New newbie

[Jezlilolme]

Hi everyone! I am a new newbie! New to this forum and new to finding out I have moderate asthma/ possibly copd. I'm 46 and after a recent er visit, was surprised to find out that I have a respitory issue that I probably have had for quite some time. My doc has me taking a daily inhaler of qvar and of course I have the rescue inhaler.. But all of this came without instruction.. Lol so I'm trying to figure out, when to use the rescue inhaler? I'm not sure if I'm using it too much or too little? Should I have a spacer for the qvar? The more I read online the more questions I get.. Lol when I went to my last visit he gave me a peak flow meter.. And I am hanging out at 250. And even though I have been on qvar daily for 6 weeks now, it hasn't changed. Is that normal? Or are my numbers supposed to go up with treatment?does it mean that it might not be asthma and probably is copd? Sorry for the million questions.. Lol

[Hidden]

Hi Jez welcome to the forum¨!

Peakflow could be better I think, maybe it is not the inhaler for you..how many inhalers do you have? ?what is your rescue inhaler do you know the name.?.I would use all the max doses allowed to get that peak flow up while waiting for a doctor's appointment..and go and see the nurse or GP for a further check up. Take care xx

[Jezlilolme in reply to Hidden]

Right now my doctor has me on qvar 40 (beclomethasone dipropionate) 40 mcg and my rescue inhaler is proair (albuterol sulfate) 90 mcg

I only spoke with him briefly on the phone regarding the results of my pulmonary function test, and I have a appointment with him on the 22nd of this month. So I'm sure I will find out more when I go see him. This is all so new to me

[Hidden in reply to Jezlilolme]

Ok I expect you use your Qvar 40 twice daily and for acute asthma so breathing difficulties normally you can take your albuterol 90 metered-dose inhaler: 2 puffs every 4 to 6 hours as needed.

I would check with the pharmacist just in case.

I hope that helps, keep on measuring your peak flow and let us know how you are getting on. Should you feel your inhalers are not helping, do not hesitate to go to A&E.

[Jezlilolme in reply to Jezlilolme]

Thank you for the good advice happy London I've been afraid of using the rescue Inhalir too much, but I am going to use it more freely( up to the max dose) until I go into seeing him:)

[Hidden]

Hello Jezlilome, welcome to the forum.

How long have you had the peak flow metre? It can take two or three weeks (sometimes longer if you're adjusting to new medication or are in recovery from a bad attack) to work out what is normal for you. Peak flow norms are determined by looking at gender, age and height. That said no two people are alike so there can be some variation. For example, two fifty year old women of the same height might have very different readings which might be considered 'normal' for them.

Rescue inhalers (albuterol) are just that: they are designed to help you bring things back under control if your asthma suddenly gets bad for one reason or another. If your asthma is well controlled you should hardly ever need to use it. Preventer inhalers are meant to keep the condition controlled most of the time. The qvar you are on is one of many different preventer medications that can be prescribed. As Asthma can vary considerably between different individuals finding the right preventer medication for a newly diagnosed asthmatic can take a while.

The fact that you are needing to use your reliever inhaler so much is a sign that your asthma is not currently controlled. You say you have your next appointment with your doctor on the 22nd of this month - have you tried contacting either your doctor or asthma nurse to warn them that you are still having problems? If not, it might be an idea to do so. Given that we are now at the weekend and you won't be able to contact either until Monday, I suggest that you follow the advice given to you already by HappyLondon.

Hope things begin to improve for you:-).

[Jezlilolme in reply to Hidden]

Hi Maggie my doctor used the peak flow meter at my last visit and let me keep it.. That was about six weeks ago. According to the chart I should be around 460.. And honestly it hasn't really changed since that visit, so the preventer he put me on might not be the one for me. It honestly has helped as far as the chest tightness I was experiencing but I am still coughing a lot.. I think I will call my dr on Monday and maybe they can get me in a little earlier

[Minushabens]

Hi & welcome. Have you worked out what your optimum peak flow should be? As well as age & gender, your height also influences what it should be.

From that, you can start to think about what a 'good' PF needs to be. As others have said, though, this might take a little while if your problem has been there for a while. You might also benefit from a course of steroids, so maybe mention that to your GP?

[Jezlilolme in reply to Minushabens]

According to the chart it says I should be around 460.. But honestly my doctor hasn't mentioned to me what would be a good peak flow for me yet. We only had that one visit so far when we found my peak flow so low. I'm hoping at this next visit he will explain it more to me. We will be going over all my test results and everything. And I will definetly ask him about the steroids Could 250 just be my norm?

[Minushabens in reply to Jezlilolme]

If the chart says 460 then I'd say 250 seems low (well managed asthma would be targeting around 80%+. I wouldn't think of it as a norm - I tend to think about personal bests! Whatever is good, I still try to beat it.

There's a standard test you can do at home around PF. Take a reading, then take 3 or so puffs on your recovery (blue probably) inhaler. Wait a couple of minutes then take another reading. Typically, someone experiencing an asthma exacerbation would see around 10-15% improvement in the reading. It's only a guide, but a helpful one.

[Superzob in reply to Minushabens]

This is probably right, but if the largest component of obstruction is COPD rather than asthma, then that might explain why the improvement is so slight, since qvar is only likely to affect the asthma component. I was diagnosed last year with asthma and fixed small airways obstruction (COPD by any other name) and my PF is 300 when it should theoretically be 500. The spirometry tests seemed to indicate that my reversible obstruction (asthma) was only 20% of the problem, the rest being fixed. As far as I am aware, corticosteroids such as qvar only work on the reversible component, not the fixed. In that case, a combined inhaler like Fostair, might be a better bet.

[ElizabethC in reply to Minushabens]

I would agree re Personal Bests too.

I should be around 450 for my height and gender but my personal best is 350. At present I'm probably around 250 but am coming out of a month long viral lung infection which exacerbated asthma and resulted in emergency A&E visit (reason being in surgery I was down to 150 peak flow even after nebuliser!).

So to the original poster - you may not yet know your personal best, but 250 is low but as you've just been diagnosed it may be that it will be a while before you know your personal best.

[Hidden]

Hi to answer your question you use the preventer according to the doctors instructions. It's usually 1-2 puffs twice a day. Your blue ventolin inhaler is a reliever and should only be used as and when you are extra breathless.

If you haven't been shown how to use them properly then ask your pharmacist to help you with it. Or you can look on Youtube for a demonstration.. x

[Jezlilolme in reply to Hidden]

When I was in the er, they told me to not out my mouth directly on the mouth piece of the Inhalor.. And I actually looked it up in YouTube to see if I was doing it correctly and all the demonstrations had their mouth directly on it.. lol so it confused me a little.. Haha that's a great idea to ask the pharmacist. I need to pick up a refill next week and that would be a great time to ask!!

I am using the preventer 2 puffs two times a day.. And the reliever I have been using if I am having shortness of breath or coughing a whole bunch.. Is that okay?

[ElizabethC in reply to Jezlilolme]

You will need to put your mouth directly on the inhaler - or you can't keep the seal as you inhale as you press the pump. You asked in your original post re Spacer.

I would say YES - use one. I find I use it when I've had issues in controlling my asthma either due to triggers, or as I am now, during in after a viral lung infection.

The spacer really helps as you can pump the medication into it (I was told in the hospital (yes, this infection resulted in emergency A&E visit) I could pump up to 10 into the spacer and slowly, and gentle naturally breath it in through the spacer as a normal breath (though through the mouthpiece).

Its really helped. If you don't have one, you can get them from a pharmacist or online.

[risabel59]

If Newly Diagnosed it's quite difficult to titrate doses. It's good you have a peak flow meter. Take readings before meds twice a day. Take 3 readings write down the best. Also keep a note of when and how much reliever inhaler you are using. Using a lot of reliever shows your asthma is not well controlled, but you should use it if you are coughing, wheezing and short of breath. It is literally a life saver. When you go back to dr. You can show all these notes and he/ she will find it helpful

Re spacer for Qvar, Qvar is a great starter inhaled steroid as it is small particle. It does help to use a spacer and your pharmacy will sell one. The Qvar inhaler does not fit all spacers , so make sure to get the right one. If you can be bothered to carry it around it is also good to use reliever with spacer, as it really improves intake of drug.

When you next see your doctor get a written Asthma plan. Which will help you manage your condition. There are templates on the Asthma U.K. Website. Which you can print and take with you.

Everyone here is very friendly and will answer questions as best we can, but if any doubt you should always go straight back to the doctor. Asthma is no joke, it's a killer.

Best wishes

R

[ElizabethC in reply to risabel59]

Can't like this enough! Well said.

[Hidden in reply to ElizabethC]

Yes I totally agree - very well said. x

[Jezlilolme in reply to risabel59]

Thank you so much for the amazing advice risabel!!! Starting today I started documenting everything and I will show it all to my doctor. And if I see that I'm getting worse I will definetly call to try and get in sooner!

[Hay133]

You can use blue inhaler up to ten puffs but only use inhaler if you get out of breath and cant control it

[Jezlilolme in reply to Hay133]

Thank you hay! I will keep that in mind and will talk to my doc in the 22nd to see if this preventer med is right for me.. And if a steroid might help!

[Hay133 in reply to Jezlilolme]

Glad to be some help

[Hay133]

Predisolone might be better