"My Inhaler Stopped Working"

I hear this A LOT - people say "My inhaler stopped working."

Well... I hate to say this - but inhalers don't just "stop working." The medicine doesn't change, but your body can and the way you use your inhaler can make a difference in how you feel.

Inhaler not working? Check your technique

My colleague teases me about "user error" when I have problems with my computer. We lovingly call her the Computer Whisperer and she can fix anything. Whenever I am having problems with my computer and call her for help, she easily fixes it right away (even though I already tried) and teases me about user error. Guilty as charged.

I may not be skilled with computers, but I am with inhalers!

User error is very common with the inhaler technique. In fact, did you know that 92% of people do NOT use their inhaler the right way?!¹

Yes, you read that right - 92%! Some people have said, "How hard is it? I've been using an inhaler for years - it can't be that hard!"

Well, the problem is that there are so many kinds of inhalers. There are metered-dose inhalers (MDI's), dry powder inhalers (DPI's) and soft mist inhalers.

Most common problems with metered-dose inhalers

• Forgetting to shake the inhaler (gotta mix up the propellant and medicine!)
• Not exhaling all the way BEFORE your press the inhaler (empty those lungs first  - so you can breathe in deep and inhale all of the medicine from your inhaler!)
• Forgetting to hold your breath to the count of 10 (or as long as you can)
• Not rinsing your mouth if it's a controller inhaler

Did you know that controller inhalers (the kind you take every day) are made with a yeast base?  That means you can get a really annoying fungal infection (thrush) that is very hard to get rid of. Seriously. Awful stuff.

Most common problems with dry powder inhalers

• Thinking the inhaler needs a spacer (no need - there is no propellant!)
• Blocking the vent with your lips or fingers (take a peek - they have cool vents on the top of the inhaler or near the mouthpiece)
• Inhaling WAY too softly

Since dry powder inhalers do not have a propellant, you get to be the propellant. I tell people the only way to get the powder out is to "suck like a milkshake" (hard and fast).

Which happens to be the opposite of metered-dose inhalers. Is it any wonder people get confused and don't take their inhaler the right way?

Many people have both kinds of inhalers. Their controller inhaler may be a dry powder inhaler, and their rescue inhaler is a metered-dose inhaler. So, they have to do the opposite technique for each inhaler.

A brief review

• Metered-dose inhaler - breathe in slow and steady (and use a spacer).
• Dry powder inhaler - breathe in hard and fast (and don't use a spacer).
• We know how expensive inhalers are, right? I want to get my money's worth by making sure I use my inhaler the right way. Plus it works better when you get more medicine into your body.
• Asthma and Allergy Foundation of American (AAFA)¹ has a video that shows how to use different types of inhalers and there is a video here on Asthma.net. Take a peek and see how you are doing.
• If you remember nothing else from this article, remember that inhalers don't "stop working."

If you have watched the inhaler technique video, and are using your inhaler the right way but are still having a hard time with your asthma -  call your doctor! You may need a stronger inhaler or a different type of inhaler.

There are a rainbow of inhalers on the market. Make sure you find the right one for your body - and use it the right way!