Do you Use your Asthma Spacer correctly? You will save money, your lungs and greenhouse gases!
February 10, 2020
It’s Sunday morning and I usually would go to the beach, but my body is very tired and I am afraid I might fall. I am trying to stay in tune with my body and most mornings I have the energy and the need to go plastic picking. But last night, we had our department party and it was a big success. It was fun to put on the little black dress I wear just once a year and fancy sparkly wedge heels. Mr. Plastic Picker agreed that I looked nice. Mr. Plastic Picker looked very nice too in his blue blazer from Macys. Despite leaving early the fun and the revelry early at 9pm, drplasticpicker is too tired to go plastic picking. Plus I have to work this afternoon at our after hours clinic from 130-5pm. Humans are not meant to stay up late, and the world is not meant to have so much light pollution as humans are partying late into the late. Light pollution is causing the insect apocolypse https://drplasticpicker.com/xeres-invertebrate-society-can-a-pediatricians-avatar-drplasticpicker-help-save-the-western-monarch-butterfly/.
But I live in the real world where the modern world has shifted our circardian rhythms, despite my trying to fight against it. I still work in middle management, despite my wanting to spend more timing on ocean plastic pollution, so I had to go to the party. Being tired this morning I will use this morning to write about something I have been meaning to write about for a long time.
Asthma! How do you use your Asthma Aerochamber Correctly? It is important to always use your aerochamber with your asthma metered dose inhalers. I have conducted two studies in my office and published two abstracts that have been presented at the Pediatric Academic Society Meeting and the other at the American Academy of Pediatrics National Meeting. I never finished writing those abstracts into papers, because who has the time? Both studies I did as part of my uncompensated “work” as the Pediatric Asthma Lead and I did it with joy. But since I do clinical work to get paid, it didn’t make much sense to actually write the papers up – because I’m not sure who would read them? But here are their titles for you to acknowledge that I did those studies!
Asthma Spacer Teaching Decreases 12-Month Total Albuterol Use and Albuterol Dispensing Events in an Outpatient Pediatric Population. Poster Presentation Pediatric Academic Societies 2015, San Diego, CA, April 2015.
Brief Face-to-Face Asthma Teaching on Spacer Use Decreases Nebulizer Use in an Outpatient Pediatric Population. Poster presentation, Pediatric Academic Societies, Boston, MA, April 2012.
There are a lot of internet resources on aerochambers, but I’ve always just returned to the National Jewish Health website https://www.nationaljewish.org/conditions/medications/inhaled-medication-asthma-inhaler-copd-inhaler/metered-dose/aerochamber. It’s a health care system in Colorado, which now makes sense why they would be prominent in the internet sphere for asthma since Denver is at such a high altitude. Denver Children’s Hospital has some of the most well reknown pediatric pulmonology research and faculty due to the altitude and I think higher burden of pulmonary disease up there. We are exactly at sea level, and our department with 92 pediatricians does not even have a pediatric pulmonologist. We have to refer out. Maybe that is why? I have stopped trying to understand certain truths of middle management at our HMO.
But, anyway – if you use any asthma inhalers please always use your aerochamber! You only get a partial dose of the medication without the aerochamber. And did you know your asthma inhaler could emit as much green house gases as a lorry trip from London to Sheffield https://www.independent.co.uk/news/health/asthma-inhaler-hfc-greenhouse-gas-carbon-footprint-nice-nhs-a8861421.html? This was reported in the Indpendent, a British paper. I did not know the distance from London to Sheffield but through the magic of Ecosia https://drplasticpicker.com/ecosians-drplasticpicker-has-always-liked-alien-like-names-change-your-search-engine-to-ecosia-they-plant-trees-you-become-an-ecosian/ now know that it is about 163 miles. This is the same distance as San Diego to Los Angeles.
How to Use Aerochamber FaceMask Yellow (little kids)
- Hold the mask to the face so that both the nose and mouth are covered. It is important to create a good seal between the face and mask so that all medication will be delivered to the airways.
- Press the inhaler once. The medication will be delivered into the AeroChamber®.
- Breathe in and out at least 6 times. The diaphragm should move with each breath.
- Remove the mask from the face.
- Repeat steps 1-4 when more than one puff is prescribed. https://www.nationaljewish.org/conditions/medications/inhaled-medication-asthma-inhaler-copd-inhaler/metered-dose/aerochamber-mask
How to Use Aerochamber Zstat: Blue (mostly older kids)
- Gently breathe out.
- Put the mouthpiece in your mouth between your teeth and close your lips around it.
- Press the inhaler once. The medication will be delivered into the AeroChamber®.
- Breathe in slowly and deeply over 3 – 5 seconds. If you breathe in too fast, the AeroChamber® may whistle.
- Hold your breath for up to ten seconds. This allows the medication time to deposit in the airways.
- Resume normal breathing.
- Repeat steps 1 – 6 when more than one puff is prescribed.
This aerochamber should last you forever. Essentially. It can be cleaned and cared for. At some point during the two projects above, I did two literature searches for the bibliography of the posters. Someone at some point did a study where they cultured out aerochambers and showed that they don’t actually get that much bacterial contamination. I don’t remember the study, and it has since probably disappeared into the medical literature abyss – just like my two studies cited above that I never wrote up. But now I blog, and more people will likely read this blog post than came by my two posters! I did have a pediatric pulmonologist from China come by my poster in Boston and we had a heated discussion about aerochambers. I’m not sure who won?
Anyway there are fancy instructions about how to clean the aerochamber, but really just remove the parts and rinse everything in warm water and mild soap and air dry. That is it. Those aerochambers retail can go for $30 a piece! I am not sure how much patients are charged for them. Before our trip to Peru for medical work, I found them for $15 a piece on the internet. I was shocked that I had no children with asthma in the Andes region of Peru? But I saw so many children with parasitic diseases. I had mentioned this the last time I visited Dr. Young-Ho Yoon in Boston https://drplasticpicker.com/dr-young-ho-yoon-pediatrian-and-environmentalist-1/, and he is very smart and reminded me that it likely has to do with helper T cells and immune response and helminthic infections. It was a flashback to residency, and I just nodded and listened but did not fully process. He is very smart.
There is a funny video online by the Chief of Allergy and Immunology and Assistant Professor of Pulmonology at UCSF on how to make a spacer with a soda bottle https://www.youtube.com/watch?v=iyBhfvzLHEk ! LOL I am not sure what message that sends out to folks from that HMO? We are the sister HMO down in Southern California. There is another video online about how to make it an aerochamber with a smaller Minute-Maid juice bottle but it involves boiling water, a sharp kitchen knife and a lighter. This is a pediatric blog so I don’t want any kids to get hurt. If you are in that desperate straights, please just come in and I’m sure I can find you one somewhere! Geeze Louise people. But likely you have a spacer that is made by a company and not made from a repurposed soda bottle, just use it!
So that is it! Just use your aerochamber, that is 90% of the battle. If you use your aerochamber, try to use it correctly. If you use it correctly, you will improve your lung function, save money, save greenhouse gases. But don’t try to save money by making your own with a repurposed soda bottle, that would just be penny wise and pound foolish.
It’s Monday morning now (I was working on this blogpost on and off during the weekend) and 5:55AM. I have about 15 charts to finish from yesterday’s after hours clinic so will try to pound those out this morning in 30 minutes before making breakfast for the kids and getting them off. I am so happy we were able to spend these few moments together.
Remember my disclaimer. ” I am passionate about the environment and children’s health. Here is general advice that is delivered in tongue-in-cheek, entertaining blog format. This is not meant to be definitive and I always ask you to check with your own medical provider, and use common sense.”