Rick, the author of the Respiratory Therapy Cave , wrote to me the other day talking about what it was like growing up with severe asthma. One of the things he mentioned that I thought was kinda funny, was how he used to sleep with an inhaler under his pillow. Boy, can I relate to that. To this day I still sleep with an inhaler under my pillow, and one on the bedside table, and one next to the laptop….
Ever see the movie the 1954 classic “The Lost Weekend” with Ray Milland who plays a hopeless alcoholic? Well, it got me to thinking. Short of keeping one on a string dangling outside a window or hiding one in the chandelier for safekeeping, Ive got Albuterol inhalers laying around just about every where.They’re all over my house. Under the couch, under my bed ( tons of them under my bed). Ive got them in my car, in Doug’s car. I even have a few in my travel luggage. Occasional I’ll find one in the pockets of clothes I haven’t worn in months. I don’t really “stash” or hide them , at least not conscientiously , they just seem to accumulate .
It’s important to note that I don’t abuse the drug (though I probably use more than I should.) When I was young it was a different story. I’d, sometimes go through an entire inhaler in less than 3 days . And we’re not talking about the newer,much safer beta agonist drugs like Albuterol, were talking about the heart pounding over-the counter concoctions like Primatine mist. Seems like my life revolved around having enough inhaler medicine to get me through the day ( and more important, the night.) We were so poor, sometimes my friends would shoplift the stuff because they couldn’t stand to see me suffer.
After using inhalers for 50 years, I’ve developed quite a tolerance. Nowadays, I get more relief by inhaling the drugs through the nebulizer instead of the MDIs. A mixture of Albuterol and Atrovent 4-6 times a day, and as needed, seems to works the best. I still use the inhalers , but mostly for their convenience and portability. They’re still very handy during my walks.
So anyway, to satisfy my curiosity, today I scoured my house to take inventory….. and this is what I found:
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Hahaha as if!
I sleep with my inhalers under my pillow no matter where I go. Its a habit that if I am not home (though I avoid that at all costs as triggers pop up EVERYWHERE) I always make a point of taking my inhalers out of my bag and putting them under whatever pillow i’m sleeping on. If I happen not to have a pillow, and I will sleep with it in my hand. Seriously!
I got a cold recently (started last friday). Last time that happened, I ended up intubated in the ICU, and since this time I was literally able to listen to my lungs worsen over a single day, my physician decided to put me on Solumedrol and Prednisone I.M., daily, for two weeks!! Goddammit, that’s a sore thing to inject, turns out! The total dosage in ml comes up to 3cc’s and is fairly viscous, so its a lot to inject, especially in the smaller muscles like your deltoid.
I’ve been warned that my lungs simply can’t get much worse than they are at this point without causing me significant harm or death. ha! Amazing how fast things change. I used to be able to run half marathons. I was recently diagnosed with COPD on top of everything else as well.
Oh, and my bucket of puffers and pumps is bigger than your bucket! 😉 😛
(I just read the WHOLE post, and now I have more to say 🙂 Bear with me!)
I’m not sure what is it like where you are (U.S., right?)
In recent years here the Emergency Room staff and physicians have come to the conclusion that 10 puffs via a MDI with an aerochamber is more effective than a treatment via nebulizer.
Obviously we’ve both had many admissions and its only recently that they have started withholding the nebulizer upon my arrival to the ER and giving me the MDIs instead. Needless to say, I think its ridiculous and no matter how often I told them i got much more relief from nebules, they wouldn’t listen.
Finally, during a nursing conference in Banff, B.C., many nursing friends and I went up to lake louise and into the glacier bowl. I was prepared: I had 02 and the right meds on me, but all the other non-asthmatic nurses were huffing and puffing due to the altitude. Some of them were wheezy, so they used one or two puffs of my ventolin pump (i don’t suggest this – but were nurses, we know what it is and how it works) and they all said the same thing: Is it ever HARD to get that DEEP BREATH in required with an MDI when you can hardly breathe in the first place.
Since then I’ve spoken with many ER physicians and nurses and we are working on reverting back to nebulizers for asthma attacks. At least with nebules you don’t need to time your breaths and you don’t need to have a perfect deep breath to get the full advantage of the drug. Also, the mist in a nebulizer settles inside your mouth and throat, and since mucous membranes are highly vascular, it is also another route to be absorbed.
Nebulizers work better – but only an asthmatic who’s been through the wringer can tell know for sure.
I’m curious as to why you don’t use any salbutamol (ventolin) or at least have any on hand?
It is still my ‘drug of choice’, however I am steadily growing a tolerance to it. Is this what happened to you? Do you find the Albuterol works better, in general?
I guess because I work in a healthcare setting, I don’t really care about over-using my bronchodilators. Even when i get tachycardic to the point of chest pains and the jitters to the point of not being able to draw up insulin in a syringe, as long as I can still breathe, I tend to over-use it. … Terrible habit. But I like breathing.
Sorry you have such bad asthma.
Are you a Nurse ?
Btw..Salbutamol is just another name for Albuterol, the two are one in the same. In the USA we call it Albuterol. Ventolin and Proventil are the brand names for each.
As far as MDI use in the ER, I totally agree with you, It is not as effective as nebulizer treatments for severe exacerbations. We had a similar protocol at the hospital I worked out, but discontinued it because it didnt work.
I’ve never heard of the practice of giving both Solumedrol and Prednisone together at the same time? What’s the rationale behind that? Solumedrol is appx 9/5s stronger than oral prednisone.
I’m laughing because I joked about the bowl full of inhalers a few weeks ago… but it was inhalers that were prescribed and didn’t work well when I was first diagnosed.
I do have inhalers in my purse, home office, work desk, hiking pack, bike pack, car and camera bag. I hate using them but it’s better to have them around. When I flare, I also do the albuterol/atrovent nebs… more effective and longer lasting than just straight albuterol.
Glad to see you’re feeling better.
LOL….I don’t have a ton around my house. My kid’s are scattered around this county with everyone who could possibly need to medicate her—the school, her grandma’s, etc.
I’m grateful just about everyday that I don’t have to give AG anything like Primatene. I’ve got a couple of friends with horror stories about the meds they had to take when they were little—thank God for medical research and new, improved meds.
Trick or treat 😉
I’m sure the kids would love that…as if candy wasn’t enough to get them bouncing off the walls…
Funny, before I emailed Steve I thought I had the lifetime record for most inhalers. No wonder guinnes turned me down.
Ironically, I was cleaning out my room the other day, and I found an unopened box of Albuterol I bought 6 months ago. A few years ago I never thought that would have been possible.
Neat post.
Wooow! You should be in the book of Guiness! 🙂 In my country You can’t have so many inhalers – doctor can write prescription only for 3 inhalers – it is maximum. Most prescription in Poland are written for 1-2. If doctor write one more, he or she must pay very high penalty.
It is fascinating for me to know cultural and medical differences between asthma in Poland and in USA.
Im fascinated by cultural differences as well. Here in the USA most insurance companies will authorize a 3 month supply of inhalers and nebulized medications. I one use inhaler of Albuterol per week, so this means 12 inhalers every 3 months. For nebulized Albuterol , I use 1 vial every 2-3 hours ( 8 per day) so this means 720 vials for 3 month supply. And this is just for Albuterol.
My medicine cabinet looks like a drug store.