Along with being an RT, I am also a recovering bronchodilatoraholic, and despite what I believed before I became an RT, I am not alone.
Bronchodilatoraholism is not necessarily bronchodilator abuse. However, bronchodilatoraholism can lead one to make irrational decisions that may be considered abuse. Such as when I once went through an entire Albuterol inhaler in a day.
I know that sounds stupid, but it’s true. And it’s my confession. I am a bronchodilator-aholic who, when I was a kid, abused his inhaler.
In 1980, when I was 10, my doctor prescribed my first Alupent inhaler. It worked great for my asthma and soon I asked my mom for it regularly.
Two years later, mom started trusting me to carry my own inhaler. That may have been a mistake, but how was she to know I would become an Alupentaholic? Asthma was a new thing to mom and dad, and they wanted me to have RELIEF when I needed it.
I would go through about one inhaler a week. I often joked that I’d “never leave home without it.” Soon, that infamous puff-puff became my calling card among my friends and family. They’d hear that and think, “Yep, Rick is here.”
A few times, my asthma was really bad and I puffed, puffed, puffed on my Alupent inhaler, and my heart would thump-thump-thump in my chest. I’d lie in bed stressed, yet not say a word to my parents because then I’d have to confess I was using it too much.
I’d simply put my head on the pillow and concentrate on the strong heart palpitations, wondering if my heart might stop. Of course it never did, but the fear was there. Eventually, I learned Alupent wouldn’t kill me so long as I spaced out the puffs. Once I realized that, it became easier to use the medicine when I thought I needed it.
Sometimes I knew that what I really needed was to go to the doctor or emergency room, but I’d simply use my Alupent instead. Eventually my inhaler was empty, and I was afraid to tell my mom to get me a new one because I thought she’d get mad at me for using it up so fast. And maybe I was just a boy who didn’t want to see a doctor all the time.
I’d sometimes make it through the night and ask mom to get me a new inhaler when I saw her in the morning. Those were good nights; lucky nights. Other nights, I’d end up in the ER. Once there, I’d be stressed because I’d think the doctor and the RT would KNOW I was overusing my inhaler. Sometimes, not always, the doctor would order blood tests. As that needle pierced my skin, I’d wonder if there was a test to detect bronchodilatoraholism.
The funny thing is, I never heard a word about bronchodilator overuse. The doctors and nurses did what they always did to get me feeling better, and then I’d either be on my way home or, occasionally, be admitted to the hospital.
I was still afraid that my doctor would one day corner me about my bronchodilatoraholism. I mean, he had to know, right? Finally, when I was about 18, I decided to ask him before he got to me:
“Um,” I said, "Is there, like, um, a long-term problem with using too much Alupent?"
He calmly said, “There are far worse consequences to not being able to breathe than there are consequences to overusing your inhaler.”
So I thought, “I guess you don’t mind if I use my inhaler as much as I do. It must be relatively safe. Cool. Now I can get back to not worrying about it.”
In 1991, when I was 21, I was introduced to Albuterol. This new medicine, I quickly learned, didn’t cause palpitations like Alupent . I, in turn, became an Albuterolaholic.
I went to college and ordered four inhalers in the first month at the college pharmacy. The campus pharmacist became the first and only person EVER to corner me about my bronchodilatoraholism.
He said bluntly, “You can’t be using this inhaler this much.”
“My doctor knows how much I use it,” I humbly said to him. “He’s cool with it.”
And this lead me to the point where I used an inhaler in one day.
Again, I cannot write here that all bronchodilatoraholism is abuse. Some people have asthma that is difficult to control, so they may need their rescue inhaler more often than asthma guidelines might recommend.
Yes, I made some unwise decisions when I was a child. Perhaps my doctor and even parents made some unwise decisions too. But the ultimate goal for all of them was to do what they thought was best for me, and that is why my doctor continued to renew my bronchodilator prescription, and why my parents allowed me to carry it.
Armed with the latest asthma wisdom and new preventative medicines such as Advair and Singulair, the adult me has his asthma controlled. I have turned into a gallant asthmatic.
The best part is, unlike when I was a kid, I now CAN leave home without my rescue inhaler. In fact, I hardly even think of it anymore.
I hate talking about myself, yet in Bronchodilator’s Anonymous we learn that talking is good therapy. So, you might ask, why then have I taken the time to tell this story? I wrote this because I know for a fact I am not the only bronchodilatoraholic.
Since you won’t read about bronchodilatoraholism in any book, some of my fellow bronchodilatoraholics and I have defined and compiled a list of the signs of bronchodilatoraholism. I will reveal this list in my next post.
A Registered Respiratory Therapist and asthmatic