Nebulising - does it work?

[Timberman]

See edit below.

I have severe COPD and am now on O2 (3lpd) with a cocktail of medications, including the use of salbutamol as a reliever. Whenever I have been to hospital one of the first treatments they turn to is nebulising me with salbutamol. The idea of course is to deliver more of the med over a longer period and thus deliver more of the expected freeing up of the airways.

But I have to say that, while the effect is the same as with the handheld spacer it is slight, mild and transient. Yes, really. And now I am provided with a nebuliser at home and pouches of salbutamol to use 3-4 times a day. And I do use it three times a day.

And I detect absolutely no improvement. Edit: OK, so now after nearly four weeks I do detect some slight improvement. Whether this is mere recovery from the exacerbation or the nebbing I cannot say. But the jury is still out on its true value.

If at the time I use the nebuliser I am seriously short of breath (which is usual if I have had to walk a few yards to start) I have to wait while I slowly manage my breathing back to normal and an O2 Sat of about 92-3. I then nebulise.

At the end my sats will be at best 95 and my breathing regular, as it was when I started. If I then have to do anything - like a trip to the toilet - I shall be rendered seriously breathless, my sats will fall to mid or even low 80s and I will take 1-3 minutes to get back to 90+.

The nebulisation seems to have achieved no more than a spacer puff or two on the salbutamol.

I have discussed this with clinicians and they seem entirely unmoved.

Anyone out there have anything to say that might help me?

[H2o1511]

Hi Timberman! I also have been prescribed the nebulizer treatment,,I also find little difference than when using the albuterol rescue inhaler. The thing is when I'm that low & out of breath I need help right now. There isn't time to set up the nebulizer to get that instant boost. My provider tells me to use it when out of breath?I've tried using it just to see if my breathing improves remarkably and it does not . I keep it on hand in case of emergency only and have not included it in my regime. Hope this gives you a bit of other experience opinion.

Wishing you a fantastic new year filled with much joy and improved health😊

[Timberman in reply to H2o1511]

Hi H2o, Ditto me regarding speed - the blue inhaler is the one to go to - and it does have a slight and temporary effect which can be reassuring since gasping for breath can be scary. Anyway, I am getting responses which seem to suggest nebulizing is of limited real value!

Hope you have a great new year - and get the right president; we are hoping for the right PM...

All the best

Richard

[PaulineHM]

Hi Timberman, it’s a complicated thing isn’t it - managing our condition.

I last used a nebuliser some years ago now before I needed supplementary oxygen.

Using it would make me breathless too because it would temporarily raise my heart rate.

Am not too sure exactly what you are asking ? Yes it should relieve breathlessness although won’t necessarily help your 02 sats if that’s what you are asking ? That’s a different mechanism.

Are you using your 02 for your trip to the loo ? If not then that could be why your sats are dropping?

Have you spoken to the Asthma + UK Helpline ? They may be able to advise you ?

Go well

Pauline

[Timberman in reply to PaulineHM]

Many thanks Pauline. I am on O2 (3 lpm)all the time including mobility. Our sats level is critical to organ maintenance/[performance as well as protecting the distant limbs. If we are short of O2, signals are sent to our brain to raise heart rate (increasing blood pressure) and breathing rate (increasing O2 uptake). That last is where we COPD sufferers have a problem.

I have some heart issues and am on beta blockers and ACE inhibitors plus other stuff to avoid thrombosis so my heart rate does not rise as much as my brain wants so it tells me to breath faster! Catch 22 then.

I go into controlled breathing mode for 2-3 minutes, check my sats and when they regain 92 I relax.

I get excellent service from the COPD team locally and pretty good (now) from my GP surgery.

All the best

Richard

[PaulineHM in reply to Timberman]

Yes Richard, really tricky isn’t it ?

Salbutamol via a neb gave me a sinus tachycardia…and in any case I hated being tied to the flippin machine. So dropped it as fast as I could.

I guess there will be an interesting interaction between the beta blockers and the salbutamol ??? Hope you sort the issue which is puzzling you out soon.

Yes, thanks for reminder re. benefits of 02. Been on 02 for 7 years and now using 4-5 lpm . Very grateful to be still only needing it when I am on my feet - so ambulatory only.

Right off to fill the LOX flask,

Go well.

Pauline.

[Timberman in reply to PaulineHM]

Interesting comment on the interaction - I shall investigate so thank you.

[Timberman in reply to PaulineHM]

I have checked and am shocked. I shall pursue on Monday. Most angry since I specifically told the heart people of my concern about conflicts. I have been suffering what I have called asthmatic events of low but incapacitating intensity on exertion ever since I started on the beta-blockers! Many many thanks.

[Trevor6]

totally see were your coming from , my husband who is a qualified nurse always says the patient KNOWS their own body and recognises any changes. I was not convinced the nurse at my gp knew anything about COPD , that was 3 years ago , before I was referred to Respiratory team , who have been great, am still using my Nebuliser, few times a week , but the one thing which really annoys me is getting serious short of breath going to my bathroom/kitchen. Just a few steps and Am shattered, am due to begin Pulmonary Rehab , I have given up smoking which to be honest has been so easy this time , although I have been very much enjoying a Famous chocolate 🍫 each night, but that’s ok as I need to out weight on , which I am , as am being considered for valves or LVR surgery this year , this site is great , so many nice people and great advice .

[Timberman in reply to Trevor6]

Many thanks Trevor. We sound similar although I am on O2 and too far gone for another PRS - I have been on six but now cannot manage enough to be a safe bet. They need you to maintain at least 88-92 sats after a few score steps.

[highburyted]

hi

Yes I’ve used the nebuliser for years but since my heart operation in August I’m hardly using it. I’m afraid I was a smoker too and didn’t realise the total effect this was having until I stopped before my operation and haven’t continued since. Often if i smoked I would be on the nebuliser.

I had salbutamol too, 5mg not 2.5mg, I used it the minute I felt breathless and waited a few minutes after where it generally helped me. I still use the Trimbow inhaler, which is a steroid but not one to get worried about and I definitely feel this one helps. I never really found the others did much.

Obviously my use of the nebuliser has gone down from constant all day to hardly at all, perhaps 2-3 short bursts since I stopped smoking.

If your not on it I would ask about the trimbow inhaler .

Hghburyted

[Timberman in reply to highburyted]

I gave up smoking at age 50 some 30 years ago. I was diagnosed with emphysema and bronchiectasis about 15 years ago. Have been on many drugs since - currently Trimbow, carbocistine and salbutamol for the COPD elements. Have heart issues too; loadsameds!

Started nebulising two weeks ago at home. I have to now say that I detect a slight effect and will update my entry.

But the way the hospital turns instantly to it on admission does suggest the idea that it might be more rapidly efficacious!

[pepparuby1 in reply to highburyted]

Thank you for sharing about Trimbow I was taken on spiriva respimat and symbicort role these especially symbicort is causing all these breathless exasperations. Been on it a week and using a massive chamber two puffs a day so I’m pleased you’ve said about it