Bronchospasm

The inhaled steroids usually take about 10 days or so to get up to speed. Pre-treatment with albuterol usually helps immediately -- many people need both. My observation has been that inhaler technique has a huge impact on success of treatment. If someone puts a metered dose inhaler (pressurized canister) directly in his/her mouth and puffs, then most of the medicine is wasted.

I thought that was it, the reason I mentioned it in the original thread

Pendaluft: Thanks for the reply. I have two different opinions regarding the inhailer. The directions say to place in the mouth using the lips as a seal. My own physician advises to hold the inhailer away from an open mouth the distance of a closed fist. What to you hear/know?

The way to get the most medication into your lungs is to use a valved holding chamber -- I think the best one available is the Optichamber Advantage (and its pretty cheap now you can even buy it through Amazon). If you put the MDI in your mouth, most of the med winds up on your tongue or the back of your throat, then you swallow it. Holding the inhaler away from your mouth is a slight improvement but still far from optimal. This is one of the few things in the world that I am sure of. I see many many people of all ages who aren't doing well until I insist that they use a spacer and use it correctly. It's not just about coordinating your inhalation (as many believe). If you puff that thing in the air you can see how fast the med comes out and no one, not even a swimmer, can breathe it in fast enough to get the med into the lungs before it hits the tongue and posterior pharynx. If you want to maximize the effect of your treatment and you are using MDIs, then a good spacer is key. ps. The Vortex is also a good one, but usually costs more.

I just have to respond to this - and I agree with all said regarding spacers!! BUT, where was I going? Oh yeah, there have been plenty of rotten times when I (and my son) have found ourselves swimming, or running or whatever, and OMG, where is that inhaler? Positive self talk can help you through this -- no the asthmatic spasm will not go away, but by not panicking, by telling yourself, "I'm going to be ok" and slowing down your breathing a bit, believe it or not, you may be not only able to finish the set, but finish the workout. MUCH better than getting out disgusted, only to find it on the floor of your car, after sloshing through the snow with wet hair! :frustrated:

I think pendaluft hit the nail on the head. Another option for a spacer is the AeroChamber Plus. They're the same thing. They both have a whistle that lets you know if you're inhaling too quickly which is pretty convenient. These products are definitely the best way to ensure you're getting the optimal dosage. Also, it's really important to clean your inhaler frequently. Cleaning should ideally be done before every usage, but realistically it should be done 2x a week. Otherwise dirt and dried medicine can build up and reduce the efficacy of the device. Depending on what medication you're taking may affect how you clean it since theres a bunch of different designs. I'm assuming its your conventional MDI so you'd remove the canister and wash the plastic mouthpiece of around 30 seconds and let it air dry COMPLETELY. It's best not to use the inhaler if the mouth piece is still wet. If it's wet and you have to use it, do a test spray first. Check with your instructions though to see their recommendations. Can I ask what Rx they gave you?

Pendaluft/EJB190 and Celestial: Thank you so much for your advice. I ordered a spacer and should be here in a few days. My pulmonologist gave me QVAR 40mg. I have now used this medication at 1puff at night and 1 in the morning for one week and have now increased to two/two with two puffs of albuteral prior to swimming. BUTT, little or no results so far. My condition is specific to swimming (my favorite sport). I do 2 mile soft sand runs with sprints twice a week, bike 30 miles once a week, row 3 miles 1/wk and surf and paddle off So. Cal beaches when the waves are good and have no bronchospasms with any of these activities.

Pendaluft/EJB190 and Celestial: Thank you so much for your advice. I ordered a spacer and should be here in a few days. My pulmonologist gave me QVAR 40mg. I have now used this medication at 1puff at night and 1 in the morning for one week and have now increased to two/two with two puffs of albuteral prior to swimming. BUTT, little or no results so far. My condition is specific to swimming (my favorite sport). I do 2 mile soft sand runs with sprints twice a week, bike 30 miles once a week, row 3 miles 1/wk and surf and paddle off So. Cal beaches when the waves are good and have no bronchospasms with any of these activities. Good choice on the spacer. I have actually heard really good things about QVAR. One pharmacist friend (who unlike most is very involved with his patients) told me all of his customers who switched to it noticed improvement. Like Pendulift said the steroids will take a little time to work up their efficacy so hang in there. The thing about Albuterol is that it works, but only for 15 minutes or so. In my opinion & experience, I really don't find it to be a legit long term treatment option because of it's duration. As a rescue inhaler, fine, but I guess it will "tide you over" until the QVAR kicks in. Here's a question: Do you swim indoors? Not to point out the obvious but if you're not having any issues with any of your other activities, it seems like the chlorinated air of a natatorium might be whats triggering the Bronchospams. If you have the luxury of being in a location where you can use outdoor pool now, a Cu-ionized pool, or a salt water pool, perhaps that'd be something to test out and see how you fair compared to your regular pool. Good luck with your medication and if it doesn't work, go back.

EJB190. During the winter I swim in an outdoor pool. Usual clorine is 2.7. But, I have the same problem during my 1/2 mile ocean swim. Also, when I try my albuterol on the pool deck during swimming it seems to have no quicker effect then if I just let it subside (about 20sec.)