. These inhalers can be a Godsend for awhile but will build up in your system in time. Look for the symptoms and know when to give them up. I have seen several people die from lung problems brought on by inhalers.

One more thing. I started using NAC (look it up) several years ago and it has been good for me. It is inexpensive and cures many common problems. Your doctor won't tell you about it though.

[ZM1980]

Hi Misterthomas, I was prescribed Symbicort and this is something I brought up recently in this forum (possibility of chest infections/side effects). I was only using it for a few days but had to stop, as it was making my reflux worse, gave me a sore throat and made me feel unwell. I've heard good things about NAC, how has it helped you?

[santisuk]

I can relate to all that, except the Symbicort giving me problems bit.

I was given Symbicort by a general pulmonologist 5 years ago at a time when my condition had not been fully diagnosed. It seemed to help my breathing ('cleaner' feeling and deeper) so I continued with it, and my bronchiectasis consultant post diagnosis of same did not object to that. A year ago I dropped it out just to see whether it was necessary, more based on reading* that the drug content (short-acting corciscosteroid and longer acting bronchodilator) was probably not necessary for bronchiectasis patients - unless they also have asthma or COPD - than knowing of concern over adverse effects - I did not know that, other than suspecting that corciscosteroid could presumably have the general steroid deleterious side effects if taken in quantity over time.

Since then I had not,until recently, noticed any difference in my condition other than the benefit of suffering a reduced number of infections, which may have been due to many other factors rather than dropping Symbicort, so I don't claim that it was doing me harm; still I was pleased that I didn't appear to need one of my several medicines (including for osteoarthritis as well as bronchX).

In fact when i did have an infection that gave me a slight reduction in breathing performance I did go back on the Symbicort for a couple of weeks and my breathing improved. Again I do not draw any conclusions from a statistically irrelevant sample.

I said 'had not until recently' above, as I have over the last 10 days experienced some central chest pain, particularly when excercising, which also brings on a moderately increased amount of breath recovery time when on exertion (but sputum remains clear). i'm trying to sort that out with my Thai generalist pulmonologist but will have to get back to the UK to my 'proper specialist' to get a more cogent approach. Meanwhile I intend to go back on Symbicort if it doesn't start returning to my previous very tolerable condition.

I take NAC (N-Acetylcysteine) too to thin my sputum. I like the product because it's a pleasant one-tab-a-day dose. I self-trialled myself against the other popular mucolytic, Carbocystiene, by switching a few times within a six month period and noticed no difference in effect. I suspect the reason that UK doctors don't readily prescribe NAC is because:

1. It's not a pharma - more like a supplement - probably hasn't been tested for efficacy like 'the mainstream' mucolytic drug. No big pharma money to pay for studies. Maybe next time I'll 'tweak the tail' of my bronchX consultant on the subject - she's never offered an opinion one way or the other on my choices though she expressed a passing interest in my self-test conclusion.

2. They probably don't see a need to. Neither do I, since Carbo seems to do the job of thinning mucus and few people report problems with it (based purely on my observation of similar discussions on BLF over several years and a lack of reported side effects and contraindications in the drug leaflet). Other claimed benefits (eg anti-inflammatory and free radicals) are unproven as far as I can tell, but I welcome you enlightening me/us on your 'cures many problems' reference - I don't mean to be confrontational - as you can see I start from a position of some enthusiasm for the product but I'm agnostic on debates about effectiveness of drugs that haven't been thorough research mills (but i do take several steps like consuming concentrated turmeric and adopting a lo-inflammatory diet 'just in case' they work!)

3. Carbocysteine is probably cheaper for the NHS - if my over-the-counter purchases in Thailand are any guide then the recommended dose of Carbo is about 30% cheaper than the recommended dose of NAC. I'll pay that premium to avoid having to remember to take a thrice-a-day dosing regime but I support the NHS being cost-conscious!

Best wishes for a well-managed path through life - you are clearly someone who takes charge of their own destiny, not just relying on doctors and I can relate to and salute that!

*Prior version of "British Thoracic Society - Guidelines for Bronchiectasis in Adults (2019)"

[goat-lady]

I'm with you both on this topic. Doing ok on atrovent alone. Stopped the long acting and steroids inhalers for the same reasons- constant infections. I think I prefer NAC and alternate it with carbocystiene. I don't have COPD or asthma so it could be the other inhalers are not appropriate for me/complaint- they were worth a try tho.

Best wishes.

[deenyweeny]

I had no idea these things were true about inhalers----never bothered to read about the side effects, or did and forgot. Good thing I'm now using a nebulizer twice a day and think it's helping a lot. Thanks for your input.