<p>My caregiver just called from the pharmacy, and tells me that they do not carry diffusers, and it is necessary to go to a medical supply company to get one…how is this so complicated? In any event I tried my second dose, and think I messed it up, as nothing seemed to come out of the inhaler on the second spray. Hopefully I will get better at this…</p>
<p>Somemom, I am deeply embarrassed at how arrogantly I treated my excellent health for 40+ years, and how little thought or regard I had for others. I am especially shocked when I hear of people like my colleague’s wife - I have been to visit her in her home on some issues; she did some graphics work for me a couple of years ago. I had no idea. How does a person have permanently low blood counts, and why don’t we have some science to answer this? She will be short of breath the rest of her life??? Housebound forever? Why are we tolerating this?</p>
<p>I will point out that the whole POINT of drugs is that they mask symptoms. Why should it be a problem that steroids keep you from being short of breath? Isn’t a GOOD thing that something (a drug, even) can ease your shortness of breath? Yes, you might not know your counts are down… but that’s what blood tests are for! </p>
<p>You talk about your colleagues wife… if steroids could ease her shortness of breath, shouldn’t she take them?</p>
<p>I get up every morning and take drugs–mild ones–for my knee pain. So what? That way I can lead a normal life and stop worrying about it.</p>
<p>We have diffusers but beware that you cannot easily carry them on planes these days because they “look like” water bottles in your carry on. You will get hand searched each time. In the meantime here is the way to properly use an inhaler. </p>
<p>First, shake the inhaler. Always. Then, the first time you use the inhaler, make sure it is primed. Just fire it several times until you see the drug come out. Unless it is going to sit for months until the next use, you shouldn’t have to do this again. Then, put up you pointer and middle finger together. Hold these in front for your mouth pointing towards the ceiling, ring and pinky curled down. Make note of this distance between your lips and your mouth. The inhaler should be this distance from your mouth! </p>
<p>So, now take the inhaler that is just shaken and put it at this “two finger distance” from your mouth. Hold it level to fire into the oral cavity - not onto your tongue or your eyes or anywhere else. Open wide and move your tongue to the “ah” position- you don’t want the meds on your lips or tongue.</p>
<p>Begin to inhale, about a second or two into the inhale depress the inhaler and accelerate the breath to a deep breath (or whatever you can manage). Hold your breath. Pretend you are in a movie using illegal substances!!!</p>
<p>Exhale. </p>
<p>Wait a few minutes for the drug to start working. Then repeat for puff #2. Rinse your mouth afterwards. The inhaler bothers some people. Why risk it?</p>
<p>Be forewarned that albuterol has a pronounced interaction with caffeine if you are not used to it. You will get the TOTAL jitters if you do your meds near the time you have some coffee when you first start using it (at least that’s the experience in our household). Don’t be scared. It will wear off. But it’s unpleasant. I doubt you are drinking coffee though … It may make you a bit jittery anyway. It is shortlived. Don’t worry.</p>
<p>The spacer will make you less likely to cough when you inhale since the entire inhale is slow with a spacer. But after a while my son thought they were just annoying.</p>
<p>As always, good luck and much love. And you lucky duck to be so healthy till now!</p>
<p>LTS, S2 used a diffuser for his albuterol inhaler when he was young. It was available by prescription. Any pharmacy that doesn’t have them in stock should be able to get one within a day. I used to use S2’s when I needed to use an inhaler (and I don’t have asthma – but a lot of dust makes me wheeze pretty badly. I read something in the paper recently about that inhalers have just been modified because they are no longer using the same propulsion ingredients (they’ve switched to something more environmentally friendly). I’ll see what I can find, becaue I recall that administration is new and takes a little getting used to.</p>
<p>If you take Advair at some future point (another inhaler), that is a slightly different delivery system and doesn’t use a diffuser.</p>
<p>dmd77…depending on the indication for a particular drug they work in many different ways. “Masking” is usually not a primary reason. If one has pain which origin is of an inflammatory cause than anti inflammatory meds like motrin
(ibuprofen) are often used. For example with osteoarthritis of a hip or knee which is a mechanical deterioration of a jt with secondary inflammation that responds to anti inflammatory meds but with enough time they will no longer be effective and total joint replacement will be needed. Steroids are used to lessen the inflammation of more systemic conditions and thereby decrease pain or improve symptoms such as shortness of breath due to inflamed airways. Inhalers provide meds directly to airways and can be brochodialators to relax constricted airways and/ or steroids that act locally in the airway. Narcotic pain meds on the other hand do mask pain in such that they decrease your perception of the pain without addressing the cause (post op surgical pain, severe nerve or bone pain ect). As for steroids if the symptoms are due to a process that results in some form of inflammation be it in the lungs( COPD, Asthma ect), joints( Rheumatoid arthritis) or other organs such as with systemic autoimmune conditions ( Lupus, Scleroderma and certain chronic blood disorders) than symptoms may improve while using the drug because the underlying process is being suppressed not masked. If shortness of breath is due solely to low blood counts ie decreased red blood cells, then the blood is unable to carry enough oxygen and steroids/inhalers will have little effect. With severe anemia the body won’t run well like a car without gas and fatigue and shortness of breath will be major symptoms that worsen significantly with any activity where muscles call for more fuel. Steroids are used with chemo because the toxic effects of these drugs hit the cancer as well as healthy tissue and organs and the body fights back with inflammation. It is all a very complex system the human body and modern medicine so the best thing to do as LTS has done is have the best doctors who can oversee and treat this mighty disease with all the power they have. That combine with your own inner strength LTS has gotten you far and I continue to pray for your victory in this battle.</p>
<p>Dmd, you’re right of course; in my case, I get scared because small cell grows so fast, and I can already see situations where drugs - specifically steroids - masked progression that we could have addressed earlier than we did. And I get the total heebee jeebees with drugs and all things medical related - for example, it gave me the creeps to click on the links that CountingDown posted, but I made myself do it anyway, because I need the information. </p>
<p>Delicate Arch, I have now read your post 20 times. Hopefully I can follow it LOL. (This is why things like Yoga are beyond me). And thank you for the warning about caffeine - I made a very, very light cup of coffee when I got home today, and now I understand why I felt as if the world suddenly began to orbit too fast…thank heavens for an explanation because that wasn’t a very pleasant hour or two and I don’t want to do that again.</p>
<p>Another voice for lifesaving (and quality-of-life-saving!) drugs here. I have a chronic condition, but I have 100% symptom control thanks to a drug. I would be miserable without it.</p>
<p>Your masking fear is understandable, but when I think of your fight, I imagine the chemo as a flame-thrower you’re aiming at the dragon, and the steroids/inhaler as the armor you wear to use the flame-thrower without burning yourself. You aren’t masking the dragon in that armor, but protecting yourself from your own fearsome weapons. You can fight all the harder when you wear better protection.</p>
<p>LTS,
I didn’t mean to give you the creeps…sorry! Hope you are now armed with info that will help you be comfortable with this treatment decision.</p>
<p>I AM SO FRUSTRATED. I am moving (& packing) and I had two diffusers here from when my son had asthma as a little boy, and I would have LOVED to have fed ex them to you, but they have been tossed!</p>
<p>Arrrrgh… don’t tell my mother (the pack rat) or it will be a life time of “I told you so!”</p>
<p>Hanna, thank you, I rather like looking at it as protection. One thing is certain, I cannot win if I am miserable to the point of crying. </p>
<p>Countingdown, it’s not you, it’s me! I have to see this information even if I don’t want to. </p>
<p>I think I just wrecked my dose though. I am obviously not very good at this, or, my cannister is defective, because I am getting a devil of a time getting it to spray actual medicine when it it supposed to. I just spent 15 minutes trying to use it and I am not sure I actually got any medicine, so, willl try again in four hours. Frustrating, this. </p>
<p>SBmom lol thank you for trying. If you’re like me they will turn up somewhere when you do not need or want them. LOL.</p>
<p>New question - does it make sense that the effects from the inhaler may not be evident or “kick in” for, say, an entire hour after you’ve used it?</p>
<p>inhalers effect should be immediate if it is a bronchodilator acting on bronchospasms or airway constrictions and steroid inhalers act on a gradual longer basis.</p>
<p>LTS, my D uses Levalbuterol (a form of Albuterol) for her exercise-induced asthma, and she found out by experimentation that she has to take it approximately 20-30 min before the start of her 1.5-2 hr training sessions to have the lasting effect throughout her entire practices.</p>