Asthma without an inhaler

6 Ways To Control Your Asthma Without Using Your Inhaler

It can start as just a little cough, some discomfort, and before you know it you’re gasping for air, listening to the whistle of every breath and starting to panic. If you’re not asthmatic, chances are you know someone who is.

More than 18 million Americans live with asthma, a lung condition in which the small airways become inflamed and constricted, causing wheezing, poor respiratory function, and sometimes even death.

Traditionally, patients are treated with inhaled and oral medications to help control airway inflammation and acute attacks. Many times these are necessary to avoid frequent attacks and hospital visits.

Increasing evidence also suggests that specific lifestyle changes and integrative treatments not only have evidence for helping control Asthma but can also help reduce severe attacks.

Ginger: Researchers found that when combined with commonly used inhaled asthma medications, ginger enhanced airway dilation more than medication alone. The ginger compounds used to treat airway smooth muscle are thought to work by directly reducing contraction of the muscles surrounding the airways.

Omega-3 fatty acids: One study showed that those with a diet high in omega- 3’s had improved quality of life with less reliance on rescue medications. Easy ways to add Omega 3’s to your diet include walnuts (mix with carob chips and raisins for a quick snack), salmon, and pumpkin seeds (can be added to Greek yogurt, or applesauce).

Vitamin B6: Vitamin B6, also known as pyridoxine has also shown benefit, particularly for asthmatics who are steroid dependent. Individuals taking B6 had better breathing early in the morning, and in those individuals with low levels of B6, supplementations reduced acute wheezing episodes. However, some studies have shown no significant difference, so you should discuss your target levels with your primary physician before starting.

Yoga: If you haven’t gotten enough out of from this total body and mind practice, here is another benefit. The deep breathing was shown in studies to help asthmatics reduce hyperventilation and in turn improve symptoms and outcomes, particularly during attacks. Regular yoga practice helps focus on deep and prolonged breathing to improve airflow and can be extremely beneficial during asthma attacks.

Vitamin C: Studies also found another juicy reason to fill up on citrus fruits if you are asthmatic. Research demonstrated that a diet high in Vitamin C reduced episodes of wheezing in children. While we still need more data for adults, it can’t hurt to add this to your diet through a few extra orange slices, grapefruit, or kiwi.

Butterbur: This herb has been used for years to treat asthmatics in Asia and Europe. It has both an anti-inflammatory effect on the body and can reduce the contraction of muscles in the airways that lead to wheezing and acute attacks.

Herbs and supplements may interact with other medications. Check with your personal physician before starting any of these supplements.

Have you tried any of these treatments? Tell us in the comments or tweet me @ShilpiMD and tell me what has helped you.

How To Treat An Asthma Attack Without An Inhaler

Summer is almost here which means it is time for camping, road trips, and numerous other adventures. Unfortunately, for the millions of people in America who have or have a loved one with asthma, it is also a peak time to find yourself dealing with an asthma attack without an inhaler.

To be clear, it is important that anyone who suffers from asthma to be sure to do everything they can to follow all medical advice given to them and to keep up their supply of any prescription medications. It is especially crucial to make sure you have access to your inhaler at all times—sometimes an asthma attack can strike with very little or no warning. Asthma is an incredibly serious condition and by no means should you ever forego professional medical advice to try to treat asthma yourself. That being said, life happens. If due to some unforeseen circumstances you do find yourself without an inhaler (like if your rescue inhaler turns out to be empty), here are some steps you can take to try to make the best of the situation and achieve asthma relief without an inhaler.

Asthma Relief without Inhaler

Having an asthma attack (without an inhaler, especially) is an extremely stressful situation—perhaps even more so if you are the parent of a child having an asthma attack without an inhaler. But it is more important than ever to remain calm. Concentrate on breathing (or help your child too) and remember that the asthma attack will end eventually. You (or your child) needs to try inhaling deeply through your nose and exhaling through your mouth with your lips pursed.

Sit Upright

While many people have the urge to lay down when they are suffering from an asthma attack without an inhaler, it is important to remain upright as much as possible. This will open up your airways and allow your lungs to take in as much air as possible. If you need to, sit down, but sit up straight.

Identify the trigger

You likely know your asthma triggers already and do your best to avoid them. However, it is pretty inevitable that you will encounter them at some point over the course of your life—hopefully not while you are experiencing an asthma attack without an inhaler. If you do find yourself in this situation and there is something specific that is triggering an asthma attack (say, for instance, cigarette smoke or dust), get as far away from it as possible. Move to another location or remove the trigger itself. This will help keep your asthma from becoming further aggravated. If you are not able to completely remove yourself from exposure to the asthma trigger, try breathing through your shirt or something similar to filter the air you are receiving to the best of your ability.

Drink a Hot, Caffeinated Beverage

Hot coffee or tea can be helpful in alleviating some of the symptoms if you or a loved one is suffering from an asthma attack without an inhaler. If you are able to, try sipping some to slightly open your airways and get some relief. While caffeine should never be used as an outright replacement for prescription asthma medication, studies have shown that the caffeine in 3-4 cups of coffee, for example, can be helpful in providing asthma relief without inhaler for a couple of hours. Furthermore, asthmatics should not consume large amounts of caffeine on a regular basis; save this trick for if and when you truly need it!

Dial 911 if Needed

A shocking number of people put off seeking emergency medical attention when they really need it because they are worried that their symptoms will subside before an ambulance arrives or that their ailment will turn out to be nothing. Do not put off calling 911 or visiting the emergency room if you feel at all that you need it. It is better safe than sorry! If you cannot speak or are having trouble walking, it is a sure sign that you need attention right away. Having a medical ID bracelet or a medical card detailing the fact that you suffer from asthma is a good preparation to help in the case that you encounter and asthma attack without an inhaler and need someone else to dial 911 for you and to help medical personnel more quickly identify and treat your symptoms while you are indisposed.

If you are having any trouble controlling your asthma or would like to explore new treatment options that may be a better fit for your condition and your lifestyle, be sure to schedule an appointment at one of our Valley-wide locations. Our practitioners provide a variety of specialty treatments and are eager to find strategies to make managing health conditions, well, manageable.

Alternative to daily inhaler use may offer asthma sufferers a new option

People are so reluctant to take their inhaler medication for mild asthma on a daily basis that a pharmaceutical company has come up with a different approach.

Asthma is an inflammatory disease of the airways and lungs that can lead to wheezing, coughing, chest tightness and shortness of breath that can keep people up at night and lead them to miss school or work.

About 2.4 million, or eight per cent, of Canadians have been diagnosed with asthma. Most have a mild form and can go for weeks without symptoms.

The gold standard treatment for mild asthma is twice daily inhaled corticosteroid. But evidence from studies tracking people after they’ve filled their first prescription — in British Columbia, for instance — suggests that fewer than half fill the script a second time.

That means that over time, airways become swollen and inflamed. When asthma is not well controlled, it increases the risk of worsening or even life-threatening asthma attacks.

Doctors and pharmacists say it is human nature to want to avoid taking medications, especially in some chronic illnesses.

There are many reasons why people with mild asthma rely on “rescue inhalers” alone instead of ones to treat the underlying problem of inflammation, said Dr. Paul O’Byrne, a respirologist and professor of medicine at McMaster University in Hamilton.

“It’s a complex issue in my view, which involves a lot of patient psychology,” said O’Byrne.

He said the reasons include:

  • To take a medication every day, patients have to accept the view that they have a disease that needs to be treated. For some, that’s not easy.
  • After feeling well for weeks, some just forget the medications, because they aren’t reminded by symptoms.
  • Concerns about side-effects, driven in part by misunderstanding how inhaled steroids act differently from steroid pills.

Most people with mild asthma just use a fast-acting rescue inhaler when they have an asthma attack.

Now, however, researchers have tested an alternative that gives longer-acting, inhaled corticosteroid along with the rescue-inhaler medication when symptoms flare up.

Dr. Paul O’Byrne aims to reduce severe asthma attacks, also called exacerbations. (McMaster University)

That way, symptoms are quickly relieved and the patient benefits from the longer-term inflammation-fighting properties of the corticosteroid.

All of the medications in the study are sold by Astra Zeneca. The company funded the research.

O’Byrne was the lead investigator on a year-long trial of more than 3,800 people aged 12 and older in Canada, China, the United Kingdom, Australia, Brazil, South Africa and elsewhere.

In this week’s issue of the New England Journal of Medicine, the researchers found that taking a maintenance inhaler twice a day remains the best option — if people will take it.

As a reliever medication, the combination inhaler with corticosteroid was better than a short-acting drug alone used to relieve asthma symptoms, O’Byrne said.

Months off inhaler

Patients have been doing this for years on their own, against medical advice, said Dr. Shawn Aaron. He treats people with asthma and is a professor of medicine at the University of Ottawa. Aaron was not involved in the research.

“There are a lot of patients with mild asthma who I tell, ‘Take your inhaler every day.’ And I know they’re not taking it every day. They even tell me that when they feel well, they’ll spend months off the inhaler completely, and they’ll start it again when they feel unwell. So in effect, what this trial doing is scientifically testing that approach,” Aaron said. “They’re listening to the patients.”

Aaron called the trial interesting, but said it won’t revolutionize care.

To reduce ‘terrifying events’

“The safest, most effective way to treat mild asthma is with low dose, daily inhaled steroid. That’s what this study has shown,” Aaron said.

The inhaler medications all cost less than a dollar a day for maintenance puffs, O’Byrne said. Very occasional side-effects include hoarseness and oral fungal infection if taken with antibiotics.

Asthma attack rates in the two groups using a corticosteroid were similar, and were lower than the rate with just short-term reliever puffs.

“Reducing severe exacerbations is the objective I would like to see mostly impacted, because these are such terrifying events to patients,” said O’Byrne. He vividly remembers the severity of his own asthma attacks as a child when no treatments existed, saying it drove him to want to minimize the risk for patients.

Last month, the Canadian Institute for Health Information reported that hospitalizations for asthma among children and teens fell over the past 10 years, but it continues to be one of leading reasons for people under the age of 20 to be hospitalized.

What’s the Difference Between a Nebulizer and an Inhaler?

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Asthma medicine needs to get into your lungs to work, but do you know how it gets there? Inhalers and nebulizers — that’s how! Your doctor will tell you which device is best for you.

What’s a Nebulizer?

Nebulizers are electric- or battery-powered machines that turn liquid asthma medicine into a fine mist. This mist comes through a tube that is attached to a mouthpiece or facemask. (A facemask is a kind of plastic cup that covers the mouth and nose.)

Nebulizers are easy to use because there isn’t much to do — just place the mouthpiece in your mouth or the mask over your nose and mouth, and breathe in the medicine. But nebulizers take at least 5 or 10 minutes to get the medicine into the lungs and sometimes even longer. They can be big and noisy and not always easy to carry around.

What’s an Inhaler?

Inhalers are little devices that can fit in your hand and are small enough to carry in a backpack, purse, or pocket. There are two types of inhalers:

  1. Metered dose inhalers (MDI) are the most commonly used. Like little aerosol cans, these inhalers push out a spray of medicine.
  2. Dry powder inhalers deliver medicine in powder form, but it does not spray out. The person must do more of the work by inhaling the powdered medicine quickly and deeply.

Dry powder inhalers can be a little easier to use than metered dose inhalers, which are sometimes tricky. With practice, kids get very good at using them, though. The best way to use an MDI properly is by using it with a spacer.

What’s a Spacer?

A spacer makes it easier to breathe in medicine when using a dry power inhaler. It attaches to the inhaler and puts the medicine into a kind of holding chamber.

From that chamber, you can inhale the medicine slowly when you’re ready. When using a spacer, it usually takes only a couple of minutes or even less to get the medicine into the lungs.

Without a spacer, medicine from the inhaler can go to the back of the throat instead of into the airways (breathing tubes) inside a person’s lungs. A spacer helps get the medicine into the lungs, so it can start working on breathing problems.

During an office visit, your doctor might ask you to take a puff from your inhaler. The doctor wants to watch you take your medicine to make sure you’re comfortable doing it.

What Else Should I Know?

Learn how to use the device your doctor recommends so you get the medicine into your lungs. Taking your asthma medicine the right way can prevent flare-ups and keep a flare-up from getting really bad if it does happen.

Reviewed by: Elana Pearl Ben-Joseph, MD Date reviewed: June 2017

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