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Rescue Inhaler–How do you know when?

I'm still new at this asthma business. I have never had a serious, life threatening attack, and the asthma doesn't seem to be associated with allergy.  I'm in a quandary. My doctor has said, the more I use my rescue inhaler, the more I will need it. Which makes me think I shouldn't use it unless the situation is dire.

But the very changeable weather of the last four days (at least that's what I'm blaming) has brought a return of symptoms. Mild, I think. Some chest tightness, a little cough–mostly I just feel wiped out, tired, but not sleepy.

I know the rescue inhaler would make me feel better. But is there a downside to using it? Or have I misunderstood the doctor?

What do you think?

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  • Pljohns

    Holly-that has always been my quandry too.  i don't have asthma "attacks" as what you think they are, mine turn into flares that last for weeks.  I tend to put off the albuterol because I legit don't feel like I need it but have learned that when I feel tight or short of breath, a dose is what its' meant for.  It's far better to use it for a hit like that that what I'm dealing with now-every 3-4 hours for going on 6 weeks.

  • K8sMom2002

    Hugs, @Holly! Those first few days, weeks and months of an asthma diagnosis come with a steep learning curve!

    First, do you have a good ?  You can print one out and take it to your doctor to discuss. It should include what to do when — kind of like AAFA's asthma zones.

    Second, could you circle back and talk to your doctor and say, "Hey, I'm not quite sure when to use my inhaler?"

    When I did that, my doc pointed out something that seemed really counter-intuitive: Using my inhaler sooner would mean ultimately using it less. 

    She pointed out that the only way the meds could work was to touch the areas of the lungs they needed to treat, and that the only way the meds could touch those areas were if my lungs were moving enough air to get them to the bottom of my lungs. If I waited until later, then my lungs couldn't move the medication down as well into all the areas I needed.

    We had a really good conversation where she was happy to run through some if/then situations — which really, really helped me!

  • Holly

    Thanks. That rational for using the inhaler makes a lot of sense. I wasn't sure if the inhaler had to be saved for a "last ditch" measure.

    I will bring the question up with my pulmonologist at the next appointment.

  • K8sMom2002

    Holly, each person is unique, and your doctor knows YOUR case best, so I like your plan of asking your pulmonologist.

    When my asthma is flaring and I have doubts about what to do when, that's when I know I should jot that question down and ask my doc. Sometimes I call my doc ahead and ask — either the nurse or leave a message for the doctor. 

    My doctor has warned me that doctors tend to think, "No news is good news." So they'd rather hear from me sooner if I'm having problems. 

    The first time I ever heard that, the doctor asked, "Why did you wait to call me? If I don't hear from you, I think you're able to take your medication, that you're getting better, and that I don't need to change things."

    So now I call. You may even have a web portal that you can send a message through.

  • Kathy P

    I'll second talking w/ the doc about what symptoms and even length of symptoms should indicate what treatment. Maybe even have specific questions / situations you've now discovered and don't know if you should use your rescue med.

    I know I used to avoid using mine til things got "bad" – but I didn't really know where that line was. And I also didn't know that if I'd have used it sooner, I probably could have avoiding things getting bad!

    There are also other factors – like is your asthma under control? There is a great video on this that explains the different types of meds and how to know if you are taking them correctly. The page also talks about the different types of meds.

  • Marie E Natzke

    Holly as everyone has told you, ask you Dr to clarify when is the right time. I hesitate to use my rescue inhaler at times too. But give learned when we have big weather changes temperature changed and storms before I go outside I use a couple puffs of albuterol to help my breathing the cold or very humid air. That usually helps me.

  • Holly

    Thanks for the concern and helpful replies. 

    After a lot of ups and downs, several medication changes, and some lifestyle changes, I think we've got a handle on the asthma. I've felt well and haven't needed the rescue inhaler for several weeks. I've even gotten through pollen season–which with all the trees in this area can be intense–better than I have in years.

    I took your advice and did talk with the pulmonologist to get clarification on when to use the albuterol. He said to use it whenever I felt I needed it, but if I used it and it didn't help, or needed it for several days in a row to call.

  • K8sMom2002

    Holly, that is terrific! I'm so glad that your asthma is under much better control! Sounds like you have a clearer idea of what do do when, and I'm pumped that your combo of med changes and lifestyle changes have helped. 

  • Brenda Silvia-Torma
    Kathy P posted:

    I'll second talking w/ the doc about what symptoms and even length of symptoms should indicate what treatment. Maybe even have specific questions / situations you've now discovered and don't know if you should use your rescue med.

    I know I used to avoid using mine til things got "bad" – but I didn't really know where that line was. And I also didn't know that if I'd have used it sooner, I probably could have avoiding things getting bad!

    There are also other factors – like is your asthma under control? There is a great video on this that explains the different types of meds and how to know if you are taking them correctly. The page also talks about the different types of meds.

    So, I have a follow up question about "if you are you using quick-relief medicines more than 2 days a week". I use mine if I have to spend any time outside and the weather is yellow or higher…So, for example, I used it yesterday before I went to an outdoor concert in DC. If I need to use it this weekend (because the air quality is bad) and I have to be outside for a period of time, that would be my second day using it in less than a week. Do I need to contact my doctor and let her know? Or is this expected during the months with really bad air quality? I'm guessing that I should send a message, just to keep her in the loop and see what she says.  Thanks for the input!

  • Pljohns

    A note to your doc wouldn’t be a bad thing but I would think it’s expected if you are going to be out in bad air.

  • LK

    I agree with Lynn that it is a good question for your doctor.  Also I asked my pulmo the same question and he said if I am using it to pre-treat the it isn't counted as one of those "2 times per week" uses.

  • Kathy P

    That would definitely be a good conversation to have with your doctor. And it's one I have had with mine. I pretreat any time I know I'm going to exert myself, so I'd be blowing up my limit weekly! For me, the questions he asks are how often I'm symptoms per week, how often I'm waking at night / coughing and can't get to sleep, and if I'm able to do what I want to do. 

    Those are the guidelines for when to talk with your doctor.  And remember, everyone's asthma is different.