There are more than 20 million Americans suffering from asthma, and according to the American Academy of Allergy, Asthma, and Immunology, there are more than 5,000 asthma-related deaths each year. That's why I was alarmed by a study published last fall in Chest, the medical journal published by the American College of Chest Physicians, which showed that many asthmatics could be unknowingly misusing their inhalers -- meaning they won't get potentially life-saving medicine when they need it most. The problem stems from not understanding exactly how the canister of an asthma inhaler works. "Metered-dose inhalers all use a propellant of some sort," says Martha V. White, MD, director of research at the Institute for Asthma & Allergy, "and the actual medicine runs out before the propellant does." So even if you hear your canister working when you give it a squeeze, you might only be inhaling the propellant, and not the medicine. And that's a big problem.
DOING IT RIGHT
Even if you've been using an inhaler for years and think you're doing it right -- please, read this article anyway. You never know what you might learn. Here's how to do it right, according to Dr. White...
Count. All new metered-dose inhalers come with an automatic dose counter -- they need one in order to be approved by the FDA. If your inhaler doesn't have a counter, ask your doctor for a new prescription to get one with a counter. In the meantime, you'll need to count for yourself. Divide the number of times each day you use your inhaler by the number of doses in the canister -- that's how many days the canister will last. Mark it on the canister, and on a calendar.
Don't waste it. "Remember, every time you spray, it counts as a use," says Dr. White. "Even the first couple of sprays when you're priming the canister." And, according to Dr. White, you only need to prime your inhaler when you first put in a cartridge. If you're priming before each use, you're using medicine. Be sure to include this usage in your calculations.
Count some more. Most physicians recommend that the puff is inhaled and held for 10 seconds, or as long as is comfortable, to deliver the full dose.
Carry a spare. Bronchodilators -- asthma medications that quickly relax the lungs during an attack -- can be harder to track because they aren't used on a daily basis. That's why Dr. White recommends always carrying a spare canister. "If your asthma medication suddenly stops working, you can trash the canister and go to a new one," she says.
Consider a nebulizer. Those who have difficulty taking a deep breath and holding it -- a must for any asthma medication -- should consider using a nebulizer, a machine-and-mask system that delivers medicine over a five-minute period. This is especially useful for infants, the elderly and people who have bad asthma attacks.
Know when to get help. If you feel as though your asthma symptoms have changed or you've had to go to the emergency room (or if your asthmatic child is suddenly very lethargic) talk to your health-care provider about what you're experiencing. Perhaps it's time to review your medications as well as diet, nutrition and exercise programs. A simple change could have you back up and running. Literally.