The Asthma Gap: Another take on the Inhaler Changeover

by Sloane Miller Patient Advocate

One of the things I noticed in the comments in the inhaler changeover post is that many of you are using your rescue inhalers often, daily even. Also, there is a feeling that the new HFA ones aren't working to help ease asthma symptoms and in some cases making you feel worse

I was thinking there may be a few reasons for that.

First, your old CFC inhaler may have stopped working a long time ago; it's my understanding from my pulmonologist that the more you use your rescue inhaler the less it continues to work. Does this sound familiar?

Second, the new inhalers need to be cleaned more often; the powder is fine and clogs the system quicker than the old CFC ones. [Did you clean your old inhalers?] If you're using the new one every day and not cleaning them you may not be getting the full dose of medication.

Third, and this is a crucial point, rescue inhalers are for emergencies, not daily use. If you're having asthma symptoms daily, you need daily medication but your rescue inhaler isn't it.

I've a dear friend, a lifelong asthmatic like me, who uses her "puffer" daily. She's uses it on autopilot; she puffs it during a conversation when it doesn't even seem she's wheezing. She says she's addicted.

The last time I used my rescue inhaler was in February in South Beach, Florida. I was a wheezy, itchy, sneezy mess. I even asked my doc if I could use it every three hours instead of four because it felt like it wasn't working. He said, "Yes, but it stops working if you use it that frequently." Hmmmm.

Luckily for me I'm in "remission" (my doc's words) from the asthma of my childhood. It is rare that I wheeze these days (I'm knocking wood as I write this), which is why a cup of tea will usually help my low-grade symptoms.

However according to a recent study many people believe their asthma is "under control" when in fact it is anything but. "The Asthma G.A.P. in America: General Awareness and Perceptions [study] found that two-thirds of asthma patients surveyed report that they have their condition under control; however, over half report that they experience symptoms (such as shortness of breath, wheezing, coughing, chest tightness and/or phlegm production) at least once a week. Despite the fact that many asthma patients surveyed feel they have their asthma under control, they use rescue medication regularly. In fact, one in three report that in the past four weeks they had to use a rescue inhaler at least once a day. "

Hmm, might this sound like you?

This study continues: "Using a rescue medication regularly is a sign that asthma is not properly controlled and you may be unnecessarily ailing from the disease. According to National Asthma Education and Prevention Program respiratory guidelines, asthma patients should ideally use their rescue inhaler no more than twice a week," said William E. Berger, MD, Division of Allergy and Immunology, University of California, Irvine."

So basically, what many of us perceive to be an acceptable level of asthma may in reality be more uncontrolled asthma than previously thought!

I urge all of us, me included, to check with our doctors about our asthma care plans. There may be some other preventative medications that could ease asthma symptoms and cut down on regular rescue inhaler use.

Read more of Sloane's blogs:

Breathing techniques for your asthma

Is cleaning your house dangerous?

Sloane Miller
Meet Our Writer
Sloane Miller

Sloane Miller, MFA, MSW, LMSW, specialist in food allergy management and author, is founder and President of Allergic Girl Resources, Inc., a consultancy devoted to food allergy awareness. She consults with private clients, the healthcare, food, and hospitality industries, government and not-for-profit advocacy organizations. In 2006, Ms. Miller started Please Don't Pass the Nuts, an award-winning blog for and about people affected by food allergies. In 2011, John Wiley & Sons published Ms. Miller's book, Allergic Girl: Adventures in Living Well With Food Allergies, the definitive how-to guide. Ms. Miller combines a lifetime of personal experience and passion with professional expertise to connect with people about how to live safely, effectively, and joyously with food allergies.