Self management with COPD and inhalers.

[2greys]

Since retiring from work I have changed the routine of taking my inhalers which has had a marked improvement with being excessively breathless. Like many others I used to be so much worse in the afternoons. When working it was a relief to finish and get home.

I used to take the reliever, Bricanyl, at 5:00 am, Spiriva at 6:00 am and Fostair just before setting off at 7:30 am two separate doses in the afternoon of the reliever until 7:00 pm when I would take the final 2 puffs of Fostair, with another dose of the reliever before going to bed at 11:30 pm.

Since retiring I have changed that routine, for the better. It is so easy to get stuck in the rut of habit. As my breathing degraded, I was getting breathless in my sleep needing the Bricanyl once again, I was exceeding the prescribed 4 doses a day. So I gave this a bit of thought. The only instruction regarding the timing of the inhalers was with the Spiriva, "to be taken at the same time of day. So I consciously moved the timings around over a few weeks.

Now my breathing and reliever use is markedly different, for the better.

On the good days, I now take my Fostair before going to bed at 11:30 pm, and sleep uninterrupted all night long. I get up at 5:30 am, I take the Spiriva at 10:00 am I do not need the reliever until midday I take one puff of Fostair at 2:00 pm and the other at 2:30 pm. I then need then reliever at 9:00pm. Then back to the nighttime dose of Fostair at 11:00 pm again. The nighttime dose of Fostair should last for around 12 hours, giving ample time for a good night's sleep.

On bad days, I need the reliever more, to be able to get up and get dressed in the morning and another at 9:30 am.

That is a lot different. Reliever use has gone down from 5/6 doses to 2/4 doses per day and my breathing is better. On these very few, exceptionally good days, I can get away with just a single dose of reliever, at midday.

Of course, I still get breathless, but it is not excessive, to the point of being unable to function at all. I still get good and bad days. I hope I have made some sense, of course I have no idea of how other inhalers would work out. My real point is that this is what self management is all about, to not be afraid to experiment a little for your own benefit, you can always go back to what you are used to, if that suits you better. Take your time with any routine change, adjust it slowly.

My GP raised his eyebrow in surprise when I told him, but all importantly did not say "No, do not do that", my guess being that it was a new revelation to him.

[MELNEL]

That's very good explained 3greys. Can I ask do you have any troubles with Spiriva bad side effects? Because I took Spiriva for a long time, but last year I have stopped it. Because everytime I took it I became very wheezy and furthermore I got trouble with my eyesight, blurry vision and chest pain. So I always checked when I took it. And I couldn't think of it that I got problems with Spiriva, till I read the side effects that all was fitting to my troubles.

Of course I talked to my consultant about it and he told I should stop taking it for a bit to see if the trouble disappeared.

And it did.

I tried the other one without to add a capsule, can't remember the name but it was the new version of Spiriva. I got horrible chest pain and was told to stop taking it.

So now I don't take anything else for it.

And I believe that my breathing got worse because of it.

You made me think about this again to check and definitely speak to GP to might try a different one, if there is any.

Take care 😃 👍 x

[2greys in reply to MELNEL]

I did get some blurry vision and sparkly artefacts, but that subsided after a month. My GP did change it once to Onbrez (active ingredient being Inadacterol) but it made me have coughing fits after inhaling and an extremely tight chest after just 3 days, it was changed back to Spiriva.

I would describe the efficacy of Spiriva as a "slow burn" it takes an hour to start working with only a mild improvement to breathing but that is supposed to last for 24 hours.

[MELNEL in reply to 2greys]

Always thought that spiriva also help with infection to fry it out. It worked good so far for me till those effects starting to affect me. I took it over 3 years I believe if not longer. Well cheers anyway for your response 😌 x

[Pentreath Volunteer]

Hi 2greys - glad to hear that your new regime is helping you. I too use Fostair 200 and Bricanyl but I have two puffs of Fostair after breakfast - usually about 8.00 and two before going to bed - usually around 9pm but I read for half an hour to an hour before going to sleep. I don’t use the Bricanyl every day but often enough to need replacements during the year.

[deni-123red_]

Self help seems to be the way and playing about with timings has certainly paid off for you. I’ve tried quite a few different inhalers before settling on Trelegy Ellipta which is a once daily dose. It’s called Trelegy because I believe it has a combo of 3 active substances. One is a steroid and the others are bronchodilators. I take it in the morning before breakfast and it seems to work well for 24 hours… unless I over exert myself when I need my reliever inhaler.

A very interesting read 2 greys. Thanks

[stamford1234]

Lovely, thanks for this. I like the idea of self management and have got myself into a routine which works well

[B0xermad]

Hi 2greys, that's really good to hear, its amazing how being retired helps you adjust your routine and medication also being more relaxed helps cope with breathing difficulties and choosing where and when you need your inhalers ,what a relief getting a good night's sleep is too .

[Dizzart]

👍🏻👍🏻

[Izb1]

Good to hear that you have found a new routine that suits you, no point in following the instructions if they dont work for you. Inhalers dont do much for me so take them when I need to. We are all different and have to adjust to what suits us best x

[Med75]

Good morning, can I please say how much I enjoy this site, it’s a great help reading how people cope with their conditions & medication. I don’t have COPD but I’m a long term asthma sufferers.

What I’ve learned is I think we all feel if your told to take meds a certain way by the respiratory nurses or consultants then we follow that advice.

Reading post on here, you realise it’s not a sin to experiment with your inhaler regime to fine out what the best for you.

I’d also say don’t be nervous to preserver if some meds are not working for you with your nurse or doctor, it helps them understand we are all different & whats good for 1 may not be for all.

Thanks for the positives & negatives I read on this site it help greatly when having a poor breathing day to find help from people who truly understand what your going through.

The sun is out where I live & the birds are singing so I’m going to look at all the positive aspects of my health today. Thanks again folks for your posts.

[Cheriebobo]

I am trying to move timings of my Flixotide Accuhaler. As I have been having trouble with excessive tachycardia since pharmacy is having problems with my usual dosage. Tachycardia starts after i take my morning dose... Even although I've reduced the dose.. Im going to take it later in morning to see if it reduces tachy 1st thing.. But my bedtime dose doesn't seem to be a problem.. Although I wake jp early with tachy and low blood sugars.Being admitted to the hospital for 72 hr fast to check for nsulinoma even although not diabetic. These problems have all started since problem getting Flixotide Accuhaler 100mc.. Blf not aware of problem.. Or who's telling porkies ??

[Bluenotes]

I never thought of trying a different routine 2greys . Will experiment with my meds . Thanks 🤗🤗🤗🤗🍅