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Confused re using blue inhaler

Ghoulette profile image

Hi everyone.

I was diagnosed with adult onset asthma around 2 years ago and have yet to get it fully under control. I was started on Fostair 100/6 but this was increased around a month ago by the GP to Fostair 200/6.

To be honest, I've kind of been muddling through on my own as I haven't really been getting brilliant help from my surgery. The asthma nurse never seemed to listen to me when I tried to explain that my symptoms were still causing me problems. The ANP at my surgery referred me to the Respiratory team at my hospital as I had around 6 courses of antibiotics and/or steroids in about 3 months.

So, my question is this.....I'm still not great at using my blue inhaler. I used to work as a prescription clerk in a GP surgery and it was always frowned upon when people had a blue inhaler every month. Also, the asthma nurse at my surgery kind of made me feel bad about using it. How do you know when is the right time to use it? Even as I sit here typing this, my chest feels tight and I feel a bit like I'm breathing through a straw, BUT, I have no wheeze, no shortness of breath, just a big of a cough. Do I use blue inhaler?

As i say, I have kinda been muddling through on my own. When i was diagnosed, it was just a case of yes you have asthma, here are 2 inhalers and montelukast, now on your merry way. I didn't even have an asthma plan until I saw the respiratory consultant. I do now take fexofenadine 120 and mometasone nasal spray too.

So, am I ok to use it like now, when there us no wheeze or shortness of breath, but my chest still feels tight and constricted?

Sorry for the long post, but I just find it all a it confusing.

32 Replies

Use the blue inhaler when you feel like breathing through a straw. I had asthma for approximately 4 years now and I use my blue inhaler when required. Also you can take fostair 3 time's a day in short bursts. I am fostair 100/6

Ghoulette profile image
Ghoulette in reply to

Thank you. I have done as it was getting a little tighter. Still feels tight even after 2 puffs of ventolin so I'm gonna have another two. Can I just ask.....do you have tightness without wheeze or shortness of breath? Or do you always have shortness of breath with associated tightness?

in reply to Ghoulette

Depends on the person and the condition, or what triggered it. Try asthma uk team and caffeine. Also I have find evergreen mints help me a friend strong mints. So maybe look into that

in reply to

I don't know anything like just a stabbing pain in my lungs

Hi there. I was diagnosed with late adult onset too. Was ill for a long time, lots of tests to rule out things first. Anyway enough of me. I still don't have a plan my GP, practice and consultant have never given me one.

So as regards the blue inhaler. How do I know. Constant cough with or without short of breath. I check my peak flow too. Then I use it. My symptoms improve I know I've done the right thing. With tight chest and very short of breath I don't get relief long enough and need intervention.

Hope that helps?

Thank you. I guess I just need to get over the issue with feeling that I 'shouldn't ' be using it. I'm still on a steep learning curve and I know everyone's symptoms are different. I probably should take my pf more regularly as well. At first I took it twice a day, every day, but my asthma nurse at the surgery said that I didn't need to. I ended up buying my own pf meter as my surgery didn't prescribe me one. I only use a spacer because the pharmacist where i work said i would probably find it really helpful.

Sometimes I get really short of breath, wheezy, coughing, tightness and can't speak so I use my blue inhaler then with no question. It's just I struggle when I'm not like that and not knowing whether to use it or not. I think I'm just gonna use it even when I don't get all the symptoms.

I don't take my peak flow every day. It's just good to know your best and your worst. That way for me I can guide if the ventolin has worked. Remember also you can have a good peak flow and feel absolutely rubbish. Be guided by your symptoms.

That makes sense. I'll start taking it again, just not as often. Thank you.

Gazza01 profile image
Gazza01 in reply to Ghoulette

Using peak flow everyday makes the throat quite sore and gives a twinge like cough. I made that mistake. I was also told not to use ventolin more than three times a week as this means my asthma is not under control. I think the big push against ventolin is because a lot of asthma deaths were due to people only using the ventolin or salbutamol (the blue one, whichever you have) and not using the steroid. Trouble is everyone seems to have lost sight of this and are treating anyone using it as if they are guilt of something. Now we have people struggling to breath all day because some so called asthma nurse ( many of whom I would trust to walk my dog) tell you you shouldn't need it.

I too felt guilty when using it but I found if I opened up the conversation on asthma and copd medications she was lost. And started googling for information from NICE.

I know for a fact there are many many people using ventolin as an add on every day, more than they are told to.

The way I see it is if your chest is tight it's going to make you anxious, which in turn will make your breathing worse. You do sound as if you could do with some relaxation to me by the way. Take the blue when you need it. That's what it's for. Your asthma nurse would if she was tight chested. And cut back on the peak flow meter, especially if its becoming a bit of a constant checking thing with you. That'll really mess up your throat from all the irritation. Good luck.

Ghoulette profile image
Ghoulette in reply to Gazza01

Thank you. I'm so glad I found this forum. I'd be lost without it.

Hi Ghouette!

I was also diagnosed two years ago and I'm in a similar boat as you- I never wheeze and don't always get shortness of breath either, but can have a very tight chest and trouble breathing out (feels like I have to cough the air out). I also am terrible about using the blue inhaler and often wait till it gets to the point where can't stand it before I take it.

I'm also still very embarrassed to use an inhaler in public and always find a restroom if possible (which I know is completely ridiculous😅) I know I should probably be using it more than I do, but I've always been the type to "tough it out". An example of this is when I limped around on a broken big toe for a week before finally going to the doctor 🤦🏼‍♀️

It doesn't sound like you've had the best experiences with your healthcare providers either. I can totally relate to the part where you were told "you have asthma, here's some inhalers now be on your merry way" It's kind of like being thrown into the deep end isn't it? I don't have an asthma plan, but not sure if they are a thing here in the US?

Sorry for the rambling post, just know you are not alone, and hopefully they'll get your asthma under control soon🤗

Ghoulette profile image
Ghoulette in reply to Lindeer

I'm so glad I'm not the only one who is like this. I too am a bit stubborn and sometimes wait til things worsen before using the blue inhaler.....partly because I don't know if i need to use it and partly because I think it will go away on it's own. Today has been particularly challenging, I think because of the atmospheric pressure and weather here in the UK.

My GP surgery has been less than helpful, but I saw the respiratory consultant for the first time this month so I'm hopeful he can help me get things under control.

I'm sorry you feel embarrassed about using your inhaler in public. Nobody should be embarrassed when using their medication 😞.

I hope we both get sorted soon xx

Poppins23 profile image
Poppins23 in reply to Ghoulette

Hi I was also diagnosed with hard to control mature onset asthma. I never knew when to use my blue, used to get embarrassed in public... it does get easier as you get to understand your condition and how it affects you. I rarely wheeze but had a persistent cough and pain across my shoulders. I started on seritide and was then switched to forstair which didn't agree with me. I never felt that I could take a deep breath and experienced chest tightness which wasn't relieved by my blue inhaler. Switched back to seritide and last year to symbicort which has eased my cough no end. It could be that forstair isn't the best inhaler for you and that ultimately that is the problem. I know it works well for many people but it doesn't agree with everyone. I also take my blue inhaler through a spacer which I find helps. The best advice I can give is listen to your body and do what you think works best. If things don't improve then go back to your gp.

Ghoulette profile image
Ghoulette in reply to Poppins23

Thank you. It's helps knowing that it's not just me being daft 😊

Hi Ghoulette, I too was diagnosed with late onset asthma 18months ago at age 58 and like you was unsure about when to use inhalers etc but I found phoning Asthma Uk line & getting help from nurses who listen to you and advise was a fantastic boost and if I have any future problems would not hesitate to call that line again...it’s a godsend!!

Ghoulette profile image
Ghoulette in reply to Chokit

I never thought to ring the helpline (I can be a numpty sometimes ☺). I'll give them a call. Thank you

The help line have given me more advice than anyone else. Yes do call them. My last attack put me in resus. My out patients consultant not only changed my meds but discharged me!! Calling them helped.

Junglechicken profile image
Junglechicken in reply to Chokit

They are so lovely at Asthma Uk. Helped me so much in the last 2 months

Any symptoms = blue inhaler. Cough, tight chest, breathing through a straw, wheeze, anything that impairs your ability to breathe. Please ignore peoles opinions who are not in the medical profession and people with asthma. With regard to doctors nurses etc they see you for short amount of time so make sure they understand how this affects you and say it how it is .... asthma is not well understood in general population ... it just isn't and those peoples opinuons could have you and up in hospital id you listen to them. I got asthma as an adult and it took me 29 years to REALLY understand it for me .... so not blaming others it's just not understood well by those who don't have it.

Ghoulette profile image
Ghoulette in reply to Emer1000

Thank you. I think I need to stop being daft and just use it when I get any symptoms.

Superzob profile image
Superzob in reply to Emer1000

Good response. I think there's a problem with getting the wrong end of the stick here. Because Ventolin is a "rescue" inhaler, regular use of it may indicate that the preventer regime is insufficient, and that is why medics don't like Ventolin being used regularly. However, if you need it, whatever the circumstances, then you should use it, and report the fact that you have had to if you are using more than once a week. But you can still use it quite safely up to 8 puffs a day!

The important thing is to get the asthma symptoms under control by whatever means are available, and discuss the most appropriate regime with the doctor/specialist if it looks like the regime needs to be amended/improved; I am dead against the simplistic view that you should not be given Ventolin if you're using it too often, not until you have a preventative regime that works - asthma is too important an illness for medics to play games with.

Ghoulette profile image
Ghoulette in reply to Superzob

Thank you. I am due to be seen in the hospital nurse led asthma clinic in around 2 months, so I will make a note of my pf, symptoms and ventolin use to try and give them a better picture of my asthma.

Have you tried different types of blue inhalers and have you tried a spacer?

Ghoulette profile image
Ghoulette in reply to Brujah

I use a spacer (thanks to the pharmacist where I work). I know that my ventolin sometimes seems to take a while to work so maybe I need to consider an alternative? I know there are are different presentations of salbutamol inhalers, but did you mean an alternative to salbutamol completely? I didn't know there were any. I just thought all rescue inhalers were salbutamol?

I find it always best to use a spacer with the blue inhaler to make sure that the medication gets to where it needs to be. Also sounds like you need to try a different doctor.

Ghoulette profile image
Ghoulette in reply to DaveW27

Hi DaveW27. I use a spacer for both my ventolin and a separate one for my fostair.......definitely feel that they help the meds get to where they need to be. I think.the main issue with my surgery is the asthma nurse. I had to see the GP for a separate issue and she made the mistake of asking if my asthma was under control.........errrr nope 😏. She then immediately upped my fostair to the 200/6. I'm hoping the hospital will be of more use 😏

Hiya, I was diagnosed 10 years ago as an adult, although my asthma nurse thought I'd probably had asthma as a child, just never diagnosed.

I take Symbicort, Montelukast and Ventolin (blue one). Theoretical I shouldn't need to take the Ventolin, however I swim and it seems the enclosed environment with the chlorine isn't too helpful to my lungs, so take Ventolin when I swim. Don't use it for any other sport. I do use it when feeling wheezy, especially with the high air temps and humidity. Also, when I have a cold.

So use the Ventolin when you feel tight chested. I was told you shouldn't be taking it everyday as that means the asthma isn't well managed. I've agreed with my asthma nurse that I need to take my Ventolin when I swim.

If you feel wheezy use your peak flow meter to see if you are lower than your usual readings. When I was going through diagnosis I had to take my peak flow morning and night and plot on a graph to see what happened and also to see the effect of the meds. Would it be worth trying a different med? Becotide (brown inhaler) didn't do anything for me.

Good luck!

Ghoulette profile image
Ghoulette in reply to Swims

Thank you. I will start taking my of a bit more so at least i might have an indicator,but I will definitely start using my blue inhaler when I need it.

diagnosed with late adult onset also, I was given a blue inhaler and that was it, only shown how to use a spacer and that was it, no asthma information no follow ups nothing that was 4yrs ago. I was wheezing coughing out of breathe still in ignorance of what asthma is and can do. I would cough cough all night and sometimes wake up looking to see who was whistling only to find it was me.

Then it happened I couldn't breathe thought I was going to die, I was coughing that hard I lost control of my bladder with every cough and thought my lung was going to pop out my mouth, I live alone and panicked called 999 could hardly talk ambulance came and sorted me out was in hospital 2 days it was the most terrible ordeal I've ever experienced. My PF was 100 oxygen was low can't remember what they said, I can only get my PF to 300 every other day other days it's 200. I don't seem to have a trigger it just happens have been round grass,chemicals etc and nothing triggers it.

Had the steroids and now on clencil and salbulol the forstair made my PF go down not up and set me coughing again. Made sure with my GP that I am on asthma nurse register now .

Ghoulette profile image
Ghoulette in reply to msbling

That must have been so scary for you. My pf doesn't seem to go very low, although I starting to take it .net regularly so I can try and get a better picture.....although in hospital on Tuesday, I don't think it dropped that low anyway.

I'm glad that your surgery will start to look after you properly now.

I am on max dose of Fostair, Montelukast and 15mg oh Prednisolone at the moment. Still needing Between 6 and 15 puffs per day of Ventolin as I am currently in the amber zone of my plan but going into red without taking Ventolin. Waiting to be seen in resp clinic where I may be started on Spiriva as my asthma is still uncontrolled. If I wasn't using Ventolin like this I would be in hospital.

I have had asthma since being a teenager but I have had a similar experience. I have gone from Fostair 200/6 to Relvar and I not a big fan of using my blue inhaler since it does not a lot for me beyond giving me palpitations when I use more than 3 puffs at once.

There are two ANP at my GP surgery, one nice one and another that is 'full of herself.' I have 'kicked off,' about the latter ANP though complaining and flat out refused to deal with her.

I take spiriva for tightness.

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