Inhalers

[primrose71]

Hi all I have had COPD for 10yrs always been told when I use my inhaler to inhale deep and hold for a few seconds now respitory nurse says that’s wrong when using a spacer to take 3to5 short breaths in and out keeping spacer in mouth would like to hear how some of you take yours thank you .

[Oshgosh]

I think that you use a different technique when using a spacer than just using an inhaler.

If you’re still in doubt try the BLF website.its got videos showing techniques.

[primrose71 in reply to Oshgosh]

Thank you will have a look

[CDPO16]

Your nurse has advised you on the correct way to use a spacer. The technique is as you describe for using an inhaler without a spacer.

[primrose71 in reply to CDPO16]

Ok thanks a lot

[CDPO16 in reply to primrose71]

I use a spacer as I can't manage the correct technique without. Spacers are said to be a more efficient way of getting the medication into your lungs but they don't have to be used.

[primrose71 in reply to CDPO16]

Thankyou

[peege]

I think both ways are okay. I was taught to take one long deep breath in whether using a spacer or not. I have to demonstrate I'm doing it correctly at annual check ups too. The way your respiratory nurse described is for people who find that method easier than taking one breath in - they don't always get it right! One once told me that it was impossible for steroids to causd thinning skin and bruising 😄

[Jehinch in reply to peege]

I don't use a spacer (spacer causes me to be more breathless) I inhale for a count of at least 15. I can often inhale for count of 25 but don't think that's necessary. It's only way my Respitory nurse had told me how to use my inhaler

[ilos in reply to peege]

They should live inside my skin! Tissue paper comes to mind.

[Elsie1930]

I have just been told I have bronchiectasis any one else been diagnosed with this and how are they doing

[hypercat54 in reply to Elsie1930]

There are a number of sufferers on here and Littlepom is probably the most experienced. I have tagged her so she will see you. Also have a look at previous posts.

healthunlocked.com/search/p...

[Boudica1 in reply to Elsie1930]

Hi, I have Bronchiectasis along with a number of other lung problems. I seem to be managing okay but I have to be aware of any chest and throat infections.

Hopefully this winter will be easier to dodge them with people wearing face masks so it may be a bonus for us.

♥️

[Tinker26 in reply to Elsie1930]

I have Bronchiectasis and am just in the middle of an exacerbation ,first one in over 9 months ,bit of a nightmare getting correct diagnosis at first but have felt so much better since getting a nebuliser and azithromycin.

[Elsie1930 in reply to Tinker26]

What is ment by exacerbation please

[Tinker26 in reply to Elsie1930]

A flare up ,chest infection xx

[Spanielblue in reply to Elsie1930]

I suffer with it too and find some days better than others. I also have rhinitis which makes the problem of excess mucus worse. I have been prescribed a Dymista nasal spray which I thought helped in the beginning but doesn't seem much use now. I do have coughing attacks during the day and night but then can go nearly all day without coughing at all. Eating certain foods will often start me off and also eating cold items like yogurt and ice-cream. Laughing, yawning and getting up after sitting or laying down for a long period will make me cough. Obviously, I get fed up and tired with it all but in myself feel fine and able to enjoying gardening and walking even though I often get out of breath. Bringing up mucus has always been very difficult so I don't do the huff and puff method because it doesn't help help me. Just have to wait until I start to experience chesty coughs and then find I can clear a little . I am a patient with a local hospital respiratory department so do have opportunities to talk over my illness with them. The illness is livable and doesn't have to spoil life.

[santisuk in reply to Elsie1930]

Hi. I have bronchiectasis. Diagnosed 5 years ago by Papworth Hospital Cambridge. I had been under the care of a general lung consultant in Thailand for 2 years prior to that at times when I was suffering about 3-4 infections a year, including the odd hospital stay for pneumonia. He was treating me along his general lung infection principles of sputum sample, rescue antibis (amoxyclav for most, levafloxacin if pneumonia suspected). He also prescribed as routine daily treatment the Symbicort inhaler (pre-prepared mix of bronchodilator powder and corciscoteroid) a doxofylline long stay bronchodilator (later changed to the better "Puroxan" which the UK doesn't get) and NAC acetylcistine mucolytic.

In the initial years my Papworth bronchiectasis consultant did not tweak that as I seemed to be getting fewer exacerbations and my lung performance was quite good. However, as I began to feel I was on top of the disease and as the 3-times-a week prophylactic kicked in and as I benefited from more rigour to my diet, daily exercise and huffing up lung clearance I took the initiative to delete some of these myself. I dropped the Puroxan out first, then I saw that bronchX sufferers are not supposed to take inhaled steroids (British Thoracic Society guidance) so I dropped the Symbicort (thinking I would take it back up temporarily if I got a real nasty exacerbation). So I am currently on only prophylactic azithromycin and the mucolytic and thinking of seeing how things go without the azith! Down to one exacerbation a year and not a horrible one at that. Actually I'm overdue one if I'm to continue my one-a-year

I'm lucky but dedicated to the cause of preventing this disease get the better of me. I'm prepared to self-experiment and I value my annual family trip to the UK including a checkup by the excellent Papworth team (lung performance and CT scan being the core). In the last 4 years I've also been diagnosed with osteoarthritis, had a microsurgery on a herniated disc and undergone an unexpected triple heart bypass op one year ago. Still optimistic and powering through - I organise a running (and beer drinking) club here in Thailand and want that to continue.

Maybe luck is the key, but I would definitely advise in favour of taking your destiny into your own hands. Get a good bronchX consultant even if you have to pay for it, take the lifestyle changes seriously and belt the little blighter bugs with antibis before they get a grip (but equally don't over-react too quickly to one flag of impending infection, unless it's severe chest pain or consistent blood in your sputum).

Try dipping into the BTS guidelines which guide doctors and specialists on the treatment of bronchX and listen to your own body responses as much as you listen to the docs. Finally and most importantly, get yourself on azithromycin 250mg , 1 cap, 3 times a week if you are suffering exacerbations 3 times a year or more. It's a wonder drug for most bronchX patients who fit the criteria of frequent infections

Best of luck

[Willanna in reply to Elsie1930]

Hi I have bronchiectasis only found out about 1 year ago after being treated for copd for over 6 years turns out I was on wrong medication & probably why I was having chest infections every 6/8weeks.

Been put on new regime of antibiotics 6 weeks on then 6 weeks off plus normal meds hopefully it will work 🤞

[Elsie1930 in reply to Willanna]

I just been put on 1 month steroids and wanted to know how it’s took so long, would have thought cos of Covid that would mess it up time wise was told I had asthma end of 98 asthma sprays never changed anything went ont fostair 100/6 now 200/6 and the montelukast not much change now by phone call said bronchiectasis not knowing if I can believe them Or not hopefully my chest infections will be less after another month would like to know what tablets you are on please

[Willanna in reply to Elsie1930]

I was on Doxycylin 3 times a week as well as Trimbo, ventolin & carbosisten (for phlegm). Had telephone consultation with chest specialist he uped my antibiotics to 6 weeks on 6 weeks off because I was still having infections.

Have you had a scan!? that's how I found out plus blood tests.

[Elsie1930 in reply to Willanna]

Been given theophylline today as well not had scan or blood test cos of Covid no unessary things being done

[Willanna in reply to Elsie1930]

What other meds you on? I would try to push for a scan because bronchiectasis can't be seen on a normal xray, do you get a loot of chest infections?

[Elsie1930 in reply to Willanna]

I have had steroids 5th time in 12 months my go wanted me to have a scan but not got one yet since before March telephone consultation with respiratory clinic diagnosed me with bronchiectasis most admit I have felt better lately but say not doing scans yet ?meds on now theophylline montkast fostair 200/6and I am a diabetic and take tablets for nerve damage also x

[Willanna in reply to Elsie1930]

I also have bronchiectasis diagnosed year a go I'm on Trimbo inhaler, carbosisten & now Doxycylin 6 weeks on then 6 week break. This is something new my consultant is trying to help with the constent chest infections.

[Hidden]

For a spacer, your nurse is correct, you should take several breaths, but it’s actually slightly more complex than just saying it’s 3-5 breaths for any spacer, it depends on what spacer you have. Some will be 5 slow, deep breaths for spacers like the aerochamber plus, some will be breathing over 30 seconds per puff for something like the volumatic, and the instructions provided with the device will determine what you need to do. If you have no instructions, most are available from the manufacturers online. However, it’s been proven in multiple studies that using a spacer results in much better lung deposition and drug effectiveness, and is actually the preferred option by medics. It’s also been proven that it’s a much more effective way of taking a reliever if you’re in the middle of a bad bout of breathlessness or an asthma attack: taking (or trying to take!) a single breath in and the meds sticking in your throat or ending up in your stomach rather than properly reaching your lungs isn’t particularly helpful, and that’s actually what happens to a lot of the dose if you take it like that. Some people do still use the single breath technique minus a spacer, but it’s no longer taught to children or new adult diagnoses in an effort to discourage the practice. Those that persist in doing it often argue that it’s inconvenient to carry a spacer when they can just stick their puffer in their pocket, but in a severe asthma attack, using a spacer has been demonstrated to save lives.

[corriena]

I find just breathig normaly with the spacer works for me. I think they call it flow breathing. But it makes taking my inhalers easy with no trying to deep breath and hold my breath. Not easy at the best of times impossible on bad days.

[knitter]

My aero chamber spacer whistles if I use the wrong breathing technique .

My big spacer is different again .

[MoyB]

When I had my asthma review in December, the nurse asked me how I was taking my Ventolin and I showed her my spacer and said I had been advised to use 'Tidal breathing' which is five normal breaths in and out. She said that I was right, up to a point, but that I was using the wrong kind of spacer. She prescribed a different one that has a little valve so that you are able to breathe in and out of it without taking it out of your mouth.

I think the people advising us sometimes get a little confused themselves as there have been a good number of changes to technique since I was diagnosed with asthma 10 yrs ago!

Charlie_G suggested the best thing to do was read the instructions that come with your spacer and I think that's probably the best thing to go by. At least you will know then that your technique is compatible with the one you have.

xx Moy

[Return]

This is interesting - I was told long deep inhale and hold too - not always easy to do sometimes ! Would love to see what others say about this thanks for sharing

[Izb1]

My physio nurse told me to take a deeper breath and hold for 3 when using my aerochamber, seems to work when I need it x

[Hidden]

If you are using a spacer the nurse is correct. If you are not using a spacer you are correct.

[Eastend555]

A spacer you inhale more of the inhalent and it is much better

However when your outside its awkward to use at least i find it is

but do use spacer indoors it helps

[barbs47]

There are some inhalers that you can’t use a spacer with eg Bricanyl, Spiriva, and Symbicort. These are all dry powder inhalers so one big breath and hold for 3. Barbs x

[HampshireLass in reply to barbs47]

Spireva can also be supplied as an inhaler to be used with Aerochamber. I could not use the powder ones as I could not inhale strongly enough, doctor prescribed the Spireva Respimat which can also be used with the Aerochamber.

[barbs47 in reply to HampshireLass]

Thanks I didn’t know that. I’ve had emphysema for 30 years and have always had dry powder inhalers. Barbs x

[Jehinch in reply to barbs47]

I use the Respimat. Much easier than the dry powder inhaler. I never use a spacer though. For some reason my breathing deteriorated when I used one. I tried again another time but same thing.

[Hidden]

That’s the way I was told to do it with spacer. It has been working well for me.

[Kristicats]

Not heard of that technique before.

[Bluenotes]

I was told by respiratory nurse that you can do either with a spacer . It depends on what's easiest for you . 🤗

[Cade1 in reply to Bluenotes]

I think you’re correct. If you look at techniques online - there is the one breath technique & also the multiple breath technique. I think this is because spacers have got smaller, so whichever way you feel comfortable with works.

[gillmorecanter]

Either way works. If you have trouble holding in your breath then the the latter is best as the medication stays in the spacer until you use it all.

[lyndene]

Hi Yes I have a spacer and for every spay I breath in about 3 to 4 times on the spacer thats what I was always told.

[SJCJ]

Hey Primrose - either technique is fine. Your nurse needs to keep herself up to date with current guidance. If one long inhalation works for you then stick with it.

[Sops]

Hi Primrose, that is how i was taught by the respiratory nurse at PR.

Must the same method that you are using.

I was told by a new member of my surgery that nebulisers are ‘out of fashion and unsafe’ i asked what alternative could i use and he was flummoxed, have not seen him since.

Wish advice did not change due to fashion, that should be left to frocks!!

Take care Sopsx

[primrose71 in reply to Sops]

Hi Sops yes nurse told me that too that not using nebulisers now so things have changed have decided I am sticking to my way as tried her way for a few days and felt worse thanks for your answer and take care x

[Sops]

Agree, i am doing. ‘Frank Sinatra ‘ as well.

Stay safe Sopsx