I would like to take this opportunity to say Thanks again for making me feel so welcomed by you all! I love the way you all share your experience and knowledge with everyone. I have noticed that you have different medications than we have here in the US. Also I was reading some older posts and I was wondering why it is that nebulized Albuterol isn't done? I know that I will probably have more questions like this when I get stumped, so please don't take it personally, you are all such wonderful people to be as kind as you have been! So Take Care, Nadine ☺
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in hospital with my last flare up of albutamol nebs, yet the policy here unless you are at the acute stage you will be discharge with inhalers plus a chamber (volumatic) spacer) and my family doctor fourthright about it charge they ask you to see your own doctors about nebulizing he was very fourthright about it. He told me about both sides of the coin, the face side was yes a neb will get the medicine deep into the lungs and therefore have a much more lasting effect while on the obverse side it decreases you life span as the lungs soon start to loose their elasticity and becomes weaker.
Using the chamber with a metered shot from your inhaler taking at first 4 inhalations and soon as your COPD increases in its severity you (like I do) need to take more shorter inhalations, so long as you keep the business end in place you never loose what you have in the chamber.
I know this may sound bewildering to you have a chat with either your respiratory nurse or family doctor.
I count my self lucky I am in a young doctor practice who in turn each bring their own area of knowledge into play.
My doc then gave me the choice he would prescribe either one or the other, the option I took was inhalers plus spacer I am good for a few more miles yet.
Re nebbing you say: "the lungs soon start to loose their elasticity and becomes weaker"
Do you know why that is please?
Ive just had a very acute flare up (in hospital with double pneumonia) and since then - about a month ago - I have been nebbing ipratropium and salbutomal which I've never done before for any length of time (previously just nebbed saline and very occasional salbutomal).
I also use symbicort 200/6 which I've taken for years. I have no problem inhaling the symbicort even when very sick. Im Stage 3 copd.
Ive certainly breathed better since doing the nebulising but its disturbing to learn that this may destroy elasticity.
As the family doc pointed out to he think of your lungs as muscles the pull required to inhale and as do it all the more worked muscles get bigger and stronger giving the lungs that much more time an out and of the nebs true we may need them at the end I have made my choices known in end of life care I do not want any more chemical assistance'
Advil is a Nsaid, and Tylenol is Acetaminophen, pain relief, fever reducer. As you know I was an RT, in school we were taught that if you use your inhaler correctly it is a better dose than a neb,but on the flip side of that is if you are struggling this would be difficult to do. We always gave nebs in the hospital. Thanks for sharing your thoughts with me. Take care, Nadine
anothy634, thanks for your help and your time. I found your reply very helpful. It explains so much. You have a lot more guide lines to follow for your health care! Over here because everyone one wants what ever they can get, but the down side to that is no one wants to pay for it! There are so many that use our emergency departments as their Dr's office. However this has been going on for so long now, its a way of life. Now that they are trying to get this under control, with what most Americans are calling Obamacare,it is still not changing the way it has been for generations. Our Dr's are way over paid, they have never really had to follow as many guide lines as it sounds like your MD's do. I did have a great job that was not in the hospital, it was education only. It started out with only insured pt's. This was to help keep pt's out of the ED. All was good until we started with our welfare pt's, we had to lower our reading level on our hand outs from a 6th grade reading level to a 3rd. I would make appt's and they would be a no show. This service was provided to them at no cost. I just don't understand that way of thinking, that is not the way I was brought up.
So now that I have gone on and on, I just wanted you to know that I think our medical care is abused here and has been for a very long time. Thanks for listening and sharing, take care, Nadine
yes I am fortunate to live in the UK where health care is virtually, things like specs, dentures and hearing aids all have a base or NHS standard style for those who can often pay that bit more for cosmetically preferred ones these generally fall into one of the great designers.
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As regards the ER being used as a doctors surgery we also have similar problems over here leaving a frustrated health service groaning at the seams.
Hello Nadine. Nice to have you on board. They're a great lot on here. Even if they can't help you with medical solutions, someone will cheer you up with their lovely stories or a joke or two. You'll soon discover who does what the most, each one such a comfort in their own way. Take care. XX
Nikkers,just wanted to say hello and thanks, Take Care Nadine 😊
Hi Nadine, very interesting to get your accounts of how the health service works over there. Nebs are widely prescribed here ( in Ireland and in the UK too, if I'm reading these posts correctly). I hate nebbing at home, it's time-consuming and labour intensive and I seem to get very little benefit from it. All last year my meds regime was nebbed Combivent to open the airways, then nebbed Colomycin to kill Pseudomonas followed by nebbed 7% hypertonic saline to bring up Sputum. Before starting I would use a ventolin inhaler and finish off with Symbacort inhaler. This was in addition to the oral meds and in July I was started on Spiriva. How did this cocktail of nebs + meds help me ? Not at all. 2014 was a dreadful year for me. I was almost constantly sob and unwell. Taking the three nebs together, morning and night took about 75 minutes when you added getting them ready, taking them, washing and drying the neb attachments and putting them all away. That was 2.30 minue out of my day for something that achieved nothing and totally exhausted me on the very sob days. In hospital the nebs salbutamol/itropromium were hiked up to four a day but I had to protest about this because of the side effects. I finally managed to persuade my consultant that the nebs weren't helping and now I'm using the three inhalers and a combivent or saline neb, if and when I feel I might benefit from one. I've suffered no disimprovement since stopping, the nebs. If anything, I would see an improvement in sob levels.
Ant , you really seem to have excellent doctors who give you good advice. I suspected that this longtime nebbing wasn't helping me and had read that inhalers were better for the long haul but it took a battle royal for my consultant to discontinue the nebs.
Absolutely, breathing like that for that amount of time would make anyone Sob,sick or not! We as therapit's if we saw the MD. all we needed to do was ask to change an order like that and most would. We would always switch some of the meds to inhalers. We did use a lot of pep therapy, CPT W/O postural drainage, the reason for that was, putting our lung pt's in the trendelenberg position would cause distress. Younger pt's handle that much, much better. Also when we changed over their meds, we could send home the inhaler with the pt. Win,win situation. Our hospitals charge so much a lot of our senior pt's were forever making choices, paying a bill, eating, rent /housing, whatever or meds. I and I many other's would try to help so that they didn't have to make that decision. Personally I think that stinks! Sorry, just venting, Take Care Nadine 😊
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steroid withdrawal again!
Big thank you (bottle update)
