Spacers - volumatic v aerochamber?

I've been having voice problems for ages (ie NO voice) and got referred to ENT etc

They did biopsies a couple of weeks ago and at my follow-up they said i've got necrosis on my vocal cords.

The ENT consultant wants me to come off my seretide cos of the high steroid content and the fact that the inhaler coats the vocal cords as the stuff goes past. I tried to tell him the seretide is the first inhaler that's actually calmed my asthma so i'm reluctant to come off it. He did say he's not respiratory so can't actually advise on inhalers / asthma, He's going to write to my GP and i've got to go back to see him toward the end of next week when he should have the consultant letter.

Anyway i was thinking i currently use an aerochamber spacer with my seretide and wondered if anyone knew if it would make a difference if i used a volumatic instead? Would it make the particles any bigger / smaller, would it be more / less likely to coat my vocal cords? Basically could i get away with just swapping my spacer? As it's the preventer i'm not bothered if i have to use a huge device to take it, it's not like i might HAVE to take it while i'm in company!!!

12 Replies

  • Hi Jinglfairy,

    Not sure whether this is going to help or not.

    I'm currently encountering a similar difficulty to you, though in my case the flixotide I'm on (so fluticasone - which I think is the same steroid as is used in seretide) is being blamed for repeated attacks of thrush in my oesophagus resulting in oesophagitis (this is despite thorough rinsing out, gargling etc). I use accuhalers which I find work well for me. Like you I'm very reluctant to switch my medication (flixotide 250 does a very good job at keeping my asthma under control). My gastroenterologist consultant has now acknowledged that I cannot come off my inhalers, but a respiratory consultant and my local GP surgery have considered alternatives - none of which we have yet tried, none of us thought it would be a good idea to trial a new medication in winter. However, one of the GPs at my local surgery has mentioned a new asthma medication which uses ultra fine particles which he suspects may do less collateral damage. Annoyingly, I can't recall the name of the medication ( except that it certainly wasn't Seretide). You could ask your doctor about it though. He/she should know what it's called.

    Hope this is of some use to you.

  • hi Maggie, thanks for that

    Yes you're right, fluticasone is the same steroid as in flixotide and seretide, the difference being seretide also has salmeterol in it as well. The new medication you're talking about wouldn't happen to be Fostair would it?? I've already tried that and it was no use :( I had been on Qvar for years and that became ineffective so we were actually on the merry-go-round of trying new inhalers. Fostair was the first different one i got - that's the same drug as qvar (beclamethasone) but plus a 12 hour broncholdilator (can't remember which one). That made not one jot of difference to my then troublesome asthma, that's why i was put on the seretide. That calmed things down asthma-wise but then i got a chest infection towards the end of january and that triggered my lost voice and began a new merry-go-round *sigh*

  • Was it Spiriva Respimat Mggie?

  • No, neither of those. For some reason budesonide keeps coming to mind. I know I was not happy at the thought of being taken off medication that was doing a very good job, and the thought still worries me.

  • Hi, I take fostair, it's beclometasone and formetorol combined. A few years ago I went through months of loosing my voice, throat infections and laryngitis due to attempts to take inhalers like seretide. In the end I stopped taking preventers unti my throat had recovered and tried taking qvar with the aerochamber. This wasn't perfect as still got throat irritation and wasn't helping the asthma. I don't know why it took doctor so long to recommend fostair but it's so far been fantastic. It works in minutes and it's the first inhaler I've been able to use without spacer, which I never really thought did much good anyway! Everyone's different of course but for the time being I'm sticking with the fostair.

  • Happy easter everyone.

    I do have a spacer, but I only use it if my asthma is so bad tht I cannot use an accuhaler adequately well - a rare occurence these days, thank goodness.

    Fostair was a medication suggested for me by the consultant I saw, but I don't have a particularly happy history with beclametasone. I was on becotide in my late twenties and early thirties - my asthma we not good during that time. Things improved markedly when I got put on flixotide instead. Seretide has also been suggested for me, but I refused point blank to consider it - I had a very bad experience whilst using serevent a few years back.

    As BexRee says, everyone's different, and finding the medication that is right for an individual with asthma can make such a difference. So it's really very frustrating to be told that it's affecting other parts of your anatomy and perhaps something else should be tried.

    If only fluticasone was available in an ultra fine particles form. But as far as I'm aware, it's not.

  • Thanks guys,

    Maggie, I'm now even more upset that ENT wants me off seretide. Yesterday i went for my first run (5k parkrun) since the chest infection which triggered this and although i did officially overdose on my salbutamol by taking it before, during and after the run, by about 20 minutes after the run my breathing felt pretty good. This is the first time i've been running since the seretide has had chance to properly be in my system since i was put on it at the end of December. It's also the first time my breathing has been ok - even with salbutamol before / during / after!! Normally i would spent at least a few hours after a run coughing loads or if i've done a 10k it usually takes me 2 full days to recover!!!

    I'll be going to the GP sometime next week, i hope he can find a suitable alternative

    Because it's mainly exercise that sets me off, one of my friends suggested the doctors (GP or hospital) might tell me if they can't find a suitable alternative to seretide then i'd have to stop my exercise - psychologically / emotionally that would kill me!!

  • Exercise is a known trigger for me too. Aerobic exercise such as running is a no no - the most I can do for any distance over a hundred metres is brisk walking (I was really pleased that I managed six miles in just under two hours a couple of weeks ago, without needing salbutamol). I do anaerobic exercise though - ballet and Pilates. Suitable exercise for me is a must. I have hypermobility syndrome and it's quite important that my muscles keep strong enough to support my joints.

    Good luck next week!

  • Thanks Maggie,

    (Sadly?) all the exercise i enjoy doing is aerobic - running / swimming / tap dancing. My absolute favourite is my dancing, I have a private lesson and i'll move all kinds if there's an offer of a lesson. Even if i'm ill or injured i'll dance if i possibly can so when i had the chest infection and was physically incapable of doing anything i *think* that was the first time i'd had to cancel through illness and definitely the first time i've had to cancel 2 weeks in a row. It's really funny, my dancing teacher knows me and my asthma well and every so often she'll ask if i'm breathing LOL

    i used to do ballet as a child but stopped that when i was 16 and never went back to it, i stopped my tap at age 18 but went back when i was about 25 / 26 and 10 years later i'm still going - and still loving it!!

    As long as i get a preventer of some kind i reckon i should definitely be able to carry on with my swimming, and my dancing but will have to be a bit more careful with it. I *may* have to stop running which will upset me, especially as i was hoping to do a half marathon and i've made a lot of friends through running that i don't see at any other time. Psychologically I think i could cope with stopping running but not the dancing and swimming

  • Swimming is something I have to be careful with, and it's a no unless I wear a nose peg and goggles; I'm allergic to chlorine. Swimming with no goggles or nose peg results in streaming hayfever at best - at worst asthma. I'd love to be able to do running. My husband and eldest son both enjoy cross country and my younger son (another asthmatic but not exercise induced, and he's virtually symptomless now anyway) is hoping to do a half marathon later this year.

    See what the GP says. If he has found a good alternative, I'd be interested to know what it is.

  • will do Maggie,

    I'll let you know what happens :-)

  • Hi, I'm on seretide and flixotide. I kept having a hoarse voice and lost it a few times too. My specialist put it down to acid indigestion and I was put onto omeprazole. This seems to have helped.



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