Are you Using your Asthma Inhaler Correctly? You and Venus Williams May Want a Review

The weather in New York and much of the country has been frigid. We are hitting new records for snow and cold temperatures. I see this affecting the health of my allergic and asthma patients. For starters, my patients with asthma are requiring increased use of their asthma inhalers because of the cold weather. This is understandable because very cold weather can cause the bronchioles (the lung tubes) to spasm and a patient with asthma may experience chest tightness, wheezing or coughing. It is imperative that asthmatic patients take precautions before going outside in this weather.

1) use a scarf to cover your mouth when outside: breathing in cold air through your mouth can immediately trigger an asthma attack; your nose is supposed to be doing the breathing , because it warms and humidifies the air before it gets to your lungs.

2) if you are going to be walking outside many blocks or for an extended time use your inhaler at least an hour before you go outside to open the airways and give you extra protection.

3) Make sure you know how to use your inhaler (s) correctly.

My nurse, Mildred, is an avid sports fan. She was watching the Australian Tennis Open on TV, and she happen to see Venus Williams struggling to breathe. She saw Venus use an asthma inhaler on the change-over to help her breathing. However, Mildred, who has worked with me for many years and knows how to use an asthma inhaler correctly, quickly told me: she was shocked that Venus Williams appeared to be using her asthma inhaler incorrectly ! Venus is not alone. I frequently see patients that have asthma, who before coming to my office were never shown the correct way to use an inhaler. In my book, Dr. Dean Mitchell’s Allergy and Asthma Solution (Marlowe 2006 ), a chapter called,” The Asthma Action Plan“, discusses and illustrates the correct way to use an asthma inhaler.

“The Asthma Action Plan” shows you the proper technique and strongly encourages anyone using a rescue inhaler, like Ventolin or ProAir, to use a spacer device . A spacer device is essentially a holding chamber so that the aerosolized medicated particles can be inhaled deeply into the small air tubules where the spasm is taking place. There are studies that show a spacer device is as good as or even better than the nebulizer machine many asthma patients rely on. I also discuss in this chapter the common mistakes patients make when using their inhalers. One important tip: Wait a few minutes if possible between puffs of your inhaler. Many patients rush to get it done. By waiting a few minutes (2-3) between puffs, you are allowing the larger bronchioles to more fully open, and then the 2nd puff can go deeper to open the small bronchi where the blockage is occurring.

In the meantime, Stay Warm! Spring is only a month away.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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