Asthma inhalers

[missy]

So it's been a challenging August so far regarding my allergic asthma.

My levalbuterol tartrate HFA inhaler (only one my crappy insurance covers) isn't helping at all.
I mean it's like breathing in nothing.

I got an RX for albuterol yesterday (and used Good RX) and it seems a bit better.
Not great but a little bit more relief.

I don't want to use a steroid inhaler or steroid pills (the urgent care doctor wanted me to get the steroid pills).

Do any of you use a nebulizer? I have used one a few times at work and I found them helpful. I think I should get an RX for that to try next. I have an appointment with an allergist in 2 weeks so want to arm myself with knowledge about this topic before I go.
I used to take singulair decades ago. Do any of you find that helpful?

Just wondering what those of you who have asthma use and if this August (for me in the NE) has been worse for you than usual?

Thanks.

 

[liaerfbv]

Hi Missy! I have lifelong asthma, so I am right there with you. First and foremost, get the nebulizer. It will be a life changer for you. I can't tell you how many times my neb has saved me a trip to the ER over the years. You might need to play around with the different solution formulations available to see which works for you, but honestly any of them dramatically open your lungs as compared to an inhaler.

I prefer the ProAir brand rescue inhaler to all the other options - I'm not sure what the generic of that is called. The Ventolin brand inhaler is my second choice.

When I'm having a terrible flair, I do resort to oral and inhaled steroids. I take Advair inhaler and Prednisone (not the typical 6 day "pack" but 40mg 2x a day for 7-10 days). I hate steroids and the side effects, but it's hard to argue with the results when you've been choking on your own breath. Otherwise, I find that taking a daily antihistamine helps control my seasonal asthma. I'm not picky - whatever is on sale - Allegra, Zyrtec, etc.

Asthma is terrifying. Particularly now! I hope the allergist can help you. Feel free to email me if you have any other questions (I think you have my email - if not lmk and I can post on LT).

 

[Arcadian]

I do have a nebulizer and prefer not to use it too often though its coming in handy now. I don't remember the brand I have (machine), its one I got off amazon to replace the one that died. You CAN get them through insurance though they tend to be more expensive. You can also get the saline off amazon though best to get it from the pharmacy because of freshness. I've done both, I saved no money going either direction.
The juice is generic albuterol. I don't even care right now...lol but mine is in pre measured vials which I had requested.

Also I do prefer the emergency inhaler because of its size. I don't like that sometimes that damn click don't work to the next dose but the size is good. I have them pretty much all over the house/in my handbag.

IMO you should have both, they have their uses.

I have Ventolin, ProAire, as well as a few generics. All are Albuterol Sulfate. I think they taste awful, they do get the job done. The ProAire has a much lighter spray than the Ventolin (glasko ) does. Proaire is 90mcg and Ventolin is 108mcg. The other I have is generic Albuterol Sulfate (prasco) which looks like the brand named Glasko inhaler but does have its issues with having to spray twice. Its also 108mcg. And yes I DO have to use more of the ProAire if thats the one I grab. I usually carry it on bike rides because its small.

I will say that if you're having any type of heavy inflammation, a short course of prednisone can help get it under control. Nebulizing can also be a help during this time because it goes in much deeper than an emergency inhaler. The tube in the mouth does a better job and over the mouth/nose for me.

@missy do you also have allergies and if so are you using anything for them? My asthma is heavily tied to my allergies though it can be exacerbated by me getting ill too. I rinse my nose daily with saline solution, and I do use allergy meds when I have to (I try not to, they can cause migraines)

 

[smitcompton]

Hi Missy,

I have both the inhaler and nebulizer. The inhaler is Ventolin, and the medication for the nebulizer is albuterol. I have tried very expensive meds for the nebulizer but the albuterol works for me. I do it 2 --4 times a day --depending.
My bad breathing is not caused by allergies, but 2/3 of one lung has been removed and 8 tumors were removed from the other. This happened 30 yrs ago so I have been using meds for yrs.
My insurance company also stopped one med and my breathing got worse. While in hospital a Lung Specialist told me I was using the wrong meds now. He scolded me, and told me I needed to see a lung specialist. At any rate he improved my breathing with a new med, which is a steroid, but I need it. It is called Brio Elipta. This brand has many options to cover different types of problems.

Perhaps a lung specialist might help you. I admit I have never gone to an allergist. Its the expertise in the meds that I would be interested in. We experimented with very high cost meds that were not as good as the Brio and the albuterol.

I take 2 puffs of the Ventolin. I wait 5 minutes between the first and the second puff. Later in the day I may take 1 puff, and at nsite I take my 2 puff before I go to sleep. So I hope you take two.

Annette
Nebulizer cost about 50.00

 

[MrsBlue]

Is albuterol sulfate the one that tastes faintly of garlic? Disgusting.

I use the same levalbuterol HFA rescue inhaler. It works well for me. I don't like using the nebulizer because it gives me heart palpitations but I have no choice sometimes.

I know other people who did great on singulair but it did nothing for me except give me an upset stomach. I've been taking 5mg zyrtec daily during bad allergy season and that works well for me. I think both are worth exploring.

 

[rosethorn]

I’m going to be the odd one out and say that as an adult I haven’t found my nebulizer to be any more or less helpful than my inhaler. When I was a kid and didn’t have great inhaler technique it was a lifesaver.

I used to have regular asthma flares that ended in prednisone every. single. time. I got a cold. Inhaled steroids made all the difference for me - I start taking them at the first sign of illness, then discontinue when the cold/flu/sinus infection is gone, and I haven’t needed a course of prednisone since I started doing that.

As far as allergy induced asthma, I’ve found that taking flonase every night before bed helps a lot. If it starts to get bad, I’ll do a couple days of inhaled steroids and that’s usually enough to get everything under control.

Tl:dr - inhaled steroids have made a huge difference in my quality of life and I only ever take them short term.

Asthma sucks.

 

[Karl_K]

ok this is a complex subject but since its allergy related I would ask for a 2 part nebulizer solution and order the nebulizer off of amazon.
You want the air pump one for at home and maybe a mist type for other semi-permanent locations such as work.
The solution you want is ipratropium bromide and albuterol. Pretty much every insurance plan covers it.
The next step up would be https://www.asmanex.com/
Then the next step is inhaled steroids like generic advair.
I'm on generic advair and incruse with 2 part neb solution treatments as needed.
I have been on pretty much everything over the years except for some of the very newest stuff as the insurance companies are extremely fickle about which they will cover so have had to change often.

Edit: covid has made nebs expensive they were available in the $25 range pre-covid

edit2: you still need the emergency inhaler for when your not around your neb.

 

[missy]

Thanks everyone for the helpful info and advice.
I am sorry you guys know all too well how much asthma can suck.

I didn't develop it until I was in my early 30s a few years after adopting rescue cats.
All was fine until 3 years in of having the kitties and I had a persistent dry cough for 7 months. Yup, I ignored it for that long. Greg finally said to me I should make an appointment with a doctor and I did some reading and realized it could be asthma.

I saw a pulmonologist who after testing my lungs etc immediately told me if I got rid of my cats my asthma would disappear. That wasn't an option obviously but I did kick them out of the bedroom.

I also went on singular and inhalers including steroid inhalers which provided relief and emergency inhalers as necessary.

It took a number of years but eventually I became naturally desensitized to the cats and my asthma went into remission.

For the past decade or so I have had to use the emergency inhaler maybe a few times a year.
A few weeks ago I started needing it around the clock. With little relief.

I realize an emergency inhaler is just that. For emergency use only. But given a few issues I developed over the past decade steroids are a last resort for me as they are contraindicated with two of my conditions.

Obviously if have no choice I will do what I need to do because breathing is critical to life lol.

Can anyone link a nebulizer they recommend? I used to be hooked up to one at work when I had a bad attack but it was a long time ago and do not remember which one it was and what features to look for.

Glad everyone has found what works for them and wishing all of you easy breathing.

 

[smitcompton]

Hi,
I am also in the camp of hating steroids. However my brio inhaler has no reaction on me at all. So I think it is not like prednisone. My previous inhaler as well did not effect me at all.
I have a "Drive" nebulizer, and the meds are delivered through a mask. I have no idea what air pump is about.

I remember that the Proair inhaler was also my favorite until the insurance company changed it to Ventolin.

Annette

 

[Tremsi]

If your asking about nebulizer brands I purchased the Devilbiss Traveler Portable Compressor for my mom. It’s rechargeable has a travel bag and she really liked it.

 

[Karl_K]

Air pump/compressor units are just that they use an air pump hooked up to a neb cup like ones used in hospitals:

Amazon.com: Desktop Nebulizer Machine, Portable Compressor with Exquisite Design, Pro Compact Cool Mist System for Kids Adults Home Use Travel Friendly for Breathing Problems : Health & Household

Buy Desktop Nebulizer Machine, Portable Compressor with Exquisite Design, Pro Compact Cool Mist System for Kids Adults Home Use Travel Friendly for Breathing Problems on Amazon.com ✓ FREE SHIPPING on qualified orders

www.amazon.com

I pprefeere the hospital style cups over the fancy ones, for me they work better:

Amazon.com: VixOne New Version : Musical Instruments

Amazon.com: VixOne New Version : Musical Instruments

www.amazon.com

The mist portable kind:

Amazon.com: UNOSEKS Portable Nebulizer, Cool Mist Steam Inhaler, Effective Handheld Mesh Nebulizer Machine with Exquisite Design, for Kids Adults, for Travel or Home Daily Use : Health & Household

Buy UNOSEKS Portable Nebulizer, Cool Mist Steam Inhaler, Effective Handheld Mesh Nebulizer Machine with Exquisite Design, for Kids Adults, for Travel or Home Daily Use: Respiratory Aids & Accessories - Amazon.com ✓ FREE DELIVERY possible on eligible purchases

www.amazon.com

The air pump gives you better delivery but is large, need electricity and is not that portable.
Having both is not a bad idea.

 

[missy]

Thanks everyone for your input.

Interesting thought my DH’s friend posed. He feels my asthma, which has been basically in remission for a long time, is being exacerbated by the wildfires out west.

It’s been raining here for the past 2 days but no relief for me.
Tomorrow I see an allergist and hopefully that will go well.

Thanks again.

 

[Arcadian]

Well Sahara Dust is coming over as well. Our skies here are a bit yellowy and I can't say my lungs were happy on the morning walk either.

 

[missy]

Well Sahara Dust is coming over as well. Our skies here are a bit yellowy and I can't say my lungs were happy on the morning walk either.

Hope you’re feeling better @Arcadian

Update:

The allergist appointment went as well as possible. He agreed with me we didn't have to go to steroids yet. He gave me a nebulizer and prescribed the solution that goes into it (albuterol) and also RXd generic Singulair and Brand Ventolin. Which my insurance won't cover but breathing is more important than money obviously haha. I cannot say it has yet made a difference but I am just not getting relief. It's a persistent cough.

Just did the nebulizer. It was about a 6 minute treatment. I feel better. Still an urge to cough but less strong. Relief. I hope it continues to help and reduces my urge to cough even more. It’s been a challenging few weeks. Thanks for your advice everyone. Very helpful and I appreciate it.

 

[doberman]

So it's been a challenging August so far regarding my allergic asthma.

My levalbuterol tartrate HFA inhaler (only one my crappy insurance covers) isn't helping at all.
I mean it's like breathing in nothing.

I got an RX for albuterol yesterday (and used Good RX) and it seems a bit better.
Not great but a little bit more relief.

I don't want to use a steroid inhaler or steroid pills (the urgent care doctor wanted me to get the steroid pills).

Do any of you use a nebulizer? I have used one a few times at work and I found them helpful. I think I should get an RX for that to try next. I have an appointment with an allergist in 2 weeks so want to arm myself with knowledge about this topic before I go.
I used to take singulair decades ago. Do any of you find that helpful?

Just wondering what those of you who have asthma use and if this August (for me in the NE) has been worse for you than usual?

Thanks.

Why don't you want a steroid inhaler? The level of the steroid is pretty low and the efficacy is proven, as it does reduce inflammation. Combined with albuterol the effect is synergistic. (I've administered zillions of breathing treatments, so I'm going on patient input here, as I've never had a breathing issue myself).

 

[smitcompton]

Hi,

Missy, your nebulizer looks so big. Mine is 6"L x 5"W x 3" height. Have you changed your brand of cat litter? You said you became desensitized to the cats. That may not last forever.. Sadly, I just lost our last cat. She was 16 yrs old. I am amazed at how clean the house has stayed(no dust). Vacuum cleaner empty. Don't kill the messenger!. My breathing has slightly improved.

Annette

 

[Karl_K]

Hope you’re feeling better @Arcadian

Update:

The allergist appointment went as well as possible. He agreed with me we didn't have to go to steroids yet. He gave me a nebulizer and prescribed the solution that goes into it (albuterol) and also RXd generic Singulair and Brand Ventolin. Which my insurance won't cover but breathing is more important than money obviously haha. I cannot say it has yet made a difference but I am just not getting relief. It's a persistent cough.

Just did the nebulizer. It was about a 6 minute treatment. I feel better. Still an urge to cough but less strong. Relief. I hope it continues to help and reduces my urge to cough even more. It’s been a challenging few weeks. Thanks for your advice everyone. Very helpful and I appreciate it.

If you feel the neb is not giving you enough relief after a couple days ask for a script for the 2 part solution I mentioned above.
Edit: ipratropium bromide and albuterol

 

[MollyMalone]

Hi,

Missy, your nebulizer looks so big. Mine is 6"L x 5"W x 3" height. Have you changed your brand of cat litter? You said you became desensitized to the cats. That may not last forever.. Sadly, I just lost our last cat. She was 16 yrs old. I am amazed at how clean the house has stayed(no dust). Vacuum cleaner empty. Don't kill the messenger!. My breathing has slightly improved.

Annette

It's (thankfully) been years since a nebulizer was part of my son's life & I know there have been improvements in both kinds since then. But at the time, tabletop nebulizers were more efficient/powerful than smaller portable ones, so the treatment sessions didn't take as long & tabletop nebulizers were more versatile because they could dispense all possible solutions whereas you were limited to albuterol with the portable ones.

I hope everyone is soon breathing easier!!

 

[missy]

If you feel the neb is not giving you enough relief after a couple days ask for a script for the 2 part solution I mentioned above.
Edit: ipratropium bromide and albuterol

Thanks Karl!

 

[missy]

Hi,

Missy, your nebulizer looks so big. Mine is 6"L x 5"W x 3" height. Have you changed your brand of cat litter? You said you became desensitized to the cats. That may not last forever.. Sadly, I just lost our last cat. She was 16 yrs old. I am amazed at how clean the house has stayed(no dust). Vacuum cleaner empty. Don't kill the messenger!. My breathing has slightly improved.

Annette

Aww I am so sorry for your loss.

Greg changes the litter (I'm a lucky woman ) but to answer your question no we haven't changed anything. My nebulizer is pretty small. No bigger than yours if I had to guess the dimensions.The photos I shared give a false perspective. Thanks Annette.

It's weird. One second I was fine and the next BAM breathing and coughing problems. Started the beginning of August. Wondering if it is the wildfires out west causing air quality issues here that is behind my breathing issues.

 

[missy]

Why don't you want a steroid inhaler? The level of the steroid is pretty low and the efficacy is proven, as it does reduce inflammation. Combined with albuterol the effect is synergistic. (I've administered zillions of breathing treatments, so I'm going on patient input here, as I've never had a breathing issue myself).

Unfortunately steroid inhalers can cause bone weakening. I have seen it happen in even not long use durations of 6 months or more. If I have to I will of course as breathing is critical to life but I am reserving it as a last resort. Thanks for weighing in.

 

[missy]

It's (thankfully) been years since a nebulizer was part of my son's life & I know there have been improvements in both kinds since then. But at the time, tabletop nebulizers were more efficient/powerful than smaller portable ones, so the treatment sessions didn't take as long & tabletop nebulizers were more versatile because they could dispense all possible solutions whereas you were limited to albuterol with the portable ones.

I hope everyone is soon breathing easier!!

I am glad your son doesn't need the nebulizer any more. I got asthma as an adult so probably no outgrowing it for me...the nebulizer treatment takes less than 6 minutes. Pretty fast.

 

[Karl_K]

Just an fyi ipratropium bromide is not a steroid its in the same class as abuteral but they work differently and compliment each other which is why they are mixed in the same solution.

I had to use my neb for the first time in over a year today.
Someone in the building got a meat smoker and the smoke gets in our apartment.
Used the 2 part ipratropium bromide and abuteral solution.

 

[missy]

Just an fyi ipratropium bromide is not a steroid its in the same class as abuteral but they work differently and compliment each other which is why they are mixed in the same solution.

I had to use my neb for the first time in over a year today.
Someone in the building got a meat smoker and the smoke gets in our apartment.
Used the 2 part ipratropium bromide and abuteral solution.

I’m sorry you had to use the nebulizer today. But glad it works for you. I know ipratropium bromide is an anti cholinergic because the allergist discussed that as an option if the albuterol alone doesn’t work for me. I’m definitely going to be asking him for the combo solution. I appreciate you taking the time to share your knowledge with me. Thanks Karl.

 

[Daisys and Diamonds]

I am glad your son doesn't need the nebulizer any more. I got asthma as an adult so probably no outgrowing it for me...the nebulizer treatment takes less than 6 minutes. Pretty fast.

I hope you can ditch that cough soon
ive had it off and on for most of my adult life
I think adult onset asthma never trully goes away
I do love how you became desensitized to cats - me too !
But for me its all down to air quality and avoiding the damp

I was thinking of you just before because i looked out the window and Borris was on the roof of the car* rolling in yellow pollen - funny but also not funny




*yes we have a garage and im sure the cars both wish they lived in there

 

[Dancing Fire]

It's weird. One second I was fine and the next BAM breathing and coughing problems. Started the beginning of August. Wondering if it is the wildfires out west causing air quality issues here that is behind my breathing issues.

Missy, aren't you on the east coast? . The closest wildfire is like 50 miles away from us.

 

[Daisys and Diamonds]

Missy, aren't you on the east coast? . The closest wildfire is like 50 miles away from us.

Take care DF

 

[bright&shiny]

Missy, aren't you on the east coast? . The closest wildfire is like 50 miles away from us.

It’s traveling via the jet stream down to us

 

[bright&shiny]

@missy, I’m late to the party but here’s my 2 cents worth. I am also an adult diagnosed asthmatic. As a classical singer and runner, you can imagine the challenges. I have cough variatiant asthma - meaning I cough instead of wheeze. I have a monthly injection of NUcala - which has been a game changer. I also take symbicourt (steroid inhaler which has significantly less bone impact than prednisone), and use levelbuteral as my emergency inhaler and in lieu of a nebulizer (we learned about this from several great articles at the NIH). So far, no big doses of steroids or significant illness (bronchitis or phenomena) since this combo started. I’ve also learned that post nasal drip is my biggest enemy (well, after mold - for which I take sub- lingual drops) and controlling that has been a key factor to success.

With all that said, we are all individuals and finding the right combo is tricky. There is truly no one size fits all solution. I hope you find your combo and start feeling much better soon! It’s such a hard time of year. I hate winter, but I generally end up looking forward to the first freeze after spending weeks on the brink of falling off the asthma cliff.

 

[missy]

@missy, I’m late to the party but here’s my 2 cents worth. I am also an adult diagnosed asthmatic. As a classical singer and runner, you can imagine the challenges. I have cough variatiant asthma - meaning I cough instead of wheeze. I have a monthly injection of NUcala - which has been a game changer. I also take symbicourt (steroid inhaler which has significantly less bone impact than prednisone), and use levelbuteral as my emergency inhaler and in lieu of a nebulizer (we learned about this from several great articles at the NIH). So far, no big doses of steroids or significant illness (bronchitis or phenomena) since this combo started. I’ve also learned that post nasal drip is my biggest enemy (well, after mold - for which I take sub- lingual drops) and controlling that has been a key factor to success.

With all that said, we are all individuals and finding the right combo is tricky. There is truly no one size fits all solution. I hope you find your combo and start feeling much better soon! It’s such a hard time of year. I hate winter, but I generally end up looking forward to the first freeze after spending weeks on the brink of falling off the asthma cliff.

Thank you for chiming in @bright&shiny! I am sorry you are dealing with this especially as a singer and a runner. It's challenging to say the least. This is also my form of asthma. The Cough variant. So annoying. I have a constant urge to cough all the time. Sometimes a cough drop helps but only as long as it is in my mouth.

I will inquire about the monthly injection NUcala. I am glad it is working well for you and appreciate you sharing this info with me. If I have to go to Symbicort I will (my sister takes this I think) but again studies do indicate it can cause bone loss and I am already starting from a deficit regarding bone health. Which is the only reason I am hesitant. If it is my only recourse I will do it though as breathing trumps all else really.

How often do you take the Symbicort? Is it daily?
And may I ask what sublingual drops you are taking?

Thanks so much and wishing you and everyone here who is dealing with asthma easy breathing.