What to do when your inhalers are empty - and it's only the 25th of the month?

What to do when your inhalers are empty - and it's only the 25th of the month?

This is one of my favorite answers (not!) when I ask one of my patients why they come to class panting and barely able to breathe. I have to pause before I figure out how to tactfully ask the question: You know you need your inhalers. So how can you not know when you're running out of breath?

And then the REAL question: If this person regularly refills their inhaler every month, how is it that they've run out?

Have you perhaps been using your inhalers “as needed” more often than usual?

This happens to many patients. You're making good progress, 2 moves 4 times a day, then the weather changes. Or you get a mild cold. Or something stressful happens. The next thing you know, your inhaler is empty and you still have 5 days before you can get a new inhaler.

Everyone takes extra “rescue” moves every now and then. However, it's important to track how many of these extra puffs you take in a day and why.

Some inhalers come with a built-in counter to alert you when you are near the bottom of the canister. Even with a meter, it's a good idea to make sure you have enough medication so it's there when you need it most. Make it a habit to look at your counter on the 15th of the month. If you've taken more than half of your doses, it's time to talk to your doctor.

However, some insurance companies only pay for one inhaler per month. What can you do in this situation? Many people pay the cash price for another rescue inhaler. Your doctor should have no problem writing a prescription for you.

For asthma, we divide the diagnosis into “controlled,” “poorly controlled,” and “uncontrolled.” Controlled means the medications are doing their job and the patient is having very few exacerbations or episodes of shortness of breath.

“Poorly controlled” means the patient has many episodes or exacerbations that often send them to the hospital. “Uncontrolled” means that nothing we prescribe is working or the patient is not complying with the medications and inhalers we prescribe.

This also applies to COPD. I had a patient who took a puff of his inhaler every hour. This is not a symptom control strategy!

If you find that the inhaler regimen you have been prescribed is not covering you and keeping you symptom-free, it is time for a medication review with your doctor.

Inspired by Kelly Welton