I have had asthma since childhood (over 40 years!) and have recently been diagnosed with COPD.
Cold weather, pollen are not my friends And pick up more than my fair share of man flu thanks to nieces and nephews sharing their colds!
I take seretide 250 and spiriva. But still need ventolin when my chest gets tight.
Recently, my GP has started to limit me to 1 ventolin pump per month. I’m finding this a bit hard going, and am turning down walks/trips out as I worry my supply won’t last if I get tight chested. Trying to lose a bit of weight, so like walking! Currently got about 10 puffs left to last me until the end of the month
I was wondering if there’s any over the counter alternatives? Or should I not be taking ventolin when tight chested and wait to see if my symptoms get worse?
Thanks everybody
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WheezyBee
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They limit ventolin to 1 a month because it’s a sign of poor control if you need more. 3 doses of ventolin a week (6 puffs) is what AUK seems as poor control and needing attention so if you’re using it more than that you need to inform your GP so they can escalate you treatment. You shouldn’t wait til you get worse, if you need it you need it. If you only have a small amount left you need an urgent GP appt for tomorrow so you can get a replacement and so they can review you
Only had an asthma/COPD review 14 weeks ago, and did bring this up, but no additional medication was offered. Did get referred to respiratory rehabilitation. That appointment was short though as they weren’t happy with blood pressure readings and referred me back to my gp (turns out I’m diabetic and have got my first appointment for that in a few weeks).
Hello wheezyBee I have stage three Emphysema I do have two Ventolin inhalers per month, last month they arrived in a small CFC inhaler unsuitable to fit my Haleraid I bought as I can’t press down, it’s brilliant for arthritis.
But my gripe is not the amount like you ,this inhaler needs a pair of Perfect working lungs to Inhale , the powder rests on my tongue, doesn’t reach its destination. I have bought another Haleraid to fit the new contraption.
You should complain to your Doctor and emphasise you Need two a month.
My Symbicort has also arrived in a completely different housing.
Why can’t they leave it if it works .
I hope you do have a successful outcome WheezyBee best wishes Janet.
I understand why GPs do this, but there's a flip-side which is they should also be asking the question 'why IS your asthma poorly controlled?'
I'd try & get an appointment & maybe ask about a referral to a specialist, or at least some time with the asthma nurse where you can discuss what you are doing, identify any problems then consider if you're on the right amount/type of preventer.
Hello Wheezybee. I also have had asthma forever and I'm now on COPD meds too even though COPD hasn't been diagnosed. NICE now allow COPD meds to be used treat asthma.
Do you have an annual review with an asthma nurse or do you have access to a specialist respiratory clinic? It's good to discuss a medication review at least annually with a specialist other than the GP. The review is to check you're on the right meds and using them correctly.
That aside, there appears to be a drive to limit Ventolin use despite individual need. I was asked by a specialist to stop taking it - back on it now as using Symbicourt as a rescue inhaler made my asthma worse. An indication that one size doesn't fit all.
A review of Seretide and Spiriva may prove beneficial as there are other meds in those groups (LABA & LAMA respectively). I've personally found both Seretide and Spiriva have made my health worse - Seretide exacerbated my asthma and Spiriva cause high blood pressure.
Fostair & Symbicourt are both LABAs (like Seretide) and are combination inhalers that include steroids and they come in different strengths.
I'm now on Eklira Genuair instead of Spiriva as research showed it to be a better bet re blood pressure. Did you have high BP before going onto Spiriva?
If you keep a diary of your symptoms, peak flow, activity and Ventolin use for a month that may prove helpful to pinpoint what is driving your Ventolin use - good evidence for your healthcare professional to make decisions regarding your medication needs.
Do you know if you have an aspirin sensitivity as this may indicate a need for dry powder inhalers as wet inhalers can irritate the lungs?
Finally, inhaler technique - this should be part of an annual review. Poor technique can mean meds not reaching right down into the lungs. I have to focus like mad when I take my inhalers as my diaphragm does the complete opposite to what it should and my shoulders raise (bad). For someone with a lifetime use of inhalers you'd think I would be an expert by now - far from it. And if you can tolerate wet inhalers a spacer may prove beneficial.
At my annual asthma check-up the nurse said that as my main preventer inhaler was dry powder, breath-activated she didn't need to see whether I was using my inhaler properly. Had she decided to watch me I'm sure she would have told me I wasn't going it right.
I was shocked that the best peak flow I could manage was 350
When I got home I re-read the patient's leaflet. I'd become complacent in the way I used the inhaler. I wasn't breathing out as much as I could, and often forgot to take the second dose after 2 minutes..
Now I concentrate on emptying my lungs as much as possible before opening the inhaler which deposits the dry powder in a chamber ready for me to breathe in. Then I breathe it in and close my mouth and count off the seconds before I need to take another normal breath. Often, in the morning, it's as low as 5 seconds before I need to breathe normally.
I then wait at least two minutes before the second dose. I can normally hold my breath for a count of about thirty that time and then can release the breath through my nostrils. rather than gasping for another breath.
Over the 45years that asthma has been diagnosed I've been really bad with chaotic asthma, and have had changes of medications. I do have a blue inhaler, salbutomol, but I rarely use it. My preventer is DuoResp spiromax 320/9.
Poor you, it's very difficult to say what your problem is when you have both copd and asthma and they do tend to come hand in hand during exacerbation of either. I've had asthma most of my life too and diagnosed copd in 2011. We both have the same treatment seretide and spiriva plus our life saver ventolin. Please speak to your Gp and say you are literally housebound without Ventolin, really they need to weigh up pros and cons what they do for you. More Ventolin? or do you just stay in and become sad and depressed for the sake of sticking to guidelines... life is too short and at the end of the day yes they are guidelines!!!! A guide!! everyone is individual some need more and some of us less. Please explain your fears and anxieties hopefully they will listen. I too get 1 per month but always have a spare and if I need more I ask and get more my gp says they would rather I breathe and not struggle and end up in hospital. You take care and hopefully you get sorted.😀
Hi, I am sorry to hear how you are suffering so badly with your asthma and that it is effecting how you feel. As others have said, more than 1 reliever inhaler per month is a sign of poor asthma control, so whoever is treating you should be looking into why this might be the case and what to do about it to keep your asthma under control. It could be increased exposure to triggers -- which you could try to avoid, or a sign that you need a course of steroids or a change your inhalers
How is your peak flow? Do you have an asthma plan and perhaps a course of steroids to take to bring your asthma under control? When did you last take a course of steroids? Perhaps you might need an additional course if your asthma isn't under control. GPs usually give a week's dose, but sometimes you need to take a 14 day course to calm things down.
In your post you say "I worry my supply won’t last if I get tight chested." But worrying IF something might happen and not doing an activity you enjoy on this basis is the key here. You also say, "should I not be taking ventolin when tight chested and wait to see if my symptoms get worse?" If you have an asthma action plan, this should tell you when you should take ventolin and if you need it more often, then your plan / treatment needs reviewing. As you have both COPD and Asthma, it is likely going to be harder to treat and find the right combination of medication which works for you, but it is important not to worry, as this in itself can trigger asthma.
Personally, I don't take a reliever inhaler if my symptoms are mild. I always wait and see. To maintain control I also take Spiriva and Seretide, which both work well for me without side effects. In addition, I take another steroid inhaler (Flixotide), plus Intal inhaler - which is for allergic and exercise induced asthma - and Beconase, a nasal steroid inhaler, plus monthly injections of Mepolizumab. With this regime, I am managing to limit my Brycanyl (reliever inhaler similar to Ventolin) to less than one per month and am doing OK with this. I know my GP will give me more if I ask and I have Brycanyl nebs to take if I need the bricanyl inhaler more frequently. However, I hardly ever need these now and if i increased my use, this would show up when I see the consultant as they check prescription records as a sign of compliance with medication and also to check that you aren't using too much reliever meaning you asthma isn't under control. Before this, I was regularly taking courses of steroids in order to maintain control.
I would say, this boils down to whether you have an asthma action plan and what this plan says regards when you should take ventolin and other medication and what to do if you are still experiencing uncontrolled asthma symptoms when strictly following the plan. So, first thing I would suggest you do is to get a written asthma action plan if you don't already have one. And if you do, then ask for this to be reviewed. You can make an agreement with your doctor about when and how you use your medication and what to do if your symptoms worsen even when you are following the plan. Your plan might say you need to take a course of steroids to bring things under control ... not more ventolin.
Once you have things under control, you can review your own use of ventolin at home by seeing if your symptoms worsen before you take it. Keep a diary of your symptoms so , you can show your doctor when asking for a plan or asking for a review of any existing plan.
One ventolin a month really should be enough! I feel I take mine way too often at times but I've rarely ever ran out of one. Rather than limiting your amount (which I don't disagree with) your GP should be looking at your asthma a big more carefully. You shouldn't be limited your activities due to lack of medication. It seems your asthma is not well controlled. You would be requiring ventolin far less otherwise.
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