Delivery Diversion: An Inhaler Story
Initially, I was concerned when I got the notice that my inhaler was changing in a form letter from the mail-order pharmacy. My medical team will work with me to find the right treatment if this is not it. No choice in the matter, the inhaler was changing whether my team or I liked it or not. I was apprehensive that this change could cause my control to slip. I took a beat and checked that the old combination controller inhaler was still on my formulary. Worst case I'd end up back on that inhaler to get control back and then we'd find a new steroid only inhaler.
A new inhaler
I recently got a new controller inhaler from the pharmacy. The controller does the same thing as my old inhaler, but with a new mechanism. Up to this point, all my inhalers have been metered dose inhalers that aerosolize the medication into a spacer and from there I breathe it into my lungs. For whatever reason, breath-actuated inhalers have not been the type of treatment my team has selected for me. We’ve discussed priorities and pros/cons of various treatments over the years. I’ve never gone to the nitty-gritty detail level of metered dose aerosols versus dry powder breath actuated devices.
Discussing inhaler concerns
I trust my team will happily discuss different inhaler types with me were I concerned. I am so far loving my new delivery mechanism! Breath actuated is so much easier than trying to coordinate hand/breathe for me even with a spacer. Until this device switch, I didn't think I had bad hand/breath coordination. This new inhaler has shot down any dreams I had of being a world champion all-star inhaler user. I will have to relegate myself to the cheering fans section for that segment of the asthma feats of strength.
Making sure you have all the inhaler supplies
In my years of using a spacer and a metered dose inhaler (MDI) I never felt like it was a hassle. Sure spacers aren’t exactly small. I already toss EpiPens in my bag everywhere I go so what’s one more thing? I am also not the most precise with getting my inhaler on the 12-hour mark exactly for my twice a day controller. Even less so now that I don’t feel the Long Acting Beta Antagonist component start to fade as I cross hour 12.
My preventative inhaler only leaves the house with me if I have a day where I am leaving for work early in the morning and returning late into the evening. I know on these days I will get home drop my bags and want to head straight to bed. As always it’s a balance between being a “perfectly compliant” asthma patient and a person who leads a “normal” life.
Since this new inhaler requires no spacer it is much more likely that I will toss it in my bag when I know I won’t be home 12 hours after my last controller does. Yes, the change to this new inhaler was a bit unexpected and completely outside my control. It, however, has been largely positive. The cost is comparable to my old inhaler, I'm really enjoying the easier to use design, and will likely take more doses exactly "on time".
Have you been forced to switch inhalers? Were you also pleasantly surprised?
Do you get muscle cramps caused by your asthma medicine?