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Home Nebuliser

Hello I'm a brittle asthmatic and I've been hospital and needed more nebulisers this last year than ever before and I am now starting to question whether a home neb would be any good?

Whether you use one or not please give me your opinion on using them at home

Thx in advance for your advice x

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Hi - I don't use one as my issues don't require a neb often luckily.

Sorry to hear about the issues you've been having, sounds pretty rough. Hope things improve for you!

I reckon if you have been requiring them more often than normal it might be worth investigating. I have two family members who use home nebs and for both it has kept them out of hospital/ decreased the frequency of their visits the last few winters - they just use their nebs and go to the GP when they feel worse/need more than recommended or have moderate exacerbations for steroids/antibiotics as deemed necessary.

I know at one stage I was up at my GP's on a neb and the nurse suggested I investigate getting one - it was my second time that month on a neb and I think she thought my winter months were all going to be like that, luckily that didn't transpire. And most of the time I get away with puffing away through a spacer...thankfully.

On the reverse side of things, as a student I have spoken to some patients in hospitals who have home nebs and found it gave them a bit more freedom as they weren't needing to go up to their GP every month or every week for a neb. It really is up to you though - how often you need nebulising, etc. I reckon though that if you are at the stage of asking about using a home neb and are a brittle asthmatic that you might be feeling you could benefit from one? It's worth looking into. You can buy nebulisers for 50-100 pounds usually and they do last years. It's worth the investment if it makes your life easier, I feel.

Next time you see your GP or asthma nurse you could bring it up with them? The GP would have to add the nebules onto your regular prescription, and decide then what type of medicine would be best for you - if that was something they thought was a good idea.

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I don't have one, because my consultant is dead set against them. He and others have a concern that for many people it isn't safe, because they will neb at home instead of getting help and when the nebs aren't working they're in real trouble.

Having said that, the asthma nurse in my specialist clinic said he would have a word with the cons about it. It may come to nothing but I have had several episodes where I am really not great and my inhaler barely works but it's not really quite bad enough for hospital, just enough to keep me bedbound, and persists for ages. I think he felt that it might help for me to have a neb at home in those instances. This is also something the Asthma UK nurse mentioned to me independently. After hearing the whole story she said in most cases she and colleagues don't recommend home nebs, but at times for hardened repeat visitors who are very symptomatic a lot like me, she thinks they could have some use.

Incidentally, you hear a lot about how nebs are no better than inhaler plus spacer. In my experience there is a point where this isn't true as I can take huge amounts with a spacer and it will only help a little or not at all. Sustained nebbing (this will be in hospital) will not be immediate but will have more effect and start to help.

A nurse a few admissions ago said that she had a nurse friend who worked on medical devices. Apparently for everyday meds, nebs aren't really better for delivery - there you need a spacer. However, for someone struggling to breathe, the neb is better as it's very passive - a spacer does deliver but you do have to breathe it in and keep going and going. I admit I do find it easier to just have the neb mask on when really struggling.

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I have a home nebuliser and a portable nebuliser and I wouldn’t be without them.

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How are you?

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Hi- if your a brittle asthmatic your specialist would be able to recommend if they think you need a home nebuliser. They are not often given out for home use anymore because of the number of people abusing them and not going to hospital when they should, they think instead that because they have a nebuliser it will stop them going to hospital. It doesn't so most people with a home nebuliser have a very strict protocol for it.

Are you under a tertiary centre?When you went through the difficult asthma protocol did they identify what your triggers are and what the pain thing is that is driving your asthma because it might be that they can offer you other drugs which are more specific for example if you have high eosinophils then you may qualify for one of the monoclonal drugs to help and it may stop you needing hospital so much etc.

Any other questions just ask. More than happy to help!

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Hi I have one (after needing nebs weekly 30/52+ weeks of the year with multiple hospital attendances too).

I was advised to get one by my GP (where I had most of my nebs) and multiple a&e/amu staff suggested it although my consultant isn’t really happy that I have one, tho if I do end up in hospital he is now more likely to send me home earlier than he would have before.

Mine came with a set of ‘rules’ as the main reason people don’t like prescribing them is that we can over depend on them and put off seeking more help and thus get a lot worse (especially if it’s just for emergency treatment as some people will need it for maintainence).

My rules are 1 neb in a day I have to inform my GP (phone or face to face), 2 maximum - if I need a 3rd have to go to hospital. If I’m on a neb also have to up pred to 40mg (if I haven’t already). Though I should say that on a good day I don’t even need ventolin.

Still I know it has led to me delaying treatment during severe flare ups as I’ll usually only go in if it’s not lasting 4 hrs and some a&e docs don’t understand I’ve already had nebs and they haven’t lasted yet they still insist on giving me a neb, wait and see and try to send me home. A&E also told me in the past that as I have a neb at home I shouldn’t come to hospital unless really bad which led straight into a month of 2 hrly nebs, waking 2-4x every night til I just couldn’t cope anymore then I was told off for waiting so long 🙄😤 (I had a chest infection that I got over but my lungs didn’t).

On the plus I have managed to get a life back, be able to plan things, work and go to uni without planning my life around hospital/GP appts.

My tertiary hospital isn’t happy I have one as it’s not of maintenance and are trying to make me go in to hospital when I know I could treat at home - due to the length of time I was poorly managing my asthma my brain now only registers as symptomatic when below 50% PF, I don’t notice anything at 70% hence me not feeling bad (I was living at 50% for over 6 months at one point).

There are plus and minuses to home nebs, so discuss it with your docs and see if they think you’d benefit from one or not (it took about 18 months of mulitple GP/hospital visits before I got mine, docs in essence ‘made’ me get one as I felt guilty for ‘wasting’ their time/NHS money so was waiting later and later before seeking help 😕).

Hope that helps with some of the pros/cons for emergency home nebs.

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Said this on your other post but really is it any surprise people misuse home nebs if A&E are actually saying to stay at home and neb instead of coming in?! I don't think people would push it like that if they hadn't been made to feel like timewasters.

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I know. Especially as I’m now at the point when I’ll only go in if I feel unsafe and my home neb is not working. Plus I can usually tell after a&e if I’m going to need to stay in or not (something I always try to avoid on principle!). I think my main problem is that without ‘rules’ or instructions I will just go until I can’t anymore so when they said to manage at home they didn’t give me any end point (as in if you’re still bad in 2 weeks/after antibiotics etc) so I way over pushed myself!

In someways being allowed to do this meant I can have a life/go to uni etc when I’m triggering plus it stops me overdoing the ventolin (which I have no rules for and will happily do 50 in a day and not think about getting help 😅 - at least with the neb there are boundaries!)

But I know Brompton really don’t want me to have one as it stops me getting more help when in a bad spell.

It really is swings and roundabouts. I could cope without it but I’m probably better with it!

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Yes I would like one to give me more freedom! I think I can tell if I need to go as in those cases several nebs in hosp won't be getting on top of it so I think I would be able to tell at home that it wasn't helping and I need to do something. If I'm multidosing with inhaler and it's sort of working I feel there's no point going as it just grumbles on. It's times like those I would like a neb as I feel it would make me feel better and would actually help.

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Hi - I have home nebs, had for a couple of years now. I have severe persistent with allergies. I carry epipens.

My asthma gets bad (and improves) very quickly. I started out with consultant allowing 2 nebs in a day then get medical help. Now I can take 3 a day if I need them. I usually don’t need them. Today I am snowed in behind half a mile of drifts and having the nebuliser gives my family confidence about managing my asthma at home.

I have a portable too and use it routinely twice a day on holiday as I am very reactive to holiday air (doesn’t seem to matter where I go)

My nebulisers allow me to participate in family outings and generally make life more manageable for my family.

Sorry for rambling - hope you sort out something that helps xxx

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Sorry to hear you have had to use the nebuliser a lot. I found if I was using it I Would not have had to wait in a&e for hours before. So invested in one I have used it a few times and it has helped it wasn’t cheap but probably stopped me going to a&e so often.

I was told by Drs that it can repress your condition so be aware and don’t use it too much. Know your body and how you react when you have not had to use. Don’t use regularly. Wishing you well.

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I only call an ambulance when I know I need a nebuliser I know my body well enough to know when to take it or not so yeh and I would be very careful about it

I'm just fed up of my asthma you see and if a home neb does the trick and keeps me breathing and out of hospital than that's what I need

Thx for advice

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I also have Chronic Brittle Asthma, I use a home nebuliser as part of my daily meds. I have 5mg Salbutamol & 500mcg Atrovent 4 times daily, with Salbutamol if I need extra nebs. I also have a portable neb which I take everywhere with me , just in case & so that I have the freedom to get out & about. Good luck with it.

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I have just bought one. I use it mainly at night to clear the mucous. Using it with saline loosens mucous. I discussed with go about having ventolin news after a particularly bad attack at work. He said talk to my asthma nurse, but said they prefer them with oxyge,

When I spoke to my asthma nurse, he thought it was a good idea, as I’d had 8 puffs of ventolin before I showed any signs of improvement and it took a few days to get over it. I have been advised to try my inhaler first, but if it isn’t working, use the nebuliser.

I had another bad attack on Friday, whilst at work. I tried the inhaler first, but then used a nebuliser. I couldn’t go to work the following day, as my breathing was bad and I’m going down with a cold. Without the nebuliser. I think I would have had to call the paramedics which, being the worst day for the snow, may have taken quite a while for them to get to me. Having the nebuliser enables me to take charge and make decisions for my self. If it hadn’t have worked though, I would have called someone. I am fortunate to work in a hospital, so plenty of nurses around me.

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