# How Many Puffs Have You Inhaled?

I recently celebrated my 20th anniversary at my current place of employment. I announced this on Facebook. I wrote:

*"So, my boss said that today is my 20th Anniversary. I'm estimating here, but that comes to more than 64,000 breathing treatments (not including ones I gave to myself).**"*

In case you don't know, I'm a respiratory therapist. I also have severe allergic asthma.

On average I have 10 patients a day taking breathing treatments. Most treatments are ordered QID. So, during my 12-hour shift that's 3 treatments per patient (the 4th one is given by night shift). Multiply 10 by 3 and you get 30 treatments a day. Multiply 30 by 52 weeks in a year and you get 4,680 treatments a year. Multiply that by 20 years and you 93,600.

Oops! So, my Facebook estimate was a little off. That kind of shows you how good I am at math.

Still, you can see that's a lot of treatments. But, this estimate might actually be high considering we're not always that busy. But, the estimate doesn't include treatments given in the emergency room either. So, that 93,600 treatments could be close to accurate. In either case, it's still a lot of treatments. That's a lot of lives made better.

So, how many treatments have I given myself? It's hard to estimate this because I only use my nebulizer when needed. I've taken lots of treatments. But, I won't even try an estimate here. But, there is something else I'd like to estimate.

## How many puffs of rescue medicine have I taken in my lifetime?

"Lots!" I want to say.

But, let's use this same formula. I was given my first inhaler in 1980. It was Alupent. Since 1985 I have used Ventolin. Between 1980 and 2005 I had uncontrolled asthma. From 1980 to 1985 I used Alupent. From 1985 to current I use Albuterol.

Let's assume during this period I went through an inhaler a month. So, there are 12 months in a year. That's 12 inhalers a year. There are 200 puffs in an inhaler. So, multiply 12 times 200 and you get 2,400 puffs per year. Now, multiply that by 25 years and you get 60,000 puffs of either Alupent or Ventolin each year.

That's an estimated 60,000 puffs between 1980 and 2005. Around 2005 I started using Advair. That was when my asthma started to get better. That was when I was able to cut back on my rescue inhaler usage.

Here's the problem with my estimate. There were many times I went through an inhaler every week. There were even a few times I went through an inhaler a day. True story. I know the experts frown on this, but I had severe asthma. It's just controlled now.

Just for fun, let's assume I went through an inhaler every week for 25 years. That's 52 weeks in a year. That makes 52 inhalers a year. So, that's 52 times 200 equals 10,400 puffs a year. Now we have to multiply that by 25 years. It comes with a total of 260,000 puffs.

So, how many puffs of rescue medicine did I take between 1980 and 2005? The answer must fall somewhere between 72,000 and 260,000. I doubt it's less than 72,000. It might be more than 260,000. That's possible. Okay? I had it pretty bad.

So, rarely did an inhaler last me a month. Many times one would last two weeks. Often one would last a week. Sometimes one lasted only a day. So, needless to say, that's lots of puffs. And, just so you know, I did this with my doctor's permission. He knew I had a rare asthma subtype.

Now, how many puffs have I taken in my lifetime? Since 2005, I would estimate I refilled my inhaler prescription about 4 inhalers a year. Each prescription is written for three inhalers. So, that's 3 inhalers times 4 refills equals 12 inhalers a year. Multiply that by 12 years and you get 28,800 puffs. This I'm sure is an underestimate. So, let's round up to 30,000 puffs.

So, you take 260,000 puffs plus 30,000 puffs and you get a grand total of 290,000. Let's just round that up to an even 300,000. That, my friends, is a lot of puffs of Alupent/Ventolin.

That makes me a definite member of the inhaler club. Nothing to be proud of there. But, that's how I've made it this far in life.

Thankfully, asthma control is far better these days. My albuterol inhaler isn't used very often anymore. This is a testament to modern asthma wisdom and medicine. Sometimes I even go months without using it. But it's there, tucked away in my work bag as I write this. It's there for when I need it.

I do not take it for granted. I very much appreciated all of the 300,000 puffs. I appreciate it even more now in its unused status. So, how many puffs of rescue medicine have you inhaled? I hope not as much as me.

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